The Pros and Cons of Studying to Become a Physician Assistant in an Age of AI, Gene Editing and Telemedicine:

The basics of the Physician Assistant profession: what you should know before choosing this career

The Physician Assistant (PA), also called a doctor’s assistant, is a young non-medical healthcare profession in Germany that serves as the interface between doctors and nursing staff. PAs take on delegable medical tasks exclusively under medical supervision and responsibility; the doctor bears overall liability and decides what can be delegated. That is why I place this profession among the medical support professions. There is no independent scope of action; strictly personal medical acts such as making a diagnosis, deciding on treatment or prescribing prescription-only medication remain reserved to the doctor. 

Typical duties in daily hospital work

Typical duties include:

• taking patient histories and carrying out physical examinations
• contributing to diagnoses and treatment plans
• preparing for and assisting with investigations (e.g. endoscopies) and procedures (e.g. surgical assistance)
• wound management, placing peripheral lines, emergency measures
• documentation, process and team coordination

Entry requirements for the PA degree

The requirement for the Bachelor of Science (B.Sc.) Physician Assistant is a higher education entrance qualification, more specifically the general or the subject-restricted university entrance qualification. In addition, depending on the institution, a completed vocational training in a healthcare profession is usually required (registered nurse, operating theatre assistant, medical assistant). Some universities even require two years of work experience in the relevant healthcare profession. 

Duration and structure of the degree

The Bachelor of Science (B.Sc.) programme usually takes 6 semesters (3 years) and is mostly offered alongside employment, less often as a dual or full-time programme. After the Bachelor of Science Physician Assistant, a specialised two-year Master of Science can optionally be added. 

Curriculum: closely modelled on the medical degree

The curriculum is closely modelled on the medical degree, with modules such as anatomy, physiology, pathology, internal medicine, surgery, emergency medicine, pharmacology, medical law and documentation, though it also includes the fundamentals of business administration and process management. Practical elements (such as placement semesters in hospitals) make up a large part of the programme, so that the delegable tasks of medicine can be learned hands-on.

Why the profession is booming right now

More and more universities offer the Physician Assistant degree (over 30, including public institutions such as Neu-Ulm University of Applied Sciences and private ones such as the Carl Remigius Medical School). Student numbers are rising sharply, with several thousand students nationwide at present. There is now also a distance-learning institution, the Diploma University of Applied Sciences, which in cooperation with smaller local training providers creates a flexible blended-learning experience, partly online and partly in seminars and workshops on site, such as Medical School 11 in Heidelberg, which cooperates with Diploma. 

The advantages: why the PA profession can be the right decision for some

The PA degree has clear strengths, particularly if you want to enter the healthcare field quickly and in a hands-on way without the full burden of a medical degree. Based on conversations with prospective students and graduates, I see the following main advantages:

Attractive earnings from the outset

As a PA you start with a salary of roughly 3.400 to 4.500 € gross per month, which depending on region, experience and employer can rise to over 5.000 €. That is considerably higher than many entry-level salaries in nursing and gives you a degree of financial stability.

Close to daily medical work with a shorter degree

The PA profession comes closest to the academic healthcare professions without your having to clear a strict numerus clausus. You take on delegable tasks such as histories, examinations or assistance in emergency medicine and thereby help relieve the shortage of doctors. That is a win-win: doctors get support, patients benefit from more efficient care, and you are directly involved in medicine, though without full responsibility.

Hands-on training and a high degree of flexibility

The part-time model (6 semesters) often builds on your existing qualifications and allows a fast start, particularly if you are moving across from another healthcare role. The focus is on practice and teamwork, which is ideal if you want to strengthen daily work in a hospital or practice.

A contribution to solving the staffing shortage

In the short term, deploying PAs relieves the healthcare system considerably. Doctors can care for more patients, and as a PA you are a valuable team member who eases the pressure in understaffed areas.

The disadvantages: where the PA profession reaches its limits

Despite these advantages I am sceptical, because in my consultations the PA profession is often perceived as a compromise that can cause frustration in the long run. Here are the biggest weak points:

Limited autonomy and career prospects

As a PA you always work under medical delegation and supervision: no independent diagnoses or treatment decisions, no specialisation as in surgery, and no setting up your own practice. Many experience this as a taster: it tastes like medicine but does not satisfy your wish for genuine responsibility. Quite a few change profession after a few years.

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High demands with limited recognition and pay

Your daily work is physically and emotionally demanding, often in understaffed teams. Patients usually direct their thanks to the doctors, and your salary sits below that of junior doctors (who start at around 5.500 to 6.000 € gross). Many support professions have high exit rates, which is a risk if you are ambitious in the long term.

Less flexibility than a medical degree

A completed medical degree opens doors in the pharmaceutical industry, research, journalism, politics or consulting. The PA qualification ties you more tightly to one role. A later move (for example into management or abroad) is more restricted.

