Ask the Doctors by Eve Glazier, M.D. and Elizabeth Ko, M.D

Practicing NPs and PAs Must Complete Rigorous Education

Hello again, dear readers, and welcome to another edition of our ongoing conversation. We're very happy that, a little more than a year into our column, we continue to hear from you. How are your New Year's resolutions faring thus far? If you have any success stories, or thoughts on how to stay (or get back) on track, we'd love to hear them.

-- We've received a lot of feedback on the column about nurse practitioners (also referred to as NPs) and physician assistants (also known as PAs). Several letter-writers corrected our use of an apostrophe in referring to the profession of physician assistant. It may seem trivial but in fact there's a crucial difference between "physician's assistant" and "physician assistant," and it's about autonomy. A physician assistant is a clinician in her or his own right. We regret (and won't repeat) the error.

-- In that same vein (and in the same column) we neglected to fully state the educational requirements to become a nurse practitioner.

Vicki, whose daughter is a NP, filled in the details:

"Nurse practitioners must have a Master of Science in nursing," she wrote. "At the University of Memphis, the NP must take an exit exam about four weeks prior to graduation (with a passing grade), or you don't graduate with that class (extra pressure!). Once the exit exam is passed, the NP has to take state boards to actually become licensed."

Sandra, an Advanced Practice Registered Nurse (APRN) in Kansas, points out that a Master of Science is, in fact, the minimum educational requirement for a nurse practitioner:

"In our state, NPs will no longer be able to enter practice with a master's degree," Sandra wrote. "Entry into practice will require a doctorate, usually a DNP -- Doctorate of Nursing Practice. In addition to the undergraduate nursing degree, NPs have hands-on nursing practice prior to going on to advanced practice, which requires hundreds of hours of clinical training."

And Rich, a physician assistant in Massachusetts, wrote to say NPs and PAs are integral to the functioning of most hospitals and medical centers:

"Many NPs and PAs work in ICUs, often seeing the most complex patients, so this work is not just left to doctors. As any new resident in the ICU will tell you, it's an experienced ICU nurse who helps guide inexperienced interns and residents through the ICU, and likely other rotations as well. Medicine is more team-oriented today than ever before.

"Also, more and more academic medical centers have residency programs in oncology, surgery, cardiology and other fields of medicine for PAs, so they can get advanced training."

We thank all the nurse practitioners and physician assistants who took the time to write regarding the column. One thing the letters had in common was a deep passion for medicine and an even deeper concern for the patients you treat. We agree with you that the practice of medicine is a calling, and we are both proud and honored to be your colleagues.

For readers who want to learn more about these specialties, visit the American Association of Nurse Practitioners at and the American Academy of Physician Assistants at

(Send your questions to, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)