How to Become a Physician Assistant: Steps

To become a physician assistant (PA), you earn a bachelor’s degree with science prerequisites, build hands-on patient care experience, then complete an accredited PA master’s program that usually runs about 27 months. After graduating, you pass the national PA certifying exam (PANCE) and get a state license. PAs diagnose and treat patients across nearly every specialty, working with physicians.

What PAs actually do

PAs take histories, examine patients, order and interpret tests, make diagnoses, prescribe medication and assist in surgery. How independently they work depends on state law and the practice. The national professional association has adopted the title physician associate, and you may see both names.

Settings: primary care, emergency departments, surgery, orthopedics, dermatology, psychiatry, urgent care and hospital medicine.
Flexibility: PAs train as generalists, so many switch specialties during their careers without a new residency. That is one of the biggest differences from physicians.
Team role: you collaborate with physicians and nurses, and the final say on some cases may rest with a supervising or collaborating physician.

The education route

Bachelor’s degree: any major, with prerequisites that commonly include anatomy, physiology, general and organic chemistry, biochemistry, microbiology, statistics and psychology. Programs differ, so check each one.
Patient care experience: many programs require or strongly prefer direct, hands-on hours. Common jobs include EMT, medical assistant, nursing assistant, scribe, phlebotomist and paramedic. Many accepted students have years of this experience.
Shadowing: time with practicing PAs shows programs you understand the role.
PA program: a didactic phase of intensive classroom science and medicine, then clinical rotations across specialties totaling well over 2,000 hours. Programs should be accredited by the ARC-PA.

Licensing and keeping it

After graduation, you take the PANCE, the national certifying exam. Passing it lets you use the PA-C credential. Every state requires an accredited PA education and passing the PANCE for a license, though other details vary, so check with your state medical or PA licensing board. To stay current, PAs complete continuing medical education on a two-year cycle and recertify on a ten-year cycle.

A step-by-step path from high school

Take biology, chemistry and anatomy if offered, and volunteer in a hospital, clinic or care home.
Ask whether your area offers nursing assistant or EMT training to older high school students. Patient care hours start counting early.
In college, complete the prerequisites with strong grades and keep a paid patient care job alongside classes.
Shadow PAs in at least two specialties and keep notes on what you saw.
Apply through the centralized application, often during senior year or after one or more years of full-time clinical work.
Complete PA school, pass the PANCE and apply for your state license.

Make sure PA is the right fit

Shadow a PA, a physician and a nurse practitioner, then compare their days and training.
Work as a medical assistant or scribe for a year. You will see exactly where the PA fits on the team.
Do informational interviews with PAs who have switched specialties and ask why.
Take anatomy and physiology before applying to confirm you enjoy the science.

Who thrives, and why some people switch

PAs who thrive want clinical medicine without the length of medical school plus residency, like teamwork and value the freedom to change specialties. Some leave because they want final authority, which leads a few to medical school, or because of the same workload pressures found across healthcare. Others move into teaching, program leadership or administration.

Second-career PAs

PA school is full of second-career students: EMTs, nurses, athletic trainers, military medics and people from business or teaching who completed prerequisites later. Patient care hours are usually the slowest part to build, so start early. Compare related routes in how to become a doctor and how to become a nurse, and see the mid-career pivot. For current pay and outlook, see the Bureau of Labor Statistics Occupational Outlook Handbook.

Where a mentor helps

PA applicants juggle prerequisites, clinical jobs, shadowing and applications for years. A mentor helps you explore whether PA, MD or nursing fits, plan the timeline, stay accountable to weekly goals, organize applications and prepare for the first clinical job. Mentors are not prehealth advisors with credentials, admissions counselors or licensing experts. See career and education mentoring and mentoring for college students.

Common questions

What is the difference between a PA and a doctor?

Doctors complete medical school and a specialty residency and practice with full independence. PAs complete a shorter master’s program, train as generalists and work with physicians, with scope set by state law.

What is the difference between a PA and a nurse practitioner?

NPs are registered nurses who earn a graduate nursing degree, usually in a specific population. PAs train in a medical model as generalists and can move between specialties more easily.

How long does it take to become a PA?

Typically four years of college, time building patient care experience and about 27 months of PA school. Many people start practicing around their mid to late twenties or later.

Get started

Weighing PA school and want help building a timeline you can keep? Call (888) 305 5422, email contact@blackburnmentoring.com or start with a short assessment. A member of our team reviews every assessment personally and sets up a free intro call.

How to Become a Physician Assistant: Steps, School and Exam