Confessions of a PA who consults AI almost every clinical day

Somewhere between double-checking an antibiotic dose, reviewing a possible medication interaction, and having AI politely point out that I had typed naloxone when I meant naltrexone, I had a slightly uncomfortable realization:

I consult AI. A lot.

Seriously.

It is available 24/7. It answers on the first try. It never makes me feel foolish for asking a basic question at the end of a long clinic day. It can move from dermatology to addiction medicine to orthopedics to a medication interaction without rolling its eyes or reminding me that this is technically not its specialty.

It is kind. It is patient. It is relentlessly patient-centric.

And unlike at least one of my colleagues (who shall not be named ), it has never once replied to my question with, “Did you read my last note?”

So, has AI replaced the supervising physician?

No. Not even close.

But it has become a remarkably useful new member of my clinical team—and I think we need to talk honestly about that.

What Consulting AI Actually Looks Like

When people hear “AI in medicine,” they often imagine a glowing machine diagnosing a rare disease while frightened clinicians back slowly out of the room.

My reality is much less dramatic and much more useful.

I use AI to help me:

• Turn a messy pile of history, medications, labs, and prior notes into an organized clinical picture;
• Write patient letters! (maybe my favorite thing on this list);
• Compare what is new with what is merely copied forward in the chart;
• Review differential diagnoses and make sure I have not ignored an important alternative;
• Double-check dosing, contraindications, and medication interactions;
• Identify missing red flags, follow-up instructions, or emergency precautions;
• Draft a clean SOAP note from the visit I actually performed;
• Compose referral comments that make me sound like a certified genius!;
• Help get insurance approval for prior authorizations;
• Make patient instructions clearer and more compassionate; and
• Think through the administrative and social details that can determine whether a treatment plan succeeds in the real world.

That last item matters. A “perfect” plan is not perfect if the patient cannot afford it, cannot get transportation, cannot read the instructions, or has nowhere safe to store the medication.

AI can remind me to zoom out. But I still have to know the patient sitting in front of me.

The World’s Most Available Curbside Consultant

Medicine has always depended on consultation. We ask colleagues. We call specialists. We search guidelines. We check a trusted reference. We walk down the hall and say, “Can I run something by you?”

AI is not the same as a physician consultant, but it has made that first cognitive pass unbelievably accessible.

At 7:10 a.m., it is there. During lunch, it is there. When I am finishing a note after the clinic has gone quiet, it is still there. I can ask a follow-up question, challenge the answer, add a new lab value, or say, “You missed the fact that the patient is pregnant—rethink the plan.”

That availability matters because many errors do not happen from a total lack of knowledge. They happen when we are rushed, interrupted, tired, anchored to our first idea, or juggling too many small details at once.

A second pass can be powerful—even when that second pass comes from silicon.

It Never Judges Me—or My Patients

One of the surprisingly valuable things about AI is that it has no social friction.

I can ask the “obvious” question. I can admit uncertainty. I can explore an uncomfortable differential. I can ask for a simpler explanation, then a more technical one, then a version written at a sixth-grade reading level.

And when the clinical story includes substance use, mental illness, housing instability, transportation barriers, or missed appointments, AI can help me organize those factors without the sighs, labels, or moral shortcuts that sometimes sneak into healthcare.

Of course, AI systems can still reflect bias. They are trained on human-created data, and humans have supplied plenty of bias to work with. “It never judges” does not mean “it is automatically fair.” It means I can use the interaction as a private space to slow down, examine my own assumptions, and rewrite a plan in a more respectful, patient-centered way.

Can AI Really Improve Clinical Reasoning?

The early evidence is interesting—and more nuanced than either the evangelists or the doom crowd would have you believe.

The American Medical Association calls this “augmented intelligence,” a phrase I like because it keeps the human clinician in the driver’s seat. In a 2025 randomized clinical trial involving 92 physicians, clinicians using GPT-4 scored an average of 6.5 percentage points higher on simulated patient-management reasoning than clinicians using conventional resources alone. The AI-assisted group also took about two minutes longer per case—an important reminder that better deliberation is not always faster. You can read the study in Nature Medicine via PubMed.

Another study published in JAMA Internal Medicine compared physician and chatbot responses to 195 health questions posted online. Independent evaluators preferred the chatbot responses 78.6% of the time and rated them substantially higher for empathy.

That does not mean a chatbot is a better clinician. It means something narrower and useful: a language model can be very good at producing thorough, readable, emotionally considerate answers.

Those are real clinical skills. They just are not the only clinical skills.

Now for the Giant, AI-Generated Elephant in the Room

AI can be confidently, beautifully, spectacularly wrong.

It may invent a citation. Misread the timeline. Treat an old medication list as current. Miss a contraindication. Flatten a complicated patient into a tidy textbook case. Or produce a note that sounds so polished you almost forget to ask whether it is true.

A polished fabrication is worse than a blank space.

Here is the necessary caveat: sometimes AI quite literally is in the room—because I invite it in.

Ambient AI scribes can listen to a live patient encounter and turn the conversation into a remarkably organized clinical note. In that sense, AI may hear the history, capture the plan, and preserve details I might otherwise struggle to document at the end of a busy day.

AI may be in the room. But it is not present in the room the way we are.

It still did not auscultate the patient’s lungs, palpate the abdomen, assess the gait, appreciate the expression on a spouse’s face, or feel the shift in the room when the conversation became difficult. It may record the pause—but it does not necessarily understand the pause.

And giving AI a seat in the room creates additional responsibilities. Patients should know when it is being used, applicable consent and privacy requirements must be followed, and every generated note still needs careful human review.

AI may hear the encounter. It does not own the encounter.

The Most Important Part of My Workflow: I Correct It

I do not hand AI a chart and accept whatever comes back. I work with it.

I say:

• “That lab is from last year.”
• “The patient is actually here for the shoulder.”
• “I already gave the injection.”
• “That medication name is wrong.”
• “You are missing the transportation barrier.”
• “This plan needs clearer emergency precautions.”
• “Show me the source.”

Then it revises, and I review again.

This is not a minor detail. The moment I stop correcting it is the moment it becomes dangerous.

Used well, AI is not an oracle. It is a tireless junior consultant, medical editor, safety checker, and cognitive sparring partner rolled into one. It can surface possibilities and organize complexity. I remain responsible for deciding what is accurate, relevant, ethical, and safe.

My Rules for Using AI in Clinical Practice

1. Protect patient privacy

I do not paste identifiable patient information into a general consumer AI tool. Clinical use must follow my organization’s policies, applicable law, and the privacy and security requirements that govern the specific platform. The U.S. Department of Health and Human Services remains the place to start for HIPAA responsibilities—not a chatbot’s privacy promise.

2. Treat every answer as a draft

AI output is the beginning of review, not the end of thought. I verify doses, interactions, guidelines, contraindications, citations, and anything else that could change patient care.

3. Give it context—but only appropriate context

Better inputs usually produce better outputs. I provide the clinically relevant facts, ask a specific question, and clearly separate current information from old chart material. I also leave out details the tool does not need.

4. Ask it to disagree with me

One of my favorite prompts is essentially: “What am I missing?” I may ask for dangerous alternatives, reasons my plan could be wrong, or findings that would change management. AI is most valuable when it challenges my anchor—not when it simply congratulates me for having one.

5. Never outsource the relationship

Empathetic wording from a machine can help me communicate better. It cannot perform empathy on my behalf. The patient deserves my eyes, ears, presence, honesty, and accountability.

6. Own the final decision

If my name is on the chart and my patient is living with the outcome, “the AI said so” is not a clinical defense. I own the note. I own the plan. I own the follow-up.

So, Has AI Replaced the Supervising Physician?

No.

A physician colleague brings lived clinical experience, accountability, institutional knowledge, physical examination skills, procedural judgment, and the kind of human pattern recognition that develops after caring for thousands of real people. AI does not replace that.

It also does not replace PA training, teamwork, professional standards, or the physician–PA collaboration required by an individual practice setting and state law.

But AI may replace some of the friction that used to stand between a question and a useful first answer. It may catch the medication slip, expose the stale lab, improve the discharge instructions, widen the differential, or help me see a patient’s story more clearly.

That is not replacement. That is augmentation.

And our profession is already part of the policy conversation. In 2026, the American Academy of Physician Associates urged HHS to include PAs in future reimbursement rules for AI technology. The question is no longer whether PAs will encounter AI. It is whether we will use it thoughtfully, safely, and in a way that preserves what patients actually need from us.

The New Clinical Team

My preferred equation is not:

AI > PA > physician.

It is:

Patient + PA judgment + human collaboration + AI assistance

The patient remains the center. Human clinicians remain responsible. AI helps us think, organize, communicate, and check our work.

That is less cinematic than a robot replacing the healthcare team. It is also far more interesting—and far more likely to improve care.

And yes, I used AI to help me develop this article. Then I challenged it, fact-checked it, corrected it, removed the parts that did not sound like me, and took responsibility for the final result.

Which, come to think of it, is exactly how I use it in medicine.

Now I want to hear from you: Are you using AI in clinical practice? What has it caught for you—and where has it led you wrong? Share your experience in the comments.

Thanks for reading!

Stephen Pasquini, PA-C

Editor’s note: The clinical examples in this article are generalized composites of routine workflow and contain no patient-identifying information. AI use must follow employer policy, applicable law, and the privacy and security requirements of the specific platform. This article reflects the author’s experience and is not medical or legal advice.

