Physician Assistant Forum and Jobs FAQ

Physician assistants are health care professionals licensed to practice medicine with physician supervision. PAs employed by the federal government are credentialed to practice. 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. PAs are trained in intensive education programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) . Because of the close working relationship the PAs have with physicians, PAs are educated in the medical model designed to complement physician training. 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 recertification every six years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure.

In the mid-1960s, physicians and educators recognized there was a shortage and uneven distribution of primary care physicians. To expand the delivery of quality medical care, Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of PAs in 1965. He selected Navy corpsmen who received considerable medical training during their military service and during the war in Vietnam but who had no comparable civilian employment. He based the curriculum of the PA program in part on his knowledge of the fast-track training of doctors during World War II.

Physician assistant-certified. It means that the person who holds the title has met the defined course of study and has undergone testing by the National Commission on Certification of Physician Assistants (NCCPA). The NCCPA is an independent organization, and the commissioners represent a number of different medical professions. It is not a part of the PA professional organization, the American Academy of Physician Assistants (AAPA). To maintain that "C" after "PA", a physician assistant must log 100 hours of continuing medical education every two years and take the recertification exam every six years.

Physician assistants are educated in intensive medical programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). The average PA program curriculum runs approximately 26 months. There are currently more than 130 accredited programs. All PA programs must meet the same ARC-PA standards. 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 retested 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.

PA programs look for students who have a desire to study, work hard, and to be of service to their community. Most physician assistant programs require applicants to have previous health care experienceand some college education. The typical applicant already has a bachelor's degree and approximately 4 years of health care experience. Commonly nurses, EMTs, and paramedics apply to PA programs. Check with PA educational programs of interest to you for a list of their prerequisites.

Physician assistants (PAs) are found in all areas of medicine. They practice in the areas of primary care medicine - that is family medicine, internal medicine, pediatrics, and obstetrics and gynecology -- as well in surgery and the surgical subspecialties. Physician assistants receive a broad education in medicine. Their education is ongoing after graduation through continuing medical education requirements and continual interaction with physicians and other health care providers.

What a physician assistant does varies with training, experience, and state law. In addition, the scope of the PA's practice corresponds to the supervising physician's practice. In general, a physician assistant will see many of the same types of patients as the physician. The cases handled by physicians are generally the more complicated medical cases or those cases which require care that is not a routine part of the PA's scope of work. Referral to the physician, or close consultation between the patient-PA-physician, is done for unusual or hard to manage cases. Physician assistants are taught to "know our limits" and refer to physicians appropriately. It is an important part of PA training.

Forty-eight states, the District of Columbia, and Guam have enacted laws that authorize PA prescribing. In California, PA prescriptions are referred to as written prescription transmittal orders.

Most physicians who have worked with physician assistants like having PAs on staff. The American Medical Association, the American College of Surgeons, the American Academy of Family Physicians, the American College of Physicians, and other national medical organizations support the physician assistant profession by actively supporting the PA certifying commission and the PA program accrediting agency. Studies done by the Federal Government have shown that PAs, working with the supervision of physicians, provide care that is comparable to physician care. The Eighth Report to the President and Congress on the Status of Health Personnel in the United States (released in 1992) states, "Physician assistants have demonstrated their clinical effectiveness both in terms of quality of care and patient acceptance."

The relationship between a PA and the supervising physician is one of mutual trust and respect. The physician assistant is a representative of the physician, treating the patient in the style and manner developed and directed by the supervising physician. The physician and PA practice as members of a medical team. In 1995, the American Medical Association developed suggested guidelines for how physicians and PAs should work as a team in the delivery of medical care.

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 educationl. In addition to time in school, physicians are required to do an internship, and the majority also 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.

PA Salaries by Specialty 2005 In its 2005 census report, the AAPA reported mean total income (MTI) from primary employer for clinically practicing PAs working at least 32 hours a week. ADVANCE compiled this chart using data from AAPA’s individual specialty reports.   Specialty MTI CT/CV Surgery $99,134 Dermatology $95,973 Neurosurgery $91,201 Emergency Medicine $90,079 Surgical Subspecialties $87,711 Orthopedics $86,982 Plastic Surgery $82,825 Radiology $82,099 Occupational Medicine $81,192 General Surgery $80,682 Urology $80,434 Pediatric Oncology $79,924 Medical Cardiology $79,660 Geriatrics $79,291 Psychiatry $78,055 Pediatric Subspecialties $77,223 Family Medicine $76,171 Allergy $75,891 Otorhinolaryngology          $75,788 Surgical Oncology $75,538 Addiction Medicine $75,504 Pediatric Cardiology $75,479 Medical Nephrology $74,973 Medical Oncology $74,938 Medical Gastroenterology $74,422 Radiation Oncology $74,179 General Pediatrics $73,013 Medical Rheumatology $72,835 Medical Endocrinology $71,327 Ped. Gastroenterology $71,252 OB/GYN $70,619

Source: American Academy of Physician Assistants

PA Salaries by State 2005 The AAPA reported mean total income (MTI) from primary employer for clinically practicing PAs working at least 32 hours a week in its 2005 census report. ADVANCE compiled this chart using data from AAPA's 50 individual state reports.   Arkansas $91,144 California $90,447 Alaska $90,276 Nevada $90,053 Connecticut $88,829 Mississippi $87,480 Texas $86,132 Florida $84,736 Delaware $84,692 Oklahoma $84,548 Arizona $84,490 New Jersey $84,393 Tennessee $83,938 Georgia $83,687 Missouri $82,332 Michigan $82,329 Rhode Island $82,224 Washington $82,215 Louisiana $82,473 Alabama $82,607 Massachusetts $81,484 Wisconsin $81,027 Utah $80,433 D.C. $80,366 North Carolina $80,203 Hawaii $80,091 New Hampshire $80,080 Wyoming $79,922 New York $79,502 Illinois $79,205 Minnesota $78,991 Iowa $78,835 Maryland $78,318 Virginia $78,058 Idaho $78,049 Oregon $78,025 Nebraska $77,965 New Mexico $77,013 Maine $76,268 Kentucky $76,199 Ohio $75,921 Indiana $75,856 South Carolina $75,720 Colorado $74,959 South Dakota $74,866 Montana $74,520 Kansas $74,485 Vermont $74,272 West Virginia $73,490 North Dakota $72,991 Pennsylvania $70,348   Source: American Academy of Physician Assistants