NP or PA? What influences student choice

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The physician assistant (PA) and NP professions have been growing since 1967 and collectively been identified as part of the solution toward expected primary care shortages in healthcare delivery in the United States.1 Community acceptance of PAs and NPs has increased and both professions have become mainstream choices for students seeking a career in healthcare.2 The Affordable Care Act also has facilitated the understanding and advancement of both careers and contributed to the long-term progression of each.3
In their research study on page 35, Craig and colleagues have used career return on investment (ROI) metrics as a marker for assessing student interest in either the PA or NP profession. This article takes a unique avenue toward understanding individual career choices for two relatively young healthcare professions. The career ROI metric has been used successfully to determine decisions for medicine and nursing; however, this may be premature for PAs and NPs for several reasons:
The authors have attempted to take on a unique view of medical career decision making and must be commended for using this model for assessing interest in PA and NP careers. However, and as mentioned by the authors, these two professions are still young and have a significant number of influencing variables other than career ROI that make them appealing to prospective students. Compared with formalized medicine, medical education has been structured for more than 150 years with influences stemming from familial generations and legacies to documented financial gains and benefits, while the PA and NP professions are just at the stage of retiring their first graduates. Economic projections of long-term career benefits to prospective students are unlikely to have much bearing on students' decisions to enter into a PA or NP career at this time and subsequently are less influential than familial legacies of medicine and nursing professions.
Clearly this article addresses an abstract viewpoint for healthcare career decision making; however, other more influencing factors are likely driving prospective student decisions. With the passage of time and the inevitable growth of both professions, economic benefits and career ROI will become a stronger marker for students deciding which career to pursue. However, career ROI appears to be a premature marker at this time in the lifecycle of the PA and NP professions.
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