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A physician assistant or physician associate (PA) is a type of non-physician practitioner. While these job titles are used internationally, there is significant variation in training and scope of practice from country to country, and sometimes between smaller jurisdictions such as states or provinces. Depending on location, PAs practice semi-autonomously under the supervision of a
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
, or autonomously perform a subset of medical services classically provided by physicians. The educational model was initially based upon the accelerated training of physicians in the United States during the shortage of qualified medical providers during
World War II World War II or the Second World War (1 September 1939 – 2 September 1945) was a World war, global conflict between two coalitions: the Allies of World War II, Allies and the Axis powers. World War II by country, Nearly all of the wo ...
. Since then, the use of PAs has spread to at least 16 countries around the world. In the US, PAs may diagnose illnesses, develop and manage treatment plans, prescribe medications, and serve as a principal healthcare provider. In many states PAs are required to have a direct agreement with a
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
. In the UK, PAs were introduced in 2003. They support the work of the healthcare team, but are dependent clinicians requiring supervision from a physician. They cannot prescribe medications nor request ionising radiation investigations (e.g., x-ray) in the UK. PAs are widely used in Canada. The model began during the
Korean War The Korean War (25 June 1950 – 27 July 1953) was an armed conflict on the Korean Peninsula fought between North Korea (Democratic People's Republic of Korea; DPRK) and South Korea (Republic of Korea; ROK) and their allies. North Korea was s ...
and transitioned to the present concept in 2002. Skills and scope of privileges are similar to those in the US.


Nomenclature

The occupational title of physician assistant and physician associate originated in the United States in 1967 at
Duke University Duke University is a Private university, private research university in Durham, North Carolina, United States. Founded by Methodists and Quakers in the present-day city of Trinity, North Carolina, Trinity in 1838, the school moved to Durham in 1 ...
. The role has been adopted in the US, Canada, United Kingdom, Republic of Ireland, Netherlands, Australia, New Zealand, India, Israel, Bulgaria, Myanmar, Switzerland, Liberia, Ghana, and by analogous names throughout Africa, each with their own nomenclature and education structure. In Malawi they are called clinical officers. Most of them study clinical medicine at the Malawi College of Health Sciences and other colleges within the country


Services

Physician assistants or associates may: * conduct patient interviews and take medical histories * conduct physical examinations * order and interpret diagnostic tests and exams (''As per International labour Organisation code'') * diagnose illnesses * formulate treatment plans * coordinate and manage care * perform medical procedures * prescribe medications (As per International labour organisation ''norms if any'') * conduct clinical research * provide patient counselling * offer advice on preventative health care * first assist in surgery * Can serve as a clinical tutor/Demostrator, assistant professor, associate professor, or professor (depending on academic qualifications along with experience). * In Administrative sector, can serve as principal/Director, Dean etc as per experience & Qualifications.


Workplaces

Physician assistants or associates train to work in settings such as
hospital A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...
s, clinics and other types of health facilities, or virtually via telemedicine. PAs are commonly found working in teaching and research as well as hospital administration and other clinical environments. PAs may practice in
primary care Primary care is a model of health care that supports first-contact, accessible, continuous, comprehensive, and coordinated person-focused care. It aims to optimise population health and reduce disparities across the groups by ensuring equitable ...
or Health Sciences specialties, including emergency medicine, surgery and cardiology.


Training

Physician assistant (or associate) education is shorter than a medical degree required to become a physician. It also typically does not involve residency training, although this is increasingly offered in a variety of specialties. Renewal of certification is usually required every few years, varying by jurisdiction.