Your first two questions are free, and Maya talks back. Here is what that actually means for your interview prep.

I have sat on the other side of hundreds of PA school mock interviews, and the same thing happens over and over.

The applicant is sharp. Prepared. They have read every article on this site, they have picked their stories, they know exactly what they want to say.

Then I ask, "So — why do you want to be a PA?"

And they freeze.

Not because they don't know the answer. Because it's the first time they've ever said it out loud to another person.

That's the gap we built this to close.

We just opened the PA Life Mock Interview Studio, and the coach inside it is named Maya. She asks you a real PA school interview question in a real voice, listens to your actual spoken answer, and tells you what landed and what didn't — right then, while it's still fresh in your mouth.

She's there at 5 a.m. before your shift. At 11 p.m. the night before your interview. As many times as you need. She doesn't get tired of you, and she never sighs.

Why saying it out loud is the whole game

You can know a question cold and still fall apart answering it.

Understanding what you want to say is the easy half. The hard half is organizing it on the spot, pulling the right example out of the ten in your head, sounding like a person instead of a brochure, and landing somewhere on purpose — all while someone sits there waiting on you.

Reading doesn't build that. Rehearsing in your head doesn't build that. Only your mouth builds that.

Speaking also exposes the things you can't see on paper: the rambling, the example that felt great in your head and lands vague out loud, the answer that just… stops, the phrasing so polished it stopped sounding like you.

Better to find all of that here than in front of a committee.

A place to be bad at this first

Most applicants skip practicing out loud for exactly one reason. It's mortifying. Nobody wants to hear themselves flub an answer, and nobody wants a witness.

So we took the witness away.

Pause. Restart. Ask for the same question again. Pull up an answer blueprint when you're stuck. Load a sample response to see the level of detail a strong answer carries — then throw it out and say it your own way.

No committee watching. No score going in a file. No penalty for stopping halfway and starting over, which is the entire point.

Your mic stays off until you press Start live interview, and you decide when you're finished talking.

What's actually in there: 70 questions across 7 tracks

This isn't ten predictable prompts on a loop. The library runs 70 questions, sorted so you can work on the thing you're actually worried about:

• PA foundation (13) — "Why PA?", "What is a PA?", PA versus NP, where the profession is headed
• Readiness (13) — the academic load, how you study, how you handle stress, how you plan to pay for it
• Behavioral (18) — the biggest track, because this is where most applicants quietly lose ground
• Program fit (6) — "Why our program?" and what makes you different from the person sitting next to you
• Medical ethics (8) — confidentiality, informed refusal, the impaired colleague, the vaccine conversation
• MMI practice (8) — reasoning stations, communication stations, and live role-play
• Unexpected (4) — the ones built to see what you do when you have no prepared answer

If you've been working through the top 46 interview questions or the 300+ question workbook, this is where you finally take them off the page.

What Maya is listening for

When you stop talking, she doesn't hand you a grade. She walks four things:

1. Did you answer the question? Connect it to something personal and something clinical.
2. Does it have a shape? Two or three clear points beat one long stream of consciousness.
3. Is it yours? One specific experience, action, or detail nobody else on the interview trail could have said.
4. Did you close the loop? Finish with what you learned, or how it will help your patients, your peers, or your program.

Then she names one real strength, the single most important fix, and a short blueprint for your next attempt.

Notice what she doesn't do — hand you a script. Memorized answers sound memorized, and they collapse the second an interviewer asks a follow-up. The goal is a better answer in your words, not a polished answer in ours.

Ethics and MMI, where most applicants are flying blind

Ethics questions aren't a guessing game with one correct answer hiding behind them. Committees want to watch you find the competing obligations, notice what information you're missing, protect the patient, respect autonomy, stay non-judgmental, and recognize the moment you'd pull in a supervisor.

Maya's feedback follows your reasoning, not just the verdict you landed on.

The MMI stations are the ones I'd most want you to rehearse, because they're the least like anything else in your life. Explain the PA profession to somebody outside medicine. Handle the group member taking credit for work they didn't do. De-escalate a patient who's been waiting two hours and is finished being polite.

For role-play, say the actual words. Not "I would validate their frustration" — the words. Maya reacts to what you really say.

Want the background reading first? Start with the MMI strategies guide and how to answer behavioral questions.

One honest caveat: these ethics scenarios are interview practice, not legal or clinical guidance. Real decisions turn on current law, policy, supervision, capacity, urgency, and the facts in front of you.

What it costs

Your first two questions are free, and that includes Maya's full spoken feedback. Not a teaser — the real thing.

After that:

• $9 — Focused practice. One 20-minute live session.
• $19 — Interview prep day. 24-hour access, up to three 20-minute sessions, up to 60 voice minutes total.

Both unlock all 70 questions, Medical Ethics and MMI included. Voice time only counts while a live session is actually connected, so your thinking time is free.

And let me be plain about something: buying practice doesn't buy you a seat. Nothing does. It just means you walk in having already said the words out loud once.

Is Maya replacing the human mock interview?

No. And I'd rather tell you that up front than let you figure it out later.

Maya is the gym. A live mock interview with a real person is the game. A human throws follow-up questions Maya wouldn't think to ask, reads your face, feels the pause, and hits you with the thing that isn't on anybody's list.

What works best is running both:

1. Practice with Maya until the words stop feeling foreign in your mouth.
2. Find your patterns — the rambling, the one story you lean on too hard.
3. Take it to a live human and get stress-tested.
4. Go back to Maya and drill whatever fell over.

If you want a fuller game plan around all of it, here's my full interview preparation strategy.

What happens to my voice?

Fair question, and here's the straight answer. The PA Life does not save your audio and does not save your transcript. Your audio is processed live through OpenAI so Maya can coach you in the moment, and you can clear the on-screen transcript any time you like.

Nothing you say in there follows you anywhere.

You'll get the most out of this if…

• You've never done a formal PA school interview and have no idea what it feels like
• You know what you want to say but it comes out sideways
• You're worried you sound generic, or over-rehearsed, or both
• You have an MMI coming and you've never done one
• There's one specific question that makes your stomach drop
• Your practice time is 6 a.m. or midnight and nobody's available then

And if interview nerves are the real problem, read how to squash interview day stress and what a real PA school interview actually looks like before you start.

A few questions I expect

Is Maya a real PA school interviewer?

No. Maya is an AI practice coach we built. She doesn't represent a program, she has nothing to do with admissions decisions, and she can't guarantee you anything. She's here so interview day isn't your first rep.

Will she write my answers for me?

She'll show you a blueprint and an illustrative sample, but the strongest answer has to come out of your own experience. Her whole job is making your answer more yours, not handing you a script to memorize.

Can I practice MMI and medical ethics?

Yes — both are dedicated tracks, with ethical dilemmas, communication stations, conflict scenarios, and role-play. Every pass unlocks them.

Do you keep a recording of me?

No. We don't create or keep an audio recording, and we don't save your transcript. Audio goes through OpenAI live so Maya can respond, and you can clear what's on screen whenever you want.

Go say it out loud

Your PA school interview shouldn't be the first time you hear yourself answer these questions.

Make the mistakes here, where they're free and nobody's grading you. Then walk in and do it for real.

Your first two questions are on me.

Thanks for reading — and good luck in there. I'm rooting for you.

— Stephen Pasquini PA-C

The best PA school scholarships, grants, and loan repayment programs can make an expensive education more manageable. PA school is expensive. It is also demanding, which means you will have limited (if any) time to work while attending.

With the average undergraduate education debt prior to PA school hovering around $36,300 and the average PA school debt load now reaching $112,500 (with some graduates carrying over $200,000 depending on program and location), it has never been more important to have a rock-solid plan for how you will fund your PA education. PA school tuition alone averages $98,075 for a 27-month resident program and $107,288 for non-resident programs — and those numbers don't include fees, housing, equipment, or lost wages.

The good news? There is real money out there in the form of scholarships, grants, loan repayment programs, and federal assistance — you just have to go after it. Remember: apply for scholarships and grants first, before you accept any loans. Then, only accept the loans you actually need.

Funding sources vary, and federal loan programs will likely form the foundation of your financial aid package. Many states also offer their own programs. Work closely with your financial aid office — they will know about special loans and scholarships for which you may be eligible. And if you want to see what one of these programs actually looks like from the inside, here is how I went to PA school for free through the National Health Service Corps.

New for 2026: Major changes to federal student loan programs took effect July 1, 2026, including a new Repayment Assistance Plan (RAP) replacing most income-driven repayment options. See the repayment section below for details.

Search PA School Scholarships, Grants, and Loan Repayment Programs

Below are the PA school scholarships, grants, and loan repayment programs we could find and verify for PAs and PA students: federal, military, all 50 states, and the PA organizations. Search it by your state, by where you are in the journey, or by how much money is on the table. Tap any row for the service commitment, the eligibility fine print, and a link to the program’s own page.

Three things to know about how to read it. Award figures are ceilings, not promises — “up to $75,000” almost always means full-time, at the highest-need site, if you’re funded at all. “Cycle closed” doesn’t mean dead — most of these run once a year, so note the month and set a reminder. And “unverified” means we couldn’t confirm it from a primary source — we’d rather tell you that than pretend.

First, the news that changes everything for the class of 2027

If you read one section on this page, read this one.

