SAN ANTONIO — Advanced medical degrees offer a higher return on investment for physician assistants (PAs) compared with nurse practitioners (NPs), according to research presented at the 2016 annual meeting of the American Academy of PAs (AAPA).

Christopher K Craig, MMS, PA-C and colleagues, of the Wake Forest School of Medicine Department of General Surgery in Winston-Salem, North Carolina, completed an analysis comparing the return on investment in PA versus NP careers incorporating national salary data, federal income taxes, and student loans. Data were collected from the 2012 Bureau of Labor Statistics Occupational Employment Statistics database. The researchers calculated a net present value (NPV) at a 5% discount rate, incorporating salary as a positive cash flow and subtracting both federal income taxes and student loan repayments as negative cash flow. NPVs were compared to analyze projected return on investment at the time of retirement.

Final cost of educational loans upon repayment for both PAs and NPs was averaged at $129,484. The median salary for PAs was $90,930 per year, while median salary for NPs was $89,960 per year. NPV for PAs was nearly $17,000 higher for PAs — $781,323 compared with $764,348 for NPs.

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“These data show that physician assistants have a higher return on investment when compared to their nurse practitioner colleagues,” said Dr Craig. “[M]ost PA programs allow candidates to matriculate immediately after obtaining a bachelor’s degree, while NP schools often require at least 1 year, if not 2, of nursing experience prior to entering their program

“NPs and PAs are expected to fill the void of physicians and provide care for the growing and aging population.… The burden of student loan and tuition increases has many young adults carefully assessing differences in reimbursement among advanced practice providers,” Dr Craig concluded.


  1. Craig CK, Carter JE, Holmes JH. Return on investment of advanced practice medical degrees nurse practitioners vs physician assistants. ePoster presented at: American Academy of PAs 2016; May 14-18, 2016; San Antonio, TX.