The physician assistant (PA) profession began in the mid-1960s when the first PA program was established in response to a shortage of physicians. Since then the field has grown dramatically and is expected to continue to expand due to the projected shortage of many health care professionals, especially doctors and nurses, as well as the growing demand for health care services from an aging population. The 2008 Census by the American Academy of Physician Assistants (AAPA) estimated that there were about 80,000 PAs eligible to practice and 68,124 in clinical practice at the beginning of 2009.
PAs are licensed health professionals who practice medicine as members of a team with their supervising physicians. PAs are certified to practice by the National Commission on Certification of Physician Assistants (NCCPA) and, in addition, are licensed or registered by the states in which they practice. PAs are eligible to practice in all 50 states, the District of Columbia, and Guam, and they practice in virtually all health care settings, including hospitals, physicians’ offices, HMOs, correctional institutions, military installations, nursing homes, public health agencies, community clinics, and research centers.
PAs are educated as generalists in medicine, but practice in more than 60 medical and surgical specialties. The top specialties are family/general medicine (26%), general surgery and surgical subspecialties (25%), emergency medicine (11%), and internal medicine subspecialties (10%). PAs exercise autonomy in medical decision making and provide a broad range of medical and therapeutic services to diverse populations in rural and urban settings. PA responsibilities include performing physical exams, diagnosing and treating illnesses, ordering and interpreting lab tests, counseling on preventive health care, assisting in surgery, and prescribing medications. PA responsibilities may also include education, research, and administrative services.
There are 145 accredited PA programs in the United States and they offer a variety of credentials, including master’s, bachelor’s, and associate degrees, and certificates of completion. More than 80% of the programs award master’s degrees. The average PA program length is 116 weeks (or just over 27 months) and includes about one year of didactic studies (classroom instruction) followed by 12 to 15 months of clinical rotations. About 80% of PA programs are housed at a university or college, 14% are housed at academic health centers, and 5% are in community colleges.
The typical student applying to a PA program has completed a baccalaureate, most commonly in biology, and has an average of 3.69 years of health care experience. Not all programs require applicants to have earned a college degree; however, most programs require some college-level courses and prior health care experience. According to PAEA, 74% of applicants are female and 26% are male.
Research studies show that PAs have a high level of job satisfaction and that most would choose the profession again, as well as recommend it to others. Results of the 2008 AAPA PA Census survey indicate that the mean total income for PAs who are not self-employed and who work at least 32 hours per week is $89,987 from their primary employer.
The Future of the Profession
The PA profession is well positioned to help meet the future demand for health care providers. The Bureau of Labor Statistics (BLS) has consistently ranked the PA profession as one of the fastest-growing occupations in the country and fourth among all professions. The BLS projects a 27% increase in the number of PA jobs over the 10-year period, 2006-2016, which is significantly higher than overall job growth — including that for physicians and surgeons — ensuring PA graduates ample employment opportunities.
Demand for more health care providers has led many programs to expand their enrollments. While the majority of programs are willing to consider increasing the number of students they accept each year, limited clinical training sites and preceptors (specialists who provide training to students) are the main barriers to increases in PA programs enrollment.
Admission to the PA programs is highly competitive, but those with a serious interest in the profession who demonstrate the qualifications to become proficient practitioners will enter a profession that is one of the fastest growing in the country and offers generous compensation and high levels of job satisfaction.