How to become a physician assistant

Despite the name, physician assistants (PAs) work in collaboration with physicians and other members of the healthcare team far more than they assist. Their duties include conducting physical exams, ordering and interpreting test results, diagnosing illness, developing treatment plans, and performing procedures.

Between 2020 and 2030, the Bureau of Labor Statistics (BLS) anticipates PA employment growth to be 31%, much faster than average. In 2020 there were over 129,000 PA jobs in the U.S., and it is projected that less than 128,000 PAs will be licensed in 2025. This means the future looks promising, with more job openings than candidates.

What is a physician assistant?

A physician assistant, also referred to as a physician associate, is a licensed medical provider who has the expertise and training to diagnose and treat patients. PAs can work in numerous settings including hospitals, clinics, nursing homes, and correctional facilities.

Although a physician assistant is competent in some of the tasks of a physician, they are not doctors. Most states still require PAs to work under the supervision of a physician.

Why become a physician assistant?

Physician assistants often cite the intense focus on patient care as a primary reason for this decision. PAs tend to have less bureaucratic tasks than physicians, freeing up their time and energy to serve patients.

The study time to become a physician assistant is significantly shorter than it is to become a doctor. This means candidates spend less time in the classroom and can start work with patients sooner. Physician assistants also tend to work shorter hours with more regular schedules.

» Read: Demand for language diversity in healthcare

Where do PAs work?

Over half of all PAs work in physician offices and clinics. The remainder work in hospitals, outpatient care centers, educational institutions, and employment services.

PAs who are willing to work nights or weekends and be on call are likely to find higher-paying work than their 9-5 colleagues. While most PAs work full time, there is often an opportunity to work part time, or even on a casual or fill-in basis.

How hard is it to become a physician assistant?

It is difficult to become a physician assistant, and for good reason. PAs make life or death decisions on a daily basis, and so require a high level of proficiency.

PAs usually earn an undergraduate degree in a relevant field, get a few years of experience in the healthcare industry, complete a 2-year PA program, get licensed and credentialed, and then begin work.

Throughout the process, there are school-specific requirements that may include maintaining a high GPA or foregoing work during the course of their studies, which adds to the challenge of becoming a physician assistant.

How long does it take to become a physician assistant?

It takes at least 6 years to become a physician assistant. Many students take time off to gain clinical experience after earning their bachelor’s degree and before applying to PA school, extending the total study time required.

8 steps to becoming a physician assistant

Below are the steps required to become a physician assistant. Depending on where you are in your career and education, some may not be relevant to you.

Step 1 —Study relevant subjects at high school

Although high school students often feel helpless when it comes to preparing for their future career, there are several steps you can take to prepare yourself for a career as a physician assistant, even at this young age.

Take advantage of any opportunity you have to take honors or AP science courses. If dual credit is offered, leverage that, too. These courses can help you earn a bachelor’s degree early, or improve your application to PA school.

» Read: What is STEM?

It’s also helpful to build healthcare experience. You can do this by volunteering at a local hospital or nursing home, getting certified as a certified nursing assistant (CNA) and working part-time, or joining relevant clubs in your school or community.

Step 2 – Get an undergraduate degree

Physician assistants usually begin by earning a 4-year undergraduate degree in a healthcare field. The benefit of this is that they can gain patient care experience to strengthen your application for PA school.

Bachelor’s degrees that support a career as a physician assistant include:

• respiratory therapy
• medical laboratory science
• radiology technology
• athletic training
• physical therapy
• dietetics

Other students choose the pre-med track, majoring in biology, chemistry, or a related field. They plan to apply directly to PA school using other healthcare experience like Hospital Nursing Assistant (CNA) or Emergency Medical Technician (EMT). Programs that are highly competitive are less likely to accept students who don’t have professional-level healthcare experience.

» Read: Earning a bachelor’s degree at community college

What’s most important is that your bachelor’s degree program includes the prerequisite courses required for the PA program(s) you’re interested in attending.

Common jobs students hold after completing their bachelor’s degree and before applying to PA school include:

Step 3 – Get some experience in the field

Most physician assistant programs require applicants to have 1,000 hours of healthcare or patient care experience. Students who have a healthcare-related bachelor’s degree, and who have been working in healthcare since they graduated, typically meet this requirement without difficulty.

