Nurse Practitioner (NP) vs. Physician Assistant (PA): What Are the Key Differences and Which Is Better?

Nurse Practitioners (NPs) and Physician Assistants (PAs) are two advanced practice healthcare professionals whose roles, scopes of practice, and daily responsibilities share many commonalities while also showing significant differences.

The primary duties shared by both NPs and PAs include diagnosing illnesses, prescribing medications, and managing patient care. However, despite these overlapping responsibilities, there are significant differences in many areas, which we will discuss below.

Understanding the NP vs. PA comparison is crucial for determining which career path aligns best with your goals.

PA vs. NP: Role Overview

Both Nurse Practitioners and Physician Assistants play vital roles in modern healthcare delivery and clinical practice, with the key distinction lying in the educational paths and models pursued, as well as in the type of practice they employ in their respective work settings.

Generally, Nurse Practitioners are trained under the nursing model, which emphasizes holistic, patient-centered care (addressing physical, emotional, and social factors). In contrast, Physician Assistants are trained under the medical model, focusing on disease pathology, diagnosis, and treatment.

In practical terms, it means that NPs often incorporate and center health promotion and patient education, whereas PAs tend to focus more on biomedical aspects of care. It should be stressed that neither role is in any way above or higher than the other; NPs and PAs fulfill distinct but complementary roles and frequently collaborate in many healthcare teams and contexts.

What Is an NP (Nurse Practitioner)?

A Nurse Practitioner is a type of Advanced Practice Registered Nurse (APRN) who has completed graduate-level training in nursing. NPs are licensed clinicians qualified to provide comprehensive care across diverse settings and patient populations, evaluating patients, ordering and interpreting diagnostic tests, diagnosing acute and chronic conditions, and initiating treatment plans, including prescribing medications.

Usual NP responsibilities include:

• Diagnosing and managing acute and chronic illnesses (e.g., infections, hypertension, diabetes)
• Prescribing medications and therapies (within their scope and formulary authority)
• Ordering and interpreting diagnostic tests (lab work, imaging studies)
• Providing preventative care and patient education on lifestyle, wellness, and disease prevention
• Coordinating patient care and making referrals to specialists as needed

NPs often specialize in a patient population or care area, with the term Nurse Practitioner also serving as an umbrella term for the many specialties and career paths pursued by APRNs, including Family Nurse Practitioner (FNP), Psychiatric-Mental Health Nurse Practitioner (PMHNP), Pediatric Nurse Practitioner (PNP), Adult-Gerontology Nurse Practitioner (AGNP), and others.

What Is a PA (Physician Assistant)?

A Physician Assistant (PA) is a licensed advanced practice provider who is educated in the general medical model, similarly to physicians, typically earning a master’s degree in physician assistant studies. 

PAs are trained to perform many of the same clinical functions as physicians, in collaboration with or under the supervision of a physician. They conduct physical exams, take patient histories, diagnose illnesses, develop treatment plans, and prescribe medications. PAs also often assist in surgeries and can perform procedures for which they are trained, making them integral to many specialty practices (such as surgical, emergency, or orthopedic teams). 

While the title “assistant” might imply a subordinate role, PAs actually function as medical providers who can work fairly autonomously within the physician-led team.

Key PA responsibilities include:

• Performing patient exams and histories (evaluating patients in clinic or hospital settings)
• Ordering and interpreting tests (blood work, X-rays, MRI, etc.) to inform diagnoses
• Diagnosing and treating illnesses and injuries (from infections to minor injuries or assisting in the management of chronic diseases)
• Assisting in surgeries and procedures, such as suturing wounds, casting broken bones, or operating on surgical equipment
• Prescribing medications and therapies (in coordination with their supervising physician)
• Educating and counseling patients on treatment plans and healthy practices

PAs are educated as generalists, which gives them flexibility to work in various specialties without additional formal training. A PA might work in family medicine for a few years, then transition into cardiology or surgery, adapting their skills on the job, a versatility that is a hallmark of the PA profession.

Differences Between Nurse Practitioner and Physician Assistant Roles

Although NP and PA roles overlap in many areas, there are also significant differences that you should consider, especially when choosing a career path for yourself. Below, you will find the central areas where the two roles differ and the details that should inform your choice as a specialization.

