How Hard is PA School – (15 Biggest Challenges & How to Overcome)

Written By: Darby Faubion BSN, RN

Are you considering a career in the medical field but do not want to go to school for years on end? Do you like the idea of being a care provider but becoming a doctor or nurse practitioner is not a path you want to follow? If so, you may enjoy becoming a physician assistant. Maybe you have thought of becoming a physician assistant, but you are wondering, “How hard is PA school?” If that sounds like you, the information in this article could help you decide.

As you continue reading, you will learn about the 15 biggest challenges you will face in PA school and how to overcome them and find answers to some frequently asked questions about these programs. When you finish reading, you will have information to help decide if becoming a physician assistant is the right career path for you.


Is PA School really that hard? Yes, regardless of what you have heard, PA school is hard. Many students choose to go to PA school because they know it takes fewer years of education than medical school. However, what most do not realize is that much of the same information med school students learn is taught in PA school but is compressed into a smaller timeframe.



Despite how it may feel as a student, physician assistant school is not hard because instructors are out to get you. It is hard because you are preparing to care for the well-being of others and that requires challenging work and dedication. If you can identify reasons why PA school is hard, you can prepare for the challenges and overcome them. The following are three main reasons why PA school is hard.

1. The curriculum in PA School is course-heavy and rigorous.

In PA school, you will learn a lot of information in a brief time. Many physician assistant programs take two to three years to complete. In that short time, you will learn in-depth content in classes like Clinical Anatomy, Epidemiology, Integrative Medicine, Pharmacology, Obstetrics & Gynecology, and Critical Care.

2. If you do not make the grades, you are OUT!

As if learning tons of content in a short span of time was not stressful enough, students in PA school must maintain good grades to remain in the program. If you score below the school’s progression requirement, you could end up in remedial classes, or worse... out of the program.

3. The clinical phase of PA school is hard.

After you complete the first phase of your PA program, you will transition to the clinical phase and begin providing care to patients. Physician assistant school clinicals often involve long hours of on-the-job training, late nights of studying, and little time for much else.


(The following are the 15 biggest Challenges you will face in PA school and ways you can successfully overcome them.)

CHALLENGE #1: You Need to Gain Clinical Experience Before Starting PA School

About the Challenge:

Unfortunately, PA School is hard even before you start. Why? Because programs require candidates to have some type of clinical experience before applying. Many schools require 2,000 or more clinical experience in a healthcare related field.

How to Overcome:

To meet clinical experience requirements, you can take one of several paths. You can get a job in an assisted living facility or physician’s office. A great way to gain experience is by obtaining certification in a healthcare role, such as a Respiratory Therapy Aide, EMT or CNA. When you get one of these certifications, it gives you real-world experience with patients, improving your ability to hit the ground running when you start PA school. Of course, if you are already an RN, LPN, or paramedic, then you will have no issues accumulating the required clinical hours.

CHALLENGE #2: The First Year Is Full of Heavy Coursework

About the Challenge:

Many people report the first year of PA school (also known as the didactic year) is the most difficult. The sheer volume and diversity of information you study during your first year makes PA school hard from the beginning.

You will jump right into learning the body’s systems and various diseases. This means you will cover topics like cardiology, pulmonology, pharmacology, and much more. You will learn about disease processes in adults, children, and infants. The amount of information can be overwhelming for new students, so it is important to be prepared.

How to Overcome:

The best way to overcome the challenge of your first year is to develop good study habits early. Create a study schedule that gives you plenty of time to complete assignments and focus on content. Most instructors suggest students dedicate three to four hours of study time for each credit hour they are taking each week. For example, if you are enrolled in 12 credit hours, you should prepare to spend 36 to 48 hours weekly studying and preparing for class and exams. Try to enjoy learning about all the things Physician Assistants do - It is all about getting ahead and staying ahead.

CHALLENGE #3: Trying to Avoid Burnout

About the Challenge:

The rigorous curriculum and busy schedules required of PA students make it easy to become overwhelmed and experience burnout. If you do not address these issues as they occur, it could lead to increased stress and anxiety, which could cause you to struggle or fail.