History

In 1961, Charles Hudson recommended that the American Medical Association create new medical provider certifications. Eugene A. Stead of the
Duke University Duke University is a Private university, private research university in Durham, North Carolina, United States. Founded by Methodists and Quakers in the present-day city of Trinity, North Carolina, Trinity in 1838, the school moved to Durham in 1 ...
Medical Center assembled the first class of physician assistants in 1965, composed of four former
US Navy The United States Navy (USN) is the naval warfare, maritime military branch, service branch of the United States Department of Defense. It is the world's most powerful navy with the largest Displacement (ship), displacement, at 4.5 millio ...
Hospital Corpsmen. He based the curriculum of the PA program on his first-hand knowledge of the fast-track training of medical doctors during
World War II World War II or the Second World War (1 September 1939 – 2 September 1945) was a World war, global conflict between two coalitions: the Allies of World War II, Allies and the Axis powers. World War II by country, Nearly all of the wo ...
. Two other physicians, Richard Smith at the
University of Washington The University of Washington (UW and informally U-Dub or U Dub) is a public research university in Seattle, Washington, United States. Founded in 1861, the University of Washington is one of the oldest universities on the West Coast of the Uni ...
, and Hu Myers at Alderson-Broaddus College launched their own programs in the mid-late 1960s. J. Willis Hurst started the
Emory University Emory University is a private university, private research university in Atlanta, Georgia, United States. It was founded in 1836 as Emory College by the Methodist Episcopal Church and named in honor of Methodist bishop John Emory. Its main campu ...
Physician Assistant Program in 1967. The Liberian model of PAs was a curriculum intended for graduates to work in areas absent of physicians as physician substitutes. Advisors for this program included UNICEF, American physicians, and Agnes N. Dagbe, MS, RN, a Liberian nurse educated in the US. Additional training was done in the USSR. The Liberian government inaugurated the program in 1965 with Dagbe as PA program. Beginning in January 1971, the US Army produced eight classes of physician assistants, at 30 students per class, through the Academy of Health Sciences, Brooke Medical Center (academically accredited by Baylor University). In 2017, approximately 68% of physician assistants in the United States were women and approximately 32% were men. The profession expanded globally. It can now be found in Afghanistan, Australia, Canada, Germany, Ghana, India, Israel, Liberia, the Netherlands, New Zealand, Saudi Arabia, and the United Kingdom. As a profession, physician assistants have greatly influenced the theory and conceptualization of socially accountable health professional education.


Jurisdictions


Australia

In 2011, Health Workforce Australia began developing the role of physician assistant throughout the country culminating with registration and a PA Program based out of James Cook University. The Australian Society of Physician Assistants in 2011 published a code of practice. Despite all initial indicators showing that the new profession would be successfully integrated into the health care system, in 2013 it was reported that the progress had floundered resulting in the majority of PAs in Australia being unemployed.


Canada

As of 2024, there are approximately 1000 physician assistants working in healthcare settings in Canada. The first formally trained physician assistants graduated in 1984 from the Canadian Forces Medical Services School at Borden, Ontario. The Canadian Medical Association (CMA) recognized physician assistants as a health professional in 2003. Physician assistants are able to perform medical functions such as ordering tests, diagnosing diseases, prescribing medications, treating patients, educating patients and performing various medical and surgical procedures. Physician assistants are labeled under the federal government national occupational classification code 3124: allied primary health practitioners.


Education and certification (Canada)

The first civilian physician assistant education programs were launched in 2008 at the University of Manitoba and
McMaster University McMaster University (McMaster or Mac) is a public research university in Hamilton, Ontario, Canada. The main McMaster campus is on of land near the residential neighbourhoods of Ainslie Wood, Ontario, Ainslie Wood and Westdale, Ontario, Westd ...
. In 2010, a third civilian program was launched by the consortium of physician assistant education (
University of Toronto The University of Toronto (UToronto or U of T) is a public university, public research university whose main campus is located on the grounds that surround Queen's Park (Toronto), Queen's Park in Toronto, Ontario, Canada. It was founded by ...
, Northern Ontario School of Medicine, and The Michener Institute) while further programmes were added in 2024 at
Dalhousie University Dalhousie University (commonly known as Dal) is a large public research university in Nova Scotia, Canada, with three campuses in Halifax, Nova Scotia, Halifax, a fourth in Bible Hill, Nova Scotia, Bible Hill, and a second medical school campus ...
and at the
University of Calgary {{Infobox university , name = University of Calgary , image = University of Calgary coat of arms without motto scroll.svg , image_size = 150px , caption = Coat of arms , former ...
. A new programme has been announced to be housed at the University of Saskatchewan to start in 2025. In Canada, the education of a physician assistant generally consists of three years of professional post-graduate university education. The education is delivered over a two calendar year time-frame by completing fall, winter and summer semesters for both years of the program in either a master level university physician assistant program or post-graduate professional university bachelor level physician assistant program. Physician assistant graduates become eligible for the certification exam by being a graduate of a Canadian physician assistant program that is recognized by the Physician Assistant Certification Council of Canada (Canadian Armed Forces physician assistant program, University of Manitoba, McMaster University and the consortium of physician assistant education all of which are accredited by the Canadian Medical Association).


