PA vs NP

[JY51]

Hi, I'm starting a college this fall and trying to decide which route to take between PA and NP.
I went through almost every single posts and videos on Google/Youtube that are related to PA vs NP topic. But, since I still couldn't decide, I'm here to ask you guys' opinion.

I understand that both of those professions' duties are almost similar, the time it takes to become one, educational level, salary wide, etc. As far as I know, the only difference is that PAs are learning based on a medical model and NPs are based on a nursing model.

What I want to achieve the most in the healthcare field is that I want to perform procedures, it can be assisting in surgeries, treating minor injuries, like suturing, etc.
I might be wrong, but based on my research, I think PAs are more likely to get to do that kind of jobs than NPs and I want to know if that's true.
And I also want to know which specialty in NP gets the most chance to perform procedures and if they actually get to learn how to do them in school.

I'm not just asking these questions lightly, I've been thinking about it over and over for months now and I'm here to get some advice, so please no judgment, I really need you guys' help.

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[Noisewater-TDX]

Hi, I'm starting a college this fall and trying to decide which route to take between PA and NP.
I went through almost every single posts and videos on Google/Youtube that are related to PA vs NP topic. But, since I still couldn't decide, I'm here to ask you guys' opinion.

I understand that both of those professions' duties are almost similar, the time it takes to become one, educational level, salary wide, etc. As far as I know, the only difference is that PAs are learning based on a medical model and NPs are based on a nursing model.

What I want to achieve the most in the healthcare field is that I want to perform procedures, it can be assisting in surgeries, treating minor injuries, like suturing, etc.
I might be wrong, but based on my research, I think PAs are more likely to get to do that kind of jobs than NPs and I want to know if that's true.
And I also want to know which specialty in NP gets the most chance to perform procedures and if they actually get to learn how to do them in school.

I'm not just asking these questions lightly, I've been thinking about it over and over for months now and I'm here to get some advice, so please no judgment, I really need you guys' help.

This is coming from an RN. I highlighted some stuff from your post. You want surgery and procedures, do PA. PA's curriculum is superior in 95% of the cases, minus places like Hopkins or Vanderbilt.

You will get much more experience doing stuff as a PA student. I've seen PA students shove MD students out of the way in a trauma bay and throw a chest tube in like a champ. Most of the NP programs i looked at had 2 week "skills labs" on campus where you would go and learn how to do stuff on dummies. Most NPs will be in family med or internal med ( i know many that are in ER or Ortho, but generally it's primary care ). There are some specialty programs like the ACNPs which train you in the ICUs and ERs. I would think their training is more in line with the PA curriculum.

 

[JY51]

This is coming from an RN. I highlighted some stuff from your post. You want surgery and procedures, do PA. PA's curriculum is superior in 95% of the cases, minus places like Hopkins or Vanderbilt.

You will get much more experience doing stuff as a PA student. I've seen PA students shove MD students out of the way in a trauma bay and throw a chest tube in like a champ. Most of the NP programs i looked at had 2 week "skills labs" on campus where you would go and learn how to do stuff on dummies. Most NPs will be in family med or internal med ( i know many that are in ER or Ortho, but generally it's primary care ). There are some specialty programs like the ACNPs which train you in the ICUs and ERs. I would think their training is more in line with the PA curriculum.

Thank you so much for your response! I've always wondered which profession would give me more chance to perform procedures because most posts that are discussed over PA vs NP topic only tell you that they are different in learning models, medical and nursing, but don't really have any specific information about their jobs/duties in the clinic, hospital, etc. Your answer really helped me to figure out which career path to jump in

 

[pamac]

For someone at the beginning of their academic career, I think that setting up to go to Pa school is the best option, and I’m an Np student with a heavy pre med educational background. It gives you the most options down the line if you change your mind. For instance, if you decide you want to become a doctor, you aren’t locked in like you would be if you went after nursing (PA prerequisites are essentially prerequisites for medical school). If you decide you don’t want to do PA or MD, then you can go find an accelerated RN program and become an RN in a year after you get your undergrad degree, then go to Np school while you work as an RN. Or you can even find a direct entry Np program. But having a biology foundation is helpful. My RN/NP peers might be more skilled at certain things than me based on their immersion in nursing, but with my background in biological sciences, I can quickly understand how things work at the smallest levels of function. Whether or not that translates to better treatment in a given moment is up for debate, but I like having that foundation for me personally. However, if I had to do things over again and end up exactly where I am (like that’s how the world works, right?), I might have just become a nurse practitioner ASAP in the beginning and I’d be sitting pretty right now on a bundle of cash with over 10 years more of experience behind me. I didn’t take the most efficient path towards becoming a provider, but I’ve done well for myself and my family along the way.

