RN to PA: How Nurses Become Physician Assistants
Considering switching from nursing to physician assistant? This guide covers the path from RN to PA, including prerequisites, how your nursing experience counts, and whether it's the right move for you.
Why Do Nurses Consider Becoming PAs?
Medical Model Training
PA programs follow the medical model, similar to physician training. Some nurses prefer this approach over the nursing model used in NP programs. PA education emphasizes diagnosis and treatment across all specialties before specializing.
Specialty Flexibility
PAs are trained as generalists and can switch specialties throughout their careers without additional certification. NPs must choose a specialty before starting their program and need new certification to change fields.
Standardized Education
PA programs are more standardized than NP programs. All PA students complete similar rotations and graduate with comparable clinical experience. NP program quality and clinical hours vary significantly.
Career Change Desire
Some nurses want to step away from the nursing profession entirely. PA offers a fresh start with a different professional identity while still using clinical skills.
NP vs PA: Side-by-Side Comparison
Before committing to PA school, understand how these careers compare.
The Path from RN to PA
Earn a Bachelor's Degree
PA programs require a bachelor's degree. If you have a BSN, you're set. If you have an ADN, you'll need to complete a bachelor's degree first—any major works, but science-heavy degrees help with prerequisites.
Time: BSN holders: 0 additional time. ADN holders: 1-2 years for RN-to-BSN or another bachelor's.
Complete PA School Prerequisites
PA programs require specific science prerequisites that may not have been part of your nursing education.
| Course | Credits | Notes |
|---|---|---|
| Anatomy | 3-4 | Usually 2 semesters with labs |
| Physiology | 3-4 | May be combined with anatomy |
| Microbiology | 3-4 | With laboratory |
| General Chemistry | 6-8 | 2 semesters with labs |
| Organic Chemistry | 3-4 | At least 1 semester |
| Biochemistry | 3 | Some programs |
| Statistics | 3 | Required by most programs |
| Psychology | 3-6 | General and/or abnormal |
| Medical Terminology | 1-3 | Some programs |
Critical: Chemistry requirements trip up many RNs. Most nursing programs don't include organic chemistry or biochemistry. Budget 1-2 years to complete missing prerequisites.
Gain Patient Care Experience
This is where RNs have an advantage. PA programs typically require 1,000-3,000+ hours of direct patient care experience. Your RN experience counts.
Good news: Most RNs already exceed the experience requirements. Two years of full-time RN work = 4,000+ patient care hours. This is a major advantage over non-healthcare applicants.
Take the GRE
Many PA programs require the Graduate Record Exam (GRE). Some have dropped this requirement, but competitive programs often still require it.
Target scores: 300+ combined (verbal + quantitative), 4.0+ analytical writing. Prepare 2-3 months before testing.
Apply Through CASPA
Most PA programs use the Centralized Application Service for Physician Assistants (CASPA). Applications open in late April, and programs have rolling admissions.
Apply early. Many programs fill by late summer. Competitive applicants apply to 8-12 programs.
Complete PA Program
PA programs are intensive 24-36 month master's programs with didactic and clinical phases. Clinical rotations cover all major specialties.
Didactic Phase (12-15 months)
- Anatomy (often with cadaver lab)
- Physiology
- Pharmacology
- Clinical medicine
- Physical diagnosis
Clinical Phase (12-16 months)
- Family medicine
- Internal medicine
- Surgery
- Pediatrics
- Emergency medicine
- Psychiatry
- Women's health
Pass PANCE and Get Licensed
After graduation, pass the Physician Assistant National Certifying Exam (PANCE) and apply for state licensure.
PANCE is a 300-question, 5-hour exam. National pass rate is approximately 93% for first-time test-takers.
Realistic Timeline: RN to PA
Compare to NP: BSN to NP takes 2-4 years, often while working. RN to PA typically requires leaving work for the 2+ year PA program, since most programs don't accommodate working students.
Cost Comparison: NP vs PA Path
NP Path Costs
- MSN program (2-3 years) $30,000-$80,000
- Can work while studying Yes (most programs)
- Net cost (with income) $20,000-$60,000
PA Path Costs
- Prerequisites (1-2 years) $5,000-$15,000
- PA program (2-3 years) $80,000-$150,000
- Lost income (can't work) $140,000-$200,000
- Total investment $225,000-$365,000
The financial difference is substantial. PA school costs more and typically requires leaving your job. NP programs are often designed for working nurses.
When Does the PA Path Make Sense for RNs?
PA Might Be Right If...
- You strongly prefer the medical model over nursing model
- You want flexibility to switch specialties without new certification
- You're young enough that the longer/costlier path has time to pay off
- You want to leave nursing entirely for a fresh professional identity
- You're interested in surgical specialties (more PA opportunities)
- You have financial resources or support to attend full-time
NP Is Probably Better If...
- You need to work while completing your education
- You're concerned about cost and ROI
- You want to build on your nursing foundation
- You're interested in independent practice (NP has more autonomy)
- You already know your desired specialty
- You want the fastest path to advanced practice