A CRNA is an advanced practice nurse who specializes in anesthesia. A physician assistant (PA) is a licensed clinician trained in general medicine who can work in almost any specialty.
CRNAs earn more, but they must become experienced ICU nurses first. PAs can start school soon after college, and they can change specialties more easily during a career.
Quick comparison
| CRNA | Physician assistant | |
|---|---|---|
| Profession | Advanced practice registered nurse | PA (physician assistant or physician associate) |
| Background before school | BSN or other accepted bachelor's, RN license, 1+ year of critical care nursing | Bachelor's degree with science prerequisites and patient care experience |
| Entry degree | Doctorate (DNP or DNAP) | Master's |
| Program length | 36 to 51 months | About 27 months |
| Clinical training | Graduates average 9,432 clinical hours (AANA) | More than 2,000 hours of clinical rotations (AAPA) |
| Specialty | Anesthesia | Any specialty and setting |
| BLS median pay (May 2025) | $236,590 | $135,880 |
| BLS projected growth, 2025 to 2035 | 10% | 21% |
Education and admission
CRNA
You need a bachelor's degree, a current RN license and at least one year of full-time critical care nursing. Programs run 36 to 51 months, and all award a doctorate.
The median acceptance rate in Everything CRNA's School Finder data (October 2026) is 18%. See CRNA school requirements and how to become a CRNA.
Physician assistant
AAPA says PA programs are at the master's level and take about 27 months, or three academic years. Admission requires a bachelor's degree and prerequisite science courses.
AAPA also says incoming PA students bring an average of more than 3,000 hours of direct patient care experience. Common backgrounds include paramedic, medical assistant and athletic trainer roles. Requirements differ by program, so check each one.
After school, PAs pass a national certification exam and get a state license. Every state and DC requires PAs to be licensed.
Scope of practice
CRNA
CRNAs focus on anesthesia and related care before, during and after procedures. Supervision rules depend on the state, facility and payer.
Medicare requires CRNA supervision by a physician unless a state opts out. As of September 2026, 27 states plus DC and Guam have opted out. See CRNA opt-out states.
Physician assistant
PAs practice medicine across specialties: family medicine, emergency care, surgery, psychiatry and more. They work in teams with physicians, under rules that differ by state.
One big advantage is flexibility. A PA can usually move from orthopedics to dermatology without a new degree. A CRNA stays in anesthesia.
Pay
BLS Occupational Employment and Wage Statistics for May 2025:
| Nurse anesthetists | Physician assistants | |
|---|---|---|
| Employment | 51,840 | 162,150 |
| Mean annual wage | $248,320 | $141,280 |
| Median annual wage | $236,590 | $135,880 |
| 10th percentile | $155,250 | $99,380 |
| 90th percentile | $339,500 | $190,280 |
The 90th percentile PA earns less than the median CRNA. BLS counts employees only, so self-employed and many 1099 clinicians are left out. See CRNA salary.
Where anesthesiologist assistants fit
Certified anesthesiologist assistants (CAAs) are a separate profession from PAs. They work in anesthesiologist-led care teams, and only in states that authorize them.
BLS does not publish separate pay or projections for CAAs. In federal occupation data, anesthesiologist assistants fall under the physician assistant code (29-1071). O*NET lists them as 29-1071.01 and shows PA wage data for them.
That means any CAA salary you see comes from surveys or employers, so check who collected it. For a full comparison, read CRNA vs anesthesiologist assistant.
Job outlook
BLS projects PA employment to grow 21% from 2025 to 2035, from 168,900 to 204,600 jobs. Nurse anesthetist employment is projected to grow 10%, from 54,500 to 59,800. See CRNA job outlook.
Which path should you choose?
The CRNA path may suit you if:
- You are a nurse, or want nursing as your base
- You love critical care, pharmacology and airway work
- You want the higher pay ceiling and can commit to a doctorate
The PA path may suit you if:
- You want to start graduate school soon after college
- You want to keep the option to switch specialties
- You prefer a medical model of training over a nursing one
FAQ
Is CRNA school harder than PA school?
They are hard in different ways. CRNA programs are longer and require critical care nursing first. PA programs are shorter and broader.
Can a PA become a CRNA?
Only by becoming an RN, gaining critical care experience and completing a nurse anesthesia program. There is no bridge.
Can a PA give anesthesia?
PA training covers general medicine, with no anesthesia certification. The non-nursing role built for anesthesia is the anesthesiologist assistant.
This page is general information, not career or financial advice. Confirm program details on each program's site.
Sources
- BLS Occupational Outlook Handbook: Physician assistants
- BLS Occupational Outlook Handbook: Nurse anesthetists, nurse midwives and nurse practitioners
- BLS Occupational Employment and Wage Statistics, May 2025 national data (29-1151, 29-1071)
- O*NET OnLine: 29-1071.01 Anesthesiologist Assistants
- AAPA: What is a PA?
- AANA: CRNA fact sheet
- AANA: Fact sheet concerning state opt-outs (September 2026)
- Everything CRNA School Finder data (October 2026): CRNA school finder