If you have always been inclined to pursue a career in the medical profession, you are presented with a vast array of different careers and specializations. The medical field comprises many different professionals, each with their own unique roles and responsibilities in the medical setting.

Before you pursue a career as a licensed medical professional, you first have to make important decisions regarding your specific medical career path. Two of the most common medical career choices are physician assistants (PA) or doctors of medicine (MD).

PAs and MDs differ greatly in many aspects, such as education, skills, specialization, and roles and responsibilities. To help you decide which particular medical specialization you should focus on, here’s a comprehensive guide on the differences between the PA and MD occupations.

WHAT IS A PA AND MD?

In the professional setting, PAs and MDs both belong to the same medical team. However, they are considered distinct because of their roles in hospitals, clinics, or other medical environments.

PHYSICIAN ASSISTANT (PA)

Physician assistants are medical professionals whose main responsibilities include diagnosing illnesses, creating treatment plans, prescribing medications, etc. They typically work in collaboration with physicians but can take on independent roles and responsibilities.

PAs are considered primary healthcare providers for patients. They have a disease-centered approach, focusing on the diagnosis and treatment of biological and pathological health components.

DOCTOR OF MEDICINE (MD)

Similar to PAs, doctors of medicine are licensed medical professionals who work to diagnose and treat illnesses. However, MDs take on a more specialized field of independent practice depending on their preferences, skill sets, and education. Some specializations include surgery, pediatrics, internal medicine, etc.

EDUCATION & TRAINING

For both PA and MD professions, you need to complete a certain level of education before you can be licensed to practice. While courses and training scopes are similar to the two professions, there are some key differences. A PA program is required to become a licensed PA. On the other hand, MDs need to complete a Doctor of Medicine program before they can be licensed to practice.

PA EDUCATION AND TRAINING

To become eligible to practice the PA profession, one needs to complete a physician assistant program, which usually spans 27 months of education, depending on the particular program structure. Some PA programs consist of 3 academic school years, but there are also 4-year programs and options for part-time education.

During the first academic year, most courses will be taught in a classroom setting, covering introductory courses on medical science subjects, including:

• Anatomy

• Behavioral sciences

• Medical ethics

• Pharmacology

• Physical diagnosis

• Physiology

In the second academic year, the program shifts to medical and surgical disciplines, covering subjects like:

• Emergency medicine

• Family medicine

• General surgery

• Gynecology

• Internal medicine

• Obstetrics

• Pediatrics

• Psychiatry

During their PA education, PA students will also gain first-hand experience in the profession, applying what they learned in the classroom and lab settings. A PA supervises this pre-graduate clinical practice.

Some programs also offer courses on administrative and non-clinical aspects of the PA profession, such as healthcare delivery system concepts, quality improvement, billing and coding, licensing, medical literature, etc.

Upon graduation from a PA program, the students will possess a master’s degree and have completed the first step of their road to becoming a licensed PA. The next step would be to take the Physician Assistant National Certifying Examination, get a passing mark, and be licensed by the National Commission on Certification of Physician Assistants.

This license, however, needs to be renewed periodically for PAs to continue practicing their profession. The renewal process involves taking and passing a comprehensive exam every 10 years, as well as completing 100 hours of continuing medical education every 2 years.

PAs can also advance their professional ventures or focus on a particular specialization by gaining more knowledge and molding their skills through taking additional courses, attending boot camps or additional programs, and the like.

MD EDUCATION AND TRAINING

MDs have higher educational attainment standards compared to PAs. To become licensed, a person who wants to become a doctor of medicine needs to complete a 4-year medical degree on top of their 4-year bachelor’s degree. Typically, students need to complete college units on courses like biology, chemistry, and physics to be accepted to medical school.

After college, students can advance to a Doctor of Medicine program, which consists of 4 academic years. The first 2 years will be focused on learning in a classroom setting, covering the basics of health, disease, and other sciences.

The last 2 years of medical school will equip students with the knowledge they need to practice in an independent specialization. Some of the covered specialties include:

• Family medicine

• Gynecology

• Internal medicine

• Neurology

• Obstetrics

• Pediatrics

• Psychiatry

• Surgery

In their final year of medical school, students can choose the specialization they want to pursue.

MD education does not end after a student graduates with a medical degree. They will need to complete their residency in a hospital or clinic, where they will get the first-hand experience of what it is like to work as a doctor of medicine. Depending on the chosen specialty, the residency period can last for 3 to 7 years.

