A pediatric physician assistant (PA) provides medical care for children from birth through age 21, handling many of the same tasks as a pediatrician. That includes performing physical exams, diagnosing and treating illnesses, ordering tests, prescribing medications, and overseeing treatment plans. In practice, your child may see a pediatric PA for everything from a routine well-child visit to stitches for a cut to screening for depression.
Day-to-Day Clinical Responsibilities
The daily work of a pediatric PA looks a lot like a pediatrician’s day. They conduct physical exams, interpret lab results, write prescriptions, and develop treatment plans. They also assist physicians during surgery, participate in patient rounds in hospital settings, and manage follow-up care.
For routine visits, a pediatric PA commonly handles:
- Well-child checkups and vaccinations
- Common childhood infections like ear infections, strep throat, and bronchitis
- Minor injuries, including wound care and stitches
- Temporary splinting of fractures and reducing simple dislocations
- Removing foreign bodies (splinters, objects stuck in ears or noses)
- Puberty and sexual development concerns
- Blood work and STD screening for adolescents
- Mental health screenings for conditions like depression and anxiety
In more intensive settings like a neonatal unit or pediatric emergency department, PAs may perform procedures such as bag-mask ventilation or endotracheal intubation on newborns. The range of what any individual PA does day to day depends heavily on the clinical setting and the complexity of the patient population they serve.
How They Work With Pediatricians
Pediatric PAs can see patients on their own, but they work as part of a physician-led team. How closely a physician is involved varies by state. In 47 states, PAs practice under physician supervision, while a handful of states use collaborative agreements instead. Seven states, including Utah, Wyoming, and North Dakota, have eliminated the legal requirement for a specific supervisory relationship altogether, allowing PAs to practice to the full extent of their training.
In most states (47 of them), the specific scope of what a PA can do is determined at the practice level between the PA and the supervising or collaborating physician. This means two pediatric PAs in the same state might have noticeably different responsibilities depending on their experience, their practice setting, and what their supervising physician authorizes. PAs in 44 states can prescribe controlled medications across a wide range of categories, with a small number of states placing limits on certain drug schedules.
Where Pediatric PAs Work
Most pediatric PAs work in outpatient settings. Research published in Pediatrics found that 57% of pediatric PAs practice in primary care, predominantly in private-practice offices. These are the PAs you’re most likely to encounter at your child’s regular pediatric clinic.
Beyond primary care, pediatric PAs work in hospital pediatric wards, neonatal intensive care units, emergency departments, and specialty clinics. Subspecialty roles span fields like pediatric oncology, cardiology, and surgery. Professional organizations exist specifically for PAs in these subspecialties, reflecting how established these career paths have become.
Education and Certification
Becoming a pediatric PA requires graduating from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). These programs typically take about two to three years and include both classroom instruction and supervised clinical rotations across multiple medical specialties.
After graduating, a PA must pass the Physician Assistant National Certifying Examination (PANCE), a comprehensive test of clinical knowledge, reasoning, and professional skills. Graduates have up to six years after completing their program to pass this exam. Once certified, a PA earns the PA-C credential. Those who want to formally demonstrate expertise in pediatrics can pursue a Certificate of Added Qualifications (CAQ) in the specialty through the National Commission on Certification of Physician Assistants.
Pediatric PA Salary
Pediatric PAs earn less than their counterparts in surgical or emergency medicine specialties, but compensation is still strong. The 2025 AAPA Salary Report puts the median compensation for PAs in pediatric subspecialties at $132,000 per year. PAs in general pediatric primary care may fall slightly below that figure, while those in higher-acuity subspecialties like pediatric cardiology or critical care can earn more.
What This Means for Your Child’s Care
If your child is scheduled to see a PA instead of a pediatrician, the visit will feel largely the same. The PA will take a history, do an exam, and explain a diagnosis and treatment plan. They can order imaging, run blood tests, prescribe antibiotics or other medications, and refer your child to a specialist if needed. For the vast majority of pediatric visits, from newborn checkups to a teenager’s sports physical, a PA is fully trained and authorized to manage the appointment independently, with a physician available on the team when more complex situations arise.