Aspiring health care providers sometimes realize that though they are intrigued by the idea of healing the sick, their goal…

Aspiring health care providers sometimes realize that though they are intrigued by the idea of healing the sick, their goal is not to become a physician. The revelation often comes after they have considered and rejected the idea of applying to medical school. That decision could be motivated by a variety of reasons. For instance, they could be deterred by the lengthy time commitment required to enter the medical profession, the high financial cost of medical school or the extraordinary competitiveness of med school admissions.

For future health care professionals who do not intend to pursue careers as doctors but who still want to have significant authority and influence in the health care sector, jobs such as physician assistants or nurse practitioners may be appealing. Both professions require graduate-level education, and each allows the worker to order lab tests, diagnose illnesses, prescribe or administer medicine and provide health advice.

In addition, the demand for both physician assistants and nurse practitioners is being met with more people choosing those career paths. The federal Bureau of Labor Statistics predicts that the number of physician assistants employed in the U.S. will be 31% greater in 2028 than it was in 2018. Similarly, according to the BLS, the number of nurse practitioner jobs is expected to be 28% higher in 2028 than in 2018.

[Read: How a Physician Assistant Career Compares to a Job as a Doctor.]

Annual salaries exceeding $100,000 are common for both types of clinicians. Their pay is comparable, according to the BLS, which reports that the median salary among physician assistants in 2018 was $108,610, while the median salary among nurse practitioners was $107,030.

The level of autonomy a nurse practitioner or physician assistant has depends upon the health care regulations where he or she works, says Lindsey Hammett, chair and program director for the department of physician assistant education at the University of Dayton in Ohio. “The best way for someone considering both professions to determine which is best for them includes looking at the scope of practice for both providers in the state or states in which they are considering working,” Hammett wrote in an email.

Graduate programs in both fields often have demanding admission requirements, says Graig Straus, a board-certified family nurse practitioner and emergency nurse practitioner in New York who has a Doctor of Nursing Practice degree. Straus, who owns and runs an urgent care health practice and who has provided on-site clinical training to NP and PA grad students, notes that PA programs often require prospective students to obtain around 2,000 hours of clinical experience. In order to be eligible for admission to a NP grad program, he adds, a student may need to be a registered nurse.

The American Association of Nurse Practitioners, or AANP, states on its website that non-nurses need to acquire a registered nurse credential in order to qualify for licensure as a nurse practitioner.

“All NPs are registered nurses (RNs),” the AANP states. “Non-nurses entering an NP program must complete the requirements to sit for the RN licensure exam, either as a prerequisite to the NP program or as part of an articulated educational program that delivers general nursing content in addition to the NP-specific content.”

Straus recommends that students who are uncertain whether to become a PA or NP shadow both types of professionals so they can determine which role they prefer.

How to Become a PA or NP

Becoming a PA means attending a PA school, which typically lasts for three academic years and results in a master’s degree, according to the “Become a PA” guide published on the website of the American Academy of PAs, the national professional organization for physician assistants.

[Read: Nursing Specialists Can Earn More Than Some Doctors.]

By contrast, in order to become an NP, it’s necessary to earn at least a master’s degree in a nursing specialty, though it’s increasingly common for an NP to have a DNP. The American Association of Colleges of Nursing issued a formal recommendation in 2004, stating that the appropriate entry-level credential for an advanced practice nursing practice degree ought to be a DNP rather than a master’s degree.

Master’s programs in nursing, or MSN degrees, ordinarily require at least one calendar year of full-time study , but usually last longer, with the length of the program depending on the student’s area of specialization. Some programs last two years. Prospective nursing master’s students who have bachelor’s degrees in a field unrelated to nursing may need to devote more time to their master’s programs than their peers who already have nursing bachelor’s degrees.

An entry-level MSN program could stretch out to three years in length, since students might need to complete a year of basic nursing courses. DNP programs for incoming students who have bachelor’s degrees in nursing usually take three to four years to finish, though such programs may be shorter for students who arrive with nursing-related master’s degrees.

The PA school curriculum typically includes courses in medical science fields like anatomy and pathology, and it may also include courses on behavioral science topics, such as the science behind how people’s behavior changes as they age, and the science surrounding how people cope with mortality. PA grad students typically complete clinical rotations in several medical specialties, such as emergency medicine and pediatrics, as well as lessons on how to interview patients and record a complete medical history.

Nursing graduate coursework typically includes numerous classes on how to care for a specific population of patients, depending on what the nursing student’s area of concentration is and what types of patients he or she intends to serve: adults in emergency situations or children in primary care settings. Nursing grad schools often require students to take overview courses on the essential competencies of advance practice nursing, such as bioethics, pharmaceutical remedies and health care quality improvement strategies.

