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9 Highest Paid Physician Assistant Specialties  

November 13, 2023

Physician assistants (PAs) provide direct care to patients in all types of medical settings. You provide direct patient care and handle many of the same duties as a licensed doctor. For instance, a primary care PA examines patients and makes diagnoses. You also order lab tests and prescribe medication. 

However, often you’ll work under the oversight of a licensed doctor as a PA. The level of oversight varies depending on your experience, specialty and state policies. Many PAs have a collaborative working relationship with doctors rather than a hierarchical one. 

Like doctors, PAs can specialize in different areas of medicine such as pediatrics or surgery. You do have the advantage of being able to start immediately in a specialty or subspecialty without clinical experience. When deciding on your specialty, you need to consider all facets of how it’ll affect your career, including your earning potential. 

Some PA specialties can be very lucrative. Here’s a look at nine of the focus areas where you can expect a generous salary. 

Cardiovascular/cardiothoracic Surgery   

According to data from the American Academy of Physician Assistants (AAPA), cardiovascular/cardiothoracic surgery specialists are among the most highly-paid PAs. The median salary for this specialty is $137,000 per year. 

In this surgical specialty, you perform perioperative duties to assist surgeons operating on the heart and lungs. Your duties include supporting patients before and after the surgery and potentially assisting during the procedure.  

Thoracic Surgery 

Thoracic surgery is a related specialty that focuses on all operations involving the chest. You work with patients needing lung, heart or respiratory system procedures. The AAPA puts the median salary at $129,000 for PAs in this focus area. 

Like other surgical PA specialties, you will prepare patients for surgery. You assist during procedures and manage recovery. 

While you can undertake a residency program and seek additional certification, the AAPA says experience is key for this and other surgical PA careers. The average thoracic surgery PA has 10 years of experience. 

Emergency Medicine 

Emergency medicine PAs work in emergency rooms. In this specialty, you work with doctors to assess patients with acute illnesses or injuries. You decide on treatments or stabilize patients so that they can receive specialized medical services. 

The median salary for emergency medicine PAs is $124,100, according to the AAPA. You can gain experience in intensive care units or pursue CAQs in hospital medicine or emergency medicine.

You might start on this specialty path by performing clinical rotations in emergency rooms during your studies or as part of a residency program.


AAPA estimates put the median salary for dermatology specialists at $120,000. In this focus area, PAs work alongside dermatologists to diagnose and treat patients with skin problems. 

Your duties may include examining patients and treating problems like skin cancers. You might also help patients manage chronic conditions like psoriasis. As a dermatology PA, you may examine and treat patients directly. 

The AAPA claims dermatology PAs have seven years of experience, on average. A CAQ in dermatology is available from the NCCPA. 

Addiction Medicine 

The median salary for addiction medicine PAs is $120,000, according to the APAA. This specialty focuses on the diagnosis and addiction treatment. In some cases, you’ll work on relapse prevention of patients in recovery. PAs can also focus on prevention and education. Often, physicians and psychiatrists work with PAs to design recovery programs. The PA then helps the patient manage their treatment program. 

You can gain experience in the mental and physical health aspects of addiction medicine through a residency or fellowship program. Additional accreditations are available in psychiatry.

Occupational Medicine 

Occupational medicine PAs focus on workplace health and safety. The median salary is $119,000, according to the AAPA. 

This unique specialty may require working with employees to treat common health complaints, such as injuries due to repetitive motion. You might also perform workplace inspections to locate potential health hazards. Companies may also require pre-employment physicals or medical exams for workers’ compensation claims. 

Demand for occupational health specialists is growing, and the NCCPA plans to begin offering accreditation in 2025. 

Critical Care 

Critical care PAs earn a median salary of $118,000, according to the AAPA. PAs in this field work with patients in intensive care units (ICUs) or other acute care settings. 

In this specialty, you do not work directly in the emergency room, but you can accept transfers from this department if needed. For instance, your duties can include managing ventilators or placing chest tubes. You might also manage patient care as they leave the ICU and enter various “step-down” units where they need less monitoring and can begin recovery. 

You can start on this career path with an ICU residency program or CAQ exams in emergency medicine. 

Trauma Surgery  

Trauma surgery PAs earn $116,000, on average, according to the APAA. This challenging emergency medicine subspecialty requires quick responses. As a PA, you are often responsible for helping stabilize the patient. You collaborate with surgeons to plan the procedure. 

You will assist during surgery and monitor patients afterward as they recover. Because you are responsible for monitoring patients, your duties can include resuscitation and alerting other staff of code situations. 

The AAPA estimates that trauma surgery PAs average five years of experience. Emergency room residencies or fellowships may help advance your career.  

Urgent Care

Urgent care PAs work with patients with emergent or urgent conditions. For instance, you might treat patients with minor infections, minor burns or asthma attacks. As a PA, you may examine and assess patients and offer a diagnosis and treatment. 

The APAA says the median salary for urgent care PAs is $115,100. You can start in this specialty as a new graduate, making it a good choice for PAs who enjoy working in a fast-paced environment. 

How To Maximize Your Earning Potential As a Physician Assistant 

Regardless of your chosen specialization, you start your PA career path by earning a Master of Science in Physician Assistant Studies. You can begin gaining experience in your specialty during clinical rotations. After gaining your license, you can enroll in residency programs or pursue specialty certificates

While a master’s degree program requires an investment, a lucrative PA career will pay off in the long term. You can apply for financial aid during the application process to see if you qualify for loans or grants. 

If you carefully consider your options, you can find a lucrative PA specialty that matches your skills and interests.