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What distinguishes PAs from the medical doctors they work with? 

By Alyson Rockhold PA-C, MPH

“So, when will you become a doctor?” 

The first time a patient asked me this, I sputtered in confusion. I was so proud of my newly minted PA license. How dare he insinuate it was merely a stop-over on the way to bigger and better things!  

Then I paused and looked at the patient, an elderly gentleman wearing overalls. He had probably never heard of a PA. His comment wasn’t meant disrespectfully. I forced a smile, mumbled “Not sure,” and completed his visit. 

After a decade as a PA, I’m more likely to face the opposite problem. Many patients call me “Dr. Alyson” even after I repeatedly explain that I’m a PA. 

Here’s what I wish I could share with anyone confused about the difference between a PA and a doctor:

Doctors and PAs are both qualified medical professionals who examine, diagnose, and treat patients. In their day-to-day work, there is a lot of overlap in their tasks. However, PAs and doctors differ in their length of education, level of autonomy, scope of practice, and the financial costs and rewards of their profession.

Length of education

Both PAs and doctors start with a 4-year undergraduate degree. Then most PAs will attend a 27-month PA program, bringing their grand total of higher education to about 6 years.

After college, doctors will go to medical school for 4 years followed by 3 to 7 years of residency and possibly a fellowship. So, it will take them 11 to 15 years after graduating high school before starting their profession.

I was 25 years old when I graduated from PA school. I’d paid off my graduate school loans by 27 years old. By my 30s I was well into my career and able to focus on other parts of life. Quite honestly, I know I would not have had the stamina for medical school. However, I’m glad that some people do, because obviously that extra education leads to higher levels of knowledge and the ability to help more patients.


By definition, a PA must always practice under a doctor’s supervision. Laws vary by state. Where I practice in Texas, my supervising physician is always available for a consultation when I am seeing patients. This can be in-person or virtually. He also reviews 10% of my charts.

Personally, I love the “safety net” that my supervising physician provides. I ask him questions multiple times a week and am thankful for his guidance. In addition, it gives me peace of mind to know that I can never be sued by myself. As my supervisor, he would be included in any lawsuit filed against me. 

Scope of Practice

PAs have a few limitations to their scope of practice that are different in each state. The main one is that they are not licensed to perform surgery. They can assist in surgeries and do minor procedures, but they cannot do full surgeries. Also, there are higher-level controlled substances such as Adderall and certain opioids that PAs cannot prescribe.

I’ve never been bothered by the limitations of my scope of practice. However, I know that some PAs don’t like the restrictions of our profession.


The average PA program costs $80,318 while the average medical school tuition is around $218,792.

However, this disparity is also seen in each professions’ salaries. According to the Bureau of Labor Statistics, PAs make an average of $115,390 a year while a doctor’s median salary is $208,000.

If you’re a nerd like me, you may be wondering how this shakes out over time:

An average PA who took out loans for her entire graduate school education would graduate at 24 years old with around $80,000 of debt. By 35 years old, she would have made around $1,269,000. Then by 50 years old, she would hit a lifetime earnings of $3,000,140.

An average doctor would graduate at 31 years old with about $218,000 of debt. By 35 years old, she would have made $832,000. However, by 50 years old this would skyrocket to $3,952,000. 

Of course, this is a simplified view of things since raises, specialties, and experience all play a role in income generation. However, this example helps show how the whole projection of your life will change with whichever medical path you choose. 

Our healthcare system needs dedicated medical professionals at every level. If you feel called to the medical field, I hope this article helped you discern whether you want to be a PA or a doctor. If you want information about the difference between a PA and NP, click here to learn more. 

Once you determine what kind of healthcare provider you want to be, let Admissions Helpers help you get there with individualized consulting and one-on-one advising to polish your application and help you to shine.