Physician Assistant
Physician assistants (PA) are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. Having thousands of hours of medical training, physician assistants are both versatile and collaborative and they can practice in every state and in every medical setting and specialty, improving healthcare access and quality. There are approximately 150,000 PAs in the U.S. and 260 PA programs.1
Job Settings
They work in hospitals, medical offices, community health centers, nursing homes, retail clinics, educational facilities, workplace clinics, and correctional institutions. Most do work in offices of physicians (54%) with hospitals; state, local, and private (26%) coming in close second.2 Physician assistants also serve in the nation’s uniformed services and work for other federal agencies, such as the Department of Veterans Affairs.1
Daily Responsibilities
On a typical day, the roles and responsibilities of a PA include making rounds and performing patient exams, diagnosing illnesses, assisting in surgery, ordering and interpreting laboratory tests and x-rays, prescribing medications, developing and managing treatment plans, and advising patients on preventative care and optimal health practices.3
Important Skills
Physician assistants are both versatile and collaborative. They should be able to have adequate observation skills in order to observe a patient accurately. They must also be able to communicate with these patients both effectively and sensitively, not only in speech, but also in writing. Communication skills also allow a PA to communicate efficiently with members of the healthcare team. Candidates must also have the skills to be able to carry out basic laboratory tests, diagnostic procedures, and read EKGs and X-rays.4
Salary
The median annual wage for a Physician Assistant was $115,390 in May 2020. The lowest 10 percent earned less than $76,700 and the highest 10 percent earned more than $162,740. When surveying the top industries where they worked, those working at outpatient care centers tended to earn the most, whereas those in educational services tended to earn the least.5
Job Outlook
Employment of physician assistants is projected to grow 31 percent from 2019 to 2029, which is much faster than the average for all occupations.5
Pros and Cons
Pros:
- Fewer educational requirements than medical school: For example, the total amount of training for a PA is roughly 12,400 hours. For medical doctors, it is roughly 34,000 hours.
- Student loans: Compared to the average medical school graduate, who has around $180,000 in student loans, the average PA expects to take on around $50,000 in student loan debt before graduating.
- Flexibility: After achieving a license, a PA can easily shift from one medical specialty to another- from internist to a pediatrician for example- without additional training.
- Teamwork: PAs are an important part of any medical team- as they work with doctors, nurses, licensed practical nurses, and others.
- Financial: The average salary for PAs is around $100,000, which is nearly double what the average American household makes per year.
Cons:
- Confusion about role: Even though PAs have been around since the mid-1960s, some patients still don’t understand the role that they play in healthcare. Many physician assistants find that they spend a lot of time educating patients about what they do.
- Autonomy: PAs do work independently with patients, but this work will be closely supervised by a doctor. It is not possible to open your own office.
- Functional limitations: There are rules that prohibit PAs from caring for patients outside of the clinic or hospital setting.
Career Paths / Preparing for Graduate School
To become a PA, you must first obtain a bachelor’s degree and complete some common prerequisite coursework. The majority of programs require Chemistry, Physiology, Anatomy, Microbiology, and Biology. PA programs also look for two types of healthcare experience; one of which is healthcare experience (HCE) and the other of which is patient care experience (PCE). HCE is work in which you are not directly responsible for a patient’s care and PCE is when you are directly responsible for a patient’s care. It’s recommended that you complete these experiences as soon as possible, but some students take a gap year after completing their undergraduate experience in order to obtain the typical 1,000 hours. As always, every program is different, so it’s important to verify with the individual institution’s website, the Central Application for Physician Assistants (CASPA), or the Applicant’s Manual of Physician Assistant Program. The CASPA is typically used to apply to programs, and among other items, the requirements include transcripts, letters of recommendation (usually from professors, supervisors, physicians, and PAs), list of HCE/PCE, and a personal statement highlighting the student’s motivations. Once applications have been reviewed, candidates are chosen for interviews.
PA programs are usually full time and around 23-27 months. After completing the program, graduates take the PANCE (the Physician Assistant National Certifying Examination). It includes 300 total questions over a span of five hours and it is able to be retaken.6
Application Timeline
| September | Begin drafting a personal statement |
| October | Start requesting letters of recommendation from faculty as well as PAs, employers, clinicians, managers, etc. |
| November | Attend all relevant application process meetings and workshops if not attended in October |
| February | Research programs and schools. And individually review all application deadlines and start dates on the CASPA application and PAEA program directory. Take the GRE no later than February. |
| March | Review CASPA instruction manual |
| April | CASPA opens mid to late April |
| May | Submit CASPA, transcripts, and all letters of recommendation |
| June | If relevant, complete CASPA Academic Update. And complete secondary applications within two weeks of receiving |
| Fall | Interviews continue until spring, if relevant complete the CASPA Academic Update for fall term and any other relevant school information |
| Spring | Make final choice of school based on CASPA traffic rules |
Financing Your Education
According to the most recent statistics (from 2017), the median in-state tuition at public PA schools was $43,000 and the average out of state tuition was $77,629. At private PA schools, the average tuition was around $77,000 for both in and out of state students. There are many different scholarships and loans available to fund your education. See the American Academy of PAs (AAPA) document Funding Your PA Education and the Physician Assistant Education Program (PAEA).
Additional Resources
- American Academy of PAs: https://www.aapa.org/
- Physician Assistant Education Association (PAEA): https://paeaonline.org
- Mayo Clinic: College of Medicine and Science: https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/physician-assistant/
- Physician Assistant EDU.org: https://www.physicianassistantedu.org