High costs and false expectations

Many private universities advertise the PA as an “easier alternative”, yet the degree is demanding and usually costs 20.000 to 30.000 € in total (depending on the provider). Without prior knowledge it is hard, and the profession masks the shortage of doctors rather than solving it. The PA profession is marketed and supported by medical associations whose interest is in affordable but capable medical staff who generate the highest possible revenue for practices and hospitals at low cost. Young people risk becoming the plaything of a well-funded marketing machine in their career choice, one that subtly creates the impression that the PA profession confers powers similar to those of a doctor at a considerably lower training intensity. 

My personal view: why I recommend the PA degree only with reservations

From my perspective, as a dentist who studied abroad and has since placed more than 500 students into medical degrees, the PA profession is a solid one, but it is no substitute for a real medical degree, and still less a substitute for the dream of practising as a doctor with all its advantages and its high responsibility.  My experience is anecdotal, yet I keep hearing from young people who choose the PA route as being “close” to being a doctor and are disappointed later. It is a compromise: well paid and hands-on, yes, but without the freedom, autonomy, recognition and the economic and social advancement that practising as a doctor offers. There is a risk that young people from what would be considered the middle of society end up moving down socially when, under the illusion of being close to the medical profession, they choose the medical support profession of Physician Assistant. Even though a university of applied sciences degree is attached to it, it is and remains a support profession, an assisting rather than a leading one. 

If your dream is to heal and make decisions on your own responsibility, my advice is: study medicine. It is achievable, even without a perfect grade average, for instance abroad with full recognition in Germany, Austria and Switzerland. At Medschool Experts I offer you a free consultation, and I have seen how the direct route into a medical degree changes lives.

Moving from the PA degree into medicine abroad

The PA route is ideal for you if you genuinely want that supporting, predictable role. For most people, though, it is a detour that costs time and money. Every year I support former Physician Assistants in moving successfully into a medical degree abroad. One example: Daniel contacted me in 2024 wanting to study medicine. We not only placed him in human medicine in Slovakia but also enabled a transfer into a higher semester in Germany (Faculty of Medicine, Mainz). After some initial challenges he settled in well there.

Smaller components (such as minor subjects) from the PA degree can sometimes be credited at universities abroad, so that certain exams do not have to be retaken, though the courses usually have to be attended again. If you already work or study as a PA, that forms a solid basis for entering a medical degree abroad. In my view, though, it remains a detour or a compromise with costs attached.

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Medicine or the PA degree: choosing a career with an eye on technical developments such as artificial intelligence and economic challenges

As a dentist and entrepreneur I follow technical developments in healthcare and trends in business and technology closely. What strikes me is the growing uncertainty, driven by geopolitics, the world economy, artificial intelligence and advances such as gene editing (also called DNA surgery). These technologies are fundamentally changing many areas of medicine: gene-editing tools such as CRISPR allow precise correction of genetic defects, which can prevent or cure conditions such as cancer, heart disease or genetic disorders. That shifts the focus of medicine considerably: prevention and diagnostics become more important, because genetic risks can be identified and edited early, which changes the role of clinicians from reactive treatment towards personalised, predictive medicine. Telemedicine is the future here, combined with digitalisation, and health experts estimate that up to 80 percent of healthcare services, particularly through gene editing and digitalisation, can be delivered online.

Telemedicine in practice: the example of Hims & Hers

At telemedicine providers such as Hims & Hers (United States, United Kingdom and others), which combine pharmacy distribution with a medical practice, a wide range of medical treatments is already offered entirely online, from consultations on hair loss and sexual health through to menopause and sleep disorders. PAs and other support professions are no longer employed there; the doctors treat entirely online via chat and video, sometimes from the beach, and continue to be needed. Incidentally, I have been invested since the Hims & Hers stock market listing in January 2021 and therefore know the sector well.

Many people are not aware of how dynamic the world of work is today. Career decisions from 2026 onwards should take that into account.

Why a medical licence provides long-term security

A medical degree gives you a solid foundation: you learn the profession from the ground up, become a generalist in one of the most fundamental human needs, health, and receive the German medical licence (Approbation). It protects you from competition and gives you professional security, even in uncertain times. An AI will not be granted a medical licence any time soon, so doctors will foreseeably retain control over medical institutions for the next 50 to 100 years, even where those institutions are supported or run by AI and robotics. 

Medical support professions such as the PA, by contrast, remain subordinate and can more easily be replaced by AI or robotics, because they have no protected status.

Health as a basic need, and the role of empathy

Health is the highest good and sits at the very bottom of Maslow’s hierarchy of needs. It is in demand in good times and bad. AI can supplement, but the human, empathetic component cannot be replaced. Studies show that empathy in the doctor-patient relationship leads to significantly better outcomes: in a systematic review of empathy interventions in healthcare, 80 percent of studies showed positive effects on patient outcomes.

Think it through carefully. Your future, and perhaps one day your family’s, depends on it.