On July 1, 2026, Grad PLUS loans went away for new borrowers. In their place, the Department of Education split graduate borrowing into two tiers:

• “Professional” programs — up to $50,000 a year, $200,000 total
• Everything else — up to $20,500 a year, $100,000 total

In the final rule published May 1, the Department put PA programs in the second bucket. Their reasoning: PAs practice with physician collaboration, so a PA master’s isn’t a “professional” degree. Medicine, dentistry, pharmacy, optometry, podiatry, veterinary medicine, chiropractic, law, theology and clinical psychology all made the list. We didn’t.

Do the math on that. Total cost of attendance for most PA programs runs $80,000 to $180,000. A $100,000 lifetime federal ceiling with no Grad PLUS backstop doesn’t mean a tighter budget — it means a lot of accepted students go looking for a private loan with a cosigner, or don’t go at all.

Then AAPA and PAEA sued. On June 25, 2026, Judge Beryl Howell granted preliminary relief, finding they were likely to succeed on the merits. On July 1, the Department issued updated guidance recognizing PA programs as professional-degree programs. As of today, PA students qualify for the $50,000 / $200,000 caps.

Now the part I’m not going to soften: this is not over. The underlying case is still live. The government can appeal. What’s true this morning may not be true when you sign your next promissory note.

What to actually do:

1. If you were already borrowing for your program before July 1, 2026, a legacy provision protects you for the lesser of three more academic years or the rest of your program. Confirm with your financial aid office in writing.
2. If you start in fall 2026 or later, do not build a four-semester plan on a number that’s in litigation. Ask your program’s financial aid office what they are certifying you at, today, in writing.
3. Watch AAPA’s advocacy page. When this resolves, it resolves for everyone at once.
4. And this is the real answer — every dollar you win from the programs above is a dollar this fight can’t take away from you.

A word about what this fight is really about. Strip away the regulatory language and the Department said a PA master’s isn’t a professional degree. I have spent twenty-two years in family practice and at the Homeless Persons Health Project. The people I take care of do not experience my care as sub-professional. Neither will yours. Whatever the courts decide about the loan tables, don’t let anyone define this profession down to you.

Get the order of operations right

Most people work this list backwards. They take the loans first and start looking for PA school scholarships in year two, when the good deadlines have passed.

Do it in this order:

1. Free money with no strings. Start with PA school scholarships from professional organizations, schools, and state academies. Small individually — $500 to $3,000 — but they stack, and almost nobody applies. The competition for a $1,000 state academy scholarship is a fraction of the competition for a national award.

2. Service-commitment money. NHSC, IHS, the state loan repayment programs. This is where the real dollars are — $50,000 to $120,000 is routine, and NHSC and IHS awards are federally tax-exempt, which quietly makes them worth 25–35% more than the same money as salary.

3. Federal loans. Direct Unsubsidized first.

4. Private loans, last, and only for the gap. They don’t qualify for PSLF, they don’t qualify for income-driven repayment, and you cannot undo the choice.

The single highest-leverage move in this entire article: take your first job at a federally qualified health center, or an IHS or VA facility. You stack an NHSC or IHS loan repayment award on top of PSLF eligibility, because the FQHC is a 501(c)(3). Same job. Two forgiveness mechanisms running at once. I have watched PAs erase six figures this way while their classmates refinanced at a rate they were proud of.

Federal PA School Scholarships and Repayment Programs

NHSC Loan Repayment Program — up to $75,000 for two years full-time in primary care at an approved shortage-area site, plus $5,000 more if you’re Spanish-proficient. Tax-free. Award priority runs by your site’s HPSA score, so where you work matters as much as who you are.

NHSC Rural Community LRP — up to $100,000 for three years at an approved rural site. The biggest of the three NHSC repayment programs.

NHSC Substance Use Disorder Workforce LRP — up to $80,000 for three years. PAs are explicitly eligible for this one, and a startling number of websites leave us off the list.

NHSC Students to Service — up to $120,000, and here’s why it belongs on your radar right now if you’re heading into clinical year: you apply in your final year of PA school, before you have a job. The deadline runs in the fall.

NHSC Scholarship — full tuition and fees plus a monthly stipend, for a two-to-four-year commitment. One honest note the brochures skip: the tuition and fees are tax-free, but the monthly stipend is taxable income. Budget for that.

IHS Loan Repayment — up to $50,000 for two years at an Indian health facility, rolling from October through early August. PAs qualify in primary care and behavioral health. Note the split: PAs are eligible for the IHS loan repayment program but are not on the eligible-discipline list for the IHS scholarship. Sites conflate those two constantly.

VA Education Debt Reduction Program — up to $40,000 a year, $200,000 lifetime. The catch nobody explains: EDRP isn’t VA-wide. It’s authorized position by position. Look for “EDRP Authorized” on the specific USAJOBS listing, and apply within four months of your hire date. Unlike NHSC and IHS, EDRP money is taxable.

HRSA Faculty Loan Repayment — up to $40,000 over two years if you teach at an accredited PA program and come from a disadvantaged background. Almost nobody in our profession knows this exists.

USPHS Senior COSTEP — O-1 pay, housing allowance and TRICARE for up to twelve months of your final year, in exchange for two years of service per year of support. It is the most underused pathway on this entire page.

Your state almost certainly has a program. It might not be for you.

PA school scholarships and state loan repayment programs vary widely by location. Ninety-nine state loan repayment programs are in the table above. Some are extraordinary:

• Michigan — up to $300,000 across renewable contracts, ten years max
• Hawaii — two stacking programs, both naming PAs explicitly, up to $50,000/yr
• New Jersey — up to $200,000
• Washington — three concurrent PA-eligible tracks including behavioral health
• Georgia — the only fully PA-exclusive state loan repayment program in the country
• Colorado, Delaware, Maryland, Kansas, Minnesota, Mississippi — all clearly PA-inclusive, all with published terms

And some states have close to nothing for us. Alabama has no verified PA-eligible program in any category. Connecticut’s program is genuinely PA-eligible and has been dark since June 2024. Idaho never names PAs in its eligibility language at all. If you’re in one of those states, the federal programs and a shortage-area job are your play.

Filter the table above by your state and see what you’re actually working with.

The applications you should not waste an evening on

This is the section I’m proudest of, and I’ve never seen anyone else publish it.

There are 53 well-funded loan repayment programs sitting on the same state and federal websites as the PA-eligible ones, with generic names that sound like they’re for you — and eligibility rules that quietly exclude physician assistants.

The worst offenders:

• CalHealthCares (California) — $300,000. Physicians and dentists only. Sits on the same page as the CA SLRP, which does cover PAs.
• Steven M. Thompson Physician Corps LRP (California) — $105,000. Physicians only.
• Texas PELRP — $160,000. Physicians only. And the Texas Mental Health Professionals LRP covers psychiatric nurse practitioners but not psychiatric PAs.
• Kansas Bridging Plan — the state’s best-known rural program. Resident physicians only.
• Minnesota Rural and Urban Physician Loan Forgiveness — $132,000 each, MD/DO only. Minnesota’s PA-eligible program is separately named “Advanced Practice Provider,” and only the rural version includes us.
• Louisiana Physician Loan Repayment Program — near-identical branding to the Louisiana SLRP that does cover PAs.
• Georgia Behavioral Health Provider LRP — $150,000, and it sits directly beside Georgia’s PA-exclusive program. PAs aren’t on the list, even psychiatric PAs.
• Nurse Corps LRP, VA SELRP, VA HPSP — all real, all federal, none of them ours.

Open the “Not for PAs” tab in the table above for the whole list. Ten minutes there will save you a weekend.

And when you find your state’s program on that list — email your state PA academy and your state representative. Several of these exclusions are just a discipline list nobody has updated since the 1990s. Georgia has a PA-only program because Georgia PAs went and asked for one.

Military and uniformed service: the honest version

There’s real money here, and the recruiting material consistently undersells what you trade for it. So let me give it to you straight.

Which branches actually cover PAs, as of FY2026:

• Navy HPSP — explicitly includes PA
• Army HPSP — does not. Medicine, dental, veterinary, nursing, psych and optometry only
• Air Force HPSP — does not include PA
• IPAP (the Interservice Physician Assistant Program) — the real military PA pipeline. Army, Navy, Air Force and Coast Guard. Tuition-free PA school while drawing military pay
• Air Force and Navy HPLRP — as of FY2026, both exclude PA
• Air Force and Navy accession bonuses for PAs — currently turned off

About those two numbers everyone quotes. The “$25,000/year National Guard STRAP” figure holds up against official documentation. The “$60,000 Guard accession bonus” traces back to a single 2019 New York Army National Guard pitch to one graduating class. It is not a standing national bonus. Don’t plan around it.

And the trade. IPAP is the best financial deal in this profession — debt-free PA school on military pay. You pay for it with roughly 4.5 to 8 years on the service’s schedule, not yours: the assignments you’re given, the deployments you’re given, and for Guard and Reserve, commitments that outlast the loan repayment by years.

Take it because military service genuinely appeals to you. Don’t take it because the bonus math looked good on a Tuesday.

The PA Foundation Cut Its PA School Scholarships This Year

I’d rather you hear this from me than find out in March.

For 2026, these national PA school scholarships were harder to win: the PA Foundation awarded 16 student scholarships. Last year it was 44. The general PA/Physician Associate Foundation Scholarship — roughly 19 of those 44 awards — was discontinued, and so was the AAPA Past Presidents Scholarship.

Nine named scholarships survived: NCCPA Endowed, Joyce Nichols Memorial, William H. Marquardt Community Health Access, Ron Nelson Memorial, AAPA Rural Health Caucus, Timi Agar Barwick Scholarship for Humanism in Medicine, Ruth Ballweg Memorial, PA Moms Advocacy and Leadership, and Women in Philanthropy. The Foundation doesn’t publish per-award dollar amounts anywhere.

