Difference Between an FNP and a PA

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Differences between FNPs and PAs fall into three primary areas: work focus, education, and degree of autonomy.

For healthcare workers who want to go beyond nursing, but who do not wish to become doctors, the jobs of family nurse practitioner (FNP) and physician’s assistant (PA) can be excellent options. Both of these positions allow greater responsibility and autonomy than nursing does, while avoiding some of the stressful pressures faced by physicians.

From a patient’s perspective, there may be little apparent difference between FNP and PA providers. Practitioners, however, know the marked differences that fall into three primary areas: work focus, education, and degree of autonomy. Understanding these differences can help candidates to choose the career that best suits their personality and inclinations.

Once the path is chosen, a candidate must seek the necessary education. After navigating how to compare nursing programs, he or she will find many fine choices, such as Duquesne University’s Family (Individual Across the Lifespan) Nurse Practitioner MSN. Also offering Post-Master’s Certificate programs to meet the needs of all healthcare providers, Duquesne’s online master’s in nursing can provide a springboard to a satisfying healthcare career.

Work Focus

Nurse Journal does a good job of explaining the difference in work focus between FNPs and PAs. “Nurse practitioners follow a patient-centered model, while physician assistants adhere to a disease-centered model,” the journal says. In its simplest terms, this difference can be explained this way:

  • The nursing model looks holistically at patients and their outcomes, giving attention to patients’ mental and emotional needs as much as their physical problems.
  • The medical model places a greater emphasis on disease pathology, approaching patient care by looking primarily at the anatomical and physiological systems that comprise the human body.

This difference in focus affects the training and education necessary for FNPs and PAs. FNPs are expected to choose a specific patient population as their primary specialty. Examples include pediatrics, geriatrics, and women’s health. PAs, on the other hand, are more likely to specialize in a particular area of medicine, such as emergency or internal medicine. In their work, they will apply this knowledge equally to patients in any population.

Despite these differences, there are also many similarities between FNPs and PAs. The website Career Builder explains that nurse practitioners and physician’s assistants will both complete patient assessments; prescribe treatment and medications; and perform diagnostic tests to determine the health of their patients. Although the essential focus may be different, the ultimate goal of both professionals is to address the patient’s medical needs.

Education and Certification

To obtain these skills, Nurse Journal states that prospective FNPs and PAs will follow slightly different paths. To become an FNP, candidates must:

  • First possess a nursing-related bachelor’s degree, typically an RN-BSN, but related degrees are sometimes acceptable
  • Obtain state RN licensure by taking an exam, such as the National Council Licensure Examination for Registered Nurses.
  • Complete one to two years of hands-on nursing experience
  • Earn a master of science in nursing
  • Pass a background check
  • Pass a final certification exam upon completion of the master’s degree
  • Complete anywhere from 750 to 2,500 clinical hours, depending on the specialty

To become a PA, candidates must:

  • First possess a bachelor’s degree in a scientific field, such as physiology, chemistry, mathematics, or biology
  • Have some work experience in the nursing field, but RN licensure is not necessary
  • Pass a background check
  • Complete up to 2,000 clinical hours
  • Complete 10 to 12 eight-week rotations in varied medical fields, such as dermatology, emergency medicine, and surgery
  • Take and pass the Physician Assistant National Certifying Exam (PANCE)
  • Obtain state licensure to practice

Beyond these basic requirements, FNPs and PAs will both be expected to pursue continuing education and certification courses as they move through their careers. Like all healthcare professionals, they must keep up with the changing state of scientific and medical knowledge to be effective in their work.


After the education and certification processes are completed, FNPs and PAs can launch into their careers. Both types of medical professionals can expect to operate with a high degree of autonomy, but PA Ryanne Coulson explains that the legal distinctions and regulatory differences between the two roles.

“State medical boards are responsible for licensing PAs within their state. Licensure is built upon the concept of a physician-PA team, with each state outlining the requirements of ‘collaborative’ or ‘supervisory’ relationship,” she says. “Conversely, NPs are considered independent practitioners. The NP scope of practice varies widely based on each state’s regulations, but some states allow for independent practice with full practice authority under the state board of nursing. PAs have no such autonomous state PA boards in any state.”

In plain language, what she’s saying is that PAs must team up with a physician who oversees their work. FNPs in many states do not have this requirement, so they can operate completely independently in all respects.

In practice, however, the requirement for physician oversight is often given lip service. PAs may, for instance, run clinics where no doctors work. A supervising physician may pop in once or twice a month to ask questions and make sure all is well—but the rest of the time the PA is on his or her own, just as an FNP would be.

Salary and Job Growth

In terms of salary and job growth, the outlook is very similar for FNPs and PAs. According to the U.S. Bureau of Labor Statistics, the median annual pay for NPs in May 2018 was $110,030. The median annual pay for PAs at that same time was $108,610. Both professions were projected to grow 36 to 37% by 2026 – five times the national average for all occupations.

These figures suggest that there is little material benefit to choosing one of these professions over the other. Candidates should consider the basic work focus and pick the path best suited to their interests and temperament.

About Duquesne University’s Online MSN-FNP and FNP Post-Master’s Certificate Programs

As a leader in online nursing education, Duquesne University has helped RNs and APRNs learn skills, strategies, and evidence-based practices to become FNPs. The coursework is presented entirely online, so students can maintain their careers and personal lives while pursuing their education goals. Graduates are prepared to successfully complete the American Academy of Nurse Practitioners Certification Board (AANPCP) and American Nurses Credentialing Center (ANCC) Family Nurse Practitioner certification examinations.

For more information, contact Duquesne University today.



FNP and PA basics – Be a Physician Assistant

Work focus – Nurse Journal

Similarities between FNPs and PAs – Career Builder

Education and certification – Nurse Journal

Autonomy – Be a Physician Assistant

FNP salary and job growth – Bureau of Labor Statistics

PA salary and job growth – Bureau of Labor Statistics