NP vs. PA Differences in Education

To start with the commonality, both NPs and PAs must complete rigorous graduate-level education and practical experience in order to receive certification and practice in clinical environments. However, the two pathways of preparation and licensure differ considerably.

To become an NP, one generally must earn a Bachelor of Science in Nursing (BSN), become a licensed RN by passing the NCLEX exam, and often gain some nursing experience. They then complete a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) program, specializing in an NP role. NP certification programs generally include coursework in advanced health assessment, pharmacology, and pathophysiology. More importantly, these will also focus on a specific population, such as family nursing, neonatal care, midwifery, pediatric care, or psychiatric-mental health nursing. They also require clinical practicum hours (usually 500–1,000 hours) in that specialty, with the NTF Standards for Quality Nurse Practitioner Education requiring a minimum of 750 clinical hours for NP programs.

After graduating from the program, prospective NPs must pass national certification exams in their chosen specialty, such as the AANP or ANCC exams for FNPs. Additionally, they also need to obtain state NP licensure.

At Nightingale College, you can pursue two NP education programs with popular specialties: the MSN FNP Program for aspiring Family Nurse Practitioners and the MSN PMHNP for Psychiatric learners aiming to become Mental-Health Nurse Practitioners.

Compared to becoming an NP, becoming a Physician Assistant requires completing a Master's-level PA program, which is typically 2–3 years long and modeled after medical school. Prospective PA students often have a bachelor’s degree in a science field and around 2–3 years of hands-on healthcare experience before, for example, working as an EMT, medical assistant, or nurse’s aide. PA programs cover general medicine across all organ systems and specialties, including anatomy, pharmacology, clinical medicine, and rotations in family medicine, surgery, pediatrics, emergency, psychiatry, and others. Notably, PA students will complete extensive clinical rotations (up to 2,000 hours), often significantly more than NP clinical hours, because PAs must be exposed to a wide range of fields.

After graduating, they must pass the PANCE (Physician Assistant National Certifying Exam) to receive the PA-C certification, which does not differ by specialization, since Physician Assistant education is generalist. Additionally, to maintain certification, PAs complete continuing medical education credits every two years and take a recertification exam every 10 years.

NP vs. PA Differences in Scope of Practice

The scope of practice is a major area of difference between NPs and PAs, often governed by state laws.

NPs may have Full, Reduced, or Restricted Practice Authority, depending on the state. In Full Practice states (currently the majority of US states), NPs can evaluate patients, diagnose, order and interpret tests, and initiate treatments (including prescribing) without physician oversight. This means that Nurse Practitioners with Full Practice Authority function as independent healthcare professionals, often practicing autonomously in clinics. The situation is different with Reduced or Restricted Practice Authority, with NPs required to have collaborative agreements with physicians for a range of clinical practices, such as prescribing or treating complex cases, while, in some cases, retaining the ability to diagnose or treat independently regular cases.

As of 2023, Nurse Practitioners have Full Practice status in 28 states, with 11 states conditioning their practice on physician supervision, and the rest falling somewhere between these extremes. Still, NPs are fully licensed clinicians, which means greater autonomy in care and clinical practice. 

Compared with physicians, Physician Assistants, as their name suggests, always practice in collaboration with physicians. Their authority of practice is provided through a “delegatory model”, where a physician or institution delegates duties in line with state laws. Although the scope of practice of PAs can be very broad, encompassing most, if not all, tasks across various settings, they cannot legally practice without a supervising physician or a prior practice agreement. This does mean that, even when the physician is not required to be physically present or involved in the clinical practice of a Physician Assistant, they remain responsible for said practice.

Some states have moved to a collaborative practice model with PAs (easing strict supervision requirements), but autonomous practice for PAs is not permitted, unlike for NPs in certain jurisdictions. Consequently, PAs cannot open their own practice or operate completely solo; they must partner with an MD/DO for oversight.

In day-to-day terms, this means an NP in a full-practice state might hang up a shingle as a primary care provider and see patients independently. In contrast, a PA must work within a medical practice or hospital where a physician is part of the team. However, in team-based settings like hospitals or large clinics, NPs and PAs often function very similarly, each managing their own patients with physician collaboration available. Studies found that when working in equivalent roles and specialties, Nurse Practitioners and Physician Assistants delivered comparable patient outcomes within their respective scopes of practice.