The student cycle closes in March. Mark it now.

And then look past the national awards, because this is where most students leave money sitting:

• Your state PA academy. Iowa, Indiana, Georgia, Maryland, Minnesota, Kentucky, Alaska, Arkansas, Colorado, Connecticut, Maine and California all run student scholarships. Most require membership — which usually costs less than the smallest award.
• Specialty organizations. Oncology PAs ($2,500), cardiology, pediatrics, hospice and palliative medicine. If you know your specialty, there’s likely money attached to it.
• Your own program’s financial aid office. Your program may offer PA school scholarships that never appear in national databases. Institutional scholarships are some of the most underused money in PA education. Ask, in person, every year.

After you graduate: getting the repayment side right

PSLF is still the best deal in medicine for anyone working at a nonprofit, a VA, an IHS facility or an FQHC. 120 qualifying payments, and forgiveness is tax-free. A final rule that took effect July 1, 2026 added narrow employer exclusions aimed at organizations engaged in specified illegal conduct — it does not touch standard hospitals, FQHCs, the VA or IHS. Certify your employment every year. Every year.

RAP, the new Repayment Assistance Plan, replaced SAVE as of July 1, 2026. Payments scale with income, forgiveness comes at 30 years and is currently taxable, and RAP payments count toward PSLF. If you were on SAVE, you have to pick something new. PAYE and ICR sunset July 1, 2028.

Section 127 lets an employer pay a chunk of your student loans tax-free each year, and it was made permanent and inflation-indexed in 2025 — it had been scheduled to expire. Ask your HR department whether they offer it. Most PAs never ask.

And the mistake I see most often, by a mile: refinancing federal loans before you know where you’ll work. A private refinance is irreversible. Do it at graduation, take an FQHC job three years later, and you have permanently locked yourself out of PSLF and out of tax-free NHSC and IHS repayment — for a rate improvement that will look very small next to what you gave up. Shop rates on debt that’s already private. Leave the federal loans alone until you know.

What the NHSC brochure didn’t tell me

I was an NHSC scholar. The money was real and I’m grateful for it.

Here’s what wasn’t in the brochure: for the length of that commitment, you don’t fully choose where you live. You go where the shortage is. For some people that’s the best thing that ever happened to them — it was, more or less, for me. For others it means a town their partner didn’t sign up for, two hours from anyone they know.

I ended up at a county health department and the Homeless Persons Health Project taking care of people most of the system had given up on, and it turned into a twenty-two-year career I’d choose again tomorrow. But I want you going in with your eyes open, because the version of this pitch you’ll hear from a recruiter has all the upside and none of the geography.

If service in an underserved community is something you actually want, these programs are the best financial decision available to you in this profession. If you’re only doing it for the money, two years is a long time to be somewhere you don’t want to be.

Who Gets the Most Financial Aid?

You might think that the families with the greatest financial need receive the most aid. In fact, that's not always the case. The people who receive the most aid are the people who best understand the aid process — and who apply early, apply often, and explore every available option.

If you want personalized guidance on navigating the financial aid process, check out our Ultimate Guide to Becoming a PA, and read how I actually paid for PA school — the whole story, including the parts I would do differently.

Can I Afford Not to Go to PA School?

Can you afford to go to PA school? A better question: can you afford not to go?

If your dream is to become a PA, the financial challenge is real — but it's not insurmountable. The median PA salary is $135,880 (U.S. Bureau of Labor Statistics, May 2025) — and the AAPA’s 2026 report puts it at $140,000 for calendar year 2025. New grads are landing around $115,000–$118,000, which is NCCPA and AAPA agreeing with each other. Employment of PAs is projected to grow far faster than the average occupation — one of the fastest-growing professions in the country. With the right financial strategy, loan repayment programs, and scholarships, most PAs come out ahead in the long run.

The worst thing you can do is let financial fear keep you from applying. When I applied to PA school, the program coordinator told me: If you get in, we'll help you find a way through financially. They were right. I borrowed more than I planned — but I also earned one of the most coveted scholarships in healthcare through the National Health Service Corps.

There are real opportunities out there. It takes work to find them, but you are already proving that by being here. Set your goals, make your plan, and go get it.

For more help building your PA journey from the ground up, visit our PA School Application Timeline and explore all our PA Resources.

CASPA retired the COVID-19 essay and replaced it with the Situational Decision Making essay — a new 2,500-character question about technology and the human side of medicine. Here's the exact prompt, where it's hiding, the answer almost everyone is about to write — and how to write a better one.

So you opened your CASPA application, clicked into the Personal Information section, and found a question nobody warned you about.

You're not losing your mind. It's new.

For the 2026–2027 cycle, CASPA retired the COVID-19 Impact Essay — which had been quietly outliving its usefulness for a couple of years now — and replaced it with something called the Situational Decision Making question.

And here's the first thing that trips people up: it isn't in the Essay section.

Where the Situational Decision Making essay is hiding in CASPA

You won't find it next to your personal statement. It lives under Personal Information → Other Information, down past Language Proficiency and the infraction questions, sitting right beside the Life Experiences prompt.

Plenty of applicants are going to scroll right past it, notice it in October, and write it in eleven minutes at midnight.

Don't be that applicant. Let's get ahead of it.

The exact prompt

Here's what you'll see on screen, word for word:

Situational Decision Making

Write a statement about how you believe future PAs should use emerging technologies thoughtfully while still maintaining strong, human-centered relationships with patients, even in settings where technology may be limited.

You can enter up to 2,500 characters.

A quick note on that number: 2,500 characters, not words. That's roughly 400–425 words — about half the length of your personal statement. This is a short answer, not an essay. One idea done well beats four ideas done fast.

In the material PAEA published announcing the change, they framed the same question a little more expansively, naming the technologies they had in mind: artificial intelligence, telemedicine, and wearable health devices. Useful context for what they're picturing. But write to the prompt in the box — that's the one you're answering.

One more thing: check the programs on your list. I can't find anything from CASPA or PAEA stating whether this question is required or optional, and I'm not going to guess at something that could cost you an application. Look at your programs' own requirement pages. When in doubt, answer it. An extra 400 words has never hurt anybody.

What this question is actually asking

Read the prompt again and notice how much is hiding in that last clause: "even in settings where technology may be limited."

That's not filler. That's the whole question.

A lazy reading gives you: do you like technology? A careful reading gives you something much more interesting, and much more like being a PA:

Can you use a powerful tool without letting it do your thinking? And can you still take care of a person when the tool isn't there?

That's not a technology question at all. It's a clinical judgment question wearing a technology costume. They're using AI and telemedicine as the setting because it's current — but they're probing whether you understand that the equipment is never the point.

Which, if you've spent any real time in patient care, you already know. You've watched someone stare at a screen instead of at the person in the chair. You've also seen a tool catch something a human would have missed. Both are true. They want to know if you can hold both.

The answer 90% of applicants will give (please don't)

Let me save you from the pile.

Here's the essay thousands of people are going to submit this cycle, and I could write it right now without knowing a single thing about you:

Technology is rapidly transforming healthcare. While artificial intelligence and telemedicine offer exciting opportunities to improve efficiency and expand access, it is important to remember that technology can never replace the human connection at the heart of medicine. Future PAs must strike a balance between embracing innovation and maintaining compassionate, patient-centered care…

Perfectly reasonable. Perfectly true. Perfectly interchangeable.

Every word of that could have been written by someone who has never set foot in a clinic — and this cycle, plenty of it will be written by a machine, which is its own kind of irony on a question about using technology thoughtfully.

Here's the trap: this prompt is abstract, so it invites an abstract answer. Resist that. Abstract is where applications go to die.

Three things to avoid:

• Don't write a position paper. Nobody is grading your take on the future of AI in medicine.
• Don't be afraid of technology. "Technology is dangerous and we must be careful" reads as naive, not wise. You're going to practice with these tools your entire career.
• Don't just cheerlead either. "AI will revolutionize healthcare!" skips the actual question, which is about judgment.

How to write one that works

Start with a moment, not a thesis.

You have 2,500 characters. Spend the first few hundred putting the reader somewhere specific.

Not "technology can enhance patient care when used appropriately" — but a room. A person. A moment where the tool and the human were both in play and you noticed the difference. Two or three sentences is plenty.

You have more of these than you think:

• A time the monitor said one thing and the patient's face said another
• A patient who couldn't do a telehealth visit — no smartphone, no data, no private room, no reliable address — and what your clinic actually did about it
• Watching a provider type through an entire visit, and watching a different one put the laptop down
• A translation app that got you 80% of the way there, and what the other 20% required
• A glucometer or blood pressure cuff a patient couldn't afford, and the workaround
• A time a piece of technology caught something everyone had missed

Then say what you took from it. One clear idea, stated plainly. Not "balance" — balance is the word people use when they haven't decided anything. Something with an edge on it. Something you'd defend out loud.

Then answer the part everyone forgets — the "even in settings where technology may be limited" clause. This is where you separate yourself, because most applicants will skip right past it.

Health care in this country is not evenly distributed, and neither is the technology. Some of your future patients will arrive with a wearable full of data. Others won't have a working phone number. A PA who can only practice well with a full toolkit isn't much of a PA. If you've worked anywhere that runs lean — a free clinic, a rural site, a shelter, a mobile unit, an under-resourced ED, a community health center — that experience is worth more here than any opinion about AI. (If you want my actual view on where this is all heading for the profession, I wrote that down too.)