I think you’d like being a PA much more than an NP based on what you are saying you have an interest for. PA programs, and a career as a surgical PA, align almost perfectly with what you described as what you are looking for. It’s safe to say that most NP programs won’t have an emphasis on teaching you skills, or rotating you through different specialties to see what interests you. Most folks helping out in surgery will be PAs, although overall simple procedures can be, and are, performed by both professions.

Best advice anyone can give you as far as how to successfully get into PA school is to GET EXCELLENT GRADES. Do whatever it takes to do that. That will be the one thing you can do that will open up the most doors for you. If you have to go more slowly through school to get A’s, do it. It’s worth more than any time you would save by going fast.

 

[JY51]

For someone at the beginning of their academic career, I think that setting up to go to Pa school is the best option, and I’m an Np student with a heavy pre med educational background. It gives you the most options down the line if you change your mind. For instance, if you decide you want to become a doctor, you aren’t locked in like you would be if you went after nursing (PA prerequisites are essentially prerequisites for medical school). If you decide you don’t want to do PA or MD, then you can go find an accelerated RN program and become an RN in a year after you get your undergrad degree, then go to Np school while you work as an RN. Or you can even find a direct entry Np program. But having a biology foundation is helpful. My RN/NP peers might be more skilled at certain things than me based on their immersion in nursing, but with my background in biological sciences, I can quickly understand how things work at the smallest levels of function. Whether or not that translates to better treatment in a given moment is up for debate, but I like having that foundation for me personally. However, if I had to do things over again and end up exactly where I am (like that’s how the world works, right?), I might have just become a nurse practitioner ASAP in the beginning and I’d be sitting pretty right now on a bundle of cash with over 10 years more of experience behind me. I didn’t take the most efficient path towards becoming a provider, but I’ve done well for myself and my family along the way.

I think you’d like being a PA much more than an NP based on what you are saying you have an interest for. PA programs, and a career as a surgical PA, align almost perfectly with what you described as what you are looking for. It’s safe to say that most NP programs won’t have an emphasis on teaching you skills, or rotating you through different specialties to see what interests you. Most folks helping out in surgery will be PAs, although overall simple procedures can be, and are, performed by both professions.

Best advice anyone can give you as far as how to successfully get into PA school is to GET EXCELLENT GRADES. Do whatever it takes to do that. That will be the one thing you can do that will open up the most doors for you. If you have to go more slowly through school to get A’s, do it. It’s worth more than any time you would save by going fast.

I truly appreciate for your response, your answer from your own experience, things you learned while you are going through schools, etc. is getting me a lot of helpful ideas on deciding what would be the best choice for me. So far, I think I will go with BSN degree with prereqs for pa school, so that way, when I graduate and in case I change my mind and think that pa school is not for me anymore, I can directly go into nursing or np school.
Thanks again for leaving me a positive, realistic, and really helpful answer!

 

[pamac]

That’s unexpected to me that you decided that, but I can’t say it’s a terrible idea. However, you will be very busy as an undergrad to take that approach. PA prerequisites are difficult, and you’ll have your hands full with your BSN at the same time. The BSN isn’t particularly hard, but they tend to be very involved. And PA prerequisites are just hard. And honestly, these days, no RN finds it better for them to go to PA school. We go to Np school so we can work at the same time we complete the NP program, and also save a considerable amount of money along the way because Np programs are a lot cheaper (unless you do something stupid and pick one that costs $80k, when you could pay around $30k-40k). I’m saving well over $200k (and those are immediate savings vs long term) by doing Np vs PA school. Here’s how: over 2 years of full time work at around $84k per year, and $80k for Pa school, not to mention relocation and other expenses like rent (producing no equity) for 2 years at a rate that is higher than the house payment I have that I build equity on. This is why RNs don’t go to PA school. I know a ton of Nps and PAs, as well as nurses, and I don’t know more than a couple nurses that ever aspired to become a PA, and one of them is really glad they didn’t due to costs.