NP vs. PA Work Setting Differences

As in other aspects, there is considerable overlap between where Nurse Practitioners and Physician Assistants work, mainly in hospitals, outpatient clinics, private physician offices, urgent care centers, nursing homes, community health centers, and government or private correctional institutions, veterans affairs facilities, and many other settings.

Additionally, the roles fulfilled by NPs and PAs will be similar in scope, bearing the umbrella name of Advanced Practice Providers or Mid-Level Providers. However, differences in education, accreditation type, and allowed scopes of practice result in differences in distribution for the two specialties.

Nurse Practitioners are more likely to work in primary care settings, with 87% of NPs being prepared in primary care, according to the AANP. Many NPs work in family practice, pediatrics, women’s health, or internal medicine clinics, and also in acute care within hospital inpatient units, ICUs as acute care NPs. Family nursing represents the largest share of the NP nurse pool specialties (68.7%), followed by adult and geriatrics (15.1%), pediatrics (3%), and women’s health (2%). A defining aspect of the NP field is that it has helped fill the gap in primary care providers, running their own clinics in underserved or rural areas where physicians are scarce (and where full practice is allowed), where they generally focus on primary care, preventive health, and managing chronic conditions for patients who might not otherwise have a provider.

In contrast, Physician Assistants are better represented in specialty care and surgical fields, with a relatively smaller proportion of them working in primary care. Recent studies found that 22.3% of PAs work in primary care. They are especially common in surgical and procedural areas, serving as first assistants, performing pre- and post-operative care, and helping manage patients on surgical floors. It is also not unusual for surgical practice areas like neurosurgery or orthopedics, as well as emergency and urgent care departments, to employ multiple PAs on staff. According to the NCCPA, individual specialties where PAs are most frequently employed are family medicine (16.5%), emergency medicine (10.8%), orthopedic surgery (10.7%), dermatology (4.3%), and internal medicine-general (4%)

NP vs. PA Career Outlook Differences

One thing to keep in mind is that both Nurse Practitioners and Physician Assistants have a strong job outlook, with high demand across the board and particularly in primary care and underserved areas, where they fill critical gaps in healthcare provision.

The Bureau of Labor Statistics (BLS) states that that both professions are expected to grow faster than the average for all occupations (3%) and healthcare diagnosing or treating practitioners (8%), with a 40% increase through the decade for Nurse Practitioners, and a 20% increase for Physician Assistants, amounting to 128,000 new NP jobs and 33,200 new PA jobs by 2034. In net numbers, about 12,000 openings for Physician Assistants every year, and 32,700 new job openings for NPs, along with Nurse Midwives and Anesthetists. Additionally, the U.S. News & World Report ranked Nurse Practitioner as the #1 Best Health Care Job in 2024 and Physician Assistant as #2.

Job security in both fields is high. For anyone choosing between NP and PA, it’s reassuring that both careers offer strong employment prospects and growth. The slight edge in growth percentage for NPs suggests they may be in particularly high demand (likely due to the emphasis on primary care shortages), but PAs are not far behind. Ultimately, from a macro job outlook perspective, both NPs and PAs have a bright future in healthcare.

NP vs. PA Salary Differences

When it comes to earnings, Nurse Practitioners and Physician Assistants have very comparable salaries. Both are among the higher-paid healthcare roles due to their advanced training.

Recent data from the BLS shows the average salary for Nurse Practitioners is $129,210 per year. Similarly, the average salary of Physician Assistants is reported to be slightly higher – $133,260 per year. Compared to previous estimates, the average annual NP salary decreased by $270, while the PA salary increased by $3,240.

However, salary should not be the sole deciding factor between NP and PA, because they are so similar. Instead, factors such as the type of work, work setting, autonomy, and personal interest in nursing vs. the medical model are more significant distinctions. Both NPs and PAs enjoy competitive salaries that reflect their advanced skills and the value they bring to healthcare teams.

Read more about Nurse Practitioner salaries by state for a more detailed discussion.

