Premier PA Career Opportunities Across the Commonwealth. This page is maintained by Blake Moser, founder of Advanced Practice Recruiters in Tyler, Texas. APR places physician assistants exclusively — surgical, primary care, hospitalist, EM, dermatology, orthopedic, and procedural specialties. Below is what you need to evaluate the Virginia PA market: salary ranges, the supervision framework, where active hiring is concentrated, and how the search actually runs.
Virginia offers physician assistants a diverse and dynamic healthcare market spanning from the Washington D.C. suburbs in Northern Virginia to major medical centers in Richmond and Norfolk, as well as unique military and federal healthcare opportunities tied to the state's significant defense presence.
Inova Health System in Northern Virginia, Virginia Commonwealth University Health System in Richmond, and Sentara Healthcare in Hampton Roads are Virginia's primary healthcare anchors, collectively providing PA opportunities across every specialty and clinical setting. VCU Health's academic medicine environment is particularly notable for PAs interested in complex, high-acuity practice.
Virginia operates under a supervision model for physician assistants, requiring a supervisory relationship with a physician. The state's major health systems and military medical facilities provide highly professional practice environments with significant clinical autonomy. Virginia's combination of history, natural beauty, strong economy, and access to the nation's capital makes it an excellent state for long-term PA career development.
PA base salaries in our Virginia searches cluster around $128K, with most offers landing between $110K and $155K. Total compensation typically runs 10–25% above base once productivity bonuses, call pay, sign-on, relocation, CME, malpractice, and retirement match are included. Cost of living in Virginia sits near national average — material for translating an offer into actual purchasing power.
The factors that move offers most: subspecialty (surgical first-assist, neurosurgery, cardiovascular, EM, dermatology, and orthopedic spine/sports run at the top end), post-certification experience, the supervision model described below, urban-versus-rural placement, employer model (academic system, private group, hospital employment, FQHC, telehealth), wRVU structure, call frequency, and any NCCPA Certificate of Added Qualification (CAQ).
Reference data: U.S. Bureau of Labor Statistics — Physician Assistants (OOH) publishes the national mean wage and Virginia state-area estimates; AAPA Compensation Resources and the NCCPA Statistical Profile track specialty and credentialing breakdowns.
Supervision model: Required Supervision. Virginia requires direct physician supervision for physician assistants. PAs must maintain a written supervision agreement, may face a ratio cap per supervising physician, and may have additional limits on prescribing Schedule II–V controlled substances or signing certain orders. The hiring conversation usually centers on supervisor bandwidth, ratio room, and which procedures need cosignature.
Virginia PAs are licensed by the Virginia Board of Medicine. A written practice agreement with a supervising physician is required. PAs can prescribe medications including controlled substances within their practice agreement. NCCPA certification must be maintained for licensure. Virginia's military and federal facilities may have additional requirements or processes.
The metros and regions where we are most often opening PA searches:
Recurring employer relationships in Virginia include Inova Health System, VCU Health, Sentara Healthcare, Bon Secours Mercy Health, Carilion Clinic, UVA Health, TRICARE Military Health System, plus a long tail of regional health systems, surgical and dermatology groups, orthopedic private practices, urgent-care networks, FQHCs, and telehealth platforms credentialed in Virginia. Procedural and surgical PA roles tend to pay above the state average; rural and Critical Access roles often carry a sign-on or geographic premium.
Every search opens with a 20-minute call to nail down the role: scope, NCCPA certification + any CAQ, procedural case mix, supervision arrangement under Virginia law, geographic flexibility within the state, and the realistic compensation envelope. From there we work the active and passive PA pool — verifying PA-C status with NCCPA, Virginia licensure (or licensure-eligibility), DEA, malpractice history, and recent procedural logs for surgical or interventional roles — and present a screened shortlist within a few business days.
The engagement is contingent — no upfront fee and no exclusivity required. Permanent placements carry a written replacement guarantee covering the initial employment period; if the placed PA leaves inside the guarantee window we re-run the search at no additional fee.
Demand pressure in Virginia is currently very high. Nationally, the BLS projects physician assistant employment to grow roughly 28% between 2023 and 2033 — far above the average for all occupations. Virginia's proximity to Washington D.C., combined with major academic medical centers, federal and military healthcare opportunities, and the state's historical beauty, creates unique and diverse PA career paths not available anywhere else.
Physician assistants in Virginia earn an average salary of approximately $128,000 per year, with ranges between $110,000 and $155,000. Northern Virginia positions near Washington D.C. at Inova and federal facilities tend to offer the highest salaries. Richmond and Hampton Roads positions are also highly competitive. Virginia's overall cost of living is near the national average, though Northern Virginia is notably more expensive due to DC proximity.
Virginia's significant military presence — including the Pentagon, Naval Station Norfolk (the world's largest naval station), Langley Air Force Base, and multiple Army installations — creates substantial military and federal healthcare PA opportunities. TRICARE-affiliated facilities, Defense Health Agency programs, and VA medical centers throughout the state employ PAs in settings ranging from primary care to operational medicine.
To practice in Virginia, PAs must hold NCCPA certification, obtain a license from the Virginia Board of Medicine, and establish a written practice agreement with a supervising Virginia physician. The agreement outlines the scope of the PA's practice and prescriptive authority. Continuing medical education must be completed for biennial license renewal. DEA registration is required for controlled substance prescribing.
High-demand specialties for PAs in Virginia include hospital medicine, emergency medicine, orthopedic surgery, cardiology, oncology, and family practice. VCU Health and UVA Health recruit academic specialty PAs. Military medical facilities need PAs across primary care, occupational medicine, and emergency settings. Northern Virginia's affluent suburban communities drive strong demand for specialty practices including dermatology, orthopedics, and concierge medicine.
Reach Blake Moser at Advanced Practice Recruiters: 469-457-4570 or blake@advancedpracticerecruiters.com. Most inquiries get a same-business-day reply.
Related: PA recruiting (national) · 2026 PA Salary Guide · PA supervision by state · NP recruiters in Virginia