Close on what kind of PA it makes you want to be. One or two sentences. Land it and stop.

A structure you can steal

That leaves you a little slack. Use it on the third block — that's where the points are.

The part I can't write for you

Years ago I was a phlebotomist at a university clinic, and every Wednesday at six a woman named Margaret came in for routine blood work. She used to tell us stories about her childhood and about her husband, who had given his life to the war. She was fond of me because, in her words, I had freckles like her grandson.

By the last time I saw her, she had gotten too weak to speak. Her daughter came with her and said quietly, "The best vein is in her hand — it doesn't hurt her there." I put my hand on hers and it was cold. I drew the sample, put a bandage on, and looked up at her. Her hand was warm now. She raised her head and smiled at me. Without a word, she made perfect sense.

I never saw Margaret again.

That entire exchange happened with zero technology. No device on earth would have charted what passed between us — and no chatbot could invent it, because it only exists in my memory, and it only got there because I kept showing up on Wednesdays and paid attention.

I wrote about Margaret in the personal statement that got me into PA school after four rejections. It is still the most useful thing I have ever written about myself.

That's the bar for this essay. Not eloquence — specificity. You have your own Margaret. Go find her.

One more time on the irony

CASPA is asking you to explain how to use technology thoughtfully.

I probably don't need to say the next part, but I'm going to: do not have a chatbot write this one. Not because you'd get caught — because you'd be answering a question about judgment by demonstrating a lack of it, and the result will read exactly like that interchangeable paragraph above.

CASPA did loosen its AI rules for this cycle, and there's a lot of confusion about where the line now sits. If you're unsure what's allowed, I broke the whole thing down here: Can you use AI on your PA school personal statement? What CASPA's 2026–2027 rules actually say.

The short version for this question: brainstorm with it if you want, fix your spelling with it, and write every sentence yourself.

Your next step

Set a timer for ten minutes and answer one question on paper:

When have I seen a piece of technology help a patient — and when have I seen it get in the way?

Write both. Don't organize them. Don't make them good.

Whichever one you wrote faster is your opening.

That's the part no tool can do for you, because it isn't in any dataset. It's in your memory, and it only got there because you showed up and paid attention — which, as it happens, is the exact quality this question is trying to measure.

You've got this. And I can't wait to read what you come up with.

Stephen Pasquini, PA-C

Quick answers

Where is the Situational Decision Making essay in CASPA?

Under Personal Information → Other Information — not the Essay section. Scroll past Language Proficiency and the infraction questions; it sits beside the Life Experiences prompt.

How long is the CASPA Situational Decision Making essay?

2,500 characters, which is roughly 400–425 words. Characters, not words — about half the length of your personal statement.

Is the Situational Decision Making essay required?

CASPA and PAEA have not published a blanket answer, so check the requirement pages for the programs on your list. When in doubt, answer it — an extra 400 words has never cost anyone an acceptance.

Did the COVID-19 Impact Essay go away?

Yes. PAEA removed it for the 2026–2027 cycle and the Situational Decision Making question took its place.

Can I use AI to write it?

CASPA now allows non-substantive help like spelling and grammar, and names brainstorming as a legitimate use — but the finished writing has to be yours. On a question that is explicitly about using technology with judgment, outsourcing the writing answers it badly. Here is where the line actually falls.

Sources

• CASPA Applicant Help Center — Other Information — the live prompt and 2,500-character limit, updated June 9, 2026
• PAEA — Admission Suite of Products Updates — confirms the COVID-19 Impact Essay removal and the new question
• CASPA Application Cycle Dates — the 2026–2027 cycle opened April 30, 2026

"We make a living by what we get, we make a life by what we give." - Winston Churchill

Physician Assistant/Associate Salary and Compensation

According to the 2026 AAPA Salary Report — the most comprehensive PA compensation survey available — the national median compensation for full-time PAs hit $140,000 per year in 2025, a 4.5% raise over the $134,000 median the year before. More than 58% of PAs also took home a bonus (median: $6,000).

A median pay of $140,000 per year works out to roughly $11,667/month, $2,692/week, or $67.31/hour (annualized). To put that in perspective: the median U.S. worker earns $50,980 (BLS, May 2025) — so the typical PA earns about 2.7 times the median American salary.

According to the brand-new latest NCCPA Statistical Profile (the 2025 Statistical Profile of Board Certified PAs), the median total income of certified PAs is $125,000 per year, with a mean of $134,010 — up 14.2% over the last five years. The NCCPA figure runs lower than AAPA’s median because it casts the widest possible net: total income from all certified PAs, including part-time and newly certified practitioners. (A milestone worth celebrating from the same report: the profession passed 200,000 board certified PAs for the first time in 2025 — 201,038 of us and counting!)

The highest-paid PAs (per the AAPA 2025 report — still the most recent specialty-level breakdown) work in cardiovascular/cardiothoracic surgery, with a median base compensation of $162,914 per year. Dermatology PAs have the most extraordinary earning upside, with a median bonus of $21,000 and a 90th-percentile base salary of $290,000 — making top-earning derm PAs among the highest-compensated advanced practice providers in medicine.

More than 58% of full-time PAs received a bonus in 2025, with a median bonus of $6,000 (AAPA 2026). Here’s an insight worth pausing on: the median bonus actually shrank (it was $7,500 the year before) while base pay jumped 4.5% — employers are moving money out of discretionary bonuses and into guaranteed salary. When you negotiate, negotiate the base. The vast majority of PAs (83%) are salaried, 14% are paid hourly, and 3% are paid on productivity — where the median rate is $26 per RVU on a median of 4,000 RVUs logged per year.

On average, family medicine PAs make $125,000 per year, emergency medicine PAs make $146,000 per year, and an orthopedic surgery PA can expect to make $135,000 per year (all figures: AAPA 2025, median base compensation).

The Bureau of Labor Statistics (BLS) reports the median salary for PAs at $135,880/year or $65.33 per hour (May 2025) — up 2.0% from $133,260 in May 2024 — with the top 10% earning $190,280/year or more. Employment of physician assistants is projected to grow 20 percent from 2024 to 2034, much faster than the average for all occupations, with approximately 12,000 openings projected each year.

As of February 2026, the average annual pay for a physician assistant in the United States, according to data from ZipRecruiter, is $120,212 a year or approximately $58 per hour. Most PA salaries currently range between $100,000 (25th percentile) and $135,500 (75th percentile) across the United States.

The median salary for recently certified, new-graduate PAs is approximately $118,000 per year (AAPA 2025, PAs with 0–1 years of experience) — and NCCPA’s 2025 profile pegs first-year PAs at a $115,000 median, so the two reports agree: expect roughly $115–118K your first year. PAs who receive an hourly wage earn a median of $72/hour (part-time) to $75/hour (full-time). If you are paid hourly without benefits — per diem, extra help, or 1099 — a raw hourly comparison will flatter your rate: check whether it is actually fair with our PA hourly rate calculator.

Only 10% of PAs work part-time (fewer than 32 hours per week). PAs who work in emergency medicine, urgent care, or as independent contractors are more likely to receive an hourly wage.

Most PAs Receive Additional Non-Salary Benefits:

In addition to their base salary, most PAs receive additional non-salary benefits:

• More than 58% of full-time PAs receive a bonus, with a median bonus of $6,000 (AAPA 2026) — down from $7,500 the year before as employers shift compensation into base salary.
• Almost all PAs (87%) receive professional development compensation from their primary employer — a median of $2,200 per year (AAPA 2026). This covers things like DEA license reimbursement, CME expenses, credentialing fees, and professional dues.
• Most full-time PAs continue to have individual health, dental, and liability insurance included as a covered benefit.
• The majority of employers match between 3–7% of 401K contributions.

PA salaries — and the buying power of those salaries — vary enormously by state, and this is where most salary articles stop short. The nominal top payers (BLS, May 2025) are New Jersey ($165,690), California ($165,650), Washington ($164,360), Hawaii ($164,050), and New York ($160,880). But adjust for what a dollar actually buys (using the federal government’s Regional Price Parities), and the leaderboard flips: Oklahoma is #1 — its $136,550 median is worth $155,448 in real buying power — followed by Vermont, Washington, Iowa, and New Jersey. Washington is the unicorn: top five on both lists. Flip the “Adjusted for cost of living” toggle in the live table above to see where your state lands, or read the full deep dive in our PA salary adjusted for cost of living guide.

What is the Best PA Salary Report?

Multiple organizations report the salary of physician assistants; however, each PA salary report varies with how the data is gathered and what salary data is included.

The AAPA 2026 Salary Report (200+ pages of specialty, setting, and benefits detail) and the NCCPA Statistical Report (the majority of all certified PAs) are the most reliable. The AAPA report wins on depth and detail — specialty, region, setting, experience, and benefits — while the NCCPA report wins on sample size and is free to everyone.

What is the median PA salary in 2026? The four most reliable reports compared:

• AAPA 2026 Salary Report: Median compensation $140,000/yr (calendar-year 2025 data) — up 4.5% from $134,000 the year before
• NCCPA Statistical Report: $125,000/yr median · $134,010 mean total income (2025 Statistical Profile; free to everyone)
• Bureau of Labor Statistics (BLS): $135,880/year or $65.33/hour median (May 2025) ($133,260 in May 2024)
• ZipRecruiter: $120,212/year or ~$58/hour (February 2026)

*Consider the earning potential of locum tenens / travel PA positions, which typically pay 20–30% more than permanent positions, along with housing and travel stipends. Also see current inflation rates when projecting future salary growth.