Pros and Cons of Nurse Practitioner vs Physician Assistant

If you want to decide between aiming to become a Nurse Practitioner or a Physician Assistant, you should weigh the pros and cons of each path. Below, you can review a concise breakdown of the advantages and disadvantages of each role:

Prost of becoming a NP vs. PA:

• Greater autonomy in most states – NPs have full practice authority in over half of the US states, allowing them to practice independently, open their own practices, or work without physician supervision.
• Routes for specialization – Nurse Practitioners have to choose a specialty population during training, allowing them to focus on the field they are most passionate about from the start. For instance, if you are interested in family medicine or mental health care, you can directly go into an MSN FNP or MSN PMHNP program.

• Holistic nursing model – The NP’s nursing background often emphasizes holistic, patient-centered care and education. Many find this approach rewarding, as NPs look at the whole person and often develop long-term relationships with patients.

• Opportunities beyond clinical practice – By accumulating experience, NPs can explore alternative nursing roles and move into education, research, leadership and administration, as well as health policy. For instance, you can complete an MSN Ed program and become a Nurse Educator or Instructor, which entails also having some advanced practice experience.
• Higher demand and job satisfaction – NPs are ranked the #1 healthcare job, enjoy one of the fastest-growing job markets, and generally report high job satisfaction, with many healthcare settings offering work flexibility. 

Cons of becoming an NP vs. PA:

• Workplace autonomy varies by state – not all states grant NPs full independence. In about a dozen states, NPs still must practice under physician supervision or collaboration for all or some aspects of care. This can become frustrating, particularly if you train to be a Nurse Practitioner and discover you have limited or no independent practice authority.

• Hard to switch specialties – Given the specialized nature of their education, Nurse Practitioners may find it more difficult to pursue a different specialty than the one for which they prepared.
• Nursing background required – For someone not already in nursing, the NP path can be longer. You generally need to become an RN first and hold a BSN degree. That means if you have a bachelor’s in another field, you might have to do an accelerated BSN Program before the MSN track. The total schooling can be extensive—3 to 4 years for a BSN Program or 1 year for an RN-to-BSN Track (if you already have an ADN degree and RN licensure). In comparison, someone with a bachelor’s in science could apply directly to a PA program.
• Practice regulation and certification vary by state – NPs are regulated by state nursing boards, and the rules about what exactly an NP can or cannot do depend on where you will practice. 

Pros of becoming a PA vs. NP:

• Flexibility to work in any specialty – Maybe, the most important advantage of becoming a Physician Assistant is that your education will allow you to change specialties more easily, without additional formal education.

• Generalist education – PAs can be said to complete “medical school lite”, receiving training across all areas of medicine, something that many prospective students see as a strong pro. Their education and training are broad, standardized, and consistent. Plus, if you enjoy the idea of medical school but not the length or cost, PA school offers a similar approach in a shorter time.
• Strong salary and growth prospects – Although the figures are close, PAs earn slightly more than NPs, and, judging from the figures across years, their salary prospects are set to increase in the future. Similar to Nurse Practitioners, Physician Assistants ranked among the top jobs in the healthcare industry, albeit in a lower position than NPs.
• Team-based practice model – If you aim for a position that valorizes collaborative work, the role of a Physician Assistant may suit you better than that of a Nurse Practitioner, which involves more autonomy but also independence and responsibility. The PA role is inherently collaborative, which fosters a team atmosphere. In settings like surgery, being the PA first assistant means you are an indispensable part of a surgical team.
• High mobility and job opportunities – PAs are useful in so many areas, so they often have abundant opportunities, particularly where the job market is tight. A Physician Assistant can work anywhere a physician works, and can transition to another field more easily than an NP can. This versatility can also protect against nursing burnout, as PAs can switch fields mid-career to keep things fresh.

Cons of becoming a PA vs. NP:

• No opportunity for independent practice – The most frequently-cited argument against becoming a Physician Assistant is that you would not be able to practice independently or operate your own autonomous practice at any point in your career, because you will always be required to be under the supervision of or collaborate with a physician. Being a legal obligation that proceeds from the nature and preparation for the role, this constraint remains true even as you accumulate experience. In reality, you may work very autonomously daily, but you still need a physician, at least on paper.
• Scope of practice restricted by supervising physician – One other consequence of the reduced autonomy of PAs is a reduced scope of practice that is highly dependent on the supervising physician. More importantly, in some instances, your practice may reduce the range of duties and practices that Physician Assistants perform. This also induces variability in the scope of practice, with some PAs having a very broad range of responsibilities, and others performing only a limited number of activities.
• Competitive training – Physician Assistant programs are more competitive than medical schools and NP programs, with lower acceptance rates than the former and stricter entry requirements than the latter. They also require more healthcare experience hours, in the range of thousands. 
• Intense learning experience – While the training to become a Physician Assistant is shorter, the program can be intense due to the compression of medical school material and curricula into 24 to 27 months. Although this is a recipe for producing competent advanced practitioners, it can also put considerable stress on students, which often exceeds nursing school stress and burnout.

