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By Rev. Paulette A. McPherson, MA, MDiv, DMin, BCC | The Practical Chaplain

Chaplain vs. Pastor: What’s the Difference?

This is the question I get most often from people considering chaplaincy as a career, and from families who aren’t sure who exactly walked into their loved one’s hospital room.

The short answer: both chaplains and pastors care for people spiritually. But the setting, the scope, the training, and the clinical role are fundamentally different. Here is a clear breakdown from someone who has lived both sides.

The Chaplain

Solutions for Properties of All Types

A chaplain is a professionally trained, credentialed spiritual care provider who works in a secular institution, most commonly a hospital, hospice, military unit, prison, university, or corporate setting. Chaplains serve everyone in that institution, regardless of religious background, denomination, or whether the person has any faith at all.

In a hospital, a chaplain is a clinical professional. They are part of the care team alongside nurses, physicians, and social workers. They document their assessments in the medical record. They attend care conferences. They address spiritual distress, advance directives, end-of-life concerns, and the values and beliefs that shape a patient’s decisions about their own care.

A chaplain does not represent one religion to the people they serve. They represent care itself, meeting each person where they are spiritually.

Where chaplains work:

  • Hospitals and health systems

  • Military branches (Army, Navy, Air

  • Force, Marines, Coast Guard)

  • Universities and colleges

  • First responder organizations (police,fire, emergency services

  • Hospitals and health systems

  • Military branches (Army, Navy, Air

  • Force, Marines, Coast Guard)

  • Universities and colleges

  • First responder organizations (police,fire, emergency services

​The Pastor

What is a pastor?

A pastor is an ordained clergy member who serves a specific congregation within one religious tradition. Their role is defined by that congregation, they preach, teach, counsel members, lead worship services, and provide ongoing spiritual direction to a defined faith community.

A pastor’s primary accountability is to their denomination and congregation. Their ministry is shaped by the theological commitments of that tradition. When a pastor visits a sick member of their congregation in the hospital, they are doing pastoral care, but they are visiting as that person’s religious leader, not as a credentialed member of the clinical team.

Some pastors volunteer as part-time or on-call chaplains at local hospitals or correctional facilities. This is different from being a board-certified chaplain employed by the institution.

The Training Difference

Where the two paths diverge: CPE.

This is where the two paths diverge most significantly.

Pastors go through theological education, typically a Bachelor of Arts followed by a Master of Divinity (MDiv), and are then ordained by their denomination. Their training prepares them to lead a congregation, preach, teach, and provide spiritual guidance within their tradition.

Chaplains go through the same theological education and ordination pathway, but then they complete Clinical Pastoral Education (CPE). CPE is supervised clinical training that takes place in a healthcare, correctional, or other institutional setting. It is not classroom learning. It is learning by doing, seeing patients, writing clinical notes, processing encounters in supervision, and developing the specific skills that clinical spiritual care requires.

To become a Board Certified Chaplain (BCC), a chaplain must complete four units of CPE (approximately 1,600 hours of supervised clinical training) through an ACPE-accredited program. This is in addition to a graduate theological degree and denominational endorsement.

A pastor who has never completed CPE is not clinically trained as a chaplain, even if they are an excellent pastor.

The Clinical Role

Why it matters in healthcare.

In a hospital, the distinction is not just about title. It has direct clinical implications.

A board-certified chaplain:

  • Conducts a structured spiritual assessment using a validated framework (such as the PEACE Spiritual Assessment Model)

  • Documents findings in the medical record in a format that the clinical team can use

  • Identifies spiritual distress, advance directive concerns, and values conflicts that may affect care decisions

  • Participates in ethics consultations and goals-of-care meetings

  • Supports Joint Commission compliance requirements for spiritual care documentation

A visiting pastor provides pastoral care to their own congregant. That visit is meaningful and important, but it is not the same as a clinical spiritual assessment conducted by a credentialed professional.

The Transition

Can a pastor become a chaplain?

Yes, and many do. If you are an ordained pastor and you feel called to serve in clinical or institutional settings, chaplaincy is a natural transition. You already have the theological foundation. What you need to add is:

​

  1. 01A graduate theological degree (MDiv is the most common path; if you already have one, you may already meet this requirement)

  2. 02Denominational endorsement for chaplaincy

  3. 03CPE units (two units minimum for most positions; four units for Board Certified Chaplain status)

  4. 04Board certification through the Association of Professional Chaplains (BCC credential)

​

The transition from pastoral ministry to clinical chaplaincy is one of the most common paths into the field.

Frequently Asked Questions

Frequently asked questions about chaplains and pastors.

  • Chaplains are required to have a theological education and denominational or faith endorsement as part of their professional credentials. However, in practice, chaplains serve people of all backgrounds, including people who identify as non-religious, atheist, or spiritual but not affiliated with any tradition. The chaplain’s own faith informs their formation, but their work is not limited to serving people who share it.

  • If the chaplain is ordained, yes, they may perform rituals within their own tradition or, in some cases, facilitate rituals from other traditions with the appropriate clergy involved. Many hospital chaplains coordinate with community clergy to ensure patients receive tradition-specific rites when requested.

  • No. Chaplains serve patients across all clinical settings and stages of care, from routine hospitalizations to ICU stays, from pre-surgical anxiety to long-term inpatient stays. End-of-life care is an important part of chaplaincy, but it is not the whole of it. Chaplains also support staff and families.

  • Yes. Hospital chaplains are employed professionals, typically with benefits, and are compensated comparably to other allied health professionals. Salary varies by region, setting, and certification level. Volunteer chaplains also exist in some community settings, but board-certified clinical chaplains are paid staff members.

  • A chaplain provides spiritual care in an institutional setting as part of a care team. A pastoral counselor typically works in a counseling or therapy context and may hold a licensed counseling credential in addition to theological training. The roles overlap in some settings but are distinct professions with different training pathways.

Rev. Paulette A. McPherson, MA, MDiv, DMin, BCC, is a Board Certified Chaplain and the founder of The Practical Chaplain. She specializes in clinical spiritual care education, PEACE Spiritual Assessment implementation, and chaplaincy program development for healthcare organizations. Learn more at thepracticalchaplain.com.

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