"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).

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! A large share of 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.

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 →

PA Programs That Don't Require the GRE

Crunching The Numbers

What exams are required for PA school admission?

Here is data from the latest PAEA PA program report. The number in the right-hand column indicates the percentage of schools requiring each exam type. The good news is that the percentage of PA schools requiring the GRE is going down. Compare today's 53% of PA schools requiring the GRE to 76% of PA schools requiring the GRE in 2015!

What is considered a competitive GRE score for PA school?

According to the latest PAEA program survey and report, the average verbal reasoning score was 152.2 (SD = 5.32), and the average quantitative reasoning score was 152.0 (SD = 3.68). The average analytical writing score was 3.9 (SD = 0.28). If you like numbers, here are even more stats on what makes a competitive PA school candidate.

[testimonial name="" photo="https://www.thepalife.com/wp-content/uploads/2018/09/Stephen-Pasquini-Circle-Photo.jpg" url="www.thepalife.com "]Aim for a score of 300 + (150 + 150) overall, 3.5 in writing and > 50% in each section[/testimonial]

Find the perfect PA program to suit your needs with my Perfect PA Program Picker!

Search and sort through all 256 accredited and developing PA school programs by healthcare experience, resident and non-resident PA school tuition, PA program duration, GRE requirements, overall GPA, prerequisite GPA, and science GPA requirements. Search by PA program accreditation status, CASPA participation, PA school class size, five-year PANCE pass rates, and international student acceptance.

The Perfect PA Program Picker ⇒

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.

Average Costs of PA Program Fees: Public vs. Private

• Physician assistant program fees at public institutions: $5,937
• Physician assistant program fees at private institutions: $4,672

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
• ~$2,650 health insurance fee per year × 3 = $7,950
• ~$500 lab-intensive fee
• ~$195 clinical admin fee
• ~$160 parking/year × 3 = $480

Total in Fees (Estimated): ~$11,050

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.

The 2025 U.S. News & World Report Best Physician Assistant Programs table contains 206 ranked programs. That is not the same thing as a complete list of active, accredited PA programs in the United States.

When I compared the published U.S. News table with the PA School Finder master directory, I identified 130 active accredited PA programs that did not appear as separate entries: 56 with Accreditation-Continued, 56 with Accreditation-Provisional, and 18 with Accreditation-Probation.

That does not mean these programs are unqualified or inferior. U.S. News ranks PA programs using peer assessments of academic reputation. Its published table should not be interpreted as an accreditation directory or a complete list of programs where students can train to become PAs.

What Counts as a “Missing” PA Program?

For this analysis, a program is considered missing when it is listed as active, currently holds an ARC-PA accreditation status, and does not appear as its own entry in the 206-result U.S. News table.

We excluded closed programs, duplicate records, and developing programs that had not yet received accreditation. We also matched schools by their PA School Finder profile URL to reduce errors caused by renamed institutions and similar campus names.

Important timing caveat: The two datasets are snapshots from different periods. U.S. News published its rankings in 2025, while the accreditation information below reflects the PA School Finder master directory in 2026. A program may have changed accreditation status after the U.S. News peer survey. U.S. News also does not publish a program-specific reason for every school that fails to receive a displayed rank.

56 Accreditation-Continued PA Programs Missing From the U.S. News Table

ARC-PA defines Accreditation-Continued as the status granted when an accredited program is in compliance with the Standards. These 56 active programs currently hold Accreditation-Continued but do not appear as separate entries in the 2025 U.S. News table.

56 Accreditation-Provisional Programs Missing From the U.S. News Table

Accreditation-Provisional is the status ARC-PA grants to a new program whose plans and allocated resources appear capable of meeting the Standards. It remains in effect during the initial review process and does not guarantee that the program will later receive Accreditation-Continued.

These programs are accredited, but their provisional status helps explain why they should not be assumed to belong to the same historical peer-survey pool as long-established programs.

18 Accreditation-Probation Programs Missing From the U.S. News Table

Accreditation-Probation is a temporary accredited status. ARC-PA uses it when a provisional or continued program does not meet the Standards or when its ability to provide an acceptable educational experience is threatened. Applicants considering one of these programs should review the program's current ARC-PA history, the reasons for probation, and its next scheduled review.