As you can see, there are many arguments for and against becoming either a Nurse Practitioner or a Physician Assistant. Your final choice should consider all factors, but it should also reflect your expectations for your prospective career. Additionally, you should establish whether you want to advance your career beyond these roles and in which direction.

How to Choose Between Nurse Practitioner and Physician Assistant Roles

Given the many considerations, how do you decide between becoming an NP or a PA? The first thing to remember is that neither of the two roles is universally “better” than the other. The choice hinges on your ability to adapt and flourish given the conditions of each role, as well as your career expectations. 

Nevertheless, here are the main guidance points that will help you in choosing the right profession for you:

• Start from your current background. If you are already a Registered Nurse or aim to become one before advancing, the Nurse Practitioner route is more natural, as it builds on the nursing experience. If you have no nursing background and don’t necessarily want to become a nurse first, the PA route provides a direct path into advanced practice without detouring to get an RN license. Prospective students with a bachelor’s in another science, such as biology or chemistry, may find a PA program more straightforward.

• Do you prefer the medical or the nursing model? Reflect on whether you identify more with the nursing philosophy or the medical approach. Do you value the holistic, patient-centered nursing framework and perhaps the idea of focusing on patient education and support? Or are you drawn to the medical diagnostic process, pathology, and the idea of being trained almost like a doctor in all aspects of medicine? If the former resonates, NP might be fulfilling; if the latter, PA might suit you better.

• Decide how important autonomy and independence are. If you aspire to run your own clinic or not be tethered to a supervising doctor, becoming an NP in a state with full practice authority could allow that down the road. If you’re comfortable always being part of a physician-led team and don’t mind that oversight, PA might work well. Remember, even as a Physician Assistant, autonomy in daily practice can be quite high depending on the setting, but legally speaking, the requirement of a supervising physician remains.

• Think about your field of interest. If you have a specific area of interest for clinical practice, becoming a Nurse Practitioner in that given specialty might provide not only more targeted expertise, but also more job opportunities and career satisfaction. Conversely, if you wish to have expertise in multiple areas of medicine or want to be able to explore and potentially switch specialties, the Physician Assistant role offers more flexibility in this respect.

• Plan your career timeline and evaluate the length of your training. Consider how much time you’re willing to invest in education up front. NP programs might require first becoming an RN, which can add years if you aren’t one already. PA programs are usually around 2.5 years of intensive study after undergrad. If you are eager to enter the workforce quickly and you already have patient care experience, a PA might get you there a bit sooner. However, the nursing path allows you to slowly advance up the career ladder and practice at different levels of expertise. Whichever way you choose, always consult how long nursing school is for your chosen program.

• What is your desired approach to patient care? Do you see yourself focusing on preventive care, counseling, and patient lifestyle factors, or do you see yourself more in a diagnostic-and-treatment, procedural role? While the former represent strengths of the Nurse Practitioner role, the latter often fall in the domain of Physician Assistants. An NP will often have a greater continuity-of-care role, treating patients throughout their journey to rehabilitation. In contrast, a PA in a specialty might see patients for specific issues or assist with technical procedures, without the beginning-to-end characteristic.

• Consider the regulations in the region in which you will practice. Beyond the job demands for each role, you should look into regulations, particularly regarding the scope of practice for Nurse Practitioners. Are you going to practice in a Full Practica Authority state, or a Restricted or Reduced Practice Authority state? And, while Physician Assistants are not affected by such restrictions, the attitude of Physicians matters and can often vary with no formal restraints. 

• How is the job market for your chosen profession? Now that you may have established which role suits you better, you should also consider the job demand for it. Beyond aggregate demand, you should also consult distribution by work setting and evaluate your chances of working in your desired context. In some regions, hospitals are more accustomed to working with PAs, while others are more accustomed to working with NPs. For instance, many surgical departments strongly prefer PAs (due to their surgical rotation training), whereas community clinics might prefer FNPs. Knowing these local tendencies can inform your choice.

