How to Become a Physician Assistant

If you’ve had a medical appointment or undergone a medical procedure recently, there’s a good chance that you received care from a physician assistant (PA).

Originally licensed to—quite literally—assist physicians and increase the number of qualified medical practitioners, PAs today provide much of the same patient care as doctors. 

Like other medical practitioners, PAs undergo years of education to gain significant clinical experience before they can begin practicing medicine. However, the process for becoming a PA differs from becoming a doctor, nurse, or nurse practitioner. 

This step-by-step guide will help you navigate how to become a physician assistant so you can begin your medical career.

What is a Physician Assistant?

A physician assistant (PA), also called a physician associate, is a healthcare professional who works directly with patients. PAs work in hospitals, doctor’s offices, and other clinical settings to diagnose and treat illness, prescribe medication, and handle preventative care. 

Physician assistants have many of the same responsibilities as doctors. In numerous clinical settings, patients may receive care from either a physician or PA. In most states, PAs work under a collaborative agreement with a physician. In practice, however, many PAs practice medicine with significant autonomy.

According to the national professional society for physician assistants, the American Academy of PAs (AAPA), physician assistants can:

• Diagnose and treat illnesses
• Conduct medical histories and physical exams
• Order and interpret diagnostic testing
• Develop treatment plans, including prescribing medication
• Provide advice on prevention and preventative care 
• Perform some medical procedures and assist in surgical procedures
• Conduct rounds in hospitals, nursing homes, and other clinical settings 
• Plan and participate in clinical research

You’ll find many PAs who work in family medicine, internal medicine, and other general medicine settings. 

PAs can also specialize in a variety of roles, including anesthesia, obstetrics and gynecology, radiology, pediatrics, emergency medicine, and cardiology. 

Is Becoming a Physician Assistant a Good Career Choice?

Physician assistant can be an excellent career choice for anyone interested in practicing medicine. 

US News and World Report ranked physician assistant as the third best overall job and the second best job in healthcare for 2022. This evaluation is based on factors such as median salary, long-term demand, stress levels, and work-life balance.

Here are some specific reasons why you may want to consider becoming a PA.

Excellent Job Security

The job market for PAs is strong and expected to continue to grow rapidly. According to the US Bureau of Labor Statistics, demand for PAs may grow by as much as 28 percent between 2021 and 2031. This means there will be nearly 40,000 more jobs for PAs in the next decade.

Competitive Salaries

A job as a physician assistant can pay well. The typical annual salary range for PAs in 2022 was between $105,000 and $126,000, with a median salary of $114,000. As with many careers, PA salaries depend on level of education, years of experience, area of specialization, healthcare setting, and location.

Focus on Patient Care

If you love working with people and are interested in building relationships with your patients, PA might be a great career choice. In many settings, PAs are directly responsible for patient care. You will likely be performing hands-on medical procedures and working one-on-one with your patients to treat illnesses and advise on preventative care.

Career Flexibility

As a PA, you can pivot between specialties throughout your career. For example, you may start your career in emergency medicine, then move into a family practice. Or, you may begin in internal medicine and shift to dermatology or orthopedics. Your education and training as a PA offers the potential for a dynamic career pathway.

Schedule Flexibility

Like most careers in the medical field, PAs may be required to work long hours and fulfill on-call responsibilities. 

However, because PAs have the option to work in different types of clinical settings, you have the option to find a schedule that supports your work-life balance, such as working regular hours every week. Alternatively, you may choose shift work that allows you the flexibility, depending on your specific workplace, to choose how much and when you work. 

Steps to Become a Physician Assistant

One of the top benefits of becoming a PA instead of a doctor is that you spend less time in the classroom before beginning your career. 

That doesn’t mean, however, that becoming a PA is easy. You will still need to earn an advanced degree and pass a certification exam before you can begin to practice medicine. 

Here are the typical steps you’ll need to take to launch your career as a physician assistant.

1. Earn Your Undergraduate Degree

Earning your bachelor’s degree is the first step on your path to becoming a physician assistant. 

If you know that you’re interested in a career in medicine early in your educational journey, you should consider earning a bachelor of science (BS) degree with a major in biology, chemistry, or a STEM field. 

A BA (bachelor of arts) degree, even with a liberal arts major, will enable you to pursue continuing education for a career as a PA. However, you will likely need to take additional coursework in biology and related fields before you can apply to PA school.

2. Gain Hands-On Clinical Experience

Before you can apply to PA school, you will need to gain experience in the field of healthcare. Most PA schools require a certain number of hours of either healthcare experience (HCE) or patient care experience (PCE). 

