How to Become a Physician Assistant (PA)

Overview

By Sarah Maurer
physician assistant with young patient

With growing demands for health care services and physicians in increasingly short supply, physician assistants play a vital role in meeting the needs of patients everywhere. These professionals (who are also known as PAs) practice medicine and treat patients under the supervision of a licensed medical doctor. Typical PA duties include:

  • Take histories and perform physical examinations
  • Order and interpret diagnostic tests such as x-rays, electrocardiograms (EKGs), and laboratory tests
  • Diagnose injuries and illnesses
  • Formulate patient care plans
  • Prescribe medications and therapies
  • Perform procedures such as injections, suturing, and casting
  • Provide health counseling and education for patients and families
  • Assist physicians during surgery or procedures
  • Round on patients in hospitals and nursing homes and report on their progress
  • Document findings, decision-making, and care provided in the patient's health record.

Each state has scope-of-practice laws that spell out which functions PAs may perform and the degree of physician supervision required. In recent years, many states have relaxed restrictions on PA practice. (For example, PAs can now write prescriptions in all 50 states.)

The nature of PA supervision varies by state and practice setting. In some cases, the supervising physician and PA are in close and constant contact, sharing an office space. In others, such as a community clinic, the partners may be in phone contact but only meet face-to-face once or twice a week.

A physician assistant career offers many rewards. PAs get the personal satisfaction of helping and healing patients every day. They also have an opportunity to practice in many different areas of medicine without seeking additional training and certification (as physicians must). Finally, PAs play a growing role in reaching medically underserved populations such as those in urban centers and rural areas. Many staff clinics and travel programs serving people who would otherwise not have access to care.

Work Environment

Physician offices employ 58 percent of physician assistants, and an additional 23 percent work for hospitals. Other common employers include urgent care centers; retail clinics (such as those found at Walgreens); student and employee health centers; government and community organizations; and home health care services.

About 28 percent of PAs work in primary care specialties such as family medicine, internal medicine, and general pediatrics. Other common specialties include emergency medicine, hospital medicine, psychiatry, and dermatology.

The average physician assistant works about 40 hours per week. PAs employed in the outpatient setting generally work regular daytime hours plus some on-call hours during evenings and weekends. Hospital-based PAs usually work shifts that include evenings, weekends, and holidays.

Physician assisting can be physically demanding work that requires long periods of standing and walking. For example, surgical PAs spend several hours at a time on their feet while assisting with operations. Like other health care professionals, PAs are exposed to contagious diseases and toxic substances. It's important for them to follow recommended safety precautions, including the use of personal protective gear when appropriate.

Working as a PA can also be stressful and emotionally demanding. PAs are almost constantly interacting with patients, many of whom are distressed or in pain. Physician assistants also carry enormous responsibility for patients' health and safety. In some settings, the work can be quite fast-paced, which increases the potential for mistakes. A calm demeanor and the ability to multi-task are definite assets in this profession.

Requirements

Education

To become a physician assistant, candidates must:

High school students can prepare for a PA career by taking a full college preparatory curriculum, including four years of English, three years of math (through Algebra II), and at least three years of science (including biology, chemistry, and physics). AP, IB or dual-option courses in math and science may also be helpful, so long as students maintain a high GPA. High school is also a good time to get volunteer experience in the health care field.

Because admission to PA programs is highly competitive, college students should start researching training options in their first year. They should also complete the same prerequisites they would for medical school, including courses in biology, microbiology, chemistry, anatomy, and physiology.

Most PA programs are graduate level (leading to a master's degree or doctorate) and require a bachelor's degree for admission. However, a few programs still accept students who have completed two to four years of college-level coursework, including all prerequisites.

Training

PA training programs are offered by medical schools, universities, community colleges and the US military and usually take about 26 months (two to three academic years) to complete. In addition to classroom instruction in pathology, anatomy, pharmacology, behavioral science, and medical ethics, students complete two thousand hours of supervised clinical training. Like medical students, they rotate through many practice areas, including primary care, surgery, obstetrics, and emergency medicine.

The Physician Assistant Education Association maintains a list of accredited programs on its website.

To gain a competitive edge when applying to PA training programs, most students spend a few years working in a health-related field before applying. Examples of careers that can help students gain relevant experience include nursing, paramedicine, emergency services, or medical technology.

Licensing and/or Certification

PAs must be state-licensed in order to practice. All states now require students to pass the PANCE certification exam, a computer-based knowledge exam administered by the National Commission on the Certification of Physician Assistants (NCCPA). Certified physician assistants may use the PA-C credential after their names.

To maintain their certification, PA-Cs must complete one hundred hours of continuing education every two years and recertify every ten years.

Necessary Skills and Qualities

  • Teamwork and collaboration. Successful PAs embrace the idea of partnering with a physician (and often with a larger health care team). This requires the ability to listen, communicate effectively, accept feedback, and contribute to the team's shared goals.
  • Communication skills. PAs must be able to explain complex scientific information in a way that patients and families understand. At the same time, they must also be able to relay this information to team members of various professions.
  • Attention to detail. PAs strong observation skills help them detect tiny changes in patients' conditions that could signal the need for intervention.
  • Problem solving. PAs must apply their strong clinical and practical knowledge in order to assess patients, diagnose conditions, and formulate an effective plan of care.
  • Patient focus. Successful physician assistants say that one of the most important qualities a PA can have is a passionate desire to help others.
  • Emotional stability. PAs must be comfortable caring for people who are upset or in pain. They must also be comfortable with a high degree of responsibility and operating in fast-paced environments.

Opportunities for Advancement

Experienced PAs have the option to pursue post-graduate education in a specialty area such as surgery, psychiatry, or emergency medicine. NCCPA offers advanced certifications through its Certificates of Added Qualifications (CAQ) program.

With experience, PAs may move into management roles in which they direct the work of junior PAs. Another leadership option is to supervise PA students who are completing their clinical training. Colleges and universities hire PAs with doctorates to teach in PA training programs.

If you would like to gain the necessary education to become a physician assistant, we highly recommend that you check out our free School Finder Tool located HERE.

Salary and Job Outlook

Interactive Map of Income and Job Growth Projections

Hover over any state to explore local income and job growth data.

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According to the US Bureau of Labor Statistics (BLS), the median annual salary for physician assistants is $95,820. The lowest-paid 10 percent earn less than $64,100, and the highest-paid 10 percent earn more than $134,720.

Salaries vary with experience, practice setting, specialty, and geographic location:

  • According to the BLS, PAs employed in home health and outpatient centers generally earn the highest salaries.
  • A survey by Inside PA Training found that mental health, school-based practice, cardiology, and dermatology were the best-paid PA specialties.
  • PAs in Nevada earn the highest average salary in the country at $112,700.

Job prospects for physician assistants should be excellent for the foreseeable future. According to the Bureau of Labor Statistics, employment of PAs is expected to grow by 38 percent between 2012 and 2022, which is much faster than the average for all occupations.

Physician assistants are expected to play a crucial role in health care delivery in coming years. America's population is aging rapidly, increasing the demand for services. A growing number of people are also suffering from chronic conditions that require long-term medical management. Federal law recently expanded health care coverage to millions of Americans. On top of all of this, there is a shortage of physicians — particularly primary care physicians — to serve these patients.

PAs can improve their job prospects by specializing in primary care and by developing their skills so that they can practice to the full extent permitted by law. Willingness to work in an underserved area, such as a rural or inner city community, is also beneficial.

The American Academy of Physician Assistants offers a number of useful career services for PAs, including a job board, career coaching and resume assistance.

Further Reading

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