Discover the differences in PA vs. MD salary, lifestyle, and job role to determine which career is the right fit

A doctor wearing a white coat and stethoscope interviewing a woman for a physician's assistant position

If you dream of spending your life practicing medicine and helping others, there are many esteemed medical career options available to you. Maybe you’ve always wanted to be a doctor, but as you explore the medical field and gain healthcare experience, you’re discovering new career possibilities—including the option of becoming a physician assistant.

Now you’re asking yourself difficult questions. “Which medical career is right for me? Should I be a PA vs. MD?” While the two careers share many similarities, there are also several key differences you should be aware of before you make a decision.

Some students consider becoming a physician assistant because they’re worried they aren’t competitive enough to get into medical school—they’re looking for a plan B. Other students fear they might burn out from the high-intensity lifestyle of being a doctor and hope a PA career will offer the work-life balance they’re looking for in a medical occupation.

Regardless of your reasons for joining the PA vs. MD conversation—and both are certainly valid—we’re glad you’re here to better understand the distinction between these two medical professions. In this guide, we’ll define the PA vs. MD careers, examine the respective admissions statistics, and compare the PA vs. MD salary and lifestyle differences to help you decide which is the right medical career for you.

What is a PA vs. MD?

To better understand the similarities and differences between the PA vs. MD professions, let’s begin by defining each occupation.

Doctor of Medicine (MD)

A medical professional who is licensed to diagnose and treat patients’ diseases in independent practice. Physicians receive specialized training in a specific medical discipline, such as internal medicine, pediatrics, psychiatry, or surgery, to name a few.

Physician Assistant (PA)

A medical professional who is licensed to diagnose and treat patients under the supervision of a doctor. Physician assistants receive general training in all medical fields and may practice in many different specialty areas.

PA vs. MD similarities and differences

PA vs. MD education

Both physicians and physician assistants must complete in-depth medical graduate programs in order to qualify for licensure. An MD completes a 4-year doctorate program, and a PA completes a 2- or 3-year master’s program. Both programs include clinical rotations as significant parts of the curriculum.

PA vs. MD licensing examinations

After completion of their respective medical programs, both MDs and PAs must pass comprehensive exams in order to be licensed to practice medicine. Physicians must pass the USMLE (Steps 1 through 3) and physician assistants must pass the PANCE examination. After passing these exams, PAs and MDs must apply to be licensed in the state they plan to practice.

PA vs. MD specialized training

Physicians must complete 3 or more years of medical residency after completing their doctoral program. In these residencies, they receive specialized training in a specific medical field of their choice. More advanced specialties such as neurosurgery and plastic surgery require up to 6 or 7 years of residency before physicians can practice independently.

Physician assistants are not required to complete residencies after finishing their master’s program, although they may choose to enroll in an optional PA residency training program. For the most part, PAs head directly into the workforce after getting licensed and receive on-the-job training from their supervising physician. While many PAs work in a primary care field, they are able to work in a variety of specialities, from dermatology to surgery.

PA vs. MD daily practice

Both PAs and MDs examine patients, give diagnoses, create treatment plans, and conduct medical procedures as part of their daily practice. All PAs must work in collaboration with a physician, but the specifics of their scope of practice is determined by each state’s laws. For example, many PAs work primarily on their own and consult with their supervising physician on complex cases only. On the other hand, some PAs in certain states must work directly side-by-side with their supervisor at all times.

In many states, PAs can write prescriptions for their patients. And although they cannot perform surgeries themselves, they are able to assist their supervising physicians with surgery. In general, PAs handle routine patient care and diagnosis, but pass complex medical cases to their supervising MDs who use their advanced education and specialty training to handle them.

PA vs. MD admissions: key differences

One reason you might be thinking about becoming a PA vs. MD is because there’s a widely held perception that it’s easier to get into a PA program than it is to get accepted to medical school. We can look at the admissions data to see if this belief is true.

Which program is easier to get into—PA vs. MD?

Everyone knows the medical school admissions process is highly competitive, and increasing in difficulty with each passing year. While acceptance rates between programs can vary, the average acceptance rate for medical school is only 7%. Because of this high level of selectivity, only 41% of medical school applicants matriculated into a medical program in 2019-2020.

So the question is, are PA programs this competitive? And the answer is, yes. While fewer students apply to PA programs (about 27,000 PA applicants vs. 57,000 MD applicants), the average acceptance rate for PA school is also 7%. In the end, 32% of total applicants in 2019-2020 matriculated into a PA program.