• If possible, talk to professionals and shadow them in their daily practice. One final check when choosing your future role is to shadow both an NP and a PA in settings that interest you. Seeing the day-to-day work can be illuminating. Additionally, talk to NPs and PAs about why they chose their path and what they see as the pros/cons in their own career. Firsthand insight can clarify which role resonates more with you.

Finally, as there is no universally valid answer to which role is better, neither is there a catch-all checklist for deciding which to go for. The truth is that the choice is not straightforward, and some people may even pursue both for a lifetime. The best way to make the most of your time and chosen educational path is to ensure they align with your current position and with how you envision your future practice.

Both NPs and PAs are fulfilling careers where you can make a significant difference in patients’ lives. And, more importantly, both paths lead to becoming a skilled healthcare provider caring for patients, with only the route and practice style differing.

Resources for NPs and PAs

Whether you pursue nursing or the PA route, there are professional organizations and resources to support your education and career development. Below are some key resources for each:

Resources for Nurse Practitioners:

• American Association of Nurse Practitioners (AANP): The largest professional membership organization for NPs in the U.S. AANP offers continuing education, conferences, advocacy for the NP scope of practice, and student resources. (Website: aanp.org)
• American Nurses Association (ANA): A broad organization representing all nurses (not just NPs), which provides practice standards, lobbies for nursing issues, and offers professional development resources. It provides information on advanced practice nursing and can serve as a voice for NPs on national healthcare matters.
• National League for Nursing (NLN): An organization focused on nursing education excellence. Useful if you are interested in the academic side or the educational standards of advanced nursing programs.
• Specialty NP Associations: Depending on your specialty, there are groups like the National Association of Pediatric Nurse Practitioners (NAPNAP), American Association of Critical-Care Nurses (for Acute Care NPs), Association of Women’s Health, Obstetric and Neonatal Nurses (for WHNPs and Neonatal NPs), etc. Joining these can provide targeted resources and networking in your field.
• State NP Organizations: Most states have an NP association or coalition that offers job boards, meet-ups, and up-to-date info on state practice laws. These are great for networking and advocacy at the state level (e.g., fighting for expanded NP practice rights).

Resources for Physician Assistants:

• American Academy of Physician Associates (AAPA): (Formerly American Academy of Physician Assistants, still AAPA acronym) – This is the national professional society for PAs. It provides extensive CME resources, an annual conference, advocacy for PA practice laws, salary reports, and career support. It’s the go-to organization for PA professionals and students. (Website: aapa.org)
• Physician Assistant Education Association (PAEA): This organization is geared toward PA education programs and faculty, but it also offers resources for prospective PA students (such as program directories and application information) and conducts research on PA education. (Website: paeaonline.org)
• National Commission on Certification of Physician Assistants (NCCPA): The certifying body that administers the PANCE and PANRE exams. Their site has information on certification maintenance, CME logging, and statistics about the PA profession.
• The Physician Assistant Foundation: an AAPA affiliate focused on philanthropic efforts and patient education programs involving PAs. For example, they provide scholarships for PA students and support community health projects led by PAs.
• Specialty PA Organizations: Just as NPs have specialty groups, PAs do as well. For example, the Association of Neurosurgical Physician Assistants (ANSPA), Society of Dermatology PAs, American Academy of Nephrology PAs, etc. These organizations can provide mentorship and specialized training opportunities in your field of interest.
• State PA Chapters: Each state has its own PA association, which offers local networking, job listings, and state-specific practice updates (important for knowing things like state supervisory requirements, prescribing rules, etc., which can change via legislation).

No matter which path you choose, you can find considerable support both before embarking on your journey and while you're in education. The most important resource for your choice is the academic institution that will help you achieve your goals.

Knowing that this process is not simple, at Nightingale College, we aimed to make the educational experience of future Nurse Practitioners as accessible as possible. Our MSN-level programs seamlessly blend online instruction, in-person seminars, and preceptorship experiences, along with ongoing support systems, to deliver high-quality education in an approachable manner. If you want to become a Nurse Practitioner, you can enroll in the MSN FNP Program (for the Family Nursing specialty) or the MSN PMHNP Program (for the psychiatry-mental health specialty). Alternatively, you may consider enrolling in the MSN Ed Program to embark on a career in nursing academia.