In essence, I don’t think you are on the wrong track, because it gives you options (if you are a good student who can handle the load). But I think it’s a track that sends you the direction of RN school. Because of that, it seems unproductive to plan to be anything other than an NP. Yes, a good path, but a path that is different than what interests you at this time. I have different goals that are more geared towards the practice environment where Nps are benefitting from being independent, but if I just wanted to go work for a surgeon and help out in that realm, I’d benefit from being a PA.

 

[JY51]

That’s unexpected to me that you decided that, but I can’t say it’s a terrible idea. However, you will be very busy as an undergrad to take that approach. PA prerequisites are difficult, and you’ll have your hands full with your BSN at the same time. The BSN isn’t particularly hard, but they tend to be very involved. And PA prerequisites are just hard. And honestly, these days, no RN finds it better for them to go to PA school. We go to Np school so we can work at the same time we complete the NP program, and also save a considerable amount of money along the way because Np programs are a lot cheaper (unless you do something stupid and pick one that costs $80k, when you could pay around $30k-40k). I’m saving well over $200k (and those are immediate savings vs long term) by doing Np vs PA school. Here’s how: over 2 years of full time work at around $84k per year, and $80k for Pa school, not to mention relocation and other expenses like rent (producing no equity) for 2 years at a rate that is higher than the house payment I have that I build equity on. This is why RNs don’t go to PA school. I know a ton of Nps and PAs, as well as nurses, and I don’t know more than a couple nurses that ever aspired to become a PA, and one of them is really glad they didn’t due to costs.

In essence, I don’t think you are on the wrong track, because it gives you options (if you are a good student who can handle the load). But I think it’s a track that sends you the direction of RN school. Because of that, it seems unproductive to plan to be anything other than an NP. Yes, a good path, but a path that is different than what interests you at this time. I have different goals that are more geared towards the practice environment where Nps are benefitting from being independent, but if I just wanted to go work for a surgeon and help out in that realm, I’d benefit from being a PA.

Hmm.. Because I first assumed that keeping up with nursing school while working on prereqs for pa school at the same time would not be VERY difficult because there was no one around me who can actually give me advice or tell me about their experiences about the medical field, schools, etc.
Like NickMT-RN said above, most NPs are in family med or internal med, mostly primary care, but saying that NPs in ER, trauma unit, etc. will get more chance to perform procedures and which I'm also interested about. And since you are an NP student, I don't know which specialty you are in, but do you know if ACNP or Emergency NP students get to learn more about how to perform procedures than FNP, AGNP, etc.? or what they're mostly learning about?
The biggest reason that I wanted choose PA route is only because they get to do more actual hands-on treatments than NPs, but I was primarily interested in nursing. If those NPs that are working in the ER, trauma unit, etc. are getting the similar amount of chance to perform procedures like PAs, then I would be extremely happy to choose that career path!

 

[pamac]

I see. In light of that, you might be glad to know that NPs work in ERs. About 40 percent of ER non physician providers are NPs nationwide. The would be doing the same things that PAs would be doing there, but keep in mind that each facility will have differing policies regarding how they want their non physician personnel to function. Acute care nurse practitioners work in inpatient environments like medical surgical floors and intensive care units. In my hospital, they have NPs as hospitalists with doctors, and not PAs. RN First Assists work with surgeons in surgery and assist them there. Nurse Anesthetists operate independently in most states doing anesthesia.

So the deal with getting a BSN while taking prerequisites for Pa or medical school is that you will have to use your electives to take some pretty hard courses. Nursing school keeps you busy, and then to have an extra class to take each term alongside that can be tough sometimes. It isn’t the most fun you can have while in school. I’d suggest a less ambitious approach, and just picking a plan. If you like the idea of nursing, go for nursing.

 

[JY51]

I see. In light of that, you might be glad to know that NPs work in ERs. About 40 percent of ER non physician providers are NPs nationwide. The would be doing the same things that PAs would be doing there, but keep in mind that each facility will have differing policies regarding how they want their non physician personnel to function. Acute care nurse practitioners work in inpatient environments like medical surgical floors and intensive care units. In my hospital, they have NPs as hospitalists with doctors, and not PAs. RN First Assists work with surgeons in surgery and assist them there. Nurse Anesthetists operate independently in most states doing anesthesia.

