Physician Assistant anyone?

vigs1234 said:

Anyone ever think of becoming a PA? Are those programs easier to get into? I am thinking of becoming a Family Practitioner and wonder if becoming a PA is a better idea.

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I don't think PA programs are necessarily easier to get into at all. My understanding is that the process is somewhat more subjective than in medical school admissions. Also, you are required to have something like 2000 hours of clinical work for application.

Becoming a PA is a good idea of you want to be a PA; it is not a substitute for wanting to be a doctor, and they are not doctor replacements. Shadow both and understand the limitations of a PA. Essentially, their job is to provide mid to high level assistance to physicians, under the supervision of a physician. It is my understanding that they do have a high-degree of autonomy and can prescribe medicine. In some places, being a PA approximates what a doctor would do, but their scope of practice is still generally limited in comparison. It is my impression that they tend to handle the more run-of-the-mill cases and procedures, and/or initial assessments, and tend to consult with their physician-supervisors in the diagnoses and treatment of more serious, or unusual conditions; this frees up a lot of time for the doctor. Even then, the doctor might want to peek his or her head in for a few minutes to get to know the patient. There are some unique advantages to being a PA, such as having limited liability and the ability to move around to different specialties and sub-specialties. I think the breadth of a doctor's experience makes them more indispensable as the overall managers in the care of patients, however; doctors have a broader and more rigorous perspective from the many years of general and in-depth clinical rotations. PA's and physicians obviously work efficiently as a team. PA's cannot have their own autonomous practice; they practice under a doctor's license.

These are just my observations from shadowing IM and FP docs. Perhaps a PA will chime in, someone who actually knows the ins-and-outs of being one.

I've been a PA over 20 years and have been married to a family medicine physician for over 12 years. I entered the profession as a nontraditional student after four years in the US military. I was on the medical school trajectory with great grades and references when I discovered the PA profession. My past experience includes faculty for PAs and physicians and I've practiced in both surgery and medicine. My supervising physicians have always given me the autonomy to provide patient care while exercising their duties to assure appropriate oversight. At times, that included rural primary care where the physician treated patients at the clinic only once or twice a week while I was there 5 days weekly. There has never been a day where I questioned the decision to go to PA school rather than allopathic or osteopathic medical school. The profession is rewarding and satisfying. The renumeration has steadily increased over the past ten years.

The PA profession evolved directly from a 1960s physician shortage in rural America coupled with the return of military medics from Viet Nam who had significant medical experience in the field without the academic credentials required to work alongside physicians in practice. Dr. Eugene Stead was among the first to realize the value of training these individuals and he started the first PA program at Duke University. The profession has flourished quickly since the first class graduated in 1967. There are approximately 75,000 practicing PAs today. It is fortunate the PA profession is firmly accepted by most physicians, patients and payers given the looming physician shortage predicted within the next ten years.

PAs are committed to practicing team medicine with a licensed physician. PAs' licenses are linked to their physician supervisor(s). This relationship is central to the PA profession. Although some nonphysician providers seek greater supervisory separation between themselves and physicians, PAs are on record nationally as being inseparate from the physician-PA team concept.

I agree with what was said in the previous post: Most PAs function at the level of upper level residents with significant autonomy and independence within the agreements for practice established with the supervising physician(s). PAs practice in all primary care and specialty medicine and surgery venues. Most states allow PAs to practice in a place separate from the supervising physician as long as the supervising physician(s) provides telecommunication access and chart/case review as mandated by law or regulation.

There are approximate 135 accredited PA programs in the US and the concept has been accepted in The Netherlands, Taiwan, United Kingdom and Canada, to name a few of the countries with active PA programs or those investigating doing so in the near future.

The great majority of PA programs now award masters degrees although the roots of the profession included programs that provided certificates and/or bachelor's degrees. The average PA program is 25 months long with approximately 10,000 students enrolled in PA education annually. The competition for PA program entrance is increasingly fierce as there are a limited number of slots open each year. Most classes are capped at 50 students or less.


Although most programs prefer applicants with prior health care experience many do not ask applicants to have previous volunteer or employment in the health professions. It's interesting to note that the majority of applicants over the past five years have been women with academic achievements and grades clearly sufficient to competitively apply to medical school.