Like a fine wine, PA salaries also get better with age

Years of experience matter significantly, with salary peaking for PAs with 15–19 years of experience at a median of $146,000 (AAPA 2025). PAs with 20 or more years of experience earn a median of $150,000 per year — more than $32,000 above what a new graduate earns. PAs with management responsibilities often earn an additional $10,000–$20,000 beyond clinical-only roles.

According to the AAPA 2025 Salary Report, median base compensation by years of experience is:

PA compensation keeps climbing year over year: the 2026 AAPA report shows the median jumping 4.5% in 2025 (to $140,000), on top of a 5.5% rise the year before. That’s roughly a $13,000 raise for the median PA in just two years — comfortably ahead of inflation both years. Not bad for a profession that also keeps topping the best-jobs rankings.

Best-paying cities and metro areas for PAs

The live metro table above tracks 51 major U.S. metros, updated automatically from federal wage data. Right now San Jose–Sunnyvale–Santa Clara leads the nation at a $223,640 median — and here’s the kicker: even after adjusting for Silicon Valley prices, San Jose is still #1 in real buying power ($202,530 adjusted). San Francisco ($184,380), New York ($167,650), and Seattle ($167,290) round out the top nominal payers, while Oklahoma City and Portland sneak into the adjusted top five. (My own Santa Cruz–Watsonville metro pays a $159,030 median — worth about $144,710 after our coastal cost of living. A tough pill to swallow, but the beach helps. )

Physician Assistant Earnings by Part-time and Full-time Status (AAPA 2025)

PA Median Base Compensation by Specialty (AAPA)

Which PA specialties pay the most? Here are the top 10 highest-paying PA specialties — a short excerpt from the AAPA 2025 Salary Report (calendar-year 2024 data), which breaks down compensation across 45+ specialties. Figures are median base compensation from a PA’s primary employer; bonuses are reported separately.

Specialty	Median Base Compensation	Median Bonus	25th Percentile	75th Percentile
1. Cardiovascular/Cardiothoracic Surgery	$162,914	$10,000	$145,000	$195,700
2. Thoracic Surgery	$147,000	$4,300	$133,509	$176,000
3. Emergency Medicine	$146,000	$8,500	$128,000	$172,640
4. Vascular Surgery	$143,300	$6,583	$123,000	$160,000
5. Anesthesiology	$143,120	$2,000	$117,000	$159,120
6. Critical Care Medicine	$141,000	$7,000	$125,000	$165,000
7. Dermatology	$140,000	$21,000	$120,000	$183,040
8. Occupational Medicine	$140,000	$6,000	$125,000	$160,888
9. Oncology Surgery	$140,000	$6,000	$125,422	$160,000
10. Radiology	$140,000	$5,000	$125,000	$157,000
National total (all specialties)	$134,000	$7,500	$118,500	$155,000

A few things jump out. Surgery and acute care own the top of the list — seven of the ten are surgical or hospital-based specialties, and cardiovascular/cardiothoracic surgery leads the profession by a wide margin. Dermatology is the quiet overachiever: its $140,000 median base looks ordinary here, but derm PAs report a median bonus of $21,000 — nearly triple the national median — and top earners push past $290,000. And the spread matters: from ophthalmology at the bottom ($116,480) to CV surgery at the top is a difference of more than $46,000 a year, every year, for the same license. Here’s the best part — as a PA, you can move between these specialties without going back for a new residency — and PAs actually use that freedom: 52.7% have changed specialties at least once (NCCPA 2025). Your specialty choice is a compensation lever most other clinicians simply don’t have. (The full 45+ specialty breakdown, including bonuses and percentiles for every field, is in the AAPA Salary Report itself.)

Know Your Worth

The National Commission on Certification of Physician Assistants (NCCPA) Statistical Reports

• Includes the vast majority of all certified PAs in the U.S. — 201,038 board certified PAs as of the end of 2025, the first time the profession has topped 200,000
• FREE for everyone — the most accessible data source available

AAPA 2026 Salary and Compensation Report

• Thousands of PA respondents; 200+ pages of salary, benefits, and compensation data
• FREE to AAPA fellows, students, and retired members; $200 to non-members

Included in the AAPA annual report are the following:

• Median Base Salary and Bonus from Primary Employer by Work Setting and Years of Experience
• Professional Expenses Paid (DEA, NCCPA fees, AAPA membership, CME)
• Insurance Benefits and Retirement Benefits Provided by Primary Employer
• Paid Days Off; Call Status; Hours per Month on Call
• PA Compensation by Wage Type (annual salary, hourly, productivity pay)
• Median PA Salary by Region (West, Northwest, South, Midwest)
• Median Base Salary by Work Setting, Employer Type, and Major Specialty Area
• Cost-of-living adjusted median salary by state

Additional resources:

• Salary to hourly calculator
• Percentage increase calculator
• Inflation rate calculator
• AAPA 2026 Salary Report
• NCCPA Statistical Reports (free)
• BLS Physician Assistant Wage Data (free)

Recommended Reading:

NEW — AI-POWERED

Wondering which PA schools you can actually get into?

Paste your stats into PA Program Match AI and get your free competitiveness score in seconds — then unlock a personalized Safety / Target / Reach ranking of every accredited program, matched to your GPA, patient care hours, and prerequisites. The score is free — and you can unlock your full ranked list whenever you’re ready.

Get my free score →

The Perfect PA Program Picker

Click a column header to sort (click again to reverse). One honest-data rule to know: an — never means “no requirement” — it means the program doesn’t clearly publish that number, so confirm on its website. And when your filters can’t confirm a program either way, it stays visible below the dashed divider instead of silently disappearing.

Want the deeper program profiles — deadlines and deadline types, prerequisites, selection factors, seat deposits, and more? Every program above links to its full page on PA School Finder, or browse with the free PA Program Match tool.

Are you like me and looking to dodge the GRE?

Does the thought of studying for the GRE exam make your palms sweat and your heart flutter?

Wouldn't it be great if you could find PA schools that don't require the GRE and simply avoid the GRE exam altogether?

Well, you are in luck! Roughly three out of four ARC-PA accredited PA programs have dropped the GRE entirely — and the number grows every cycle.

Below is the always-current list of US physician assistant programs that do not require the GRE for PA school acceptance — the live counts above the table tell you exactly how many, today.

PA Programs That Don't Require the GRE

Crunching the numbers: how many PA schools still require the GRE?

What exams are required for PA school admission?

The short answer, straight from the live counts above the table: only about 1 in 4 PA programs still require the GRE. The rest either never ask for it or will not look at it at all.

That is a genuine collapse, and it happened fast. The last time PAEA formally counted — a review of accredited program websites for its Curriculum Report 6 — 52.2% of PA programs required the GRE. Programs went test-optional when testing centers shut down in 2020, watched their classes perform exactly as well without it, and simply never went back.

What about the other admission exams?

The GRE is not the only test out there, and a couple of the newer ones are quietly gaining ground while the GRE loses it. Here is PAEA's most recent national count of what programs ask for:

Source: PAEA Curriculum Report 6, a review of 273 accredited program websites. It is the most recent national count PAEA has published — so treat the GRE row as the floor of the decline, not the ceiling.

Watch CASPer and the PA-CAT. As programs drop the GRE, some are replacing it rather than simply removing a hurdle. Do not assume a "no GRE" program means no testing at all — check what it asks for instead.

What is considered a competitive GRE score for PA school?

Among the programs that actually publish a GRE expectation, PAEA's most recent figures put the average at roughly 306 total — about 153 verbal, 152 quantitative, and 4.1 on analytical writing.

Percentiles matter more than the raw number. Every GRE administration differs slightly in difficulty, which is exactly why the percentile exists. Clear the 50th percentile in each section and your score has done its job — after that, your energy is far better spent on your patient care hours, your science grades, and your personal statement.

And keep the GRE in perspective. Among students who actually got into PA school last cycle, the average was a 3.68 overall GPA and a 3.61 science GPA — and the science number is where admissions committees separate people. No GRE score rescues a weak science transcript, and a strong one rarely needs rescuing.

One last thing before you skip the test

"Not required" and "not accepted" are not the same thing, and neither is "optional." Some programs ignore the GRE completely, some will read a good score if you volunteer one, and a handful of the programs in our list do not state a policy clearly at all — those are flagged separately above.

Build your program list first, then decide about the test. If nobody on your list wants a score, congratulations — you just bought yourself two months of study time. Put it into your hours.

So — should you take the GRE?

Here is how I would think about it, in three lines.

Nobody on your list requires it? Then don't take it. You just handed yourself back two months of your life — put them into patient care hours, which carry far more weight anyway.

One program you love requires it? Take it once, clear the 50th percentile, and move on. Do not let a single exam become the reason you never applied.

Sitting below the GPA median and looking for a counterweight? A strong score can help at the margins. An upward grade trend and a stack of hours help more.

Here is the honest bottom line: the GRE is the smallest lever you have. Your science grades, your hours, and your essay are the big ones — and unlike a test score, every one of those is still in your hands right now.

Need help with the part that actually moves the needle? We will help you write a personal statement the admissions committee remembers — with services to fit every budget.

Stephen Pasquini PA-C

Then skip the healthcare experience!

Below is a list of PA programs in the United States that do not require patient care experience for PA school admission.