This requirement is one reason why becoming a PA can be an ideal choice for people interested in changing careers a bit later in life. If you have been working as an EMT, a medic,  a corpsperson in the military, a dental technician, or a radiologist, for instance, you already have the patient care experience you need to move into a career as a PA. 

3. Supplement Your Academic Record

If you earned a BS in biology with all A’s, you may be able to apply to PA school as soon as you have accumulated enough clinical experience. 

If you didn’t take many science-related courses as an undergrad, or you didn’t have a high GPA, you’ll need to supplement your academic record before you can apply to PA school. You may also need to take additional science-based coursework if you are seeking to become a PA as a career change.

Enrolling in a premedical program before you apply to PA school gives you the opportunity to take prerequisite courses you didn’t take as an undergraduate or retake them to improve your GPA. You can also complete advanced coursework to demonstrate your readiness for the academic rigors of PA school. 

4. Graduate From an Accredited PA Program

To become a PA, you’ll need to have a master’s degree in PA studies from a university program that has been accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

Most PA programs require going to school full time for two to three years. You’ll complete a mix of coursework in the medical sciences, including class time in a lab and rotations in a range of clinical settings. The clinical rotations offer the opportunity to explore and gain experience in different specialities.

5. Pass the PA Certification Test

After graduating from an accredited PA school, you must become certified as a physician assistant by the National Commission on Certification of Physician Assistants (NCCPA).

To become certified, you must pass the Physician Assistant National Certifying Examination® (PANCE). PANCE is a five-hour exam involving 300 multiple-choice questions designed to test that you have the medical knowledge you need to begin your career as a practicing PA. 

You can apply to take PANCE 180 days before your expected completion of PA school. Once your application to take the PANCE is accepted, you have 180 days to pass the exam. You may retake the exam up to three times in a calendar year.

6. Obtain State License

The final step in the process to becoming a PA is to obtain a license in the state in which you want to practice.

Every state has its own regulations and procedures for its licensing process. Once you’ve decided where you want to practice, you will need to apply to the licensing board of that state and follow the instructions for obtaining your license. 

As part of the licensing process, you will also need to apply for a National Provider Identifier (NPI) number from the US Centers for Medicare & Medicaid Services and register with the US Drug Enforcement Agency (DEA).

What Are the Requirements for PA School?

Graduating from an accredited PA school is key to starting your career as a PA. 

In most states, a master’s degree in PA studies is required for licensure. Moreover, PA school should help you gain the medical and surgical knowledge you need to pass the PANCE, also required for state license in most states.

Acceptance into PA school is highly competitive. Each university has its own set of requirements that it uses to evaluate applicants. Generally speaking, however, you’ll most likely need to demonstrate success in the following areas to qualify for admission to PA school.

Undergraduate Prerequisite Coursework

PA schools want to see that you already have a strong foundation in science. To demonstrate this foundation, you have to show that you have successfully completed undergraduate coursework and labs in courses such as:

• General chemistry, organic chemistry, and biochemistry
• Biology and microbiology
• Anatomy and physiology
• Medical terminology
• Genetics

Many PA schools will also want to see that you’ve taken significant coursework in physics, math and statistics, english, and psychology.

If you graduated with a BS in biology or a STEM-field, you may have completed many of these requirements as part of your undergraduate degree. If you did so with a strong GPA, you may not need to take additional coursework before applying to PA school.

However, if you didn’t take these types of courses as an undergraduate or if you had less than stellar grades, you may want to consider applying to and enrolling in a premedical program before you apply to PA school. 

Healthcare/Patient Care Experience

In addition to GPA and coursework, your experience working in the healthcare field is an important part of your PA school application. This experience can either be:

• Patient care experience (PCE): roles in which you have provided hands-on patient care
• Healthcare experience (HCE): more general work in the field of healthcare but not necessarily directly with patients

A few examples of PCE and HCE accepted by most PA schools include:

• EMT or paramedic
• Military medic or corpsperson
• Medical technicians or technologists
• Physical therapy aide
• Dietician
• Phlebotomist
• International healthcare based mission trips
• Hospice worker
• Dental hygienist or technologist
• Medical social worker 
• Mental health care counselor

While the exact number of hours varies from school to school, the more high-quality experience you have working directly with patients, the stronger your application to PA school will be. Most successful applicants to PA school have more than 1,000 hours of HCE or PCE. 

For many people, this means working in the healthcare field for a year or more after undergrad before beginning the application process. 

Multiple premedical programs focused on the PA school application allow enrolled students to take courses part time and online while working full time in a field that will allow you to gain needed clinical experience as well. 

There’s no doubt about it: becoming a certified PA can be a long and challenging process. The outcome, however, can be a highly rewarding career as a physician assistant. Investing the time and hard work now in your career as a PA can be a worthwhile investment in your future.