Scope of practice (Canada)

As of 2023 PAs in Canada may: : Physician assistants resemble and provide many of the functions of physicians. Physician Assistants (PA) are academically prepared health care professionals who provide a broad range of medical services. PAs are physician extenders and not independent practitioners; they work with a degree of autonomy, negotiated and agreed on by the supervising physician(s) and the PA. PAs can work in any clinical setting to extend physician services. PAs complement existing services and aid in improving patient access to health care. A relationship with a supervising physician is essential to the role of the PA. " Physician assistants may be compared to the role of nurse practitioner by the general public and may be confused as the same profession. Nurse practitioners in Canada practice under an advanced nursing model. Physician assistants practice under a medical model, similarly modeled after medical school (physician) education. Nurse practitioners practice within their defined specific scope of practice autonomously and sometimes collaboratively. The defined scopes of a nurse practitioner include the areas of (family care, adults and paediatrics). Physician assistants are permitted to practice in all medical specialties by mirroring the practice of a physician with a full range of skills and scope by practicing both autonomously as a clinician and collaboratively with physicians when required. Some examples of practice areas for physician assistants include (emergency medicine, critical care medicine, cardiology, psychiatry, community and family medicine, neurology, surgery, orthopaedics, internal medicine, oncology, gastroenterology, military medicine, respirology, dermatology, women's health and many more specialities). Physician assistants may perform certain roles which have been traditionally only provided by physicians in clinical practice, making the PA's medical training over other providers unique in this regard.


Compensation (Canada)

Physician assistant salaries in civilian practice in Canada are relatively new and can range from approximately $80,000 CAD for entry level positions to $142,000 CAD a year for experienced providers which are not on call and up to $178,000 CAD for experienced providers which are on call. The physician assistant profession is newer to civilian practice in Canada. The compensation report published in 2019 by the Canadian Association of Physician Assistants outlines the typical salaries across Canada being an entry median salary of approximately $80,000 CAD and an experienced median salary of approximately $105,000 CAD.


Regulation (Canada)

Physician assistants are currently practicing across Canada in the Canadian Armed Forces as commissioned officers in domestic and international environments and have been in practice since the 1960s. Physician assistants outside of the Canadian Armed Forces practice usually in the public health care system in the provinces of Manitoba, Ontario, New Brunswick, Nova Scotia, and Alberta. Physician assistants have been regulated in Manitoba since 1999 and in New Brunswick since 2009 and are registrants of their respective provincial college of physicians and surgeons. Physician assistants in Ontario were introduced in 2007 to the public health system as a joint venture between the Ontario Ministry of Health and the Ontario Medical Association. In PEI, Alberta, Nova Scotia, Ontario, and Saskatchewan, PA is a regulated profession. Physician assistants are represented by the Canadian Association of Physician Assistants, which originally was formed in October 1999. As of 2023, PAs scope of practice in Canada is described at their website: :The PA's scope of practice is determined on an individual basis and formally outlined in a practice contract or agreement between the supervising physician(s), the PA and often the facility or service where the PA will work. Activities may include conducting patient interviews, histories and physical examinations; performing selected diagnostic and therapeutic interventions or procedures; and counseling patients on preventive health care.


Germany

Physician Assistants / Associates were established in Germany as a degree course in 2005. ('' :de:Arztassistent'' ). Recruitment had initially been slow, but as of 2019 there were said to be several hundred '' :de:Arztassistenten'' in Germany.


India

The first PA program in India was established in 1992 with a focus on expanding cardiovascular specialty . Since then, multiple programs have developed (~130), most of them at baccalaureate level with four master's level programs. As on 2024, an estimated 10,000 PAs have graduated in India. With the enactment of the National Commission of Allied and Healthcare professions Act in 2021 in the Parliament, the profession is a recognised one. Physician Assistants in India are now referred to as 'Physician Associates.' Formation of a council for Allied and Healthcare professions is underway at the National level and in the different states. Efforts towards regulation of the profession, standardization of the curriculum, accreditation of training institutes etc., are also underway(As January 2025).


