To become a physician assistant (PA) in the US, you'll earn a bachelor's degree, gain hands-on patient care experience, then complete an accredited PA master's program, which usually takes at least 2 years. After graduating, you pass a qualifying exam to use the PA-C credential and get a license, which every state and the District of Columbia requires.
It's one of the fastest-growing jobs in healthcare. BLS projects PA employment to rise 21% from 2025 to 2035, far above the 3% average for all occupations.
Figures come from the Bureau of Labor Statistics (BLS) Occupational Outlook Handbook and the National Commission on Certification of Physician Assistants (NCCPA), both read on 26 October 2026.
Physician assistants in numbers
| Measure | BLS figure |
|---|---|
| Median pay (May 2025) | $135,880 a year, $65.33 an hour |
| Lowest 10 in every 100 earned less than | $99,380 |
| Highest 10 in every 100 earned more than | $190,280 |
| Jobs in 2025 | 168,900 |
| Projected growth 2025 to 2035 | 21%, much faster than average |
| Openings each year | About 11,500 on average |
Those pay figures are as of October 2026.
What physician assistants do
BLS says PAs examine, diagnose and treat patients as part of a team with physicians, surgeons and other healthcare workers. That includes taking medical histories, ordering and interpreting tests such as x-rays or blood tests, setting broken bones, stitching wounds, giving immunizations and prescribing medication. In rural and underserved areas, PAs may be the main care providers at clinics where a physician is present only 1 or 2 days a week. BLS also notes a key difference from nurse practitioners: PAs can provide surgical care, while nurse practitioners can't.
How to become a physician assistant, step by step
- Earn a bachelor's degree. Programs usually want science coursework, and degrees are often in healthcare or a related field, such as biology.
- Get patient care experience. Many programs want hands-on experience, for example as a medical assistant, EMT or paramedic.
- Complete an accredited PA program. It usually takes at least 2 years of postbaccalaureate study, with anatomy, clinical medicine and pharmacology, plus supervised clinical training in family medicine, internal medicine and emergency medicine.
- Pass the qualifying exam. Passing lets you use the credential Physician Assistant-Certified (PA-C).
- Get your state license. All states and DC require PAs to be licensed.
- Agree supervision or collaboration terms. In most states, PAs must hold an agreement with a supervising physician, though the physician doesn't need to be on site at all times.
Patient care hours are the hidden entry requirement
Here's the part many applicants underestimate. Good grades alone often aren't enough. BLS says applicants to PA programs typically have both a bachelor's degree and experience caring directly for patients, and programs may want that experience in roles such as medical assistant, EMT or paramedic. Start building those hours early, ideally while you're still at college, so you're not delaying your application by a year to catch up.
Keeping your PA-C: the 10-year cycle
Certification isn't a one-off. NCCPA runs a 10-year certification maintenance process made up of five two-year cycles. In each cycle, you earn and log 100 Continuing Medical Education (CME) credits and pay a maintenance fee by the December 31 deadline.
| Requirement | What NCCPA says |
|---|---|
| Cycle | 10 years, made up of five two-year cycles |
| CME | 100 credits earned and logged every two years |
| Recertification exam | PANRE (one sitting at a test center) or PANRE-LA |
| When you can sit PANRE | In the 9th or 10th year of the cycle, up to four total attempts |
| Recertification exam fee | $350, the same for either option, as of October 2026 |
If you take the traditional PANRE, NCCPA says it's four blocks of 60 questions, with 60 minutes for each block, so four hours of testing in a five-hour schedule. It runs through most of the year at over 200 Pearson VUE test centers in the U.S. and some international centers.
Where PAs work and what they earn
| Employer | Share of jobs | Median pay, May 2025 |
|---|---|---|
| Offices of physicians | 53% | $132,000 |
| Hospitals | 26 in every 100 | $141,150 |
| Outpatient care centers | 9 in every 100 | $153,500 |
| Government | 3 in every 100 | $157,040 |
| Educational services | 3 in every 100 | $134,770 |
Government and outpatient care centers paid the highest medians, as of October 2026. Many PAs work in primary care, such as internal medicine, pediatrics and family medicine. Schedules can include nights, weekends and holidays, and PAs may be on call. For a wider view of the field, our guide to healthcare jobs in demand covers other routes, and this guide to starting college helps with the first step.
Specializing later
Some PAs go on to postgraduate programs in specialties such as emergency medicine and psychiatry. To enter one, you'll need to have graduated from an accredited program and hold your PA-C. Additional specialty certification is also available.
My verdict
Becoming a PA is one of the quickest routes to a six-figure clinical career: a bachelor's degree, patient care experience and a master's program of at least 2 years. The job market is growing at 21%, well ahead of most careers. Start logging hands-on patient care early, and once you're certified, keep on top of your CME every two years so your PA-C never lapses.
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Frequently asked questions
How long does it take to become a physician assistant?
A bachelor's degree, then a PA program that usually takes at least 2 years, plus the patient care experience programs expect before you apply.
How much do physician assistants make?
BLS reports a median of $135,880 a year in May 2025.
What does PA-C mean?
Physician Assistant-Certified. It's the credential you can use after passing the qualifying exam.
Do physician assistants need patient care experience?
Usually, yes. BLS says applicants typically have experience caring directly for patients, for example as a medical assistant, EMT or paramedic.
How often do PAs recertify?
NCCPA uses a 10-year cycle of five two-year periods, with 100 CME credits every two years and a recertification exam in the 9th or 10th year.
Do physician assistants need a supervising physician?
In most states, PAs must hold an agreement with a supervising physician, but the physician doesn't need to be on site at all times.
Is physician assistant a growing job?
Yes. BLS projects 21% growth from 2025 to 2035, with about 11,500 openings a year.
Can physician assistants specialize?
Yes. Postgraduate programs exist in specialties such as emergency medicine and psychiatry, and specialty certification is available.