How to Overcome:

The best way to avoid burnout is to acknowledge your feelings and know your limits. Create personal deadlines for completing assignments or learning content and stick to your schedule. Do not overextend yourself by taking on extracurricular activities that leave you tired and frustrated. If you are stressed or overwhelmed, take a break.

CHALLENGE #4: You Could Have Difficult Preceptors and Teachers

About the Challenge:

The next thing to keep in mind is that some teachers and instructors in PA school may or may not present content in a way that aligns with your style of learning. When you were taking undergraduate classes, you may have been able to switch classes early on if you realized you were not a good fit for an instructor or class. However, because physician assistant programs are competitive and have limited class spots, you will not have this luxury in PA school.

How to Overcome:

While there are times when it is wise to avoid difficult people, you will not be able to do this as a professional physician assistant. If you have a difficult patient (or a patient who is being downright rude) you must still treat them with respect and empathy.

Try to take the same approach with difficult instructors or preceptors in PA school as you would with patients in your practice. Keep in mind, the best instructors know what you will face as a physician assistant, and they are dedicated to helping you succeed in the program and your practice after graduation. While it is important to feel respected and treated well, it is also necessary to recognize things for what they are and not take everything as a personal attack. PA school is hard, and your instructors are the best source of guidance and information to help you make it through.

CHALLENGE #5: PA School Has A Lot of Exams

About the Challenge:

The number of exams is another factor that makes PA school hard. When you completed your bachelor’s degree, you may have been used to several exams a semester. However, in PA school, it is common to have several serious exams each week. For those who find exams extremely stressful, this can be a major challenge.

How to Overcome:

To prepare for the exams in PA school, the first step is to change how you think about the program. Consider your schedule carefully and plan deliberate study time that is uninterrupted. It is better to study small amounts of content daily instead of trying to cram 20 hours of study into two days before a test.

CHALLENGE #6: You Constantly Worry About Grades in PA School

About the Challenge:

Many PA students are hardworking and want to get good grades. That is evident because getting into PA school requires a good undergraduate GPA. A tough challenge for many PA students to overcome is simply acknowledging that PA school is hard. Students accustomed to getting A’s can become overwhelmed and start making more B’s and C’s. This can lead to increased anxiety and fear of failure.

How to Overcome:

If you begin to struggle with grades, the first thing to do is examine your study habits. Then, reach out to your instructors and ask for help. They may have some advice that will help you digest information in a more manageable way.

Remember, do not be too hard on yourself. The goal of PA school is for you to learn the content and earn your Physician Assistant certification. If you are passing the classes, then you are doing a good job.

CHALLENGE #7: PA School is Hard Because You Are Constantly Learning New Things

About the Challenge:

In PA school, get used to not getting used to things. This is especially true in the first year. In your second year, things may slow down a little, but do not expect it to last. Some people become discouraged because just as they become familiar with one topic, they must learn something completely new.

How to Overcome:

The first thing you need to do to overcome this challenge is to be honest with yourself about what being in PA school involves. Expect to learn something new every day and show up ready to take on what the program has to offer. Try to have fun with it and do your best to stay fully engaged. Becoming frustrated will only hold you back.

CHALLENGE #8: You are Required to Learn ALL the Curriculum in PA School (Even if It Is Not Your Preferred Specialty)

About the Challenge:

Many PA students starting the program do not have a clear idea of where they want to work when they finish PA school. This is understandable. In fact, one of the pros of being a Physician Assistant is that you do not have to specialize, technically.

However, some students might be dead set on a specialty, such as pediatrics. There is nothing wrong with this, but it can make it feel tedious if you are forced to learn subjects you feel are not relevant to your preferred career path.

How to Overcome:

Realize that even though you are planning to work in a specialty, the information you learn and skills you acquire in the program are still valuable. No matter what specialty you choose as a PA, you will see a TON of different situations – the more you know, the better you will be able to respond. Plus, who is to say that you may choose to follow a different patient population in the future. If you embrace learning everything in the program, it will make your transition easier later.