Differences Between Physician Assistants and Nurse Practitioners

One important distinction between physician assistants and nurse practitioners is the breadth and depth of their graduate education. While graduate nursing students typically focus on learning how to treat a specific population of patients, such as pediatric or geriatric patients, PA students are not obligated to specialize in this way. PA programs are typically more general and include a variety of clinical experiences, including rotations in surgery.

Chioma Tomlinson, a certified physician assistant at Brigham and Women’s Hospital in Boston and an adjunct faculty member with Tufts University School of Medicine’s physician assistant program, says PA schools are organized like medical schools, and offer a comprehensive, generalist curriculum.

Tomlinson says if she were to meet a prospective health care professional who knew for certain that he or she wanted to care exclusively for pediatric patients, she might steer that individual toward a pediatric-oriented NP program. However, if the student wanted the flexibility to treat multiple patient populations, she would recommend a PA program, which “allows all doors to remain open,” Tomlinson says.

Experts on PA programs note that the medical model of health care is something that these programs emphasize. “The medical model is based on a disease-centered approach,” Tomlinson wrote in an email. She added that PAs are prepared to “meet the needs of all patients regardless of age in all aspects of medicine.”

One of the key features of a job as an NP is the heavy emphasis on the unique health needs, lifestyles and environmental conditions of specific types of patients, such as pediatric acute care patients, according to experts.

According to Crystal Polson, a nurse practitioner with more than 18 years of health care work experience, an NP usually has a “patient-centered” approach. That means an NP considers various components of a patient’s life, including not only the patient’s physical condition but also the patient’s psychological well-being, emotional state and social context when making treatment decisions, says Polson, who in addition to being an NP is also the creator of Prudent Patient, a website that provides guidance on how to navigate the U.S. health care system.

The philosophy of nursing often differs from the mentality within medicine, notes Joan E. Zaccardi, a urogynecology nurse practitioner in New Jersey who has a DNP. “Nurse practitioners provide patient care under the nursing philosophy, which is looking at quality of care according to the wholeness of the patient and considering all factors that affect the patient,” Zaccardi wrote in an email. “This includes the physical, psychological, emotional and social aspects that treat the whole person.”

Catherine Burger, the media and brand specialist for RegisteredNursing.org and a former clinical practice consultant who managed PAs and NPs, says there is very little difference between the types of assignments that PAs and NPs can handle on a day-to-day basis. However, one important distinction that sometimes exists is that PAs are more likely to be certified to assist with surgeries, since PA schools ordinarily include surgical clinical rotations.

[See: 12 Graduate Degree Jobs That Can Pay More Than $100K.]

Because PAs receive a broad medical education and take a comprehensive board exam, they are able to switch health care specialties whenever they wish “without returning to school,” notes Hammett, who has both a bachelor’s degree and a master’s in physician assistant studies. But NPs take board exams that are particular to their chosen field, so it is usually more difficult for them to switch specialties, Hammett says.

PAs must receive 100 hours of continuing medical education biannually and are required to retake board exams after each decade of practice, Hammett adds. “This is similar to the requirements for board-certified physicians,” she says. “Requirements for continuing education for nurse practitioners vary greatly by state and can be anywhere from 15-50 hours of continuing education every two years.” A list of state continuing education requirements for nurses in the U.S. is available online through Nurse.org, a publication for nurses and nursing students.

Individuals who are considering NP careers should be aware that national certification boards for various NP specialties do require nurses within those specialties to renew their certifications on a regular basis. Some certification boards require their certified NPs to recertify more frequently than others. For instance, national nursing certifications from the National Certification Corporation, which certifies health care providers who concentrate on obstetrics, gynecology or neonatal specialties, are valid for three years. In contrast, national nursing certifications from the American Academy of Nurse Practitioners Certification Board, which certifies NPs who specialize in either family care, emergency care or adult-focused care, must be renewed every five years.

Brandon Greiner, a Pennsylvania-based physician assistant and senior director of the Office of Advanced Practitioners at MedExpress health care company, says he’s often asked for advice by people who are trying to decide whether to become an NP or a PA.

“At their core, both of these careers require someone who is able to care for people with compassion, warmth, and understanding,” Greiner wrote in an email. “If that’s the type of care you’re interested in providing to patients, a career as either a physician assistant or nurse practitioner could be a great choice for you. More specifically, I also typically recommend doing your homework and selecting a career path that best fits your interests and the amount of time you’d like to dedicate to your education.”

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Should You Attend a Nurse Practitioner or a Physician Assistant Grad School? originally appeared on usnews.com