Posted by: keherenf | October 19, 2007

Keeping the Medical Professions in Order…MD vs FNP vs PA

In my pursuit of a career in medicine, I have been very confused as to the differences between a Medical Doctor (MD), Family Nurse Practitioner (FNP) and a Physician Assistant (PA). To try and organize this more clearly than anything I have found on the internet thus far, I thought it would be useful to share my findings on this blog:

Medical Doctor (MD)

Educational Requirements: Bachelor’s degree with appropriate science and math prerequisites, 4 years of medical school comprised of 2 years of classes and 2 years of internship, and a minimum 3 year residency (additional depending on the specialty). Total schooling: Minimum of 11 years post high school.

Roles: As the highest level in medicine, the doctor performs all tasks, makes the decisions, and is completely autonomous.

Income: $148,206 average salary reported for a Family Practice doctor

For More Information:

National Library of Medicine

American Medical Association


Family Nurse Practitioner (FNP)

There has been a great need for FNPs as the health care demands continually increase. FNPs can perform much more than a regular RN (Registered Nurse), but do not cost as much as a doctor, nor require as much schooling. FNPs can work in any clinical setting, and some even start their own practice.

Education: The FNP typically has a BSN (Bachelor’s of Science in Nursing) and an MSN (Masters of Science in Nursing). The Master’s program typically takes 1-2 years, therefore the total schooling post high school is 5-6 years.


  • take health histories and provide examinations
  • diagnose and treat common illnesses and conditions
  • order appropriate diagnostic tests
  • interpret x-rays and lab results
  • prescribe and manage medications and other therapies
  • provide health teaching and counseling
  • refer patients to specialists as needed

Income: In 2004, the average national salary was $73, 235

For More Information:

Women’s Health Channel

American Academy of Nursing


Physician Assistant

Education: PAs must successfully complete a PA program, which usually averages about 26 months. A bachelor’s degree is not required, however most accepted applicants have a bachelors degree and an average of four years of health care experience. After completing the program, PAs may have to take refresher courses and continue to be retested on their clinical skills.


  • take medical history
  • examine and treat patients
  • order and interpret lab tests and xrays
  • make diagnoses
  • prescribe medication
  • anything else an MD does, but in conjunction with the MD
  • counsel in preventative health care
  • assist in surgery

Income: In 2004, the average national salary was $72,457

For more information:

American Academy of Physician Assistants

The difference between a FNP and a PA (taken from PA world):

On a daily basis, in the United States physician assistants and nurse practitioners function in similar roles. Both can diagnose, treat, and prescribe, but the training of physician assistants is generalist in nature and modeled on medical school curriculums. All physician assistants learn primary care and rotate through the major specialties while in training. Nurse practitioners, on the other hand, have traditionally been trained in one specialty (paediatrics, women’s health, etc.). Recently, family practice as a specialty has gained in popularity. Physician assistants are employed more often as house officers within the hospital setting than are nurse practitioners; surgery and its subspecialties are the most popular in-house specialties. Physician assistants are also more involved in emergency care than are nurse practitioners.

Politically, physician assistants consider themselves to be a part of medicine as a member of the physician-led team, and some physician assistants sit on physicians’ state medical boards. In contrast, nurse practitioners come from a nursing background and feel closest to nursing. Most state legislation for nurse practitioners sets up the state board of nursing as their regulatory body. Although both groups seek to be part of the medical care team, most nurse practitioners do not feel a political need to be tied to a physician. This has led some nurse practitioners to seek independent practice, which physician assistants have not done. It is the setting and the specialty that determines how these two professions practice, rather than legislative or professional regulations.


  1. You didn’t mention the D.O.

  2. […] to go with a post about my first few days in my role as an emergency room NP, I came across this link comparing not just NPs, PAs, but Physicians as well. Although I think a lot could be added to it, I […]

  3. We get questions all the time about this, and in general your answer is fairly accurate, but not complete, or up to date.

    Both NPs and PAs are getting more education than you have listed here. NPs are now pursuing a DNP, while almost all new PAs have a Masters, and a doctorate degree is now available.

    Depending on the state practice acts, we function independently and may own our own practices/businesses. I think as we move forward, we’ll see more of this.

    The bottom line is…we all excel in various areas. No one works in isolation. Our goal is to assist our patients to the best outcomes. In order to do so, we (NPs, PAs, MDs, DOs) collaborate and refer to one another as is necessary.

  4. Thank you for informing me on the advances made in these professions!

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