Purpose This study explored the lived experiences of physician assistants (PAs) in Korea during the 2024 medical workforce shortage, focusing on how they perceived and adapted to their rapidly changing roles. The study investigated both the challenges PAs faced and the professional growth they experienced throughout the adaptation process. Methods: A phenomenological qualitative design was applied using Colaizzi’s method. In-depth interviews were conducted with 15 PAs at a tertiary hospital in Seoul between September 25, 2024 and February 1, 2025. Data were analyzed thematically. Results: Four major theme clusters emerged: changes in work environment and quality of life, role conflict and ambiguity in professional identity, dual aspects of role expansion including autonomy and burnout, and coping strategies and structural policy demands. Participants reported physical and emotional strain, but also described greater involvement in care decisions, improved patient relationships, and a stronger sense of professional identity. Conclusion: Amid the medical staffing crisis, PAs adapted to their expanded responsibilities and became key healthcare providers. While facing substantial burdens, they simultaneously experienced personal and professional growth. Institutional and legal support is essential to stabilize their roles and improve long-term healthcare outcomes.