Ireland

Physician Associates were introduced by the
Health Service Executive The Health Service Executive (HSE) () is the publicly funded healthcare system in Ireland, responsible for the provision of health and personal social services. It came into operation on 1 January 2005. The current director-general is Berna ...
in the mid-2010's. The Royal College of Surgeons has offered a PA postgraduate degree since 2016, with 28 graduating by . PAs may not write prescriptions.


Israel

Physician Assistants were introduced in Israel in May 2016 to help augment a shrinking physician workforce. The initial training programs have been overseen by the ministry of health directly, but transition to academic training is planned. Israeli PA education is modeled after United States' and Netherlands' approaches, and has focused on former paramedics with bachelor's degrees. As of 2022, the 100 or so PAs in Israel work exclusively within Emergency Departments. While PA scope of practice includes many emergency procedures, Israeli PAs are not currently allowed to prescribe or administer medicine in non-emergency settings.


New Zealand

In February 2015, Health Workforce New Zealand completed a Phase-2 trial of PAs who worked for a period of two years (2013–2015) in four clinical settings. Specifically, the sites included one rural emergency department and three primary care settings (two rural and one urban) located on the North and South Islands of New Zealand. At conclusion of the trial, several clinics continued to employ PAs while the process of health regulation makes its way through the government bureaucracy. In April 2025, the Medical Council of New Zealand announced its plan to regulate PAs.


United Kingdom

The position of physician associate was established in the United Kingdom in 2005. It evolved from that of physician assistant, developed in the US in the 1960s. In 2012, a group of physician assistants voted to change the name to ''physician associate''; this title has been criticised, however, as it is similar to the title ''associate physician'', which represents a senior medical doctor. Hillingdon Hospitals NHS Foundation Trust was asked to manage the recruitment of 200 physician associates who came from the US in September 2015. The General Medical Council began formally regulating physician associates in December 2024. They are currently not able to prescribe or order tests which require ionising radiation. Legally, physician associates must practice under the supervision of a medical doctor/surgeon. In July 2023 a motion was brought forward for discussion by the British Medical Association to rename PAs as ''physician assistants'' in the U.K. to avoid role confusion with physicians, and for them to be registered with the Health and Care Professions Council, however, the British Medical Association is a trade union for doctors and is not a regulatory body; it therefore has no statutory power to set a scope of practice, rename the profession or decide on a regulatory body.


Faculty of Physician Associates, Royal College of Physicians (UK)

The Faculty of Physician Associates was the professional body for physician associates working in the United Kingdom until December 2024. A joint venture between the Royal College of Physicians of London and the previous professional body, the United Kingdom Association of Physician Associates. The Faculty officially launched in July 2015, taking over all professional responsibilities. The Faculty oversaw the managed voluntary register, which all practising associates were encouraged to join, and set and ran the National Assessment Examination and National Recertification Examination which was optional for PAs at the time, until GMC regulation made it a requirement for all newly-qualified PAs to undertake the Physician Associate Registration Assessment (PARA). Click "FAQs" tab


Scope of practice (UK)

In the United Kingdom, PAs are dependent practitioners, and they must practice under the supervision of a physician. They perform tasks such as taking medical histories, ordering and interpreting laboratory tests. There is currently no nationally agreed-upon scope of practice for physician associates in the United Kingdom as of 2024, despite them working in the United Kingdom for over a decade. This is expected to change, however, pending the National Enquiry into the physician associate role led by Professor Leng.


Regulation (UK)

The title physician associate was not legally protected in the UK until December 2024. Prior to December 2024, physician associates were able to obtain membership of the Managed Voluntary Register for physician associates. This database, ran by PAs for PAs, aimed to identify all qualified PAs who were able to practise. Its intent was to maintain high standards. To remain on the voluntary register, physician associates were required to re-certify every 5–6 years. However, since December 2024 the General Medical Council has been the regulatory body for physician associates and the FPA has been disbanded.


