There is strong demand for both nurse practitioners (NPs) and physician assistants (PAs) in the U.S. healthcare system, and tremendous career opportunities exist for those pursuing these professions. Although NPs and PAs have similar roles in examining, assessing, diagnosing and treating patients, there are differences in the training and educational requirements for each profession.

Preparation for NP school

There are two routes of academic preparation for NP school. The first, and most traditional route is to complete a bachelor’s level nursing program (BSN) and then take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to obtain RN licensure. BSN/RNs can then apply to NP graduate programs.

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The second option is the direct entry route. Direct entry NP programs have become increasingly popular during the last 10 years. These programs are designed for students who have a bachelor’s degree from a regionally accepted and accredited U.S. college or university, but no nursing experience.

Direct entry programs include accelerated training for students to become RNs while simultaneously fulfilling the NP academic and clinical requirements. Students in direct entry programs become eligible to take the NCLEX-RN exam at the midpoint of the program.

While pre-requisite courses vary depending on the specific NP program, the following are common courses that must be completed prior to admission:

  • Organic chemistry with lab
  • Inorganic chemistry with lab
  • Microbiology with lab
  • PsychologyStatistics
  • Two semesters each of anatomy and physiology with lab.

Overall GPA should be a 3.0 or better on a 4.0 grading scale, and pre-requisite GPA should be 3.2 or better. Direct entry programs may require the GRE, whereas this may not be required for BSN/RN applicants.

Preparation for PA school

PAs are educated in the medical model, so pre-requisites to PA programs are similar to those required for medical schools. PA candidates must have a bachelor’s degree from an accredited U.S. university or college, but the degree does not have to be health or science related. Program requirements vary depending on the school itself, but there are fundamental PA pre-requisites. These include two semesters each of lab chemistry, biology, anatomy and physiology, and one semester each of microbiology, biochemistry, psychology, statistics and medical terminology.

Applicants should have an overall GPA of 3.2 or better on a 4.0 grading scale, with a prerequisite GPA of 3.4 or better. The GRE is required for most PA programs. Competitive applicants should score a combined 1000 points on verbal and quantitative tests and should have an analytical writing score greater than 4.0.

Test of English as a foreign language (TOEFL) is required of students whose primary language is not English. Generally, a minimum TOEFL score of 550 paper-based, 230 computer-based, or 88 Internet-based is required.

Overall requirements

Prerequisite coursework must be completed within the 10 years prior to applying for either NP or PA school, and, if required, the GRE within the prior five years. If TOEFL is necessary, it should be completed within one year of applying to NP or PA school.

In addition to exceptional academics, interested candidates should be prepared to provide outstanding letters of recommendation from professors as well as RNs, NPs, PAs or MDs. Admission to NP and PA schools is fiercely competitive and academic history, performance and achievement are critical considerations for admission.

Kimberely Buckley is a physical therapist and freelance medical writer living in Gloucester, Mass.