Why do you want to become a Physician Assistant (PA)? Why not a nurse practitioner or physician? To help you answer this question, what follows is a direct comparison of these three educational and professional options, focusing on three specific programs. Using information from the top ranked programs from U.S. News and World Report for each of these fields, you’ll get a better idea of the differences between them.
Let’s start with reviewing the curriculum at the top ranked program for each educational track. Requirements and costs do vary from program to program:
Duke University PA Program
A bachelor’s degree is required to apply to this program, but there are some PA programs that do not require one, and require only the prerequisite coursework.
This program takes two years to complete: one year of preclinical studies with 58 credits of coursework and one year of rotations.
Required Pre-Clinical Year Courses
(Effective for the 2017-2018 academic year)
- PHYASST-200. Basic Medical Sciences
- PHYASST-201. Physiology
- PHYASST-203. Introduction to Prevention and Population Health
- PHYASST-205. Anatomy
- PHYASST-210, 211, 212. Diagnostic Methods I, II, III
- PHYASST-220, 221, 222. Clinical Medicine I, II, III
- PHYASST-223, 224, 225. Pharmacology I, II, III
- PHYASST-230. Fundamentals of Surgery
- PHYASST-231, 232, 233. Patient Assessment and Counseling I, II, III
- PHYASST-251. Practice and the Health System I
- PHYASST-255. Evidence-Based Practice I
Pre-Clinical Year Electives
(Optional)
- PHYASST-261. Beginning Medical Spanish
- PHYASST-262. Intermediate Medical Spanish
- PHYASST-263. Advanced Medical Spanish
One year of clinical studies, 10 rotations
- PHYASST 299. Bridge: The Path to Patient Care
- PHYASST 300A and 300B. Primary Care 1 & 2
- PHYASST 305. Evidence-Based Practice II
- PHYASST 310. Behavioral Medicine
- PHYASST 320A and 320B. Internal Medicine 1 & 2
- PHYASST 370. Women’s Health
- PHYASST 360. Pediatrics
- PHYASST 340. General Surgery
- PHYASST 350. Emergency Medicine
- PHYASST 390. Senior Seminar
Plus two elective rotations
Duke University Family Nurse Practitioner (FNP) Program
This course of study takes two to three years to complete, depending on the specialty that you choose. The core courses are offered online. Depending on your specialty, those courses might also be online.
12 credits in the core curriculum
Core Courses
- Nursing 580. Nurse as Scholar I: Science Development, Study Design and Statistics
- Nursing 581. Nurse as Scholar II: Evidence-based Practice
- Nursing 582. Population Health in a Global Society
- Nursing 583. Professional Transitions: Advanced Nursing Practice
Four P’s: 11 credits
- Advanced Pathology/Physiology Across the Lifespan: A Conceptual Approach
- Physical Assessment & Diagnostic Reasoning in APN
- Clinical Pharmacology for Advanced Practice Nursing
Major: 26 credits
Nurse Practitioner Majors
- Adult-Gerontology Nurse Practitioner – Acute Care
- Adult-Gerontology Nurse Practitioner – Primary Care
- Family Nurse Practitioner
- Health Informatics
- Neonatal Nurse Practitioner
- Nursing and Health Care Leadership
- Nursing Education
- Pediatric Nurse Practitioner – Acute Care
- Pediatric Nurse Practitioner – Primary Care
- Psychiatric Mental Health Nurse Practitioner
- Women’s Health Nurse Practitioner
Approximately 49 credit hours total (depending on major)
University of North Carolina School of Medicine, ranked #1 for primary care
This medical school has a translational education curriculum (TEC) with three phases:
- The Foundation phase, which lasts three semester
- The Application phase, which lasts for 12 months of clinical clerkships
- The Individualization phase, which takes 14 months to complete and includes an optional scholarly concentration
This degree will take about four years to complete. Depending on your specialty, it may require additional training, fellowships and time spent in residency before you can practice independently.
Watch: A successful PA applicants reflects on her choice to become a physician assistant
Differences between the programs
1. The first major difference between these tracks is the time required to complete each one:
• The PA program is the shortest, with a two-year commitment.
• The FNP takes two to three years of coursework, depending on your specialty choice.
• An MD education requires four years to earn the degree, but requires years of additional training, depending on your chosen specialty.
2. All of the curriculums represented here cover the basic health sciences, the process of diagnosis, evidence based medicine and clinical skills, but to varying degrees:
• The PA track appears to be more rigorous than that of the FNP, with 58 credits completed in the first year while the FNP program covers 49 credit hours in two to three years.
• PA students gain a more comprehensive exposure to all specialties, whereas FNP’s spend more time on their area of interest after completing the core courses.
• Another major difference is that the FNP core courses are available online and depending on your choice of specialty, those courses may also be taken from a distance.
• The MD track provides a more in depth foundation as well as comprehensive exposure to all specialties, with the opportunity to specialize.
• The PA track is more similar to the MD track in the range of topics covered while the FNP offers more courses within the specialties they offer.
• The MD program is more personalized to meet students’ needs and interests and offers more variation in specialties as well as depth of study. There is also more of an emphasis on mentorship and clinical skills with the MD track.
3. The cost of attendance also varies between the programs, for 2020:
| Duke PA program | $43,518/year |
| Duke FNP program | $1,910/credit (49 credits to graduate)=$93,590 |
| University of North Carolina School of Medicine | $70,920*/year, in-state-resident $98,314*/year, out-of-state resident *This figure includes tuition, estimated room and board, health insurance, books/supplies, travel, personal expenses and more. |
The PA and FNP programs are similar in cost, while the MD track tuition is significantly higher.
4. In 2020, as published by U.S. News and World Report, the median salaries for each profession are listed as:
| PA | $108,610 |
| FNP | $107,030 |
| MD (general internist) | $194,500 |
Given that the cost of tuition for the FNP program is slightly higher, it’s interesting to note that the median income for FNPs is slightly lower than that of PAs. PAs receive an education most similar to that of MDs, spend less time in school, pay less than FNPs per year, and are better compensated, at least at graduation.
There are many reasons to choose a career as a PA over other professions, and the information above provides compelling data points and outcomes to consider. MDs take on significantly more coursework and debt in comparison. Given the high insurance rates physicians pay while practicing, the PA route may be the most time- and cost-effective while offering the highest rate of return.
Create a top-of-the-pile-worthy application when you work one-on-one with an Accepted admissions consultant– whether you’re applying to PA, FNP, or medical school programs. Learn more about our healthcare admissions services here.
Related Resources:
- The Quick Guide to Admission Resumes, a free guide
- What to Look for When Selecting a Physician Assistant (PA) Program
- What Is the Role of a Psychiatric Mental Health Nurse Practitioner? an interview with a DNP student