A physician assistant (PA) is a licensed medical professional who can diagnose illnesses, prescribe medications, order tests, and treat patients across virtually every medical specialty. PAs practice alongside physicians and other healthcare providers, typically completing about 27 months of graduate-level training before entering the workforce. There are roughly 162,700 PAs working in the United States as of 2024.
What PAs Do Day to Day
PAs handle many of the same clinical tasks as physicians. In a typical day, a PA might take patient histories, perform physical exams, order and interpret lab work or imaging, develop treatment plans, write prescriptions, and counsel patients on preventive care. In hospitals, PAs make rounds, manage inpatients, and coordinate discharges. In surgical settings, they assist during operations, position patients, handle tissue, place wound drains, close incisions, and manage postoperative care including monitoring for complications.
The breadth of what a PA can do is part of what makes the role distinct. A PA working in an emergency department might splint a fracture, suture a wound, and manage a patient having chest pain, all in the same shift. A PA in dermatology might biopsy a suspicious mole and prescribe treatment for eczema. The clinical responsibilities flex to match the specialty and the needs of the practice.
How PA Training Works
PA programs are graduate-level, meaning you need a bachelor’s degree to apply. Most applicants also bring direct patient care experience, often as EMTs, medical assistants, or scribes. Programs last about 27 months and award a master’s degree upon completion.
The training follows what’s often called a “medical model,” which mirrors how physicians learn. The focus is on diagnosing disease through symptom assessment, patient history, and clinical reasoning rather than the broader biopsychosocial framework used in nursing education. The first year is heavy on classroom and lab instruction: anatomy, pharmacology, pathophysiology, clinical medicine. The second phase shifts to clinical rotations, where students complete more than 2,000 hours of supervised patient care in areas like family medicine, emergency medicine, surgery, pediatrics, and psychiatry.
Certification and Ongoing Requirements
After graduating, PAs must pass a national certifying exam to earn their license. Certification runs on a 10-year cycle, broken into five two-year periods. During each two-year window, a PA must complete at least 100 hours of continuing medical education and pay a maintenance fee. This structure keeps PAs current with evolving medical evidence and practice standards throughout their careers.
Where PAs Work
PAs practice in every setting you’d find a physician: primary care clinics, hospitals, urgent care centers, operating rooms, rural health posts, and specialty practices. Early in the profession’s history, about half of all PAs worked in primary care. That proportion dropped to around 30% by 2013 as demand surged in surgical subspecialties, emergency medicine, and medical subspecialties like cardiology and gastroenterology.
This shift reflects both where the job market is growing and where PAs find career opportunities. A PA might spend years in orthopedic surgery, then transition to urgent care, then move into hospital medicine. The generalist foundation of their training allows this kind of flexibility in ways that highly specialized training pathways don’t.
Prescribing Authority
PAs can prescribe medications in all 50 states, including controlled substances in nearly every state, though the specifics vary. A handful of states, including Georgia and Texas, restrict PAs from prescribing the most tightly regulated drugs (Schedule II substances like certain opioids and stimulants), while allowing prescriptions for less restricted categories. Several other states cap Schedule II prescriptions at a 7-day or 30-day supply. Some states require PAs to complete additional training on controlled substances before prescribing them.
For the vast majority of medications patients need, from antibiotics and blood pressure drugs to insulin and antidepressants, PAs prescribe independently as part of their routine clinical work.
The Relationship With Physicians
Traditionally, PAs have been legally required to work under the supervision of a specific physician, though the practical meaning of “supervision” varies widely. In many settings, a PA sees patients autonomously throughout the day with a collaborating physician available for consultation rather than standing over their shoulder. The supervising physician may review a percentage of charts or be reachable by phone rather than physically present.
This legal structure is changing. The American Academy of Physician Associates adopted a policy called Optimal Team Practice in 2017, which pushes for removing the requirement that PAs be formally tethered to a specific physician. The argument is that mandated supervision agreements create bureaucratic barriers, limit where PAs can practice, and don’t reflect how modern team-based healthcare actually works. Several states have already begun loosening these requirements, allowing PAs to practice to the full extent of their training without a designated supervisory physician.
The Title Change to Physician Associate
In 2021, the profession’s national organization voted to change the official title from “physician assistant” to “physician associate.” The reasoning centers on the word “assistant,” which many PAs feel misrepresents their level of training and autonomy. As of now, a handful of states including Oregon, Maine, and New Hampshire have officially adopted “physician associate” as the legal title. The transition is expected to take years, and both terms remain in widespread use. The title change doesn’t affect what PAs can do clinically.
Job Outlook and Pay
The PA profession is one of the fastest-growing in healthcare. The Bureau of Labor Statistics projects 20% employment growth from 2024 to 2034, which translates to roughly 33,200 new positions. That growth rate is far above average for all occupations. The median annual salary for PAs was $133,260 as of May 2024, though compensation varies significantly by specialty, geographic location, and experience. Surgical subspecialties and high-cost-of-living areas tend to pay at the upper end of the range.
The demand is driven by a persistent physician shortage, an aging population, and the expanding role of PAs in settings that previously relied on physicians alone. For healthcare systems, PAs offer a way to see more patients without the longer and more expensive training pipeline that producing new physicians requires.