Curricula · Hands-On Healthcare · The Tri-Cities
Physician & Physician Assistant: the Tri-Cities Path
Medicine is the longest road on this list: a bachelor’s degree, four years of medical school and three to seven years of residency. The physician assistant route is shorter. Both clear every income bar.
Why this field is on the list · as of September 2026
Both routes clear the three-child bar. Physicians earn from about $170k to $381k depending on specialty. Physician assistants earn a median of $154,230.
The cost is time and debt. A physician usually finishes training around age 30. A PA can practice about seven years after high school.
AI exposure is low to moderate. AI helps read scans and draft notes. The exam, the judgment and the conversation with the patient stay with the clinician.
Watch for: rural and small-town family medicine is short of doctors nearly everywhere, and some medical schools have rural tracks with help on tuition. Ask about them.
01 · The ladderTwo roads to practice
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Pre-med bachelor’s
Any major, with biology, chemistry, organic chemistry, physics and biochemistry, then the MCAT. Hands-on patient hours (CNA, EMT, scribe) help an application.
Where: WSU Tri-Cities.
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Medical school (MD or DO)
Four years. Options for students from this area include Pacific Northwest University of Health Sciences in Yakima (DO), Washington State University’s Elson S. Floyd College of Medicine in Spokane, and the University of Washington School of Medicine (WWAMI).
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Residency
Three years for family medicine, internal medicine or pediatrics; longer for surgery.
Physician medians $170k–$381k · clears the three-child bar
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Physician assistant (the shorter road)
A bachelor’s with patient-care hours, then about 2½ years of PA school. PAs practice with a physician’s collaboration and can change specialties without a new residency.
Where: Heritage University in Toppenish and UW MEDEX Northwest (ask about its Spokane site).
Tri-Cities median $154,230 · 25th percentile $133,730 · clears the three-child bar
02 · BranchesWhere the work leads
Family medicine
The rural doctor who sees the whole family, from newborns to the very old.
Schedule: Clinic hours with some call.
Hospital medicine and emergency
Hospitalists and emergency physicians work in shifts at Kadlec Regional Medical Center in Richland and similar hospitals.
Schedule: Block schedules: a week on, a week off is common.
Specialties
Surgery, OB/GYN, psychiatry and others. Longer training, and more call in the surgical fields.
Schedule: Varies widely.
03 · For the familyThe schedule, for a father and for a mother
- For the one who carries the income. Either road carries a family comfortably once training ends. Plan for the lean training years and the loans.
- For a mother at home. Part-time clinic practice is common later in a career, and PAs can often work reduced hours.
- Keep the license current. Physicians and PAs renew licenses and board certification with continuing education.
04 · The home-school yearsWhat to add to the core path
Grades 9–10
- Everything in the shared core, with strong chemistry, biology and math
- Read widely and write clearly; medical school applications reward it
Grades 11–12
- College science through Running Start
- A CNA or EMT certificate for real patient hours
- Shadow a physician or PA
After high school
- A bachelor’s degree with the pre-med courses and patient-care hours
- The MCAT, or the PA school prerequisites
Tie to the Verification Track
A physician checks whether the diagnosis fits every finding, not just most of them. As AI suggests diagnoses, the doctor has to catch the one that does not fit this patient. The Verification Track trains that habit.
05 · SourcesWhere these facts come from
Checked 2026-09-26
- Wages: U.S. Bureau of Labor Statistics, OEWS May 2025, the Kennewick–Richland (Tri-Cities) metro area and the state of Washington. bls.gov/oes
- Income bars: MIT Living Wage Calculator, Benton County. livingwage.mit.edu/counties/53005
- Physician assistant programs: ARC-PA accredited programs
- Columbia Basin College: columbiabasin.edu; WSU Tri-Cities: tricities.wsu.edu; WSU College of Nursing: nursing.wsu.edu
- Pacific Northwest University of Health Sciences: pnwu.edu; Heritage University: heritage.edu; Eastern Washington University: ewu.edu