Students who are hoping to transition from their undergraduate program directly to a graduate program have to be more intentional about getting those hours via internships, volunteer work, or part-time work.

Positions that don’t require a bachelor’s degree and are sometimes considered eligible include CNA, physical therapy assistant, occupational therapy assistant, phlebotomist, EMT, pharmacy tech, medical assistant, licensed practical nurse (LPN), and surgical technologist.

How to pay for your physician assistant education

Another reason some students choose to work for a few years after their undergraduate degree is to save up for the financial burden of PA school. Keep in mind that some schools prohibit students from working while in the program.

Steps you can take to keep the cost of your education as low as possible include:

• complete as many dual-credit courses in high school as you can; they’re often offered at a discounted rate
• don’t shy away from community colleges, which can be a great and affordable option for generals during your undergraduate program
• apply for grants and scholarships every year, both during your undergraduate and graduate program
• apply for federal student aid using the free application for federal student aid (FAFSA).

Physician assistants may also qualify for federal and state student loan forgiveness programs.

» Read: Student loan forgiveness for healthcare workers

Step 4 — Complete a physician assistant graduate program

To become a physician assistant, you need a Master of Science (M.S.) in Physician Assistant Studies. These programs range from 23 to 27 months in length. Expect to take a variety of courses that include classroom, lab, and clinical instruction.

The program is divided into 2 parts:

1. the didactic phase – Courses include pharmacology, behavioral sciences, anatomy, and additional courses which often have a lab component.
2.  the clinical phase – Students complete clinical rotations in disciplines that might include emergency medicine, family medicine, pediatrics, or psychiatry. They spend time observing providers and providing supervising patient care.

Courses you can expect to take during the program include:

• human anatomy – These support your understanding of the human body through lecture and lab components.
• clinical prevention  – Focus on preparing the PA to take a preventative approach to medicine, from both individual and population-oriented perspectives.
• diagnostic methods – Students learn how to utilize laboratory tests, radiology exams, and other diagnostic tools.

Although physician assistants don’t choose a specialization during their program, most choose an area of specialization as they build their career. For example:

• emergency medicine
• internal medicine
• pediatrics
• neurology
• obstetrics

Accreditation

Physician assistant programs are accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or ARC-PA. Choosing an accredited program ensures you can be licensed and credentialed after you graduate.

Step 5 — Pass the PANCE exam to get certified

The Physician Assistant National Certifying Exam (PANCE) is administered by the NCCPA. To take the PANCE, you need to have graduated from an accredited PA program within the last 6 years. The exam give you 5 hours (along with 45 minutes in break time, divided) to complete 300 questions.

It takes about 2 weeks to find out how you scored on the exam. During the 6 years that you’re eligible to test, you can take the test a maximum of 6 times, but retakes must be at least 90 days apart. Students who fail to pass the PANCE in those 6 attempts (or 6 years, whichever comes first) must complete the PA program again to be eligible to retest.

Step  6 – Get licensed

Once you’ve completed school and passed the exam, you can apply for your physician assistant license. The AAPA provides a list of licensing boards for each state, as well as the statutory and regulatory requirements for both initial licensure and renewal. Common requirements for licensure are:

• graduation from an accredited PA program
• passing the PANCE
• current certification from NCCPA (this requirement is less common)

Step 7 – Continue your education

As a working physician assistant it is important to continue your education to stay up to date on emerging research and changing recommendations. Continuing education can also support your specialization in a specific discipline.

The NCCPA offers specialty certificates in:

• emergency medicine
• cardiovascular and thoracic surgery
• hospital medicine
• orthopedic surgery
• nephrology
• psychiatry
• pediatrics

All of these specialty certifications require current PA licensure, experience in that field, specialty-specific knowledge, and passing an examination.

Step 8 – Find a job as a physician assistant

PAs can find jobs on broad job boards such as Indeed, LinkedIn, Facebook, and Google Jobs, as well as career-specific ones like AAPA Job Source and NCCPA Career Center. New graduates might also work with their PA program coordinator to find employment after graduation.

How much do physician assistants make?

PAs who work in outpatient care centers earn the most money on average while those who work in physician’s offices and educational institutions earn the least.