Training (UK)

Training is through a two-year training programme (MSc) in Physician Associate Studies, although some PAs in the United Kingdom hold a PgDip in Physician Associate Studies. at least 32 universities offered these programs: * University of Bolton * University of Hertfordshire *
Queen Mary University of London Queen Mary University of London (QMUL, or informally QM, and formerly Queen Mary and Westfield College) is a public university, public research university in Mile End, East London, England. It is a member institution of the federal University ...
*
University of Aberdeen The University of Aberdeen (abbreviated ''Aberd.'' in List of post-nominal letters (United Kingdom), post-nominals; ) is a public university, public research university in Aberdeen, Scotland. It was founded in 1495 when William Elphinstone, Bis ...
* University of Bradford * Anglia Ruskin University *
University of Birmingham The University of Birmingham (informally Birmingham University) is a Public university, public research university in Birmingham, England. It received its royal charter in 1900 as a successor to Queen's College, Birmingham (founded in 1825 as ...
*
Canterbury Christ Church University Canterbury Christ Church University (CCCU) is a Public university, public research university located in Canterbury, Kent, England. Founded as a Church of England college for teacher training in 1962, it was granted university status in 2005. ...
*
University of East Anglia The University of East Anglia (UEA) is a Public university, public research university in Norwich, England. Established in 1963 on a campus university, campus west of the city centre, the university has four faculties and twenty-six schools of ...
*
Hull York Medical School Hull York Medical School (HYMS) is a medical school in England which took its first intake of students in 2003. It was opened as a part of the British government's attempts to train more doctors, along with Brighton and Sussex Medical School, P ...
*
University of Leeds The University of Leeds is a public research university in Leeds, West Yorkshire, England. It was established in 1874 as the Yorkshire College of Science. In 1884, it merged with the Leeds School of Medicine (established 1831) and was renamed Y ...
* Manchester Medical School *
University of Liverpool The University of Liverpool (abbreviated UOL) is a Public university, public research university in Liverpool, England. Founded in 1881 as University College Liverpool, Victoria University (United Kingdom), Victoria University, it received Ro ...
* University of Central Lancashire * Newcastle University * Plymouth University *
University of Reading The University of Reading is a public research university in Reading, Berkshire, England. It was founded in 1892 as the University Extension College, Reading, an extension college of Christchurch College, Oxford, and became University College, ...
*
Sheffield Hallam University Sheffield Hallam University (SHU) is a public research university in Sheffield, South Yorkshire, England. The university is based on two sites; the City Campus is located in the city centre near Sheffield station, Sheffield railway station, whil ...
*
St George's, University of London St George's, University of London (SGUL), legally the St George's Hospital Medical School, was a public medical school from 1733 to 2024 in South London, England. It merged with City, University of London to form City St George's, University of ...
*
University of Surrey The University of Surrey is a public research university in Guildford, Surrey, England. The university received its Royal Charter, royal charter in 1966, along with a Plate glass university, number of other institutions following recommendations ...
* University of Wolverhampton * University of Worcester Entry requirements vary, especially in terms of required first degree subject. For example, University of Bradford requires a 2:1 (or above) undergraduate degree in a Life Science, Biomedical Science, or Healthcare subject. Under exceptional circumstances, experience in healthcare practice may contribute/compensate absent the above requirements.


United States


Nomenclature (US)

In accordance with the American Academy of Physician Associates (AAPA), the official title of the profession in the United States is "Physician Associate". While this is the official title used by the national organization, utilization of this title may vary on the state and local level based on state and local bylaws and policies. Many hospital and healthcare systems still use physician assistant as titles, with some just resorting to using "PA" to avoid confusion with
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
s. A physician assistant may use the initials "PA", "PA-C", "APA-C", "RPA" or "RPA-C", where the "-C" indicates "Certified" and the "R" indicates "Registered". The "R" designation is unique to a few states, mainly in the Northeast. APA stands for aeromedical physician assistant and indicates that a physician assistant successfully completed the US Army Flight Surgeon Primary Course. During training, PA students are designated PA-S. The use of "PA-C" is limited to certified PAs who comply with the regulations of the National Commission on Certification of Physician Assistants and who have passed PANCE. Students undertaking physician assistant or associate training may refer to themselves as a physician assistant student, physician associate student, student physician assistant or student physician associate. PA students may add "S" at the end of their student designation (PA-S). Students may also use the corresponding year of their training in their student designation. For example, students in the second year of their physician assistant or physician associate training may use (PA-S2) as their student designation. The American Academy of Physician Associates has spent over $22 million since 2018 campaigning to change the word "assistant" to "associate" in the title of physician assistant. The campaign has been heavily criticized by physicians, but advocates argue that the revised title more accurately reflects the clinician's role on the patient care team. In the United States, the profession is represented by the American Academy of Physician Associates. All PAs must graduate from a nationally accredited ARC-PA program as well as passing the national certification exam. In 1970 the American Medical Association passed a resolution to develop educational guidelines and certification procedures for PAs. The Duke University Medical Center Archives had established the Physician Assistant History Center, dedicated to the study, preservation, and presentation of the history of the profession. The PA History Center became its own institution in 2011, was renamed the PA History Society, and relocated to
Johns Creek, Georgia Johns Creek is a city in Fulton County, Georgia, United States. According to the 2020 United States Census, 2020 census, the population was 82,453. The city is a northeastern suburb of Atlanta. History In the early 19th century, the Johns Cr ...
.