After the residency period, MDs need to take and pass a board certification exam organized by the state where they want to practice. If a student wants to gain advanced knowledge on a particular specialization, they are encouraged to complete a fellowship program that covers their chosen medical field.

Similar to relicensing in the PA profession, MDs also need to renew their licenses every 10 years by retaking a certification examination and fulfilling the Maintenance of Certification (MOC) requirements of the American Board of Medical Specialties.

ADMISSION REQUIREMENTS

Admission requirements would depend on the particular program and the standards of the school you choose to attend. But here are the basics to give you an idea of what you need to get accepted to a PA or MD program.

PA PROGRAM ADMISSION REQUIREMENTS

To become accepted to a PA program, you will need to meet the minimum GPA requirement, complete your units on related courses, get the minimum number of hours of healthcare experience, and submit your complete application requirements. Here’s a list of all you need to accomplish:

• Minimum GPA of 3.47 in science classes

• Minimum GPA of 3.5 in non-science classes

• At least 2,000 hours of healthcare experience

• At least a 310 score on GRE with an optional MCAT score

MD PROGRAM ADMISSION REQUIREMENTS

Medical school applications are highly competitive, with schools having high expectations from their potential students. The GPA requirement is higher than it is in a PA school application, but fewer hours of healthcare experience are required. In fact, some schools do not even require healthcare experience.

To be admitted to a doctor of medicine program, you will need:

• Minimum GPA of 3.64 in science classes

• Minimum GPA of 3.78 in non-science classes

• At least a 508 score on MCAT with an optional GRE score

COSTS

The costs of PA and MD programs would depend on the school where you decide to pursue your graduate education. There are also money grants or scholarships you may be eligible for.

PA PROGRAM COSTS

PA school can cost anywhere from $70,000 to $90,000 for 3-4 years of education. The costs will also depend on whether you are a resident in the State you wish to attend school and if the institution is public or private.

Aside from the tuition fee, there are also additional expenses, including clinical fees, laboratory fees, and student services fees, which can amount to an average of $3,775.

MD PROGRAM COSTS

The tuition fee for an MD program costs higher than in PA school, costing around $200,000 to $300,000, depending on the school, whether it is public or private, and the State where the school is located.

ROLES & DUTIES

While PAs and MDs are both found in a hospital or clinic medical team, they contribute different roles and duties that advance health and patient care.

PA ROLES AND DUTIES

A physician assistant typically works in collaboration with a primary physician. But most PAs now are not directly supervised and can perform independent roles and responsibilities. These licensed medical professionals are considered primary healthcare providers. They take on the following roles on a day to day basis:

• Performing patient exams and making rounds

• Assessing and diagnosing illnesses

• Ordering and interpreting tests and x-rays

• Prescribing medications, treatment, and medical procedures

• Assisting a surgeon during surgical procedures

• Creating and monitoring treatment plans

• Educating patients on preventive health care

The authority of a PA to conduct certain forms of treatments or prescribe medications can be limited by state laws and regulations. In some areas, PAs need the approval of their supervising physicians to conduct certain roles and responsibilities.

MD ROLES AND DUTIES

An MD is usually the main healthcare provider in a medical team, in charge of diagnosing, assessing, and treating diseases and injuries. This type of physician makes use of both traditional and modern treatment methods to fight illnesses and help the patient achieve better health and wellness.

A doctor or physician’s role would depend highly on their chosen specialization. However, almost all MDs perform the following duties:

• Assess symptoms and diagnose illnesses and conditions

• Prescribe medications, treatment, or medical procedures

• Perform medical procedures and treatment

• Interpret laboratory results

• Provide follow-up care

MDs work closely and collaborate with other medical team members, which can include physician assistants, registered nurses, nurse practitioners, and other medical professionals. Being the primary physician, doctors also have the responsibility of staying current on medical developments, research, and healthcare technologies.

SPECIALIZATION

While most PAs and MDs practice as general practitioners, most of them focus on a particular specialization.