Why an Accredited PA Program Might Be Missing

There is no single explanation that applies to every omitted program. Common possibilities include:

• The program was too new for the survey cycle. Many recently launched programs held provisional status or had only recently moved to continued accreditation.
• A separate campus was not listed independently. U.S. News may display one institutional or campus entry even when PA School Finder maintains distinct profiles for multiple locations.
• The program did not receive enough qualifying peer ratings. A reputation-based ranking depends on responses from academics familiar with the program.
• The program's status changed after the survey. Accreditation-Continued, Provisional, and Probation are not permanent labels.
• Naming differences obscured the match. Universities merge, rename schools, and reorganize campuses more frequently than ranking tables are updated.

What Applicants Should Take Away

The biggest lesson is simple: absence from the U.S. News table is not the same as absence of accreditation. Rankings may help applicants understand a program's reputation among PA educators, but they should never replace a direct review of accreditation, total tuition, PANCE pass rates, attrition, prerequisites, clinical rotations, class size, location, and student support.

Use the links in these tables to explore each program's PA School Finder profile, and confirm accreditation decisions directly with ARC-PA before applying or enrolling.

Data sources: the 2025 U.S. News Best Physician Assistant Programs table and the PA School Finder master program directory, reviewed July 2026.

Physician assistant vs. nurse practitioner vs. medical doctor: What's the difference?

All three can evaluate patients, diagnose illness, order tests, develop treatment plans, and prescribe medication, but they reach practice through different educational pathways and operate under different licensing laws.

This comparison also includes registered nurses and medical assistants for context.

Medical Assistant vs. RN vs. NP vs. PA vs. Physician

Programs, individual career paths, employer requirements, and state laws vary. The table summarizes the typical U.S. pathway and should not be read as a rule for every person or jurisdiction.

On a phone? Swipe left and right to see the entire chart.

The salary row uses the latest national mean annual wages from the U.S. Bureau of Labor Statistics Occupational Employment and Wage Statistics survey, dated May 2025 and released in May 2026. These figures cover wage-and-salary employment and are not the same as starting salary, take-home pay, or total compensation. Location, specialty, experience, call, overtime, bonuses, and practice ownership can change earnings substantially.

Important: the physician figure combines multiple specialties. May 2025 BLS means ranged from $212,110 for general pediatricians and $255,820 for family medicine physicians to substantially higher figures in some procedural specialties. The combined physician figure is therefore not a promise of income for a particular specialty.

For a deeper look at PA compensation, see our 2026 physician assistant salary report.

PA vs. NP: What Is the Biggest Difference?

The clearest difference is the pathway into advanced clinical practice.

• NPs begin in nursing. They become registered nurses and then complete graduate education in a defined role and population focus, such as family, adult-gerontology, pediatrics, neonatal, women’s health/gender-related, or psychiatric-mental health.
• PAs enter through general medical education. Their graduate programs provide broad preparation across age groups and medical and surgical disciplines. PAs can move among specialties without completing a new entry-level degree, although employers may require orientation, experience, or additional training.

Both professions diagnose and treat illness, order and interpret tests, prescribe medication, counsel patients, and work in primary and specialty care. Neither title alone tells you how experienced a particular clinician is in a particular setting.

Recommended Reading: 

Why Choose PA Over NP? Here’s the Perfect Answer

PA vs. Physician: What Is the Biggest Difference?

The physician pathway is much longer and includes required postgraduate specialty training. The Association of American Medical Colleges estimates that becoming a physician typically requires 11 to 16 years: four years of college, four years of medical school, and three to eight years of residency.

Most PA programs take about 27 months after a bachelor’s degree and include more than 2,000 hours of rotations. PA postgraduate residencies and fellowships exist, but they are optional. This shorter, generalist pathway lets PAs enter practice sooner and change specialties more readily; it does not make PA and physician training interchangeable.

Recommended Reading: 

A Surgeon Speaks: 7 Reasons Why You Should Choose PA Over MD

See also: PA vs. MD: understanding the differences, and Why my Wife is Happy I am a Physician Assistant and not an MD

Can NPs and PAs Practice Independently?

A single national “yes” or “no” is inaccurate.

NP laws are commonly categorized as full, reduced, or restricted practice. In a full-practice jurisdiction, an NP can evaluate, diagnose, order and interpret tests, initiate treatment, and prescribe under the state board of nursing’s authority without a mandated physician contract. Other jurisdictions require a collaborative or supervisory relationship for some or all of those functions. The AANP state practice environment map is updated as laws change.