Find out more about the nursing programs at Nightingale College and enroll today!

NP vs. PA FAQs

What Is the Key Difference Between a Nurse Practitioner and a Physician Assistant?

Nurse Practitioners and Physician Assistants are two advanced practice healthcare professionals with overlapping duties in patient care. However, the central difference between the two roles (which generates most other distinctions) lies in their respective educational and preparation paths — NPs follow a nursing program, whereas PAs pursue a medical-oriented learning path.

Is a Physician Assistant Above a Nurse Practitioner?

No. Both roles qualify as advanced healthcare professionals, often with similar or overlapping scopes of practice and duties. Neither is above the other. Instead, they represent two distinct paths in the healthcare profession.

What Can a Physician Assistant Do That a Nurse Practitioner Cannot?

Physician Assistants can switch specialties without additional formal education, allowing them to work across fields such as surgery, dermatology, or emergency medicine as needed. Their training in the medical model provides them with broader exposure to generalist procedures and surgical assisting, which is why PAs are more commonly found in operating rooms and procedural specialties. While Nurse Practitioners can perform many of the same tasks, they usually need further certification to change specialties.

What Can a Nurse Practitioner Do That a Physician Assistant Cannot?

Nurse Practitioners can practice independently in many states without physician supervision, allowing them to open their own clinics and serve as primary care providers under their own licenses. They often have full authority to prescribe medications and sign healthcare documents without oversight, whereas PAs cannot. NPs also leverage their nursing background in roles related to patient education, leadership, and certain advanced nursing specialties, such as midwifery or anesthesia, which fall outside the typical PA scope.

Which Is Better, Becoming a PA or an NP?

Neither role is universally better. Instead, the right choice depends on your career goals and background. If you want more autonomy and have a nursing foundation or plan to work in a specific population focus, an NP may be ideal. If you prefer flexibility to move between specialties and work within a medical team model, a PA could be a better fit. Both are respected, well-compensated, and in high demand, so the best path is the one that aligns with your interests and desired work environment.

Resources

1. American Association of Colleges of Nursing (AACN). (2022). National Task Force on Quality Nurse Practitioner Education. Retrieved from https://www.aacnnursing.org/Portals/0/PDFs/CCNE/NTFS-NP-Final.pdf 
2. Rutgers Research Portal. (2015). A comparison of nurse practitioners, physician assistants, and primary care physicians’ patterns of practice and quality of care in health centers. Retrieved from https://www.researchwithrutgers.com/en/publications/a-comparison-of-nurse-practitioners-physician-assistants-and-prim/ 
3. American Association of Nurse Practitioners (AANP). (n.d.). All About NPs. Retrieved from https://www.aanp.org/about/all-about-nps 
4. National Commission on Certification of Physician Assistants (NCCPA). (2024). 2023 Statistical Profile of Board Certified PAs. Retrieved from https://www.nccpa.net/wp-content/uploads/2024/05/2023-Statistical-Profile-of-Board-Certified-PAs5_3_24.pdf 
5. National Commission on Certification of Physician Assistants (NCCPA). (2024). 2023 Statistical Profile of Board Certified PAs by Specialty Annual Report. Retrieved from https://www.nccpa.net/wp-content/uploads/2024/07/2023-Statistical-Profile-of-Board-Certified-PAs-by-Specialty-Annual-Report.pdf 
6. U.S. Bureau of Labor Statistics. (2024). Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners: Occupational Outlook Handbook. Retrieved from https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm 
7. U.S. Bureau of Labor Statistics. (2024). Physician Assistants: Occupational Outlook Handbook. Retrieved from https://www.bls.gov/ooh/healthcare/physician-assistants.htm 
8. Mount St. Joseph University. (2024). U.S. News Best Health Care Jobs 2024. Retrieved from https://www.msj.edu/news/2024/01/U.S.-news-best-health-care-jobs-2024.html
9. U.S. Bureau of Labor Statistics. (2024). Occupational Employment and Wages, May 2023. Retrieved from https://www.bls.gov/oes/2023/may/oes_nat.htm