FNP vs. PA: What’s the Difference?

Written by: University of Tulsa • May 11, 2026

A family nurse practitioner in a white coat measures the height of a child patient.

According to the Association of American Medical Colleges (AAMC), the United States will face a shortage of up to 86,000 physicians by 2036. Many Americans already face a reality in which it’s challenging for them and their families to receive the care they need.

Both family nurse practitioners and physician assistants, FNPs and PAs, can help fill this growing provider gap. However, while PAs cannot always work without supervision, FNPs, particularly those with the skills and knowledge learned through a Doctor of Nursing Practice (DNP) program, have more medical autonomy.

What Is an FNP?

An FNP is a family nurse practitioner, a type of nurse practitioner. As a registered nurse trained in advanced practice, nurse practitioners are licensed clinicians who work in a particular practice. Nurse practitioners can choose from six fields of medicine for their specialization; family nurse practitioners focus on family care. This specialization is sometimes referred to as family/individual across the lifespan.

FNP Responsibilities and Job Description

FNPs can serve as primary or specialty care providers to families. They assess patients, make recommendations on how to improve the patients’ health conditions, and work with other health care providers to ensure the patients receive the care they need.

Common responsibilities of FNPs include:

Recording patients’ vital signs, medical histories, and symptoms
Creating care plans for patients and communicating them to the patients and their family members
Performing and ordering medical tests for patients
Diagnosing patients’ medical conditions
Collaborating with other health care providers on patients’ care

What Is a PA?

A PA is a physician assistant. These licensed clinicians can examine and diagnose patients. However, they typically work under the supervision of a physician. Some physician assistants choose to work in a specific specialty, but most are generalists. In some cases, particularly in underserved communities, a physician assistant may work as a primary care provider for families and individuals in the area.

PA Responsibilities and Job Description

PAs have many duties that are similar to those of FNPs. Common responsibilities of PAs include:

Reviewing patients’ medical histories
Diagnosing and treating patients’ injuries and illnesses
Educating patients and their families on the patients’ care plan
Collaborating with physicians and other health care providers on patients’ care
Ordering and interpreting patients’ medical tests

FNP vs. PA: Key Differences

Both an FNP and a PA can function as a primary care provider for families. However, their roles differ in many areas, including their education level, certification, and scope of practice.

Education and Experience

FNPs are advanced practice registered nurses (APRNs). To become an APRN, nurses need to earn at least a master’s degree, typically a Master of Science in Nursing (MSN), which usually takes between two and three years to earn. While a master’s degree is a common qualification for entry-level APRN roles, some APRNs also choose to pursue a Doctor of Nursing Practice (DNP), which typically takes three years or more to earn. MSN and DNP programs are offered in person, online, and through hybrid options.

Registered nurses generally need to complete at least 500 clinical hours to qualify to become FNPs.

To become a PA, individuals need to earn a master’s degree in physician assistant studies from an accredited program. These programs usually take at least two years to complete, and they are typically only offered in person. Whereas an FNP receives a specialized education in their chosen field, PAs receive a medical generalist education.

Individuals need to complete 2,000 hours of clinical rotations in different fields, including family medicine, internal medicine, pediatrics, and psychiatry, to qualify to become PAs.

Required Certifications

Both FNPs and PAs need to be certified in their field. FNPs need a registered nursing license and to pass a national FNP certification exam, with the American Academy of Nurse Practitioners Certification Board (AANPCB) and the American Nurses Credentialing Center (ANCC) being the primary certification boards.

The AANPCB FNP exam has 150 questions, which are divided into two sets of domains:

Domain 1:

Assess
Diagnose
Plan
Evaluate

Domain 2:

Newborn
Infant
Toddler
Child
Adolescent
Young Adult
Middle Adult
Older Adult

The ANCC exam, made up of 175 questions, is divided into five domains:

Assessment
Diagnosis
Planning
Implementation
Evaluation

Nurses can take the ANCC exam online, but they can only take the AANPCB exam at a registered testing center.

PAs need to pass their own certification exam through the National Commission on Certification of Physician Assistants (NCCPA). The Physician Assistant National Certifying Examination (PANCE) assesses individuals’ clinical knowledge and medical skills and is administered only at Pearson VUE testing centers. The test consists of five blocks of 60 questions each.

Different regulatory boards oversee the work of FNPs and PAs. While a state’s nursing board generally regulates FNPs, the state medical board or a separate PA board, if the state has one, oversees the work of PAs.

Scope of Practice

Both an FNP and a PA can function as a primary care provider, but their scope of practice is different. While FNPs can practice independently in more than 30 states, physician assistants almost always work under the guidance of a physician. In some situations, particularly in underserved areas, PAs receive much less supervision and have more autonomy to fill the care gap caused by a lack of physicians, though state laws still typically call for some supervision of PAs from a local physician.

Salary and Job Outlook

According to the U.S. Bureau of Labor Statistics (BLS), the median annual salary for nurse practitioners as of 2024 is $129,210. The need for nurse practitioners is growing, with jobs expected to increase by 40% between 2024 and 2034.

Physician assistants have a median annual salary of $133,260 as of 2024, according to the BLS. The BLS projects that the number of jobs for physician assistants will grow by 20% between 2024 and 2034.

The national average job growth rate for all occupations in the same time period is 3.1%, according to the BLS.

Take the Next Step in Your Nursing Career With The University of Tulsa

Both FNPs and PAs can help address the growing physician shortage and offer families, particularly those in underserved areas, the care they need. However, while FNPs and PAs have some overlapping responsibilities, following a path toward becoming an FNP can mean preparing for a role with greater autonomy in your medical practice.

If you are a registered nurse, by earning a Doctor of Nursing Practice (DNP) from The University of Tulsa (TU), you can prepare to become a leader who has the skills and experience to give families high-quality care. Designed to be completed in just three years with fully online coursework and practicum hours at a local provider of your choosing, TU offers you the flexibility to grow your career on your own terms.

With classes like Foundations for Practice, Organizational Leadership and Quality Improvement, and Diagnosis and Management, you can gain in-depth knowledge of how to care for families of all kinds.

Become an FNP with TU.

Recommended Readings

APRN vs. NP: Is There a Difference?

Can Nurse Practitioners Prescribe Medicine?

Your Guide to FNP Certification

Sources:

American Academy of Family Physicians (AAFP), Understanding Nurse Practitioner and Physician Assistant Scope and Education

American Academy of Nurse Practitioners Certification Board, Family Nurse Practitioner (FNP)

American Association of Nurse Practitioners, Scope of Practice for Nurse Practitioners

American Nurses Credentialing Center, Family Nurse Practitioner Certification (FNP-BC)

American Nurses Credentialing Center, Family Nurse Practitioner (FNP-BC) Board Certification Examination Test Content Online

Association of American Medical Colleges, “Addressing the Physician Workforce Shortage”