Education and certification (US)

, 243 accredited PA programs operated in the United States, with dozens more in development. Most educational programs are graduate programs leading to the award of
master's degree A master's degree (from Latin ) is a postgraduate academic degree awarded by universities or colleges upon completion of a course of study demonstrating mastery or a high-order overview of a specific field of study or area of professional prac ...
s in either Physician Assistant Studies, Health Science ( Master of Health Science), or Medical Science (MMSc), and require a
bachelor's degree A bachelor's degree (from Medieval Latin ''baccalaureus'') or baccalaureate (from Modern Latin ''baccalaureatus'') is an undergraduate degree awarded by colleges and universities upon completion of a course of study lasting three to six years ...
and Graduate Record Examination or Medical College Admission Test scores for entry. The majority of PA programs in the United States employ the CASPA application for selecting students. Professional licensure is regulated by state medical boards. PA students train at medical schools and academic medical centers across the country. PA education is based on medical education; it typically requires 2 to 3 years of full-time graduate study like most master's degrees. (Medical school lasts four years plus a specialty-specific residency.) Training consists of classroom and laboratory instruction in medical and behavioral sciences, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine, as well as elective rotations. PAs are not required to complete residencies after they complete their schooling (unlike physicians). Postgraduate training programs are offered in certain specialties for PAs, though these are optional and shorter in length than medical residency. PA clinical postgraduate programs are clinical training programs that differ from on the job training given their inclusion of education and supervised clinical experience to meet learning objectives. Montefiore Medical Center Postgraduate Surgical Physician Assistant Program was established in 1971 as the first recognized clinical postgraduate PA program. 49 programs address specialties such as Neurology, Trauma/Critical Care and Oncology. 50 programs joined the Association of Postgraduate Physician Assistant Programs to establish educational standards for postgraduate PA programs. In the United States, a graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam ( PANCE) before becoming a PA-C; this certification is required for licensure in all states. The content of the exam is covered in the PANCE BLUEPRINT. In addition, a PA must log 100
Continuing Medical Education Continuing medical education (CME) is continuing education (CE) that helps those in the medical field maintain competence and learn about new and developing areas of their field. These activities may take place as live events, written publications ...
hours and reregister his or her certificate with the NCCPA every two years. Every ten years (formerly six years), a PA must also recertify by successfully completing the Physician Assistant National Recertifying Exam ( PANRE) There is a growing number of doctoral programs for certified PAs leading to a Doctor of Medical Science (DMSc) but there is no requirement for one to have a doctorate in order to practice. "National Physician Assistant Week" is celebrated annually in the US from October 6 through October 12. This week was chosen to commemorate the anniversary of the first graduating physician assistant class at Duke University on October 6, 1967. October 6 is also the birthday of the profession's founder, Eugene A. Stead Jr., MD.


Scope of practice (US)

