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Physician Assistant Areas of Specialization: An Overview

March 4, 2024

Physician assistants (PAs) play a vital role in the health care system—as of 2022, about 148,000 PAs in the U.S. helped increase patients’ access to health care and provide support across dozens of specialty areas of medicine in primary care, internal medicine and surgery. 

With its six-figure salaries, career flexibility, and high rate of job satisfaction, it’s no wonder that U.S. News and World Report ranked physician assistant among the top three best health care jobs in 2023. For candidates considering becoming physician assistants and wondering about their choices to specialize, this article highlights the most popular specialties in the field using 2022 survey data from the National Commission on Certification of Physician Assistants (NCCPA). 

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Top Physician Assistant Specialties

Below, you will find an overview of the top 10 physician assistant specialties with the greatest number of practitioners, which encompass more than 55% of all PAs currently in practice. 

Family Medicine/General Practice

Family medicine/general practice PAs make up 17% of the physician assistant workforce and treat patients for injuries, acute illnesses and chronic conditions. 

While over half of PAs in this specialty work in private physician offices, roughly 30% are employed by community health centers, government organizations and hospitals. It is worth noting that 36% of family medicine/general practice PAs provide care in health professional shortage areas (HPSAs) and medically underserved areas (MUAs), which is the highest percentage of PAs to work in these geographic locations. This specialty also attracts the highest percentage of active-duty military personnel (40%). 

Overall, PAs in this specialty are among the most satisfied and well-paid, which explains why more than 56% of family medicine/general practice PAs report they haven’t changed specialties. In 2022, more than 66% reported making a total income in the six figures. They also typically enjoy 40-hour work weeks with minimal on-call commitments. Over 31% noted that their primary place of employment was recruiting and hiring family medicine/general practice PAs.

Emergency Medicine

Comprising 11% of PAs, emergency medicine PAs primarily work in hospital emergency rooms, performing triage and providing treatment for acute illnesses and injuries. They work a mean of 38 hours per week in an intense and demanding role. Around 40% of emergency medicine PAs stated that their primary employer was actively recruiting and hiring PAs.

Over (78%) of emergency medicine PAs are satisfied with their present job despite experiencing some of the higher levels of burnout among all specialties (40%)—and 82% of them remain satisfied with their career choice overall. As one of the top three highest-earning PA specialties and leading practice areas for opportunities, it’s easy to see why a majority (51%) of emergency medicine PAs have not switched specialties. The 2022 NCCPA report shows that 85% of emergency medicine PAs earn a total income in the six figures, most (66%) in the $100,00-$160,000 range. 

Orthopedic Surgery

Orthopedic surgery PAs often work in private practice and hospitals, performing physical exams and treating acute health problems. While they work more hours than most PA specialists (a mean of 43 hours), orthopedic surgery PAs have a high rate of job satisfaction (87%) and low rates of burnout (27%). Almost 35% of these PAs indicated that their primary employer was hiring for this role.

Around 87% of orthopedic surgery PAs are satisfied with their present role, and 89% are pleased with their career as a whole. The majority (82%) earned a total income in 2022 in the $80,000-$160,000 range. 

Hospital Medicine

As the name suggests, a hospital medicine PA provides patient care in hospitals; a small percentage (2%) work for government organizations. They diagnose and treat patients with acute and chronic illnesses through physical exams and diagnostic testing.

Hospital medicine PAs work a mean of 42 hours a week, often during nights and weekends, and rarely have on-call shifts. While 82% are happy with their jobs, PAs in this specialty report high levels of burnout (36%). A little over half of PAs in this specialty stated that their primary employers are hiring for this role. Around 86% of hospital medicine PAs earn a total income in the $80,000 to $160,000 range.

General Surgery

General surgery PAs only make up 3% of the PA workforce. PAs in this specialty mainly work in hospitals; some work in private practice and federal government organizations. General surgery PAs prepare patients for surgery, assist general surgeons during procedures and support patients during recovery. 