PA laws are also changing. Depending on the jurisdiction, the law may use supervision, collaboration, a practice agreement, or may eliminate a legally required relationship with a specific physician. Scope may also be determined at the practice level. The AAPA state practice environment map shows the current variation.

Legal authority is only one layer. Hospitals, clinics, payers, and credentialing bodies may impose additional requirements on NPs, PAs, and physicians.

Which Career Path Is Right for You?

Choose the role that matches the work and training pathway you want—not simply the largest salary number.

• Consider PA if you want graduate medical training, broad preparation, substantial supervised rotations, and flexibility to change specialties.
• Consider NP if you want to build on an RN foundation and practice within a defined population focus through the advanced nursing pathway.
• Consider physician if you want the deepest and longest medical and specialty training, full physician-level responsibility, and are prepared for medical school and residency.
• Consider RN if you are drawn to direct nursing care, patient education, care coordination, and a wide range of bedside and non-bedside roles.
• Consider medical assisting if you want a shorter entry pathway into hands-on clinical and administrative support work.

If the PA path fits you, use PA School Finder to compare programs and build your school list.

Sources and Methodology

This article was fact-checked on July 13, 2026. Wage figures are national mean annual wages from the May 2025 BLS Occupational Employment and Wage Statistics survey, released May 15, 2026. Employment growth uses the latest BLS 2024–2034 projections. Education, certification, and practice-authority details come from the relevant national professional, regulatory, accrediting, and certifying organizations.

• U.S. Bureau of Labor Statistics: May 2025 national employment and wage data
• BLS Occupational Outlook Handbook: Medical Assistants
• BLS Occupational Outlook Handbook: Registered Nurses
• BLS Occupational Outlook Handbook: Nurse Practitioners and other APRNs
• BLS Occupational Outlook Handbook: Physician Assistants
• BLS Occupational Outlook Handbook: Physicians and Surgeons
• National Task Force: 2022 Standards for Quality Nurse Practitioner Education
• National Council of State Boards of Nursing: APRN Consensus Model
• AANPCB: NP certification and renewal FAQs
• AAPA: Become a PA
• NCCPA: Maintain PA-C Certification
• AAMC: Education required for a career in medicine
• Federation of State Medical Boards: About physician licensure
• American Board of Medical Specialties: Staying board certified
• American Association of Medical Assistants: CMA recertification

Correction policy: because state practice acts and certification rules change, readers should verify current requirements with the applicable state board and certifying organization.

Does the PA school you attend really make a difference?

When it comes to finding a job, not so much, but when it comes to obtaining superb clinical experience along with solid faculty, excellent academics, and a top-rate student body - then yes, the PA school you attend does matter.

Below is a list of the absolute best (Duke University, University of Iowa, and Rutgers University School of Health Professions) and worst (South University, Richmond, and West Liberty University) physician assistant (PA) schools based on the most recent survey of academics at peer institutions.

This table is updated annually to reflect the latest PA school ranking data and is populated from the latest US News and World Report annual summary.

PA School Ranking by 5-Year PANCE Pass Rates

Since 1998, US News has been publishing the only known ranking of PA programs. Their rankings are based on subjective peer assessment surveys of PA program faculty. Is there a better rating system? View my post on PA school rankings by PANCE pass rates

View PANCE Ranking Data

Best Physician Assistant Programs: Latest U.S. News Rankings

Updated July 2026: The table below lists 206 physician assistant/associate (PA) programs in the latest PA-specific rankings published by U.S. News & World Report. The rankings were released in 2025 as part of the 2025–2026 Best Graduate Schools edition. U.S. News did not re-evaluate physician assistant programs for its 2026–2027 edition, so these remain the most current PA rankings available.

U.S. News based the rankings on peer-assessment surveys completed by academics at accredited PA programs. Each peer-assessment score ranges from 1 (marginal) to 5 (outstanding). These scores measure academic reputation; they do not directly measure tuition, PANCE pass rates, attrition, clinical opportunities, or student satisfaction.

I identified 130 active accredited PA programs that did not appear as separate entries: 56 with Accreditation-Continued, 56 with Accreditation-Provisional, and 18 with Accreditation-Probation.

