PA vs MD: Similarities & Differences

Overview of Main Differences for PA vs MD

What is a PA, or Physician Assistant?

Before comparing PA and MD, or even PA vs DO vs MD, we need to take a brief look at what, exactly, a Physician Assistant is and does. A Physician Assistant (PA) is a medical support professional, working under the supervision and delegation of a physician (MD). They participate directly in patient care, taking medical histories, examining and diagnosing patients, developing treatment plans, educating patients and working toward positive patient outcomes as an integral part of the healthcare team.

What are Some of the Basic Differences?

Some of the differences between PA and MD depend on where you’re practicing (state/province/country), but, on the whole, PAs do not perform surgery (they can assist), they do not take on the most complex or acute medical cases, and they may or may not be able to prescribe medications. They can, however, evaluate patients and prescribe medication under the authority and delegation of an MD.

There is a good deal of overlap between these two professions, but there are many key differences, as well. This blog will help you more fully understand the differences between becoming a Physician Assistant (PA) and becoming a Medical Doctor (MD), to help you determine which path best suits your own goals, needs, and aspirations. As such, you will need to know how to answer “what are your goals as a PA?” interview question. Ensure that you understand the ins and outs of the profession so you can speak to this when you're creating your PA personal statement and PA school cover letter.

Debating between PA or MD? Watch this video:

PA vs MD: General Summary

PA vs MD: Education and Cost

Undergraduate Education

Whether aspiring to become a PA or MD, education is crucial, and both paths require strong academic performance. In general, PA school requirements include strong marks and extensive clinical experience, which means clinical experience is one of the best extracurriculars for PA school; MD programs require exceptional marks, but less clinical experience at the time of application. During the initial 4-year undergraduate degree, the science pre-requisites and experiences necessary (shadowing, clinical work, etc.) tend to be similar for both, though those on the MD path must take more advanced science courses as prerequisites for medical school.

Most common primary majors for PAs

• Biology
• Health sciences
• Exercise science/athletic training
• Psychology
• Kinesiology

Most common primary majors for MDs

• Biological sciences
• Other
• Social sciences
• Physical sciences
• Specialized health sciences

What are Some of the Entering Statistics?

The average GPA for those pursuing PA programs is 3.36, and the average Science GPA is 3.27. Standardized testing requirements vary between different Physician Assistant programs. Both the best PA schools and the easiest PA schools to get into require the GRE (as PA programs are often Master’s degree programs). The average GRE score for the verbal section is 151.6, 150.8 for the quantitative section, and 3.9 for the writing section. Note that some programs will accept the MCAT instead of the GRE, but the current prevalence of the GRE means that average MCAT scores for PA programs aren’t available).

The average overall GPA for entering medical students is 3.62 and the average science GPA is 3.52. The total MCAT average is 506.5. Check out the tables below to compare physician assistant acceptance rates in Canada, physician assistant acceptance rates in the US, GPA, and other data of specific popular PA schools, osteopathic schools, and medical schools.

Need to know how to ask to shadow a doctor? Watch this video:

How Does Clinical Experience Differ?

As well, PA programs often require extensive clinical experience prior to application – to be highly competitive, 4000 hours of direct hands-on patient care is recommended. You will see above what some of the average hours among applicants look like for top schools. You will most likely discuss clinical experience in your answer to the “why do you want to be a PA?” interview question, because it is such a crucial aspect of being a successful candidate. This patient care requirement can be met through volunteering (e.g., as an EMT, in patient transport, or in various hospital departments), though many PAs worked in healthcare in some capacity prior to pursuing a PA program – nurses, phlebotomists, paramedics, and medical assistants are frequently applicants to PA programs.

Is Education More Difficult for MDs or PAs?

The educational rigors are much more substantial for those who want to pursue an MD. How hard is it to get into medical school? Well, for MD applicants, there are stringent medical school GPA requirements. In general, the average GPA is 3.62, and the average Science GPA is 3.52. The GRE is not required for MD programs, but – of course – the MCAT is, and a good MCAT score is required if you want to become a physician. The average MCAT score for those pursuing the MD is 506.5 (though, of course, some schools have lower and higher individual averages than that). Clinical experience gained by shadowing a doctor or holding paid or volunteer patient care positions is not always required for those hoping to attend med school but definitely adds to the overall competitiveness of one’s application even for the easiest medical schools to get into.

Specialized Education

Generally, to become a Physician Assistant, you must have a bachelor’s degree and complete an accredited PA program. PA programs are usually 2-3 years in length, and the average total cost for a PA program is between $70,000-90,000 (varying based primarily on resident vs non-resident status). Of course, the average salary and years it takes to become a PA depends on a variety of factors, including if you decide to consider PA specialties to enhance your portfolio.

PA vs MD: Roles and Duties

Physician Assistants are a crucial part of the healthcare team, and often help increase the number of patients seen in a day, by taking on key clinical responsibilities and allowing MDs the room needed to tend to surgeries and more complex cases. Their core function is as follows:

1. Be a diagnostician
2. Performing physicals
3. Collecting patient histories
4. Imaging
5. Use Labs to diagnose conditions
6. Work with patients on a treatment plan
7. Perform many in-office procedures and assist in (but not perform) surgeries.

