What Does a Physician Assistant Do? PA Career Guide

Physician assistants serve an essential role in healthcare, collaborating with physicians and providing patient care across specialties. They treat patients in diverse medical settings, such as primary care, urgent care, and emergency departments — often being the first provider patients meet when they need a diagnosis. 

For anyone drawn to a healthcare career, it’s helpful to clearly define what PAs do and what sets their work apart from other clinicians such as nurse practitioners. This career guide does just that and gives insights on salary, job outlook, and training needed to succeed in this career path.

What does a physician assistant do?

In practice, a PA functions much like a physician with training in generalist medical care. They diagnose conditions, prescribe treatments, and manage patient care while working within a collaborative relationship with a supervising doctor. That collaboration gives PAs significant clinical autonomy while ensuring a sounding board and more advanced support for complex cases.

When they encounter complex cases or need a second opinion, PAs can consult with the supervising physician, but most of their day involves making medical decisions on their own.

In any given appointment, they may:

• Ask about a patient’s medical history.
• Perform physical exams. 
• Diagnose or recommend further testing for illnesses and injuries.
• Order lab work, such as x-rays and bloodwork.
• Interpret test results to patients.
• Administer vaccines, fluids, sutures, etc.
• Assist in surgeries or other treatments.

Patient education runs through nearly every visit. For example, PAs teach people how to manage chronic conditions like diabetes or help them understand how to prevent future health problems.

How to become a physician assistant

The path to practicing as a PA typically involves advanced education for six to seven years after high school. That’s shorter than medical school but structured and thorough enough to give aspiring PAs the same diagnostic foundation physicians build.

Start with undergraduate prerequisites

Start with a four-year bachelor's degree that includes prerequisite courses. Most PA programs require anatomy, physiology, chemistry, microbiology, and statistics. At this stage, future PAs can major in almost anything, but biology, health sciences, or exercise science naturally include many of these requirements.

Gain required patient care experience

While in college, gaining direct patient care experience can help applicants prepare for more advanced training and stand out for clinical and internship opportunities. This means working in jobs that actually involve patient care. Most PA graduate programs, like Chatham University, require PA shadowing hours or other patient care experience to be eligible to apply. 

Common qualifying roles include working as an EMT, certified nursing assistant, or medical assistant: positions where applicants are responsible for hands-on patient care, not just observation. EMT and CNA roles are especially popular among PA applicants because they involve real clinical decision-making under pressure.

Complete a physician assistant graduate program

Once accepted to PA school, students complete a rigorous master's program in 24 months or longer, depending on the school. The first year usually focuses on classroom learning: medical sciences, pharmacology, and clinical skills. The second year usually involves clinical rotations where PA candidates work in hospitals and clinics under supervision — much like licensed PAs do — gaining hands-on experience in different medical specialties.

After graduation, aspiring PAs must pass the Physician Assistant National Certifying Exam (PANCE) to become certified. Once they pass this exam and obtain state licensure, they can begin practicing as a PA-C (physician assistant-certified) and building their career.

Where PAs work and specialize

PAs work in virtually every medical setting and specialty. Their generalist medical training means they can move between different areas of medicine throughout their career without needing additional degrees or stacked licenses. In practice, the settings they work in greatly influence how PAs develop specialities.

Most PAs work in physicians' offices, hospitals, and outpatient clinics. Others practice in urgent care centers, emergency departments, or surgical suites. The work schedule depends on the setting — hospital PAs often work nights and weekends, while those in private practice typically have more regular weekday hours.

Specializing for career path flexibility

The flexibility to change specialties sets PAs apart from many healthcare careers and ultimately provides flexibility to steer one’s career path. A PA might start in family medicine, then move to emergency medicine or surgery later in their career. These are just a few of the ways PAs specialize in their careers:

• In primary care settings like family medicine or pediatrics, PAs manage ongoing patient relationships and treat a wide range of conditions. 
• In surgical specialties like orthopedics or cardiothoracic surgery, their role focuses more on pre-operative assessment, assisting in the operating room, and managing post-surgical recovery.
• Emergency medicine and critical care PAs work at a faster pace with higher acuity and typically earn more as a result. 

Some specialties offer fellowship programs that provide additional training, but many PAs transition through on-the-job experience.

