Nurse Practitioner or Physician Assistant

Exploring the Differences Between an NP and a PA

Of all the degrees in nursing and medicine, Nurse Practitioner (NP) and Physician Assistant (PA) are the two most commonly compared by aspiring healthcare students. From a patient perspective, there may be little or no apparent difference; patients are simply seeing a provider for care.

Both NPs and PAs have advanced education. NPs earn their degrees in nursing and must achieve a minimum of a Master of Science in Nursing (MSN) from an accredited school to become licensed within a state. PAs need a minimum of a master’s-level degree from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

Both are certified to prescribe medications–NPs in most states and PAs in all states, including controlled substances when appropriate. Both can order and interpret diagnostic testing (e.g., laboratory and imaging tests), and both can perform office-based and hospital-based procedures. Additionally, both NPs and PAs can manage patients with acute, subacute, and chronic conditions and preventive care. At first glance, the careers have some commonalties, but the training is much different.

At second glance, you’ll find the distinction between an NP and a PA meaningful, and it significantly affects how each studies and approaches patient care.

Approach to Learning

Let’s start with PAs. Physician assistants are instructed and practice in the “medical model,” following a training very similar to that of medical school. This training is most commonly following an allopathic model focusing on diagnosis, testing, and treatment of medical disorders through a patient-centric approach.

Similar to medical school, all PA programs train in a generalist approach, allowing graduates who subsequently pass their national boards to pursue practice in any medical specialty and any practice setting, including outpatient, inpatient, emergency room, and surgery. Unlike physicians, PAs generally do not need to complete post-master’s internships and residencies, although many are open to pursue such training upon graduation.

By contrast, advanced practice registered nurse practitioners (APRNs) build medical expertise upon previous registered nurse knowledge and experience. Nurse practitioners are educated in a holistic model combining both nursing and medical science. Nurse practitioners specialize by patient population: family, pediatric, women, geriatric, and more. And within those populations they may specialize further: neonatal, acute care, etc. NPs train to focus on the patient and how they are affected by a disorder. A Nurse Practitioner course of study is highly patient-centric.

Approach to Practice

This major distinction in educational approach presents a philosophically different, if equally important, approach to practicing medicine. In oversimplified terms, the NP focuses on the individual while the PA focuses on holistic patient care, which includes the patient, the family, the environment, and the underlying medical condition. PA training has considerable foundation in medical sciences and NP training has considerable foundation in nursing sciences.

In many circumstances, the patient’s primary point of contact throughout diagnosis, treatment, and management can be an NP or a PA, with both serving as primary care providers and PAs also serving as specialty care providers. Research has shown that both NPs and PAs can improve access to high-quality and excellent care.


Depending on the practice specialty, years of experience, and state, both NPs and PAs can be autonomous outpatient providers with the ability to practice on their own licenses. NPs are generally licensed by state nursing boards. Meanwhile, PAs are generally licensed by state medical boards with some states having separate PA boards functioning within or under the medical board. Both NPs and Pas can choose to be a partner in a group clinical practice, choose a private practice, or work in a hospital-based practice.

In deciding which of these professional paths to pursue, consider the requirements of the relevant degree programs, the approach that each profession takes to patient care, and the opportunities of autonomy that both paths provide. Whichever path you choose, and wherever you opt to practice, you’ll be an indispensable authority on medicine and care.

WCU provides career guidance and assistance but cannot guarantee employment. The views and opinions expressed are those of the individuals and do not necessarily reflect the beliefs or position of the school or of any instructor or student.