So the deal with getting a BSN while taking prerequisites for Pa or medical school is that you will have to use your electives to take some pretty hard courses. Nursing school keeps you busy, and then to have an extra class to take each term alongside that can be tough sometimes. It isn’t the most fun you can have while in school. I’d suggest a less ambitious approach, and just picking a plan. If you like the idea of nursing, go for nursing.

40 percent? that's surprising! I thought most of ER non-physician providers are registered nurses, assistants, and I've never thought about NPs even though I wanted to work in the ER or trauma unit as an NP.
I don't think I'm interested in Nurse Anesthetists since I want to meet patients, diagnose them, prescribe medications, treat minor injuries, etc. those I can do outside of OR. Basically, I wanted to do the same tasks what doctors' do until my ability or hospital policy limits me.
I better go seek for shadowing opportunities, so I can actually get to see what healthcare providers do.
I'm so glad that I got to ask some questions, and talk to someone like you who is very knowledgeable about the field that I'm interested in.

 

[Noisewater-TDX]

40 percent? that's surprising! I thought most of ER non-physician providers are registered nurses, assistants, and I've never thought about NPs even though I wanted to work in the ER or trauma unit as an NP.
.

We, as RNs, aren't calculated into the provider category. I've heard the term clinician thrown around, but for the most part we are just "staff" or "nurses."

Our NPs did fasttrack and ED Ob/Holding (novice PAs did this to). The older PAs took what i would refer to as "resident spots" - they worked in the acute areas of our ER and occasionally the trauma and resuscitation rooms. This is just one ER. But most large level 1 and level 2 ERs are not going to have an NP in the trauma bays, MAYBE a PA. Mostly Docs and Residents.

Doing your BSN and taking Ochem, Chem, and physics would be, for the lack of a better word, hell. I would think twice about doing that!!

 

[JY51]

We, as RNs, aren't calculated into the provider category. I've heard the term clinician thrown around, but for the most part we are just "staff" or "nurses."

Our NPs did fasttrack and ED Ob/Holding (novice PAs did this to). The older PAs took what i would refer to as "resident spots" - they worked in the acute areas of our ER and occasionally the trauma and resuscitation rooms. This is just one ER. But most large level 1 and level 2 ERs are not going to have an NP in the trauma bays, MAYBE a PA. Mostly Docs and Residents.

Doing your BSN and taking Ochem, Chem, and physics would be, for the lack of a better word, hell. I would think twice about doing that!!

Since both of you, NickMT-RN and pamac saying that working on BSN degree and prereqs for pa school at the same will be extremely difficult to keep up with them, I'm now trying to adjust my plan. I haven't decided which career to pursue, yet. But, just want to know every extra info, thought it can help me to decide which path to take; do you know which major would be good along with those prereqs for pa school? I heard that most pa school doesn't really care what major the applicant was as long as he/she did great on their prereqs or they even seek for the diverse major since a lot of applicants' majors are in biology, etc.

 

[pamac]

Yes, you can actually major in anything you want, provided that you compete the prerequisites. At a nearby Pa school to me,if you are a business major that took the six required prerequisites for that school, you could apply and get accepted, which is actually quite common. The prerequisites are entry level stuff like intro to psychology, microbiology, anatomy and physiology 1 and 2, statistics, and a couple other very general courses. Some schools throw in biochemistry, which often is a class that requires someone to take general chemistry and organic chemistry. My nursing school actually requires more prerequisites than most of the PA schools I applied to. I had biochemistry, but I didn’t need it. I’d like to think that most Pa school applicants that are accepted have more science background than the bare minimum, but I actually know quite a few folks that took the minimum prerequisites and got As in them, and got into PA school and did just fine. But I think the more biology mastery you have, the better your chances of getting in to Pa school and doing well in Pa school. And that’s the reason you see a lot of folks that want to be PAs and are serious about it are biology majors, because they rack up a lot of science coursework for their major that also is applicable to applying and doing well in Pa school. And honestly, a lot of Pa hopefuls dreamed of medical school (or more accurately dreamed of being a physician), and when that didn’t seem viable either due to grades or else the lack of desire to train for 8 more years and go into massive debt, they switched gears and aimed for PA. But PA school is very competitive, and for a long time it hasn’t been a viable backup plan for folks that didn’t make the cut for medical school. By the numbers, a greater percentage of people don’t get accepted into Pa school in a given year vs medical school. However, I think your typical PA applicant isn’t the kind of student that could easily get into medical school either. To take the medical school entrance exam and do well, you need a very rich background in physics, biology, math, and chemistry.