Rankings and peer-assessment scores are reproduced from the 2025 U.S. News Best Physician Assistant Programs table. Program links point to the corresponding PA School Finder profile.

How Much Should PA School Rankings Matter?

A high ranking can indicate strong recognition among PA educators, but it does not automatically make a program the best choice for every applicant. Compare each program's current ARC-PA accreditation status, total cost of attendance, PANCE performance, attrition rate, curriculum, clinical rotations, location, class size, and student support before deciding where to apply.

Use the U.S. News rankings as a starting point—not as a substitute for evaluating the factors that will shape your education, finances, and future career.

Recommended Reading:

130 PA Programs Missing From U.S. News Rankings

Since 1998, US News has been publishing the only known ranking of PA programs.

Their rankings are based on subjective peer assessment surveys of PA program faculty.

These peer assessment surveys are sent to deans, other administrators, and faculty at accredited physician assistant programs.

Respondents rate the academic quality of physician assistant programs on a scale of 1 (marginal) to 5 (outstanding). They are instructed to select "don't know" if they did not have enough knowledge to rate a program.

Only fully accredited programs in good standing during the survey period are ranked. Those schools with the highest average scores appear in the rankings.

This past year, U.S. News & World Report ranked only 206 of the 350+ PA programs in the United States. And, at the time of this writing, there are several more developing and non-accredited PA programs, which means the US News rankings leave many PA schools in the dust.

A Broken PA School Ranking Model

US News ranks schools solely on the results of a subjective survey, without providing evidence of its validity. Not to mention, how much does a PA school's departmental faculty really know about other PA programs? Could their opinions possibly be biased?

A useful ranking system should be measurable, reproducible, and not opinion-based.

The current approach to PA school ranking is outdated and offers little to no value to pre-PAs seeking their PA program match.

A Better Physician Assistant School Ranking System

Multiple studies use a school’s first-time PANCE pass rate as a standardization tool to evaluate other program characteristics, such as degree granted upon completion, class size, and curriculum length.

Objectively, PAs who scored higher on the PANCE tended to score higher on the Physician Assistant National Recertification Examination (PANRE).

Not to mention, to practice as a PA, you must first pass the PANCE. In this regard, it should not be taken lightly when you are considering where to invest your 100+ thousand dollars in PA school tuition.

Our Methodology: Sourcing the PANCE Data

I contacted the NCCPA, which does not make this information publicly available, so we must rely solely on each PA school's willingness to publish its individual PANCE pass rates. The data in this post is based strictly on what PA programs choose to publish to maintain transparency in their ARC-PA accreditation.

We tried to use 5-year data whenever possible. Newer programs (for obvious reasons) do not yet have 5-year data, which is why several schools are listed below as unranked. Remember that a missing pass rate is simply a lack of historical data and is not an indicator of a poor program. Please share this post, and let's work together to create a better, unbiased, objective, fair, and useful ranking system!

Tool #1: Interactive 5-Year PANCE Pass Rate Visualizer

Tracking national metrics at a glance is easy with the summary cards at the top showing the national median, average, and standard deviation.

Because this tool looks specifically at long-term data trends, it is a fantastic starting point to gauge a program's overall stability over time. You can use the buttons to toggle between two distinct visual scopes:

• BY PROGRAM: This view breaks down individual schools so you can see exactly how they rank nationwide against the national baseline.
• MEDIAN BY STATE: This view aggregates the data by region, letting you see which states boast the highest overall historical pass rates.

You can use the built-in search bar to look up a specific school, or use the dropdown menus to filter the chart by state or specific ARC-PA accreditation status (Continued, Provisional, Probation).

Note on Unranked Programs: Because a reliable 5-year pass rate requires roughly five consecutive graduating classes, newer programs are listed transparently at the bottom rather than scored. A missing 5-year average is simply a lack of historical footprint, not an indicator of a poor program!

Tool #2: Searchable PA Program PANCE Pass Rate Database

Digging deeper into the granular data is easy with our comprehensive database that allows you to search, sort, and compare both the 5-year average and annual first-time pass rates side-by-side for over 300 programs.

You can reorganize the table in real time by clicking any column header, download the data via Excel or CSV for your own tracking spreadsheet, and use the provided links to jump directly to each PA program's official website or our PA School Finder portal.