Can PAs Prescribe Medication?

In the U.S., PAs can prescribe medications in some states, and some can obtain DEA registration to prescribe controlled substances (though not all do); in Canada, PAs can prescribe medications in some provinces, but they are not able to prescribe controlled substances. Ultimately, the procedures any PA can perform depends on the procedures performed by their supervising MD, and the work a PA does is work that has been delegated by that supervising MD.

How Does the Function of an MD Differ?

MDs, obviously, are able to practice without this kind of delegation and direct supervision. They can maintain independent medical practices and do all the things PAs do, as well as prescribing all medications and performing surgeries. That independence in their role as lead medical professional also means that they have ultimate liability, both with regard to their own patients and the patients seen by the PAs they supervise. If a PA is negligent, they are certainly liable, but their supervising MD is liable, as well.

PA vs MD: Specialization

What Specialties Can PAs Choose?

Physician Assistants generally work in primary care and do so in a variety of settings. They tend to conduct physicals, general procedures and treat more common illnesses and injuries. That said, PAs are able to specialize, and they are able to switch specialties, as well, and some work in two specialties at once. As PAs tend to get more of their experience on-the-job, a change in specialization generally means training as they go, rather than having to start over and getting additional certification after years of training. Here are some of the top specialties for Pas, ranked by percent of PA workforce by speciality:

• Primary care (23.7%)
• Family medicine/general practice (17.7%)
• Emergency medicine (11.8%)
• Orthopedic surgery (10.8%)
• Internal medicine (4.3%)

What Specialties Can MDs Choose?

Medical students must be careful when they choose a medical specialty. MDs have more opportunities to specialize during their education but don’t have the same opportunities to change specialties once they are practicing. While this varies, a major change in specialization for a practicing physician would often require completing a residency in that new specialty. With medical school taking far longer than PA programs, few doctors would want to go through another residency after already devoting so much time to their chosen program. Here are some of the most common ones:

• Family medicine
• Psychiatry
• Internal medicine
• General surgery
• Oncology

Want to learn how to become a physician assistant?

PA vs MD: Job Satisfaction, Work-Life Balance, and Burnout

What is the Day-to-Day Like For PAs?

Physician Assistants often have more room to arrange for “typical”, 9-5 workdays and 40-hour workweeks, if they so choose, and – regardless of the hours they work – they can often have a more consistent schedule than MDs. While the work they do isn’t quite as dynamic as an MD, there is still variety in their work. As PAs tend to be educated through a patient-centered approach, they know that each patient requires individualized care and treatment, based on their unique circumstances and the biological, psychological, environmental, and social determinants of health.

Do PAs Have a High Job Satisfaction?

PAs tend to have very high job satisfaction (especially compared to other medical professions) and high job stability rates. That said, the work is undeniably stressful, and there aren’t many studies that look into burnout among PAs.

Is Burnout an Issue for PAs?

It is possible that the opportunity to change specialties at any point in their career can help mitigate burnout, allowing them to learn more and take on new perspectives and approaches, should they find themselves in a rut or otherwise dissatisfied with the work they’re currently doing.



What is the Day-to-Day Like for MDs?

MDs often run their own clinics, while also doing rounds in hospitals, performing surgeries, being on-call, etc., so the work is more varied and dynamic. As a result of these multiple roles, MDs frequently work 60+ hours per week (and often even more during residency).

Do MDs Have a High Job Satisfaction?

In terms of job satisfaction, this varies considerably based on specialization, with family physicians showing greatest satisfaction and just under half of doctors indicating that they would choose the same specialty again if they had the chance to start over. Nearly 1/3 of doctors, regardless of specialty, say they would not pursue medicine as a career again if they could turn back the clock.

According to the latest statistics, 77% of physicians would choose medicine again if they were still deciding on a career path:

Is Burnout an Issue for MDs?

Similarly, rates of burnout are substantially different based on specialization, with the highest rates of burnout being in emergency medicine, internal medicine, and family medicine. Overall, physicians are considerably more likely to experience burnout and dissatisfaction with their work-life balance than the general population.

PA vs MD: Compensation

Salaries for both PAs and MDs vary considerably, based on numerous factors, including the location of their practice, their specialization, whether they work in a hospital, clinic, or private practice, and so on.

What is the Average Salary of an MD?

Across North America, medical doctor is one of the best paying traditional jobs, with the average salary ranging from about $200,000-300,000 per year in both the U.S. and Canada (with even higher salaries for certain specialists, but lower salaries during residency). Some of the highest paid doctors will get paid even more, depending on where they work and in what specialty.

Highest median salaries for MDs by state (yearly USD)

Highest median salaries for MDs by province (yearly CAD)

What is the Average Salary of a PA?