Based on this information, you’ll see that PA programs are just about as competitive as medical programs. If we look at the average GPA information for each type of applicant, we can glean further insight.

The average GPA for accepted medical students in the 2019-2020 admissions cycle was a 3.65 science GPA and 3.72 overall GPA. In the same year, the average GPA of accepted PA students was a 3.5 science and 3.6 overall. So if you were to only consider GPA, you could say PA programs are easier to get into than MD programs—but by an extremely slight margin.

(Suggested reading: PA School Requirements: The Ultimate Guide)

PA vs. MD testing requirements

We’d be remiss if we didn’t mention one of the most ominous aspects of the medical school admissions process—taking the MCAT (Medical College Admissions Test). Some medical school prospects might be ready to jump ship and join the PA career track when they discover they aren’t required to take the MCAT in order to apply to PA school. Instead, most PA programs require their applicants to take the GRE (Graduate Records Examination).

The MCAT is widely considered to be a much more difficult exam than the GRE. While the MCAT tests students’ knowledge of focused content areas such as biology and chemistry, the GRE is designed to assess students’ general writing and reasoning abilities. In general, the GRE requires much less time and effort to prepare for than the MCAT does.

Furthermore, the average GRE scores for students accepted to PA programs are 154 in verbal reasoning, 153 in quantitative reasoning, and 4 in analytical writing—these are each at or slightly above the 50th percentile. On the other hand, the average MCAT score for medical school matriculants is 511.5—the 82nd percentile.

So even though they are vastly different exams, you would have to perform better on the MCAT in order to get into medical school than you would have to perform on the GRE in order to get into a PA program.

Activity and experience requirements for PA vs. MD admissions

Outside the classroom and testing center, it’s worth noting how the activity requirements for PA vs. MD programs differ. For example, while scientific research is an important extracurricular activity for medical school hopefuls to engage in, it’s not valued as highly for PA applicants. It can certainly set them apart or make them look good, but research is not a standard PA admissions requirement as it is for medical school.

On the other hand, healthcare experience—and specifically direct patient care experience—holds a much higher level of importance for PA applicants than for MD applicants. To illustrate this point, let’s consider the standard healthcare experience requirements for PA vs. MD programs.

While the average MD program might require its applicants to accrue 50 to 100 hours of healthcare experience, many PA schools require applicants to possess 2,000 healthcare experience hours. In fact, the average student accepted into PA programs has gained over 3,000 hours of direct patient care experience, plus an additional 1,000 hours of indirect healthcare experience and 140 hours of PA shadowing.

If you’re feeling intimidated by the high number of healthcare experience hours needed for PA school, you’re not alone. This may seem insurmountable if you’re starting off with a rather low amount of healthcare experience, but it actually isn’t. Many PA applicants take a gap year or two between undergrad and PA school where they can work full-time as a paramedic, EMT, or CNA—easily gaining 2,000 hours of experience per year. In addition, some students become certified as CNA’s during undergrad and work part-time to fulfill these experience requirements.

All in all, both PA and MD programs are looking for applicants whose extracurricular activities demonstrate their commitment to medicine, their knowledge of health care systems, their leadership abilities, and their interpersonal skills. While the specific activity requirements look different, both will require you to hustle outside the classroom.

PA vs. MD salary

Because the roles, training, and requirements are different between PAs and MDs, it shouldn’t come as a surprise that PA vs. MD salaries differ, too.

Average PA salary: $112,000
Average MD salary: $208,000

Even though these are both well-paying careers, there is a remarkable salary difference—with MDs making nearly double what PAs earn. To understand why this is, there are a couple of factors to consider.

First, you must recognize that PAs spend remarkably less time on their education and training. While MDs complete 4 years of doctoral study followed by 3 to 7 years of residency before they can begin earning their high salary, PAs begin their full-time, full-pay work after just 2 to 3 years of schooling.

PAs and MDs also pay drastically different amounts for their education—resulting in different levels of student loan debt they need to repay.

Average cost of PA school: $70,000 - $90,000
Average cost of medical school: $200,000 - $280,000

Physicians both warrant higher salaries due to more in-depth, specialized training and need them due to higher debt amounts. They also have additional job responsibilities, including supervising PAs and handling complex medical cases.

PA vs. MD specialty compensation

As mentioned previously, physicians complete residencies (and possibly fellowships) within their chosen specialities after completing medical school. Some of these specialties which require highly advanced skills and many additional years of training offer MDs above-average salaries in return. In fact, dermatologists, cardiologists, and plastic surgeons can command salaries in excess of $400,000 per year.