I use "require" lightly because many of these schools, which claim no healthcare experience requirement, do "strongly recommend" or "prefer" PA school candidates with a certain amount of experience prior to application.

In other words, you can apply, but you may not stand a chance against an increasingly capable PA school applicant pool.

I recommend 2,000 hours (1 year of full-time hands-on patient care experience) to be a competitive applicant to PA school.

As you can see from this table, many schools claim to require much less.

Does this mean you should wait to apply until you have a load of HCE under your belt?

The answer to this question depends on your background, your age, your prior experience, and what else you bring to the table.

Are you a 21-year-old recent college graduate with no prior healthcare experience? Then the answer is yes,  you should get out there and find some hands-on patient care experience... no excuses!

Are you a 35-year-old mother of two with 10 years of experience as a licensed acupuncturist and extensive PA shadowing experience? Then you may have some wiggle room.

You can browse this interactive, geographical list of PA schools that don't require healthcare experience on my PA School Finder website.

You will see that most of these schools reside on the East Coast.

Remember, PA schools change their requirements all the time, so make sure to contact the PA program in question and reference their website before you make any rash decisions. If you have any updated information or corrections about these programs, please let me know in the comments section!

PA Programs That Don't Require Healthcare Experience

Jump straight to the live cost table — current tuition for every US PA program, refreshed on every page load.

Great, now how are you going to pay for it?

With the average undergraduate education debt prior to PA school at $36,300 and the average anticipated debt load from PA school now ranging from $112,500 to $116,773, it's time to ask the next logical question:

How Much Does PA School Cost in 2026?

As with most college and advanced degree programs in the United States, the cost of PA school continues to rise. Based on current tuition data supplied by PA programs, the American Academy of Physician Associates (AAPA), the Physician Assistant Education Association (PAEA), and the most recent NCCPA Statistical Report:

The Most Current Average Costs Across All PA Schools (2025–2026 Data — Most Recently Published)

• The average cost across all PA programs (public and private) for resident tuition for a 27-month physician assistant/associate program is $98,075 (up from $95,165 the prior year)
• The average cost across all PA programs (public and private) for nonresident tuition for a 27-month physician assistant/associate program is $107,288 (up from $103,660 the prior year)

Based on the latest PAEA/AAPA reports:

• The average cost of public resident tuition for a 27-month PA program is closer to $56,718
• The average cost of public non-resident tuition is approximately $88,168
• The average cost of private tuition for a 27-month physician assistant program is $91,639
• The average program length is 27 months
• The average PA graduate debt upon completing PA school is $112,500–$116,773, on top of any undergraduate debt

The Cost of Public vs. Private PA Programs

Of particular interest is the difference between public and private institution tuition and fees.

• The average total tuition for residents and nonresidents was higher for PA programs at private institutions than at public institutions.
• There was a 4% to 7% increase in the average total resident tuition for public and private institutions.
• The average total incidental costs (books, medical equipment, etc.) for public and private institutions increased by 23% and 139%, respectively.
• Today, 62.5% of PA programs are private, while only 35.6% are public.
• Nearly 85% of PA students take out loans to cover their education costs.

What PA Programs Actually Charge in Required Fees

Fees usually get reported as one tidy average, which makes them sound like a rounding error. They are not. We read the required-fee line off every accredited program’s own published cost page, and the spread is enormous:

• The median program charges roughly $7,000 in required fees on top of tuition.
• More than a hundred programs charge over $10,000, and well over a dozen charge more than $20,000.
• At the very top of the range, one program charges close to $50,000 in fees alone — very nearly doubling its own tuition.

These are not optional, and they are not living costs. A program fee, a clinical placement fee, a technology fee — they land on your student account exactly the way tuition does. The tuition-plus-required-fees column in the live table above is the number that actually gets billed.

Cost of APPLYING to PA School in 2026

Just when you thought it couldn't get worse, before you enjoy the hefty cost of PA school itself, you have to factor in the cost of applying. Based on my calculations, the total cost of applying could exceed $6,000 in 2026. Here's the breakdown of major application expenses:

• CASPA Application Fee: $184 for your first program + $61 for each additional program. If you apply to 12–15 schools (the average), CASPA fees alone run $784–$949.
• CASPer Test Fee: $85 (includes results sent to 8 programs) + $15 per additional program. A growing number of PA programs now require this test.
• Transcript Entry Service (PTE): $75–$150 depending on the number of transcripts.
• Supplemental fees: Many programs charge $25–$100 or more per secondary application.
• Interview travel costs: Flights, hotels, and transportation for in-person interviews can add hundreds or thousands more.

Note: CASPA fee waivers are available on a first-come, first-served basis for applicants with financial need (covering two programs, valued at $245). Apply early!

For my full breakdown with every cost itemized: Sticker Shock Alert! The Real Cost of Applying to PA School.

Looking for the best programs to apply to? Use my Ultimate PA School Applicant Logbook to track your hours, schools, and costs — all in one place.

Cost of All US Physician Assistant (PA) Programs

The live table below includes every US physician assistant program with published tuition — total resident and nonresident program tuition (not including fees) — pulled directly from each program’s cost pages and continuously verified by our PA School Finder directory. Tuition changes constantly, but this table can’t go stale: it re-checks the data every time you load this page — the “live data” date stamp below the table tells you exactly when the numbers you’re seeing were pulled (that’s today).

How Much Did It Cost Me to Go to PA School?

When I was enrolled in the Rutgers University PA program (formerly UMDNJ) in 2001 — yes, that feels like a long time ago — the annual tuition was only $10,000 per year (excluding fees). Since this was a three-year program, my total cost for the PA school education, excluding fees, was approximately $30,000.

I was fortunate to receive a stipend from the National Health Service Corps, which covered my PA school expenses. I strongly recommend looking into this program — especially now that Grad PLUS loans are being phased out; service-based funding is more important than ever.

How Much Would My Same PA Program Cost in 2026?

Here is the breakdown of my school (Rutgers PA program) and the projected cost of tuition and fees for the 3-year program starting in 2026.

Projected Total Cost of Attending the Rutgers Physician Assistant Program in 2026

• The estimated total cost of in-state tuition is approximately $105,374 (2025: ~$101,321; 2024: $97,424; 2023: $93,677; 2012: $69,524)
• The estimated total cost of out-of-state tuition is approximately $158,125 (2025: ~$152,043; 2024: $146,195; 2023: $140,572)

Note: 2026 Rutgers figures are projections based on the ~4% annual increase trend. Verify with the Rutgers School of Health Professions for current figures.

How About the Fees (Estimated for 2026)?

• ~$500 campus fee
• ~$950 technology fee
• ~$475 school fee
• ~$500 lab-intensive fee
• ~$195 clinical admin fee
• ~$160 parking/year × 3 = $480

Total in Required Fees (Estimated): ~$3,100

A note on what I count as a fee: Rutgers also requires a student health plan, about $2,650 a year and roughly $7,950 across the three years. Real money — but you can waive it if you carry your own coverage, which makes it a cost of living rather than a charge for being enrolled. I leave it out of the fee total for the same reason I leave out books and rent, and we apply that same rule to every program in the directory.
In a later blog post, I will discuss the cost of books, medical supplies, and general living expenses. Unless you attend PA school part-time, it isn't easy to maintain a job along with a full-time PA school curriculum.

You may also have noticed that Rutgers University has a three-year PA school curriculum. How does this compare with shorter programs? Take a look at my 14-variable Perfect PA Program Picker!

Is PA School Worth the Cost in 2026?

This is the question every pre-PA should be asking, and it deserves a real answer. The short version: for most people, yes — but only if you go in with a plan. And if part of you is still weighing PA against medical school, I’ve run that exact money comparison — tuition, years of lost income, debt, and lifetime earnings — in PA vs. MD: Following the Money.

Here's the math that matters. The national median PA salary in 2026 is approximately $133,000–$134,000, with bonuses pushing total compensation close to $141,500. That is a high income, and demand for PAs continues to grow. Check out the 10 Best Cities for Physician Assistants in 2026 and the PA Salary by Cost of Living comparison to see where your dollar goes the farthest.

However, with average PA school debt now at $112,500–$116,773 — and federal loan access shrinking thanks to the Grad PLUS loan changes — it is more important than ever to choose your program wisely. Attending an in-state public program, utilizing service-based scholarships and loan repayment programs, and minimizing borrowing can make an enormous difference in your long-term financial health.

Also, if you are wondering who gets into PA school and what it takes to put together a winning application, check out my guide: Who Gets Into PA School?

If you are just starting your pre-PA journey, the Ultimate Pre-PA Getting Started Guide is the best place to begin.

Frequently Asked Questions About PA School Costs

How much did your PA school cost? Is it worth it? Drop a comment below — I'd love to hear your story!

— Stephen Pasquini, PA-C

Updated July 2026 with the latest available national data on salaries, student debt, work hours, student loans, and taxes.

Before you read this post, I want you to take a quick survey.

What Do You Think?

Physician Assistant vs. Physician: Show Me the Money

Often, the decision between PA and physician is considered difficult—but should it be?

This was the first in a series of posts designed to help answer the age-old PA-versus-physician question. And because one of the most common searches after “physician assistant” is “salary,” I thought I would begin by addressing the elephant in the room and showing you the numbers.

Annual salary numbers by themselves are nearly useless. They do not account for the hidden variables: time spent in training, education debt, residency, taxes, career length, and hours worked each week.

So this post addresses those variables with one equation and calculates a much more useful number:

True Hourly Wage

This post is heavy with numbers, so grab your glasses—and perhaps a calculator. The results remain interesting, even after bringing the original analysis into 2026.