Despite a sometimes non-traditional schedule, burnout rates for general surgery PAs are low at 26%. Overall, the pay for general surgery PAs is good with 73% of these PAs earning a total income of $100,000-$160,000. Around 46% of general surgery PAs responded that their primary employer was recruiting and hiring for this position.

Internal Medicine-Cardiology

According to the 2022 NCCPA report, cardiology is the largest internal medicine subspecialty for PAs. Cardiology PAs work in private practice settings, hospitals and federal government organizations, where they examine patients with acute and chronic conditions and order and interpret diagnostic tests. 

While the average salary for cardiology PAs ($117,600) is lower than other specialties, burnout is also low at 29%. About 44% of cardiology PAs report that their primary place of employment is seeking to hire new PAs.


Cardiothoracic surgery is the highest-paying physician assistant specialty and the leading specialty for increased opportunities, making it a popular choice for aspiring physician assistants. Roughly 71% of cardiothoracic surgery PAs earn more than $120,000 a year, with the average salary reaching $144,000. 

Cardiothoracic surgery PAs work more hours than their counterparts in other specialties, spending roughly 45 hours a week on the clock and 10 or more hours on call. Despite this demanding schedule, cardiothoracic surgery PAs see the lowest caseload of patients each week and experience relatively low levels of burnout (29%). There are opportunities in this speciality—over 47% of these PAs reported that their primary employer was hiring for this position.


The role of PAs in providing mental health care involves diagnosing psychiatric conditions, creating treatment plans and prescribing medication. Psychiatry PAs work 39 hours a week on average in private practice, hospitals and federal government organizations. 

A majority of psychiatry PAs see patients via telemedicine—more often than PAs in other specialties. In addition, almost 40% of physician assistants in this practice area treat patients living in HPSAs and MUAs. 

Overall, PAs who choose this physician assistant specialty are happy (85%) but experience slightly higher levels of burnout than the average PA in the field (33%). At least 74% of PAs in this area earn six figures with a $119,000 average annual salary. Around 34% of psychiatry PAs noted their primary employer was recruiting and hiring for their role. 


Neurosurgery PAs work an average of 45 hours a week, primarily in hospitals, with frequent night, weekend and on-call shifts. They spend most of their time examining patients and collecting medical histories. 

It’s a demanding specialty, which could explain why the job satisfaction levels are slightly lower than other practice areas (83%), though burnout rates are also lower than average (31%). More than 90% of neurosurgery PAs make six figures, with an average salary of $132,000. Around 46% of these PAs said their employers were hiring for this job.

Critical Care

Critical care PAs typically work in intensive care units in hospitals treating patients with acute illnesses. Their patient volumes are typically low given the high level of care they provide, but their schedules can be unpredictable and demanding. 

While critical care PA job satisfaction is on par with other specialties, their burnout rates are high at 38%, which may explain why 63% of surveyed critical care PAs stated that their employers are looking to expand their staff. Overall, critical care PAs earn the highest average salary among all specialties at $134,000 a year, and more than 90% earn six-figure incomes

Should You Become a Physician Assistant?

Deciding to become a physician assistant requires reflecting on your interests, skills and goals. If you enjoy interacting with patients, have an aptitude for science, and meet PA master’s program qualifications, you could be a great fit for this career. 

The University of Pittsburgh’s Master of Science in Physician Assistant Studies – Hybrid Program (PAS-Hybrid) requires eligible applicants to have a 3.0 undergraduate GPA, finish 500 hours of patient care experience, and complete prerequisite coursework. After earning your degree, you’ll need to pass a certification exam before you’re eligible for licensure in your state. 

Pitt’s PAS-Hybrid Program prepares aspiring physician assistants with the practical skills and knowledge to pass this exam, obtain state licensure, and begin caring for patients. Courses are offered online, allowing you to study from anywhere in the United States. You’ll also visit campus for in-person immersion sessions and complete clinical rotations at health care facilities in your region. 

In as little as two years, you’ll be on your way to a lucrative and rewarding career. Ready to get started? Contact a Pitt PAS-Hybrid enrollment advisor with questions, or start your application today.

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