Differences in Education, Training and Practice between MDs, DOs, PAs, and NPs
Physician (MD) | Physician (DO) | Physician Assistant (PA) | Nurse Practitioner (NP) | |
---|---|---|---|---|
Undergraduate Education | 4 years – Bachelor’s Degree | 4 years – Bachelor’s Degree | 4 years – Bachelor’s Degree | 4 years -Bachelor of Science in Nursing (BSN) |
Entrance Exams | MCAT | MCAT | PA-CAT or GRE | GRE |
Graduate Education | 4 years -Medical School | 4 years -Medical School | 27 months -PA School | 1.5 – 3 years – Master of Science in Nursing (MSN) Program |
Pre-Clinical Hours during Graduate School | Approx. 5,700 | Approx. 5,700 | Depends on state (32 semester hours in New York) | 2,300 – 3,850 |
Clinical Hours during Graduate School | Approx. 6,000 | Approx. 6,000 +200 hours of clinical training centered on osteopathic medicine | 2,000 | 500 – 1,500 |
Residency | 3-7 years (and1-3 years of sub-specialty training, if desired) | 3-7 years (and1-3 years of sub-specialty training, if desired) | Optional | None |
License Requirements/Renewal | United States Medical Licensing Examination; Renewal of license every 2-3 years,* requiring 0-150 CME credits* | COMLEX and/or USMLE; Renewal of license every 1-3 years,requiring 0-150 CMEcredits | PANCE; Renewal timeline differs by State (every 3 years in New York); 100 CME credits every 2 years | NCLEX-RN; Renewal timeline differs by State (every 3 years in New York) |
Board Certifications/Renewal | Board Certification Exam in given specialty and subspecialty via ABMS** Member Board; Recertification Exam every 7-10 years (depending on specialty) | Board Certification Exam in given specialty and subspecialty via ABMS** Member Board; Recertification Exam every 7-10 years (depending on specialty) | PANCE to become board certified; PANRE every 10 years to recertify | Certification based on specialty; Recertification every 5 years via either 1,000 clinical hours + 75-150 CMEcredits OR re-examination |
Scope of Practice | Full scope of practice | Full scope of practice + osteopathic techniques | Practice with supervision from physician; can prescribe | Practice with supervision from physician or independently*; can prescribe |
Many thanks to Nisha Khubchandani, AMC ’23, MD/MPH Student; Loretta Ponesse, CAE & the NY Chapter of the American College of Physicians for providing this chart.
*Differs by State
**American Board of Medical Specialties
Significant differences exist between physician anesthesiologists’ and nurse anesthetists’ education training and responsibilities
PHYSICIAN ANESTHESIOLOGISTS
Medical degree (either M.D. or osteopathic) following bachelor’s degree (8 years total)
- 1-year postdoctoral internship
- 3-year postdoctoral residency in anesthesiology
- Board-certified physicians may complete an additional 1 year to 2 years of subspecialty education and training in one of the recognized anesthesiology subspecialty areas after successful completion of a postdoctoral residency
Total of 12 years to 14 years after high school
Medical education and training covers:
- Continuum of the human life cycle including health and disease, functioning of all vital systems
- Emphasis on diagnosis and treatment, indications and contraindications
- Comprehensive medical care
- Preventive care
- Acute and chronic care
12,000 hours to 16,000 hours of clinical training
Trained to provide comprehensive medical care to patients needing anesthesia, pain medicine or critical care services
NURSE ANESTHETISTS
Bachelor’s degree in nursing
- 2-year associate RN degree, or
- 3-year diploma RN degree in nursing after high school
- 1 year working as a nurse in an acute care setting
- Master’s degree from graduate school of nurse anesthesia (not required prior to 1998)
Total of an estimated 7 years after high school
Nurse anesthesia education and training covers:
- Basics of anatomy, physiology and pharmacology
- Principles and techniques of nurse anesthesia
Almost 2,500 hours of clinical training
Trained to administer and assist in the provision of anesthesia services
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