In contrast, PAs who specialize in dermatoloy or surgery won’t command a salary that’s significantly higher than the average PA salary—partly because specializing as a PA requires on-the-job training rather than formalized specialty training or fellowship programs. If you choose to be a PA vs. MD, you can still specialize into a field of your choosing, but be aware you have less room to expand in your salary.

PA vs. MD job growth

Most medical careers are projected to have stable job growth in the immediate future—PAs and MDs included. But while the MD occupation is expected to grow 4% in the next decade, the PA occupation far exceeds it with 31% expected job growth. This is partially because the physician assistant profession is still relatively new—the first PA program was started at Duke University in the 1960s. The PA career continues to grow and expand state-by-state.

In addition, PAs are a more affordable healthcare option. Looking at it from a hospital or private practice perspective, for about the same payroll cost as two MDs, you could instead get one supervisory MD and two PAs. This could increase the amount of patients seen by up to 50%.

While physicians certainly won’t struggle to find work in the coming years, it’s expected we’ll see a more urgent need for physician assistants in hospitals and practices around the country.

PA vs. MD lifestyle

Another significant factor you should consider when deciding to become a PA vs. MD is the differences in lifestyle each career offers. MDs have notoriously long and irregular hours, often averaging 60+ hours per week. In addition, they may have on-call responsibilities for their hospital or medical practice. On the other hand, PAs more routinely work a consistent 40 hours per week and can arrange for a regular 9 to 5 schedule rather easily.

However, only MDs have the freedom to start their own private practices and become their own bosses. PAs will always be under a doctor’s supervision—which might be attractive for some and discouraging for others. PAs don’t have to deal with the administrative tasks that come with owning a private practice, but they also can’t reap its rewards, such as earning business profits and wielding decision-making power.

A final key difference we’d like to point out between PA vs. MD lifestyle regards mid-career flexibility. After completing three or more years training in a single specialty field, it would be highly unfortunate for an MD to decide they don’t like their area of specialization. In fact, they would have to complete an entirely new residency in order to switch specialties, regardless of how many years of medical experience they’ve acquired.

On the other hand, it’s relatively easy for PAs to switch specialties mid-career if they wish. Since no formal training programs are required, they just need to be hired for the new role and receive on-the-job training from their supervisory physician. If you want this type of easy flexibility in a medical career, you won’t find it as an MD.

PA vs. MD—Which career is right for you?

After discovering the similarities and differences between physicians and physician assistants, perhaps you’ve already made your career choice. On the other hand, you might still be on the fence and struggling to decide which career is a better fit for you. If that’s the case, we have a few suggestions.

Ask yourself the following set of questions. If you can answer yes to the majority of them, then an MD career might be the right choice for you.

Do you crave autonomy and the ability to be your own boss?
Do you dream of running your own private practice or clinic?
Is earning a high salary one of your most important career goals?
Do you want to handle complex and challenging medical cases?
Do you hope to distinguish yourself as the best in a specific specialty field?

Now, you must also ask yourself the next set of questions to determine which career appeals most strongly to you. If you answer yes to more of the questions below than you did for the questions above, maybe a PA career is a better path for you to take.

Do you want a career with moderate amounts of stress and responsibility?
Are you eager to save time and money on education while starting your career as soon as possible?
Would you prefer regular, stable hours with limited on-call responsibilities?
Do you excel in a collaborative environment where you can receive the guidance of others?

Hopefully, this self-reflection exercise, combined with all the PA vs. MD information we’ve shared, will help you determine which medical career will offer you the greatest levels of job satisfaction and fulfillment.

Additional tips to decide between a PA vs. MD career

Shadow members of both professions. Ask MDs and PAs direct questions about the type of work and lifestyle options offered by each career.
Assess your priorities. What work values are most important to you? Independence? Collaboration? Career growth? Routineness? Novelty?
Envision your preferred future. Do you want to be your own boss? Would you like to have a family? Do you hope to have time to pursue non-work hobbies?
If you’re worried about your medical school admissions chances because you have a low GPA, don’t choose to become a PA unless you truly like the job description. There are ways to get into med school with a low GPA. Don’t pursue a career that won’t fulfill you.

Final thoughts

Whether you choose to become a PA or an MD, you will be doing valuable medical work that impacts the lives of many. Whichever occupation you choose, ensure it is the right fit for your personality, career goals, medical interests, and preferred lifestyle. So which is the right career—PA vs. MD? Only you can decide.

PA School Requirements: The Ultimate Guide

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PA vs MD: The Biggest Differences