Salary and job outlook for PAs

Demand for PAs continues to accelerate. According to the Bureau of Labor Statistics, the median annual salary for PAs is approximately $130,000, with the profession projected to grow 20% through 2034. For comparison, the national average projected growth is just 3% across all occupations. Healthcare systems rely on PAs to extend physician capacity, particularly as an aging population increases demand for care across nearly every specialty.

Specialty and setting create meaningful compensation differences. For example, PAs in surgical and emergency medicine roles often earn $20,000 to $40,000 more annually than those in primary care, while hospital-based positions may include shift differentials for nights and weekends. Geographic location also matters, as rural areas and regions with physician shortages often offer higher starting salaries to attract PAs, sometimes significantly above the national median.

PA vs. nurse practitioner: What is the difference?

PAs and nurse practitioners often work side by side doing similar clinical work, but how they're trained and how they specialize differ significantly. PAs may provide ongoing primary care, but their framework and approach to diagnostics and treatments differs from the care nurse practitioners provide.

PA medical training model vs. nursing model

PAs train using the medical model, similar to physicians. The medical model prepares PAs to treat disease and illness through biomedical expertises. In other words, they come to know disease so well that they can identify it and treat it. This means they learn a broad foundation covering all areas of medicine, preparing them to work in any specialty with advanced solutions. 

Nurse practitioners are trained with a more holistic, patient-focused model of care. This means they often diagnose and create treatment plans based on a combination of medical factors that extend beyond deep knowledge of disease. This is not to say that NPs care about patients and PAs don’t. They simply work from different starting points with the shared goal of patient health.

Licensure and certification

Medical practice authority and qualifications vary by state. In more than 25 states, NPs can have a fully independent practice, while PAs work under physician collaboration agreements. In a typical primary care clinic, though, a PA and an NP in adjacent exam rooms may handle the same conditions with similar autonomy.

Nurse practitioner licensure

Nurse practitioners must obtain licensure as a registered nurse and train for state-specific Advanced Practice Registered Nurse (APRN) license and national board exams. Nurse Practitioner training is usually a master’s or doctoral program and includes APRN specialization tracks based on populations. Some common specializations include Family (FNP), Adult-Gerontology (AGNP), Psychiatric-Mental Health (PMHNP), and Pediatrics, Neonatal, and Women's Health.

As mentioned, one of the biggest practical differences between careers for PAs and NPs is specialty flexibility. PAs can transition between medical specialties throughout their career using generalist training. NPs typically need additional certification to change their focus area, though they develop deep expertise serving their chosen population. The two national certifying boards are the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners Certification Board (AANPCB).

Physician assistant licensure

For physician assistants, licensure is more straightforward. To practice as a certified physician assistant (PA-C), they must pass the Physician Assistant National Certifying Examination (PANCE). They do not need to select or train for a specialization at this point in their career and usually prepare for licensure in a master’s or doctoral-level graduate program.

How Chatham University prepares future physician assistants

Chatham University prepares qualified physician assistants to lead in patient care, ready to collaborate in diverse healthcare settings. The Master of Physician Assistant Studies program uses Problem-Based Learning (PBL), an approach that develops the critical thinking skills essential for medical practice. Instead of traditional lectures, you'll work through real patient cases in small groups, learning to think like a practicing PA from day one.

Students learn in small cohorts with faculty who facilitate and mentor students’ individual learning and support, which matters when building the confidence to make medical decisions.

For undergraduate preparation, Chatham offers clear pathways through programs in biology, exercise science, and health sciences that align with PA school prerequisites. Chatham's focus on career outcomes means advising is oriented around getting you into clinical practice — not just through the curriculum.

When you’re ready to learn more about building your PA career, learn more about the master’s in PA studies program at Chatham and connect with our admissions team.

Physician Assistant FAQs

Do physician assistants need to complete a medical residency after graduation?

No, PAs can begin practicing immediately after passing the national certification exam and obtaining state licensure. Some choose to complete postgraduate fellowships in specialties like emergency medicine or surgery, but these are optional.

Can physician assistants switch specialties during their career?

Yes. Because PA education is generalist, many PAs move between specialties over time — often by learning on the job and, in some cases, through optional postgraduate fellowship training.