So nick mentioned how his ERs are set up. That’s different than mine, and it will vary all over the place. In my facility, there aren’t a ton of residents, but they do show up sometimes. We have ER physicians that are board certified and most completed trauma ER residencies. The PAs and Nps that do roll through handle most of what comes in apart from codes and the real heavy things, but it’s not unheard of to walk in and see one suturing. Bone setting or sedation usually is kicked up to a physician. Complicated cases or hand issues, or gunshot wounds are kicked up to specialists by the ER physicians (which goes to show there are even things ER docs don’t feel comfortable handling if there is a specialist that can do it better.... and that’s the reason we have specialists). So different places use their PAs and NPs in different ways.

 

[JY51]

Yes, you can actually major in anything you want, provided that you compete the prerequisites. At a nearby Pa school to me,if you are a business major that took the six required prerequisites for that school, you could apply and get accepted, which is actually quite common. The prerequisites are entry level stuff like intro to psychology, microbiology, anatomy and physiology 1 and 2, statistics, and a couple other very general courses. Some schools throw in biochemistry, which often is a class that requires someone to take general chemistry and organic chemistry. My nursing school actually requires more prerequisites than most of the PA schools I applied to. I had biochemistry, but I didn’t need it. I’d like to think that most Pa school applicants that are accepted have more science background than the bare minimum, but I actually know quite a few folks that took the minimum prerequisites and got As in them, and got into PA school and did just fine. But I think the more biology mastery you have, the better your chances of getting in to Pa school and doing well in Pa school. And that’s the reason you see a lot of folks that want to be PAs and are serious about it are biology majors, because they rack up a lot of science coursework for their major that also is applicable to applying and doing well in Pa school. And honestly, a lot of Pa hopefuls dreamed of medical school (or more accurately dreamed of being a physician), and when that didn’t seem viable either due to grades or else the lack of desire to train for 8 more years and go into massive debt, they switched gears and aimed for PA. But PA school is very competitive, and for a long time it hasn’t been a viable backup plan for folks that didn’t make the cut for medical school. By the numbers, a greater percentage of people don’t get accepted into Pa school in a given year vs medical school. However, I think your typical PA applicant isn’t the kind of student that could easily get into medical school either. To take the medical school entrance exam and do well, you need a very rich background in physics, biology, math, and chemistry.

So nick mentioned how his ERs are set up. That’s different than mine, and it will vary all over the place. In my facility, there aren’t a ton of residents, but they do show up sometimes. We have ER physicians that are board certified and most completed trauma ER residencies. The PAs and Nps that do roll through handle most of what comes in apart from codes and the real heavy things, but it’s not unheard of to walk in and see one suturing. Bone setting or sedation usually is kicked up to a physician. Complicated cases or hand issues, or gunshot wounds are kicked up to specialists by the ER physicians (which goes to show there are even things ER docs don’t feel comfortable handling if there is a specialist that can do it better.... and that’s the reason we have specialists). So different places use their PAs and NPs in different ways.

I truly appreciate both of y'all's opinions and help. I've been doing some research about the majors' curriculum that I was interested in and some pa schools' prereqs, etc. and I think my final decision will be nursing school with prereqs for pa school despite that you guys said it will be really difficult to keep up with them unless I try VERY best. Since the nursing school that I'm planning to apply has almost the exact same prereqs with pa school that I'm aiming for, I thought it would be better if I have a backup plan in case the pa path doesn't work out. I'm planning to shadow PAs and NPs at my local hospitals/clinics, etc. and also volunteering over this summer or during my free times to see and kind of make up my mind about which career will be more suitable for me.
Thank you and thank you, the information that you guys gave to me helped me so much!

 

[pamac]

If you get to shadow, keep in mind that folks out in the professional world are collegial to each other and typically aren’t disparaging their peers in the other professions. They won’t be as wound up about the politics surrounding the things that show up in online forums....like issues such as nurse practitioner independence, and differences in training. Be low key about talking about those things, because most folks in tenge real world don’t dwell on rivalries like keyboard warriors do. You never know who you would offend either. I shadowed a PA that was married to an NP, and was glad that I didn’t try to discuss controversial issues with that person, given their spouse was on the other side of the spectrum.

Overall, I would try to pick a pathway as soon as you can so you can maintain focus and add less stress to your life. Open ended goals are the ones that fall by the wayside most frequently.