Physician assistants have their own licenses with distinct scope of practice. Each of the 50 states has different laws regarding the prescription of medications by PAs and the licensing authority granted to each category within that particular state through the
Drug Enforcement Administration The Drug Enforcement Administration (DEA) is a Federal law enforcement in the United States, United States federal law enforcement agency under the U.S. Department of Justice tasked with combating illicit Illegal drug trade, drug trafficking a ...
(DEA). PAs in Kentucky and Puerto Rico are not allowed to prescribe any controlled substances. Several other states place a limit on the type of controlled substance or the quantity that can be prescribed, dispensed, or administered by a PA. Depending upon the specific laws of any given state board of medicine, the PA must have a formal relationship on file with a
collaborative Collaboration (from Latin ''com-'' "with" + ''laborare'' "to labor", "to work") is the process of two or more people, entities or organizations working together to complete a task or achieve a goal. Collaboration is similar to cooperation. The f ...
physician. The collaborating physician must also be licensed in the state in which the PA is working, although he or she may physically be located elsewhere. Physician collaboration can be in person, by telecommunication systems or by other reliable means (for example, availability for consultation). In
emergency department An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the Acute (medicine), ...
s the laws governing PA practice differ by state, generally allowing a broad scope of practice and limited direct supervision. During the COVID-19 pandemic, several state governments changed regulations regarding PA scope of practice, including: * On May 21, 2020, the law S.B. 1915 was signed by Oklahoma Governor Kevin Stitt. This law allows Physician Assistants to become primary care providers and receive direct pay from insurers. The reference of "supervision" was changed to "delegating" in regards to physician responsibility. This law also allows PAs to legally volunteer in the case of disaster or emergency. * On May 27, 2020, Governor Tim Walz signed into Minnesota law the Omnibus Healthcare Bill S.F. 13. This law removes references to physician responsibility of supervision and delegation of care provided by PAs. The law also removes delegated prescriptive authority.


Employment (US)

The first employer of PAs was the then-Veterans Administration, known today as the Department of Veterans Affairs. Today it is the largest single employer of PAs, employing nearly 2,000. According to the AAPA, as of 2020 there are more than 148,560 certified PAs in the United States, up from 115,547 in 2016. ''Money'' magazine, in conjunction with Salary.com, listed the PA profession as the "fifth best job in America" in May 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49.65%. In 2010, CNN Money rated the physician assistant career as the number two best job in America. In 2012, Forbes rated the physician assistant degree as the number one master's degree for jobs. In 2015, Glassdoor rated physician assistant as the number one best job in America. In 2021, U.S. News & World Report rated physician assistant as the number one best job in America. The US Department of Labor Bureau of Labor Statistics report on PAs states, "...Employment of physician assistants is projected to grow 37 percent from 2016 to 2026, much faster than the average for all occupations..." This is due to several factors, including an expanding health care industry, an aging baby-boomer population, concerns for cost containment, and newly implemented restrictions to shorten physician resident work hours. In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by
hospital A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...
s. The remainder were employed in
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...
clinics, nursing homes, schools, prisons, home
health care Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...
agencies, and the
United States Department of Veterans Affairs The United States Department of Veterans Affairs (VA) is a Cabinet-level executive branch department of the federal government charged with providing lifelong healthcare services to eligible military veterans at the 170 VA medical centers an ...
Fifteen percent of responding PAs work in counties classified as non-metropolitan by Economic Research Service of the
United States Department of Agriculture The United States Department of Agriculture (USDA) is an executive department of the United States federal government that aims to meet the needs of commercial farming and livestock food production, promotes agricultural trade and producti ...
; approximately 17% of the US population resides in these counties. For PAs in primary care practice, malpractice insurance policies with $100,000–300,000 in coverage can cost less than $600 per year; premiums are higher for PAs in higher-risk specialties.


Compensation (US)

According to Bureau of Labor Statistics, in 2020 the median pay for physician assistants working full-time was $115,390 per year or $55.48 per hour, and the highest 10 percent earned more than $162,470. Physician assistants in emergency medicine, dermatology, and surgical subspecialties may earn up to $200,000 per year.


Federal government, uniformed services, and US armed forces (US)

