PA in China / Asia

[Guest dirk]

Does anyone have any info on working as a PA in China or Asia in general? I'd sure appreciate any info out there.

[jmj11]

I've worked in Pakistan and Nepal (volunteer). Neither one has a clue about what PAs are. Nepal has a "Heath Care Worker" that is high school plus one year. They do a lot. They practice alone in the boonies. China has had their barefoot doctors (like Heath Care Workers). If you want a paying job in those areas, I suggest a job (not a volunteer) with the Peace Corp or the U.S. State Department. With the former you woud be treating American Peace Corp workers and the with the later, you wouldn't have much of a choice of assignments.

 

Maybe someone else knows more.

[underserved]

Does anyone have any info on working as a PA in China or Asia in general? I'd sure appreciate any info out there.

 

I would be interested working in SE Asia. I can't imagine how much more confusing a PA is to the international community.

[spectrum]

No "PA" in China, because there are a lot of MDs there.

[LESH]

Does anyone have any info on working as a PA in China or Asia in general? I'd sure appreciate any info out there.

Try and contact Ruth Ballweg, PA-C, MPH, the Program Director of MEDEX. She just got back from China talking to the universities and Medical Schools about the PA profession. They seemed to be very interested in the concept according to her.

[eve_du]

Spectrum is totally right. BTW, I am from China (spent my first 21 years there) ^.^

[Guest dirk]

Thanks Lesh. I appreciate the suggestion.

[jmj11]

Try and contact Ruth Ballweg, PA-C, MPH, the Program Director of MEDEX. She just got back from China talking to the universities and Medical Schools about the PA profession. They seemed to be very interested in the concept according to her.

 

 

Do you work with Ruth? She was very kind to meet with me last year as I shared with her my vision of expanding the PA role overseas by promoting the profession, clarifying the roles and bringing PA students to different countries. She seemed very responsive and had some ideals of how I could help.

 

Since then, I have not been able to get her or her office to return e-mails or messages. I've volunteered to give my own time and money to this cause. I've offered to go with her, via my own expense, and carry her bags bring her glasses of water (or beer) if I could help. But still no response. So, I'm still here with a heart to see PA spread around the world but very little ideas how I can work towards this goal.

 

BTW, as I've said before, I do have contacts in Nepal after my trip last year They have said that they are willing to take a practicing PA to Nepal in Nov 10 and I have a preceptor lined up for a PA student in March 2011. Anyone interested please contact me!

[roman6163]

SE Asia absolutely not.

 

But it would absolutely be cool to work in China. Great culture and get to mix our Western medical practices with Eastern traditional medicine.

[eddoc]

Ruth is working with the NCCPA as their International Director to provide advice on national certification processes for those countries interested in such. Be aware that there are a number of groups and individuals who, usually through personal relationships they have developed, are working with countries and/or schools. Having said that, I hear your enthusiasm and love of your profession but be careful of the idea of "promoting the profession, clarifying the roles..." based on the US model, as each country must create a professional based on their educational system, their particular health care needs and their current medical structure. For example, several sub-Saharan African nations have had a PA analogue for some time. Their education begins after high school (and in some cases must be a nurse first) after which they are independent providers, including some surgical procedures, in the rural areas.

 

I know I sound preachy and I apologize for that but I just came back from a country that drank the US Koolaid and is now struggling with a program that makes no sense in their system

[jmj11]

Ruth is working with the NCCPA as their International Director to provide advice on national certification processes for those countries interested in such. Be aware that there are a number of groups and individuals who, usually through personal relationships they have developed, are working with countries and/or schools. Having said that, I hear your enthusiasm and love of your profession but be careful of the idea of "promoting the profession, clarifying the roles..." based on the US model, as each country must create a professional based on their educational system, their particular health care needs and their current medical structure. For example, several sub-Saharan African nations have had a PA analogue for some time. Their education begins after high school (and in some cases must be a nurse first) after which they are independent providers, including some surgical procedures, in the rural areas.

 

I know I sound preachy and I apologize for that but I just came back from a country that drank the US Koolaid and is now struggling with a program that makes no sense in their system

 

 

I hear what you are saying and can only imagine your perspective having just returned from that situation, however I don't think I was clear about what I was talking about.