PA SPECIALIZATIONS

The National Commission on Certification of Physician Assistants released a statistical profile of certified physician assistants, which revealed that PAs commonly focus on the following fields of specialization:

• Family medicine and general practice – 19.2%

• Surgical subspecialties – 18.5%

• Emergency medicine – 13%

• Internal medicine subspecialties – 9.4%

• Internal medicine general practice – 4.7%

• Dermatology – 4.0%

• Hospital medicine – 3.5%

• General surgery – 2.9%

• Pediatrics – 1.9%

• Obstetrics/ gynecology – 1.5%

While these are the top 10 most popular PA specializations, there is also an influx of PAs focusing on fields like mental health, radiology, and surgery.

MD SPECIALIZATIONS

MDs also usually focus on a particular area of medicine, which becomes their specialization. Some common specialty areas include:

• Allergy and immunology

• Anesthesiology

• Dermatology

• Diagnostic radiology

• Emergency medicine

• Endocrinology

• Family medicine

• Geriatrics

• Internal medicine

• Medical genetics

• Neurology

• Nuclear medicine

• Obstetrics and gynecology

• Ophthalmology

• Pathology

• Pediatrics

• Physical medicine and rehabilitation

• Preventive medicine

• Psychiatry

• Radiation oncology

• Surgery

• Urology

These areas of medicine can also have subspecialties, which are further niches that MDs can focus their practice on.

CAREER OUTLOOK

Being primary health care providers, both PAs and MDs are highly in-demand in the medical field, especially during these times of a global health crisis.

PA CAREER OUTLOOK

The physician assistant profession emerged as a solution to the lack of healthcare providers in the mid-1960s. These professionals did a lot to meet the healthcare demands of those times and are still making significant contributions to today’s medical landscape.

There are ever-growing needs and demands for physician assistants, with projected job growth of 31% in the next decade. This growth rate is higher than that of all other occupations in the medical field. The 2018 labor statistics estimate that there are over 118,800 physician assistants employed, and this number is expected to grow up to 155,700 by 2028.

MD CAREER OUTLOOK

Doctors will always be in demand, regardless of global situations. However, there is an increasing need for doctors during this time of a pandemic. The job growth of doctors of medicine is expected to grow 7% in the next decade due to the increasing demand for healthcare, the rising rate of chronic illnesses, and an older population.

MDs have a much slower growth rate compared to PAs, which is possibly owing to the development of medical technologies that reduce the need for human involvement, whereas physician assistants have a more flexible and versatile job scope.

JOB SATISFACTION

While the medical profession is highly demanding, both PAs and MDs report being satisfied with their jobs, especially in the case of individuals who are passionate about the medical profession. Both are very noble careers that create a positive impact on society.

PA Job Satisfaction

In a recent survey, PAs report to be satisfied with their jobs and professional responsibilities. This also ties with their satisfaction when it comes to their salaries, with 59% of PA participants saying that they are satisfied with their wages.

Aside from their satisfied salary expectations, PAs also owe their high level of job satisfaction to the following reasons:

• Their contribution to people’s lives

• Passion for healthcare and medicine

• Relationships with patients

• Steady work-life balance

• Job security

• Constant learning and professional growth

• Work setting and commitment to quality

The job satisfaction of PAs also contributes to their motivation to stay in their current jobs for longer, with only 17% of respondents reporting that they plan to change employers within the following year.

Another survey aimed to uncover what PAs dislike about their jobs. The common responses include:

• Fear of malpractice or errors that can hurt patients

• Managing several patients

• Working with unequipped or unprofessional healthcare providers

• Lack of recognition for good work

• Income cap

• Limitations to autonomous practice

Despite this, 92% of the same survey respondents report that they are glad they pursued a career as a physician assistant. And if given a choice, 82% say that they would still choose to pursue a PA career.

MD Job Satisfaction

The job satisfaction of MDs seems to depend highly on their specializations and salaries. According to a recent survey, the following MD specializations are considered the most satisfying:

• Dermatology – 63%

• Pathology – 57%

• Psychiatry – 57%

On the other hand, the least satisfying specializations include:

• Internal medicine – 47%

• Nephrology – 48%

• General surgery – 49%

When it comes to salary satisfaction, 47% of primary care physicians say that they are satisfied with their salaries while 50% of those with independent specializations say the same. To break it down further by specialization, 61% of dermatologists, 60% of emergency medicine doctors, and 60% of pathologists are happy with their annual pay.

When asked whether they would still choose to become doctors if given another chance, 64% say they would still pursue a career in medicine but only 45% report that they will still stick to the same specialization.