CHALLENGE #9: Clinical Rotations in PA School

About the Challenge:

Clinical rotations typically begin during your second year of PA school. For most students, this is an exciting time, as this is when you can finally get some hands-on experience with patients.

However, clinical rotations can also leave you feeling overwhelmed. As a PA student, you will be expected to behave with professionalism. Even though you have not finished school, some nurses, physicians, and technicians expect you to know your stuff. As I mentioned earlier, there may be times when you are paired with a difficult preceptor, which can make clinical rotations in PA school hard.

How to Overcome:

The best way to overcome the struggle and fear of clinical rotations is to approach them with confidence and humility. If you do not know how to do something, explain with confidence that you are not familiar with that medication, skill, or technique and ask for help.

Many students make the mistake of believing they should know more than they do. If that were the case, you would not need to go to PA school. Instead, you could just take the certification exam and start work. Do not be so hard on yourself about having to ask for help that you make yourself miss out on learning opportunities.

CHALLENGE #10: Self-Care? Who Has Time for That?

About the Challenge:

The rigorous curriculum and busy schedule that makes PA school hard can lead you to feel like there is not enough time for important things, like caring for yourself. Unfortunately, this way of thinking could lead to poor habits that create a ripple effect of unpleasant issues.

How to Overcome:

Self-care is important because, if you want to become a physician assistant and provide care for others, you must first care for yourself. Despite what some people think, self-care does not have to be difficult to achieve.

You may not be able to go to the gym three or four times a week, but you can do small things that have a substantial impact. For example, eat a well-balanced diet, stay hydrated, and get plenty of rest and sleep. Turn your electronics off when it is time for bed so your mind can relax, and you can recharge for the next day. If you feel stressed, take a break from studying and go for a walk or sit in the park. It is much easier to practice self-care and maintain good health than to try and recover from the problems lack of self-care brings.

CHALLENGE #11: PA School Can Be Expensive

About the Challenge:

The average PA school costs between $80,000 and $100,000. On top of the expense of school, you may be forced to reduce the hours you work or take a leave of absence while completing the program. This change in circumstances can lead to financial distress if you are unprepared.

How to Overcome:

The best way to overcome the financial strain that makes PA school hard is to make financial plans before beginning the program. You may qualify for the Stafford Loan program through the U.S. Department of Education, which awards typical physician assistant students up to $20,500 per academic year. Additionally, talk with a financial aid advisor at the school you hope to attend to discuss availability of grants, scholarships, or other programs to help offset expenses.

CHALLENGE #12: Lack of Social Life and Family Time in PA School

About the Challenge:

Many people hear that PA school is shorter than medical school and they assume that it will be less rigorous or that there will be more downtime. Every PA school will be a little different, but it is important to realize that PA school is still rigorous and time-consuming. Many PA schools have few breaks and require your engagement for two or three consecutive years.

As you might guess, the time demands of PA school can significantly impact your social life. If you rely upon strong connections with friends and family, this can be incredibly challenging.

How to Overcome:

PA school is hard when it comes to balancing the hours in class, hours of study, and family or personal time. There are a few things you can do to help cope with the changes in your social life.

First, be frank with yourself and admit you may not be able to maintain the same social schedule you had before PA school. Second, be clear with family members and close friends prior to PA school. Let them know that you care for them and want to remain active in their lives, but that school is important to you, as well. Discuss how your school obligations could make you have less time for the things you would routinely enjoy. Finally, create a schedule that includes not only time for schoolwork and studying but also gives you time to spend with friends and loved ones.

Most importantly, remind yourself that the temporary inconvenience PA school brings to your social schedule could pave the way for a lifetime of convenience when it comes to having a good career and taking care of your family.

CHALLENGE #13: Adjusting to Long Hours Is One Thing that Makes PA School Hard

About the Challenge:

If you think you will start PA school and have a few hours of study time or clinicals a couple of days a week, you are wrong! If you consider the average PA student takes 12 to 20 credits per semester and multiply that by four clock hours each credit hour for studying, assignments, and testing, you are looking at 48 to 80 hours a week dedicated to PA school.

