Careers · Guide

PA vs. doctor

By The Prereq Club, a pre-PA student and her mom (not PAs or admissions advisers). Every figure below names its source and the month we checked it: October 2026.

Short answer

Both diagnose, treat and prescribe, but the training is very different in length and cost. PA programs have a median length of 27 months (PAEA's 2021 program survey). A physician needs four years of medical school plus 3 to 9 years of residency (BLS). Physicians earn more (BLS medians of $275,930 vs. $135,880 for PAs in May 2025) and, once fully licensed, can practice without a supervising relationship. PAs can switch specialties without a new degree or residency, and PAs who had changed specialties reported a median of six months to feel proficient (NCCPA).

Side by side

PAPhysician (MD or DO)
Training after collegeA master's program, median 27 months (PAEA's 2021 program survey)4 years of medical school (MD or DO), then 3 to 9 years of residency; subspecialists add a 1- to 3-year fellowship (BLS)
Licensing examPANCE (see what is the PANCE?)USMLE (MD) or COMLEX-USA (DO; many DO students also take the USMLE), taken during medical school and residency
Typical cost of schoolWhole-program tuition averaged $57,955 (public, in-state), $96,171 (public, out-of-state) and $100,212 (private) in 2020–21, not including fees or living costs (PAEA's latest report)MD schools: median four-year cost of attendance for the Class of 2026 (in-state students) was $297,745 (public) and $408,150 (private), including living costs (AAMC)
DebtAbout half (51%) of 2022 graduates with PA-school debt expected to owe less than $125,000 for PA school alone; about a third (32.8%) expected $150,000 or more (PAEA)MD graduates, Class of 2025: median $200,000 of medical-school debt among those with any; $215,000 including premedical debt (AAMC)
Pay (BLS median, May 2025)$135,880$275,930
Jobs and growth (BLS)168,900 jobs in 2025; projected growth 21%, 2025–35862,800 jobs in 2025; projected growth 4%, 2025–35
Changing specialties52.7% of clinically practicing PAs who answered NCCPA's 2025 survey had changed at least once; among those who changed, a median of 6 months to feel proficient in the new specialtyUsually means completing another residency (or a fellowship to subspecialize)
Working with physiciansMost states require a specific relationship with a physician, often a written agreement. AAPA lists 10 states that removed it (Delaware, Iowa, Maine, Montana, New Hampshire, North Dakota, South Dakota, Utah, Virginia and Wyoming), though some may still require a collaboration agreementLicensed to practice without a supervising relationship after residency and state licensing

The cost and debt rows don't measure the same things. PAEA's cost figure is tuition only (2020–21), while AAMC's is full cost of attendance (2022–26). PAEA's debt figure is graduates' expected PA-school debt, while AAMC's is actual debt. All physician cost and debt figures are for MD schools only. During residency, physicians earn a stipend; AAMC's preliminary median for first post-MD year was $66,986 in 2025.

Getting in

  • Applicants: 35,280 people applied through CASPA in 2025–26 (PAEA); 54,699 applied to MD-granting schools in 2025 (AAMC), and 23,114 applied to osteopathic (DO) schools for 2025–26 (AACOM). Many people apply to both MD and DO schools, so those counts overlap.
  • Tests: MD and DO schools both use the MCAT (2025 matriculant means: 512.1 at MD schools, AAMC; 502.95 at DO schools, AACOM). Some PA programs require neither the GRE nor the PA-CAT (though some of those require Casper); others use the PA-CAT or GRE (see PA-CAT vs. GRE).
  • Experience: about two-thirds of PA programs require direct patient care experience and another fifth prefer it (PAEA, 2021–22) (see how many hours you need).

Questions to ask yourself

  1. How many years of training do you want after college: a little over two, or seven to thirteen (more with a fellowship)?
  2. Do you want the longer training that ends in practicing without a required supervising relationship, or a shorter path where, in most states, you practice in a required relationship with a physician but can usually switch specialties without new formal training?
  3. How much debt are you willing to take on, and for how long before full pay?
  4. Have you shadowed both? (See do shadowing hours count?)

Also comparing nurse practitioners? See PA vs. NP.

Related guides

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Free: the Patient Care Hours Starter Kit. A 3-step check for whether a job counts at your schools, CASPA's categories on one page, and a simple hours log. Built from the same program pages as this guide.

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Quick answers

What is the difference between a PA and a doctor?

Both diagnose, treat and prescribe. A PA completes a master's program (median 27 months, PAEA's 2021 program survey) and passes the PANCE; most states require PAs to have a specific relationship with a physician, and AAPA lists 10 states that have removed that requirement, though some may still require a collaboration agreement. A physician (MD or DO) completes four years of medical school plus 3 to 9 years of residency (BLS), passes the USMLE or COMLEX-USA licensing exams, and once fully licensed can practice without a supervising relationship.

How much more do doctors make than PAs?

BLS reports May 2025 median wages of $275,930 for physicians and surgeons and $135,880 for PAs, a difference of about $140,000 a year. Physicians train longer: four years of medical school plus 3 to 9 years of residency, when residents earn a stipend (AAMC's preliminary 2025 median for the first year after medical school was $66,986). Median education debt among indebted 2025 MD graduates was $215,000 (AAMC).

Is PA school shorter than medical school?

Yes. PA programs have a median length of 27 months, according to PAEA. Medical school is four years, followed by 3 to 9 years of residency, according to BLS; physicians who subspecialize add a 1- to 3-year fellowship.

Sources (all opened October 2026)

Rules can change from one cycle to the next. Before you count on any of this, check each program's own admissions page or email the program. This guide is educational only and isn't admissions advice.