Lateral Mobility as a PA

If you’ve ever had a conversation with someone about becoming a Physician Assistant (PA) or considered going to PA school, you’ve likely heard the term “lateral mobility.” It’s basically the ability to switch specialties relatively easily throughout your career, regardless of prior job history or training. But like anything in life, lateral mobility comes with some positives…and some surprising realities. 

The question of lateral mobility comes up all the time, so let’s dive in a little more… 

The Good:

As a PA, you can practice in a variety of specialties—from primary care to orthopedics, emergency medicine, dermatology, psychiatry, and more. And the beauty of being a PA is that it’s possible to jump from one field to another. This flexibility can be a lifesaver, especially if you like change. 

Also, lateral mobility can help you avoid burnout. If you’re feeling bored or stuck in a rut, switching specialties allows you to shake things up and reignite your passion for patient care—without starting from scratch, like you would if you were a doctor or nurse practitioner (NP).

The Bad: 

Here’s where the reality kicks in: lateral mobility, while exciting in theory, isn’t always a walk in the park. Once you specialize in a field, your skills, knowledge, and experience are all tightly tied to that specialty. 

For example, let’s say you’ve been working in pediatric surgery for 5 years. Now you want to switch to family medicine. While you can technically and legally make the leap, it’s not as easy as just updating your resume and applying to job applications. You’ll likely need to undergo additional training, certifications, and/or refresher courses. And more importantly, most employers will be hesitant to hire someone who hasn’t worked in family medicine. On-the-job training is quickly becoming a “thing of the past,” so an employer may not be willing to spend time training you when they could simply hire someone who is more qualified. 

The reality is that the more niche your experience becomes, the harder it might be to transition into a different role. And where you live matters, too. If you’re in a rural area, lateral mobility can sometimes be more feasible. Why? Because there’s often less competition for jobs, and employers are more willing to hire someone who doesn’t have specific experience in their desired field. In smaller communities, a PA who’s worked in oncology may be able to jump into family medicine more easily because the job market is simply less saturated.

But in a large city? Not so much! Larger metropolitan areas tend to be highly competitive, and hospitals or clinics often want candidates with direct experience in the specialty they’re hiring for. You’ll likely be passed over in favor of someone with more specific qualifications. So, while lateral mobility IS a great perk, it can be a bit trickier to take advantage of in a crowded job market (and the PA job market is only going to get more competitive with time).

The Comparison of PAs with NPs, and Doctors:

Now, let’s compare lateral mobility across different roles in healthcare. 

1. Nurse Practitioners (NPs):
NPs are similar to PAs in that they also have the ability to switch specialties. However, NPs are typically trained and certified in a specific field (e.g., family practice, pediatrics, psychiatry), which can limit their ability to transition. If an NP is specialized in family medicine, for example, jumping into cardiology may require significant retraining

2. Doctors:
Switching specialties as a doctor usually requires going back to residency, which could mean years of training, more debt, and possibly starting at the bottom again (no thanks!). In contrast, PAs can usually switch specialties without as much red tape, making their lateral mobility a bit more accessible.

However, doctors tend to have more autonomy in their practice, whereas PAs are still required to work under the supervision of a physician (although this varies by state). So, while PAs have mobility, they don’t necessarily have the same level of independence as doctors do, particularly once they specialize.

The Solution: 

Okay, so what’s the solution to this lateral mobility dilemma? If you want to keep your options open without running into the potential roadblocks of becoming too specialized, consider heading into a more generalized field, such as family medicine or emergency medicine/urgent care.

Why? Because these fields are essentially training grounds for a wide variety of diseases and treatments. In family medicine, you’ll see everything from sore throats to chronic diseases to pediatric care, all while being in one place. In emergency medicine, you’re constantly jumping from one case to the next—trauma, cardiac events, infections, etc. This variety keeps your skills sharp, and it exposes you to such a broad range of medical scenarios that if you ever decide to switch to another specialty, it won’t be such a huge leap.

So while family or emergency medicine might not be at the top of your list, for those looking for long-term career mobility, working in a generalist field keeps those doors open. You’ll never have to worry about getting pigeonholed into one area, and if you’re ready for a change, your experience will translate to other specialties more easily than it would if you were working in fields such as dermatology or urology.

Essentially, more versatility = more options.

The Bottom Line: 

As a PA, lateral mobility is one of the perks of the job, but it comes with its own set of challenges. You can switch specialties, but doing so after years in one area might require a little extra effort, training, and sometimes even a step back in your career. And while PAs may have more flexibility than doctors or NPs, that doesn’t mean you can just waltz into a new specialty without considering the market and the specific demands of that field.

So, while the grass might be greener in another specialty, remember to keep your expectations in check and approach lateral mobility with a healthy dose of preparation and patience. If you’re looking for long-term flexibility, consider starting out in a generalized field like family or emergency medicine, where you’ll gain a broad skillset that can help you transition down the road.

With that being said, if you do have your heart set on a specialized field like dermatology, cardiology, or GI, don’t let the challenges of lateral mobility scare you off. If you’re passionate about a certain area of medicine, go for it! Specialization can be incredibly rewarding, and it’s VERY possible to make it work. This information is mainly for those still figuring out a path—those who might be struggling to decide where to begin. But remember, whether you’re taking the generalist or specialist route, it’s your journey, and there are so many ways to make it your own. So follow your heart, and know that there’s a place for every PA to thrive, no matter what path is chosen.