How to Overcome:

The best way to deal with long hours comes down to two things: expectation and pacing. If you expect the hours to be long and sometimes grueling, you can prepare and have an easier time making the adjustment.

Second, you need to pace yourself. Think about a marathon runner (or super marathon runner). The reason they can push themselves so far is that they take time to prepare, and once they begin, they set a nice pace and rhythm to get them to the finish line.

CHALLENGE #14: PA School Often Has Strict Attendance Policies

About the Challenge:

PA School is hard enough with homework and exams, but there are also strict attendance policies. You must make it to class and be on time to get credit for the courses. If you are someone who enjoys skipping classes once in a while, you will soon find this is not allowed in PA school. Missing enough classes might even warrant expulsion from the program.

How to Overcome:

The only way to deal with a strict attendance policy is to show up. This should be a given for those attending PA school. In some cases, there may be a special circumstance where you might need to miss a day or two of class (birth of a child, personal illness, or loss of a loved one, etc.). In these cases, you should do your best to discuss your absence with the administrators and teachers and make sure you bring the appropriate excuse to class when you return.

CHALLENGE #15: If You Fail PA School, You Require Remediation

About the Challenge:

The fear of failure can make PA school hard. In some cases, if you fail a class, you will be required to remediate the class the following year. Also, it is quite common for PA schools to require you to maintain a GPA of 3.0 or higher. The fear of failure in PA school can cause debilitating fear in some cases.

How to Overcome:

To avoid failing PA school, one of the best things you can do is go through this list and ensure you prepare for all the possible challenges PA school could throw at you. Also, try to hit the ground running. If you can get ahead at the start of PA school, you are not faced with trying to catch up later.

If you begin to feel that the workload and exams are too much to handle, talk to your faculty advisor immediately. Their job is to help you find the best path to promote success. The sooner you reach out for help, the more likely you will be able to get back on track.


Many people ask the question, “How hard is PA school?” and quickly discover PA school is extremely hard. PA school is hard because it is designed to push students to become competent healthcare professionals. However, if you consider the 15 biggest challenges you will face in PA school and how to overcome them featured in this article, you can have insight about what to expect to help you prepare. If you feel becoming a physician assistant is the right career path for you, find an accredited program and start your journey today. Despite the challenges, you can do this!


1. How Long Does PA School Take?

The average length of PA school is about 26 months or a little over two years. However, there are some programs that can last up the three years.

2. Is It Normal To Struggle In PA School?

Yes, it is perfectly normal to struggle with PA school. PA school requires an adjustment, and it is common for students to be uncomfortable, especially in the beginning.

3. Which Year Of PA School Is The Hardest?

Most PA students report that the first year, or didactic year, is the most challenging. During the first year, students are required to learn and remember a lot of new information.

4. What Are The Hardest Classes In PA School?

Many students report that pharmacology and the human sciences are the hardest classes in PA school. However, the difficulty of classes will vary based on the student’s past experiences.

5. How Many Hours Do I Need To Study In PA School?

Although some students learn at different paces and require different amounts of study time, the general rule is that students should plan to spend three or four hours studying for each credit hour of their schedule. For example, if you are enrolled in 10 credit hours, you should plan to spend 30 to 40 hours studying and preparing each week.

6. Is It Hard To Work During PA School?

Although it is possible to work during PA school, it is quite challenging. The curriculum and clinical schedule require several hours weekly participating in classroom, laboratory, and clinical settings. Some PA students might work one day each month, just to maintain a prior job; however, this is difficult and relatively rare.

7. What Percent Of PA Students Drop Out?

According to univstats, the average graduation rate for PA students is 80.58%. That means nearly 20% of students in PA programs do not graduate.

8. Is It Common To Fail PA School?

The rigorous vetting of applicants and the high acceptance standards of PA schools usually means the classroom composition is made up of academically successful students. However, like any college degree program, some students do fail PA school.

9. What Next After Failing PA School?

If you fail PA school, there are several options. Most programs offer options for remediation. You may choose to reapply to the program and begin again. Finally, if you feel passing PA school will be too difficult, you may choose to pursue another career.

Darby Faubion BSN, RN
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).