The first year consists of didactic instruction in the medical sciences, ethics, direct patient care and professional practice. The second year consists of clinical rotations with a broad spectrum of inpatient and outpatient medical and surgical disciplines. Many PA students train alongside medical students in the classroom and enjoy the same clinical rotations as well.


After graduation, PAs must pass a national certifying examination developed by the National Board of Medical Examiners and the National Commission on Certification call themselves "PA-C," or physician assistant-certified. To maintain NCCPA certification, PAs must log at least 100 hours of CME every two years and recertify every six years. In all U.S. states (except Indiana), and in Guam and the District of Columbia, PAs are permitted to prescribe medications. PAs register with the DEA and may prescribe controlled substances in many jurisdictions.


PA practice is frequently regulated by the state medical board.


PA reimbursement under Medicare is mandated by law. Most other payers, including Medicaid, reimburse for services provided by PAs, including assisting at surgery.


The PA concept originated with physicians and the profession remains one of medicine's strongest partners today. PAs train in the medical model and think clinically as do their physician partners. PA professional issues are the same as physcians in many cases and our partnerships improve health care access while liberating physicians to concentrate on those aspects of patient care requiring dedicated physician attention. Just as there is a need for more physicians intrainiing for the US to meet the demands of the retiring baby boomers and the turnover in the physician workforce, PA educational capacity should be increased alongside medical school expansion. It's an obvious professional marriage with great benefits for all involved.

Not for me either. But if it works for you, then go for it. Best of luck!

In the end I decide that I don't know what kind of specialty I want to go into. I am thinking about derm, radiology maybe even surgery. I can't do those things if I took the PA or NP route. MD gives me alot options and that is what I looking foward to.

Dorise04 said:

In the end I decide that I don't know what kind of specialty I want to go into. I am thinking about derm, radiology maybe even surgery. I can't do those things if I took the PA or NP route. MD gives me alot options and that is what I looking foward to.

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Actually, I think it is possible to do all those things as a PA; the only catch is that you can't do all those things completely autonomously, that is, without the supervision of a doctor (as was mentioned before, it can be online or offline supervision). In fact, I'd say being a PA is far more flexible, since you can actually change your specialty if you like. As a doctor, you can't really change your area of specialty easily.

EDIT: I should say that the scope of practice for a PA in each case is naturally more limited than that of a doctor of that same specialty. In many cases, depending on the state, a doctor can delegate most of their usual activities to a PA, pending final review, and/or with other appropriate supervision.

spicedmanna said:

Actually, I think it is possible to do all those things as a PA; the only catch is that you can't do all those things completely autonomously, that is, without the supervision of a doctor (as was mentioned before, it can be online or offline supervision). In fact, I'd say being a PA is far more flexible, since you can actually change your specialty if you like. As a doctor, you can't really change your area of specialty easily.

EDIT: I should say that the scope of practice for a PA in each case is naturally more limited than that of a doctor of that same specialty. In many cases, depending on the state, a doctor can delegate most of their usual activities to a PA, pending final review, and/or with other appropriate supervision.

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As the OP posted, it is probably easier to do those specialties as a PA. Do your Research...

One of the fastest growing areas of specialization for PAs is in dermatology.

Many PAs work in surgery - in any one of the specialties - with some providing first assistant operative roles, some surgical intensive care or wholly inpatient care. As previously noted, as a PA, it is relatively easy to move between specialties. My career includes extended time in urology, general and vascular surgery, internal medicine, emergency medicine family medicine and oncology.

As has been said previously, you need to do your research and find what's right for you. Having been through the application process for PA school, and seeing how competitive it really is I can say it is not easy to get into any of the programs. I changed to medical school because I would not have been happy in the role of a PA, but that is something you need to decide for yourself. As was stated by 20yearPA, those that are applying to PA school have essentially the same stats as those of us applying to medical school, and we all know how competitive that is. Most schools have 3-5 times as many applicants as spots for school so... Believe me none of application processes are easy for any graduate school, be it medicine, PA, Law etc. Good luck in whatever you decide.