Career Information for HPAG Students: Physician Assistant

“The best thing about being a PA is the flexibility to try different fields or specialties.
MDs take board exams in a specific specialty and become licensed to practice in that specialty.
As a PA, I have more flexibility in deciding what I want to do.”
John Frantz, PA in the Roanoke Valley

Physician assistants are health care professionals licensed to practice medicine with physician supervision. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and in virtually all states can write prescriptions. Within the physician-PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. A PA's practice may also include education, research, and administrative services.

What's the difference between a PA and a physician?  Physician assistants are educated in the "medical model;" in some schools they attend many of the same classes as medical students. One of the main differences between PA education and physician education is not the core content of the curriculum, but the amount of time spent in formal education. In addition to time in school, physicians are required to do an internship, and the majorities complete a residency in a specialty following that. PAs do not have to undertake an internship or residency. A physician has complete responsibility for the care of the patient. PAs share that responsibility with the supervising physicians.

The Work: Physician assistants work under the supervision of a physician. However, PAs may be the principal care providers in rural or inner city clinics, where a physician is present for only 1 or 2 days each week. In such cases, the PA confers with the supervising physician and other medical professionals as needed or as required by law. PAs also may make house calls or go to hospitals and nursing care facilities to check on patients, after which they report back to the physician.

The duties of physician assistants are determined by the supervising physician and by State law. Aspiring PAs should investigate the laws and regulations in the States in which they wish to practice. Many PAs work in primary care specialties, such as general internal medicine, pediatrics, and family medicine. Others specialty areas include general and thoracic surgery, emergency medicine, orthopedics, and geriatrics. PAs specializing in surgery provide preoperative and postoperative care and may work as first or second assistants during major surgery.

The Work Setting: Although PAs usually work in a comfortable, well lit environment, those in surgery often stand for long periods, and others do considerable walking. Schedules vary according to the practice setting, and often depend on the hours of the supervising physician. The workweek of hospital-based PAs may include weekends, nights, or early morning hospital rounds to visit patients. These workers also may be on call. PAs in clinics usually work a 40-hour week.

Entry Into Field: All States require that new PAs complete an accredited, formal education program.  Upon graduation, physician assistants take a national certification examination developed by the National Commission on Certification of PAs in conjunction with the National Board of Medical Examiners. To maintain their national certification, PAs must log 100 hours of continuing medical education every two years and sit for a re-certification every six years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure. 

Education: There are more than 135 accredited or provisionally accredited education programs for physician assistants. More than 90 percent offer a master’s degree, and the rest offer either a bachelor’s degree or an associate degree. Most PA graduates have at least a bachelor’s degree.

The average PA program curriculum runs approximately 26 months. Because of the close working relationship PAs have with physicians, PAs are educated in a medical model designed to complement physician training.  PA students are taught, as are medical students, to diagnose and treat medical problems.

Education consists of classroom and laboratory instruction in the basic medical and behavioral sciences (such as anatomy, pharmacology, pathophysiology, clinical medicine, and physical diagnosis), followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine.

A PA's education doesn't stop after graduation, though.  PAs are required to take ongoing continuing medical education classes and be re-tested on their clinical skills on a regular basis.  A number of postgraduate PA programs have also been established to provide practicing PAs with advanced education in medical specialties.

The career: Median annual earnings of physician assistants were $69,000 in 2004. The middle 50 percent earned between $57,000 and $84,000.

Job outlook: Physician assistants held about 62,000 jobs in 2004. Employment of PAs is expected to grow much faster than the average for all occupations through the year 2014, due to anticipated expansion of the health services industry and an emphasis on cost containment, resulting in increasing utilization of PAs by physicians and healthcare institutions.

Physicians and institutions are expected to employ more PAs to provide primary care and to assist with medical and surgical procedures because PAs are cost-effective and productive members of the healthcare team. Physician assistants can relieve physicians of routine duties and procedures. Telemedicine—using technology to facilitate interactive consultations between physicians and physician assistants—also will expand the use of physician assistants. Job opportunities for PAs should be good, particularly in rural and inner city clinics, because those settings have difficulty attracting physicians.

Besides the traditional office-based setting, PAs should find a growing number of jobs in institutional settings such as hospitals, academic medical centers, public clinics, and prisons. Additional PAs may be needed to augment medical staffing in inpatient teaching hospital settings as the number of hours physician residents are permitted to work is reduced, encouraging hospitals to use PAs to supply some physician resident services. Opportunities will be best in States that allow PAs a wider scope of practice.

Web Sites of Interest:

American Academy of Physician Assistants
U.S. Department of Labor

PA Schools in Virginia:
Eastern Virginia Medical School (MPA program)
Physician Assistant Program
700 West Olney Road, Suite 1110
P.O. Box 1980
Norfolk, VA
Phone: 757/446-7158

James Madison University (MPA program)
Physician Assistant Program
Dept of Health Sciences, MSC 4301
Harrisonburg, VA
Phone: 540/568-2395

Jefferson College of Health Sciences (M.S. program)
Physician Assistant Program
920 S. Jefferson Street
Roanoke, VA
Phone: 540/985-4016

Shenandoah University (M.S. program)
Division of Physician Assistant Studies
1460 University Drive
Winchester, VA
Phone: 540/542-6208