 

Yes, I knew what Ruth was doing and that is why I met with her personally.

 

Regarding my interest in promoting the PA concept abroad, I'm talking about point "A" and I think you are warning me about points "X, Y and Z." What I mean, is that the countries which I've worked in have the concept of 1.) Physician, 2.) Nurse and some type of 3.) rural health care worker. I am simply talking about introducing the concept of Physician Assistant, as a role that has a higher level of training than the rural health care worker but not a physician. I'm not talking about X, Y and Z of coming in, guns a blazing and saying that you need to develop a American style model of this profession.

 

For example, my most recent experience has been in Nepal. There they have the models that I mentioned above. There is a huge need for providers, better trained than their rural health care workers (although these workers do amazing things with virtually little resources) to work in the isolated areas. There are huge swaths of land (remotely accessed) with no doctors or nurses. The valley I worked in last year probably has 20 to 30 K people and, as far as I could count, 4-5 heath care workers. There are no roads and no air transport except for rich tourist so the heath care workers must do it all.

 

In many ways, Nepal (and many developing nations) has both true shortages and distribution issues. The vast majority of physicians and virtually all the MD Specialists reside in Kathmandu. The reason is that is where they can make the most money.

 

I worked in Egypt for two years back in the late 80s. I worked in a village of garbage where virtually no Egyptian physician (except for one who would come in part time) would tread. There was no money to be made among the poor and there was a very negative cultural stigma attached to working there. When I was there, I flew beneath the radar. Now, that is not even possible. It is illegal for a PA to practice in Egypt (except for taking care of Americans who are working there). The poor desperate people in those garbage villages aren't much better off. It frustrates me that I can not volunteer to go and work in those villages nor can I bring in PAs to volunteer to work there. I hate to see suffering and it is irritating when a small bit of that suffering could be relieved but is prevented by politics and old, stupid ideas (like no understanding of the PA role).

 

I'm simply saying that I want to be an ambassador for our profession, letting others see who we are and what we do . . . then letting them think outside the cultural box to created their own equivalent or at least allowing American PAs to come in and give away free medical care to the extremely poor.

 

Last fall I spent many of nights, high in the mountains, sitting around a campfire, sipping tea, eating goat meat and curry with the director (MD) of a large Nepalese NGO and talking about the PA concept. I think I really got to know his heart. I am absolutely sure, despite all the things I and others have said, that he still doesn't get it. He is much closer than he was a few years ago. But he still sees very little daylight between a PA and and MA. This, like even in the states, has a lot of cultural history behind it and can not change over night. There is a social caste system there as in the states, that has a high level for MDs but no platform for PAs in their minds, so it is hard to grasp the concept.

 

I stayed in Kathmandu a few extra days and talked with them about creating 6 week rotation sites so that they can see PAs in action. So far, the NGO leader has seen three practicing PAs and one student, each for two weeks. But he still worries about us making mistakes even though no one has. He has still not warmed up to the idea of American PA students or even practicing PAs in his country for longer than two weeks at a time. He needs to see more PAs and that is what I am working on now.

 

I would never come in and try to impose my ideas on to them. I've spent too much time overseas to be that stupid. It must be indigenous.

 

Yes, I am very aware of the non-Physician practitioners in Africa. I've been at this for a very long time (working as a PA overseas for the first time in 1982). I've put a huge amount of work and thought into this.

 

I wanted to go on but this post is getting too long. Just ask me, if you are interested, why I don't work inside the system (AAPA or others) and I will explain that next.

[Guest jiang.253]

Emm... I am Chinese and I am now studying in US. I was a medical student in China so I am pretty familar with the hospital policy in China. We don't have a job called'PA'. Each year thousands of medical students graduated from medical schools after finishing their five-year medicine study directly from high school. Yes, we just need five years, and to attend a med school is kindda easier than US. So we have tons of doctors in China... But u can also try... Jst contact some managers of local hospitals, they may give u some suggestions. I am glad that you feel interested in our culture~lol. Free free to contact me at jiang.253@osu.edu if u hv more questions.

[lucyji]

Though China do not have "PA" program now. China will have these programs in the near future.

[delco714]

,I imagine so^. China's barefoot drs are part of the PA history!