WORK-LIFE BALANCE & BURNOUT

Burnout is highly prevalent in the medical profession, especially because of the increase in healthcare costs, medical errors, and poor treatment outcomes. It is said that professionals in the medical field do not have a healthy work-life balance, however, this may depend on the particular medical occupation and specialization.

PA Work-Life Balance and Burnout

According to a national survey of physician assistants, the respondent PAs report that they were satisfied with their careers and have a healthy work and life balance. This helps reduce their risks of experiencing burnout. Compared to individuals in other medical occupations, PAs have more flexibility in their job and enjoy fair hours. Hence, they tend to have greater feelings of satisfaction towards their careers.

However, there are still some PAs who experience burnout brought about by the following causes:

• Poor understanding of their roles and responsibilities

• Belonging to a micromanaged team

• Lack of a leadership system in their medical teams

MD Work-Life Balance and Burnout

Compared to PAs, MDs have a higher tendency to experience burnout owing to the lack of a healthy work and life balance. A survey with 115,000 participants revealed that 42% of MDs were burnt out and most of them belonged to the following specializations:

• Endocrinology

• Family medicine

• Nephrology

• Neurology

• Urology

Among the 42% of respondent MDs who are experiencing burnout, 55% say that the cause is attributed to bureaucratic tasks. Other causes mentioned include:

• Too many hours

• Lack of respect within the workplace

• Increasing computerization

• Insufficient compensation

• Lack of autonomy on the job

SALARY / COMPENSATION

The medical profession is known to be home to competitive salaries and compensation. Below are the average annual salaries for PAs and MDs.

PA Salary and Compensation

The average annual median salary of physician assistants is $112,260, depending on several factors such as the state where they practice, their position level, years on the job, etc. The highest-paid PAs earn around $130,530 a year while the lowest-paid percentile earns about $92,800.

MD Salary and Compensation

Because of their specialization, MDs earn higher than PAs. Their average annual median salary is $208,000. How much a doctor of medicine can earn would depend on their specialization or subspecialty.

• Family and general doctors have a mean annual wage of $211,780.

• Anesthesiologists have a mean annual wage of $267,020.

• Plastic surgeons can earn over $500,000 per year.

FLEXIBILITY & CONTROL

MDs and PAs have different levels of flexibility and control in their professions. This would depend on a variety of factors, including the state legislature, regulatory bodies, level of practice, etc.

PA FLEXIBILITY AND CONTROL

The nature of a PA’s job requires them to collaborate with a physician in their medical teams. However, they work very independently and are not always under the watchful eye of their supervising physicians. PAs have the authority to diagnose illnesses and prescribe treatments, though this can be limited in some states and would require consultation with a physician.

Compared to other healthcare professionals, PAs enjoy more flexible hours and have a good sense of work-life balance. They also have the ability to switch specialties anytime they wish, owing to the versatility of their roles and responsibilities.

Statistics show that 49% of PAs changed their scope of practice and specializations at least once for reasons including a change of environment, to achieve a healthier work-life balance, or to increase their income.

Unlike MDs, PAs cannot open their own business or practice.

MD FLEXIBILITY AND CONTROL

MDs work independently and in most cases, do not require oversight. They can start their own business or clinical practice, but their ventures should be in line with their specialties. If they choose to switch to other specializations, MDs would need to complete additional education and training. This is why a lot of MDs do not change their specializations during their career. There is less flexibility but greater control in an MD career.

WHICH CAREER IS RIGHT FOR YOU?

Both PA and MD careers are noble professions that have high levels of job satisfaction. But to choose which one suits you best, you should consider your interests, skill sets, and career goals. To help you decide, you can make the effort to shadow MDs and PAs you know to get a better sense of which one you’re most interested in. Also envision the type of future you see yourself in professionally.

Additionally, you can ask yourself these questions to help you decide:

• Do you want to be your own boss and aspire to have autonomy on the job?

• Do you plan on running your own private clinic?

• Is a high salary important to you?

• Do you want to be challenged in your career?

• Are you more inclined to a specific area of medicine instead of general practice?

If you answered yes to these questions, you might be more suited for a career as an MD. On the other hand, you can consider a PA profession if your goals are the following:

• Less stress and responsibility on the job

• Save time and money on education

• Start a career as soon as possible

• Regular and stable work hours

• Collaboration with other medical professionals

Whatever career path you choose in the medical field, you are going to be a valuable professional who changes lives and makes a strong impact on society. Remember to go after your passions and interests and choose the career path that empowers you.