Debt figures describe borrowers, not every graduate. Many people finish school with less debt—or no debt at all—and others owe considerably more.

So let’s get going.

Physician (MD or DO): True Hourly Wage

Becoming a Physician Is Expensive

For the 2025–26 academic year, the average published undergraduate tuition and fees are $11,950 for an in-state student at a public four-year university and $45,000 at a private nonprofit four-year university. Once housing, food, books, transportation, and other expenses are added, the average annual student budgets rise to $30,990 and $65,470, respectively.

The sticker price is not the same as the debt. Grants, scholarships, family support, school choice, and employment all affect what a student actually borrows. Among 2023–24 bachelor’s degree recipients who borrowed, the average cumulative debt was $29,560.

Then comes medical school. The AAMC reports a median four-year cost of attendance for the class of 2026 of $297,745 at public medical schools and $408,150 at private medical schools. Those totals include more than tuition, but they are still sobering.

Fortunately, the average student does not borrow the full cost of attendance. According to the AAMC, 70% of the medical school class of 2025 graduated with education debt. Among those indebted graduates, the median education debt—including premedical debt—was $215,000.

Service scholarships, loan-repayment programs, and programs such as Public Service Loan Forgiveness can radically change the outcome for an individual physician. But they are not universal, so they are not included in the central calculation below.

The federal student-loan interest deduction is also too limited to rescue the economics. It remains capped at $2,500 and is subject to income phaseouts. More importantly, a tax deduction reduces taxable income; it does not reimburse the borrower dollar for dollar. To keep this comparison clean, the model does not include the deduction for any profession.

What Does $215,000 of Debt Cost?

The fixed rate on new federal graduate and professional Direct Unsubsidized Loans first disbursed from July 1, 2026, through June 30, 2027, is 8.07%. At that rate, repaying $215,000 with equal payments over 20 years would require about $1,808 per month and approximately $433,854 in total payments.

That is an illustration, not a prediction. Actual medical graduates commonly have loans issued in several years at several rates, and their repayment paths may include residency-era income-based payments, interest subsidies, forgiveness, refinancing, or accelerated repayment.

Federal graduate lending also changed on July 1, 2026. Grad PLUS borrowing ended for most new graduate and professional students, with transition exceptions for certain continuing borrowers, and new federal borrowing limits took effect. That change may push some future students toward institutional or private financing, so the economics of medical and PA education deserve even closer attention going forward.

Physician Income, Taxes, Hours, and Training

The latest BLS occupational wage release places the May 2025 national mean annual wage for general internal medicine physicians at $267,200.

Under the household and tax assumptions described above, that becomes an estimated $199,126 after federal income tax, California income tax, Social Security tax, and Medicare tax. This is not a paycheck estimate for every physician; it is one standardized tax case used for all three careers.

Internal medicine requires a three-year residency. The AAMC’s projected 2025 first-year resident stipend was $67,400. For simplicity, this model holds that stipend constant for all three years. After modeled payroll and income taxes, the resident earns approximately $62,244 per year, or $186,732 over three years.

The original article estimated that an internal medicine physician spends about 34,000 hours training after high school, including college, medical school, and residency. There is no single nationally standardized “training hours” figure, so that estimate is retained for continuity.

In the AMA’s 2024 data, internal medicine physicians reported 56.5 hours per week on work-related activities. We will continue to assume 48 working weeks per year.

If our hypothetical physician finishes residency at age 29 and retires at age 65, that creates a 36-year attending career.

Let’s Run the Numbers

And Now the Moment You Have All Been Waiting For...

Physician Assistant/Associate: True Hourly Wage

The latest BLS occupational wage data place the May 2025 national mean annual wage for PAs at $141,280. That number is reassuringly close to AAPA’s newer profession-specific finding: the 2026 AAPA Salary Report found median PA compensation of $140,000 in 2025.

Under the same household and tax assumptions, the BLS wage becomes an estimated $117,549 after modeled federal, California, and employee payroll taxes.

PAs are educated at the master’s level. Most PA programs are approximately 27 months and include more than 2,000 hours of clinical rotations. Many programs also require or strongly prefer hands-on healthcare experience before admission, although the amount varies by program.

The original article estimated about 12,400 total training hours after high school for a PA, including a bachelor’s degree, pre-PA patient-care experience, didactic education, and clinical rotations. Again, no single official national “total training hours” figure exists, so the estimate remains in the model for continuity.

The latest PAEA student-debt report is Student Report 6, published in January 2025 from the association’s 2022 matriculating and end-of-program surveys. It found that 83.0% of responding graduating PA students had borrowed for graduate PA education. The report publishes debt ranges rather than one exact median: the midpoint graduate borrower fell in the $100,000–$124,999 range.

For the calculation, I use $112,500, the rounded midpoint of that median range. This is a modeling estimate, not a PAEA-reported exact median. The same report found that 47.4% of responding graduates also had outstanding pre-PA education debt, with the midpoint borrower in the $25,000–$49,999 range. It would be misleading to add that earlier debt to every PA, so pre-PA debt is not added to the central model.

At 8.07% over 20 years, repaying $112,500 requires about $946 per month and $227,016 in total payments.

NCCPA data place the typical PA workweek near 40 hours; AAPA also reported a 40-hour median in several PA specialties in 2025. We will use 40 hours per week and 48 working weeks per year.

If our hypothetical PA finishes school at age 27 and retires at age 65, that creates a 38-year career.

Let’s Run the Numbers

And Just for Fun—Because Both of My Parents Are Teachers

High School Teacher: True Hourly Wage

The latest BLS occupational wage data place the May 2025 national mean annual wage for secondary school teachers, excluding special and career/technical education, at $76,320.

Under the same household and tax assumptions, that becomes an estimated $70,015 after modeled federal, California, and employee payroll taxes.

Teachers spend about 6,400 hours training after high school in the original model—the estimated classroom and study time required for a bachelor’s degree. State licensing requirements vary, and many teachers later earn graduate degrees, so an individual teacher’s training time and debt can be higher.

Among 2023–24 bachelor’s degree recipients who borrowed, the average cumulative education debt was $29,560. At the 2026–27 undergraduate federal loan rate of 6.52%, paying that balance over 20 years would require approximately $221 per month and $52,978 in total payments.

The original version assumed teachers worked only 40 hours per week for 38 weeks. That excluded too much real labor. BLS notes that teachers commonly spend evenings and weekends grading and preparing lessons, and RAND’s 2024 State of the American Teacher survey found that teachers reported an average of 53 total work hours per week, even though their contracts averaged 38 hours.

We will therefore use 53 hours per week for 40 weeks per year. If a teacher finishes college at 22 and retires at 65, that creates a 43-year career.

Many public-school teachers participate in defined-benefit pension systems, but benefit formulas, vesting, employee contributions, Social Security coverage, retirement age, and cost-of-living adjustments vary widely. Rather than invent one national pension, the model excludes retirement benefits for the teacher—just as it excludes them for the PA and physician.

Let’s Run the Numbers

For the Love of Money

After accounting for estimated training time, borrower debt, years worked, work hours, residency income, and taxes, the adjusted net hourly wage in this model is $52.58 for an internal medicine physician, $49.67 for a PA, and $30.32 for a high school teacher.

The physician’s annual gross wage is about 1.89 times the PA wage, but the physician’s true hourly wage is only about 1.06 times the PA true hourly wage in this model. The extra years of training, residency pay, higher debt, and longer workweek erase much of the apparent salary gap.

That conclusion is not universal. A physician in a higher-paying specialty, a PA with a large bonus, a teacher with an excellent pension, a graduate with no debt, or a borrower who receives forgiveness could produce a very different result. Career satisfaction, autonomy, time with family, professional risk, call schedules, geographic flexibility, and the work itself also matter—and none of them fits neatly into a salary equation.

But the central lesson survives the update: do not choose a career by comparing annual salaries alone. Compare the full path required to earn that salary and the life you will live while earning it.

Oh yeah, and how about that stay-at-home 35-year-old living in the basement in our poll? If anyone has time to run that calculation, post it in the comments. We may all be working way too hard!

If you liked this post, please feel free to share it.

—Stephen Pasquini, PA-C

Have You Seen the PA vs. Physician Infographic?

View the PA vs. Physician Infographic

Sources and Methodology

• U.S. Bureau of Labor Statistics: May 2025 national occupational employment and wage estimates
• AAMC: Medical school debt and cost of attendance
• AAMC: Resident and fellow stipends
• PAEA Student Report 6: PA education debt
• AAPA: PA education and clinical training
• AAPA 2026 Salary Report highlights
• AMA: 2024 physician work hours by specialty
• NCCPA 2024 Statistical Profile of Board-Certified PAs by State
• RAND: 2024 State of the American Teacher survey data
• College Board: Trends in College Pricing 2025
• College Board: Trends in Student Aid 2025
• Federal Student Aid: 2026–27 Direct Loan interest rates
• U.S. Department of Education: Federal graduate loan changes effective July 1, 2026
• IRS: 2026 federal tax brackets and standard deduction
• Social Security Administration: 2026 FICA rates and taxable maximum
• California Franchise Tax Board: 2025 tax rates, deductions, and exemptions

Calculation precision: displayed annual figures are rounded to the nearest dollar, while the final hourly calculations use unrounded values. “True hourly wage” is an illustrative career-adjusted earnings measure created for this article; it is not a standard labor-economics metric.