PAs are employed by the
United States Department of State The United States Department of State (DOS), or simply the State Department, is an United States federal executive departments, executive department of the U.S. federal government responsible for the country's foreign policy of the United State ...
as ''foreign service health practitioners''. PAs working in this capacity may be deployed anywhere in the world where there is a State Department facility. They provide primary care to US government employees and their families in American embassies and consulates around the world. An important part of their jobs is to get to know what resources are available locally that they can count on in an emergency. They have other important roles, such as advising their ambassadors on the health situation in the country and provide health education to the diplomatic community. In order to be considered for the position, these PAs must be licensed and have at least two years of recent experience in primary care. Military PAs serve in the White House Medical Unit, where they provide care to the president and vice president and their families as well as White House staff. They are employed by several organizations with the intelligence community, specifically the Central Intelligence Agency. While much of the job description is classified, they work under the Directorate of Support and are deployed to "austere environments" where they provide medical care, including trauma stabilization, and teach in the fields of survival, field medicine, and tactical combat casualty care.
United States Army The United States Army (USA) is the primary Land warfare, land service branch of the United States Department of Defense. It is designated as the Army of the United States in the United States Constitution.Article II, section 2, clause 1 of th ...
PAs serve as Medical Specialist Corps officers, typically within Army combat or combat support
battalion A battalion is a military unit, typically consisting of up to one thousand soldiers. A battalion is commanded by a lieutenant colonel and subdivided into several Company (military unit), companies, each typically commanded by a Major (rank), ...
s located in the continental United States,
Alaska Alaska ( ) is a non-contiguous U.S. state on the northwest extremity of North America. Part of the Western United States region, it is one of the two non-contiguous U.S. states, alongside Hawaii. Alaska is also considered to be the north ...
,
Hawaii Hawaii ( ; ) is an island U.S. state, state of the United States, in the Pacific Ocean about southwest of the U.S. mainland. One of the two Non-contiguous United States, non-contiguous U.S. states (along with Alaska), it is the only sta ...
, and overseas. These include
infantry Infantry, or infantryman are a type of soldier who specialize in ground combat, typically fighting dismounted. Historically the term was used to describe foot soldiers, i.e. those who march and fight on foot. In modern usage, the term broadl ...
, armor,
cavalry Historically, cavalry (from the French word ''cavalerie'', itself derived from ''cheval'' meaning "horse") are groups of soldiers or warriors who Horses in warfare, fight mounted on horseback. Until the 20th century, cavalry were the most mob ...
, airborne,
artillery Artillery consists of ranged weapons that launch Ammunition, munitions far beyond the range and power of infantry firearms. Early artillery development focused on the ability to breach defensive walls and fortifications during sieges, and l ...
, and (if the PA qualifies)
special forces Special forces or special operations forces (SOF) are military units trained to conduct special operations. NATO has defined special operations as "military activities conducted by specially designated, organized, selected, trained and equip ...
units. They serve as the "front line" of Army medicine and along with combat medics are responsible for the total health care of soldiers assigned to their unit, as well as of their family members. PAs also serve in the
Air Force An air force in the broadest sense is the national military branch that primarily conducts aerial warfare. More specifically, it is the branch of a nation's armed services that is responsible for aerial warfare as distinct from an army aviati ...
and
Navy A navy, naval force, military maritime fleet, war navy, or maritime force is the military branch, branch of a nation's armed forces principally designated for naval warfare, naval and amphibious warfare; namely, lake-borne, riverine, littoral z ...
as clinical practitioners and aviation medicine specialists, as well as in the Coast Guard and
Public Health Service The United States Public Health Service (USPHS or PHS) is a collection of agencies of the Department of Health and Human Services which manages public health, containing nine out of the department's twelve operating divisions. The Assistant Se ...
. The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in advanced casualty care, medical management of chemical injuries, aviation medicine, and military medicine. In addition, military PAs are also required to meet the officer commissioning requirements, and maintain the professional and physical readiness standards of their respective services. The marine physician assistant is a US Merchant Marine staff officer. A certificate of registry is granted through The United States Coast Guard National Maritime Center located in Martinsburg, West Virginia. Formal training programs for marine physician assistants began in September, 1966 at the Public Service Health Hospital located in Staten Island, N.Y.


South Korea

On 28 August 2024, the National Assembly passed a bill that would authorize some nurses to aid physicians: "The bill, which authorizes physician assistant nurses to support physicians during surgery and handle some duties presently reserved for doctors."Nursing Act Passes, Formalizing Role of Physician Assistants
2024/08/28, KBS


References

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External links


American Academy of Physician Associates (AAPA)

Physician Assistant Education Association

National Commission on Certification of Physician Assistants (NCCPA)

Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)

Canadian Association of Physician Assistants CAPA

The Faculty of Physician Associates at the Royal College of Physicians (FPA)

Israeli Association of Physician Assistants
* NCAHP, MOHFW, Government of India:: https://ncahp.abdm.gov.in/ {{DEFAULTSORT:Physician Associate Health care occupations