The average Physician Assistant salary ranges from around $80,000-120,000 in the U.S. and $75,000-130,000 in Canada. With the higher salaries of MDs come the costs of owning and operating a practice, as well – costs that PAs need not cover, as they do not run their own practices. PAs are also in high demand, as they can tend to less critical (though often more frequent) cases, freeing up physicians to handle surgeries and more specialized or complex procedures for which one needs the MD degree.

Highest median salaries for PAs by state (yearly USD)

Highest median salaries for PAs by province (hourly CAD)

PA vs MD: Flexibility and Control

How Much Autonomy do PAs Have?

Physician Assistants work collaboratively with, and under the guidance of, MDs, and thus don’t have the same level of autonomy. Some PAs do work autonomously, conferring with physicians in more complex cases; others work directly alongside physicians at all times. This difference often depends on various factors, including – but not limited to – the type of practice, the country/state/province in which they are working, and the different standards of each particular practice or specialty.

How Much Control do MDs Have?

MDs often run their own practices, and thus also control their own businesses, which has both benefits and drawbacks. As PAs are generally employees, rather than owner/managers of a practice, the business concerns, and responsibilities that come with running an independent practice and functioning as employer are beyond their purview (whether this is a benefit or drawback depends on your own position on such things).

Autonomy: The Facts of the Matter

As noted above, what PAs lack in autonomy, they make up for in a bit more control over their own schedules and considerably more flexibility in their specializations. As MDs treat more complex cases, perform surgeries, and take on less-common illnesses and injuries, they are more frequently required to be on-call. That’s not to say MDs are unable to set their own schedules; they can – especially in private practices. But physicians are more likely to take on the kinds of hospital positions that require on-call and shift work. PAs certainly can choose positions that include things like being on-call or having overnight shifts, but they often have more choice in the contracts they accept.

Want BeMo's help with your applications? Hear from one of our successful PA students!

Are There Bridge Programs to Transition from PA to MD?

Some people will want to know what it takes to go from PA to MD. Currently, there are no bridge programs that exist for PAs to become MDs. This means that if you’re interested in becoming an MD after becoming a licensed PA, you will have to apply to medical school and then to a residency program. There are no shortcuts for professionals who find themselves contemplating a career switch, but there are a few things you should keep in mind if you’re considering it:

1. Use the clinical experience to boost your application. The great thing about going from a PA to an MD is that you will have plenty of clinical experience to boost your application. Depending on with what health care workers you collaborate with, and the environment you work in, you can discuss these experiences in your personal statement and in the interview.
2. Get a strong letter of recommendation from a physician. Because PAs work directly with physicians under their supervision, if you decide to pursue medical school, you can get a strong medical school recommendation letter from one of the physicians you work with. This will give you an advantage over other applicants because you have longer and more qualified experience working with a professional who can attest to your skills.
3. Prepare an answer to the question “why do you want to be a doctor?” The admissions committee of the schools to which you apply will be wondering why you decided to make a career switch. The question “why do you want to be a doctor?” will be inevitable, as the details in your medical school resume will reveal that you’ve started a career as a PA. Therefore, you will need to be prepared to answer this question and provide a strong justification for why you’d make a strong medical doctor. If you need help getting your materials in order and preparing for this question and other, you can consider medical school admissions consulting.

Check out this video summary of the path from PA to MD:

PA vs MD: Conclusion

As medicine begins moving more consciously away from a top-down hierarchical model to an intentionally collaborative, team-based approach to healthcare, new dynamics are emerging to (ideally) ensure each patient gets the kind of attention and treatment they need, with various, overlapping professionals providing a web of care, rather than a singular life-line. While, historically, the physician-at-the-top model has been the norm, the growing understanding of patients as diverse, complex, and requires individualized care necessitates a multiplicity of approaches to assessment, diagnosis, treatment, and management. MDs, PAs, nurses, nurse practitioners and a wealth of other healthcare providers, from highly specialized surgeons to dietitians to medical social workers, all form the larger collaborative framework of patient care that drives early 21st-century medical practice.

Both paths – the PA and the MD – bring with them a heavy burden of responsibility, work, and stress, but also rewards that often far surpass the toll of either profession. If you are willing to exchange reduced autonomy for less time and money spent on education and more flexibility in terms of your long-term career trajectory, then you may want to consider the PA path. On the other hand, if autonomy and the ability to work without direct oversight are more important to you than the monetary and time investment needed for education, and you’re willing to take on the long hours and higher risk of burnout, then the MD might be the better path for you. Both are valuable, interconnected-yet-distinct, components of the wider healthcare team.

As you are deciding on your path, check out common PA school interview questions and medical school interview questions. You will find that the two are closely connected.

FAQs

About the Author:

Dr. Sarah Lynn Kleeb is an admissions expert at BeMo. Dr. Kleeb holds a doctorate degree (Ph.D.) from the University of Toronto where she examined the connections between Critical Theory and Liberation Theology. She brings 10 years of experience teaching, advising, and mentoring undergraduate students to her role as an admissions expert, having taught extensively at UofT. 

To your success,

Your friends at BeMo

BeMo Academic Consulting

Source: AACOM, USNews, MedScape, HospitalCareers

Image Credit: Vidal Balielo Jr.

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