The Physician Assistant Perspective

Relatively New Profession been around for 50 years this year!

We are unique, but what makes us that way?
o Biggest thing is we are generalists, so we are not required
to specialize

Early History of the PA Profession

3 Big Names to Know
1) Charles Hudson one of the first physicians to suggest that nonphysician clinical personnel be trained and used to help alleviate
the growing disparity between the supply and demand for health
care services.
Link to Physician Assistant History Society Website
http://www.pahx.org/hudson-charles-l
2) Eugene Stead Started first PA program at Duke University,
considered founder of the PA profession
Link : http://www.pahx.org/stead-jr-eugene
3) Richard Smith established the MEDEX Program at the University
of Washington
Link: http://www.pahx.org/smith-richard
The Language of the PA profession has changed.
We have moved from:
o being under supervision to with supervision
o to being a part of a physician led team
o to being in collaboration with physicians
We used to only be able to write a diagnostic impression we were not
allowed to diagnose now we can both diagnose and prescribe
appropriate pharmacological treatment
National Academy of Science Classifications (That arent really used
anymore but we are still learning for whatever reason)
Type A schools similar to todays PA school training models
Type B Schools specialty based so you do some general training and
primarily specialty based training ex. Pulmonary specialty

Type C like the MEDEX model you have a limited scope with more
direct supervision during training and as your skillset progresses you
are allowed more and more flexibility
Other Program Models include:
Orthopedic Physician Asssistants
Radiology PAs Weber State you have to be a Radiology Tech First to
get into the program
Urology PAs program
The Federal Role in PA Education
The Comprehensive Health Manpower act of 1972 was a catalyst for
growth of the PA profession. It did so by:
o Providing stimulus for the growth in number of programs
o Endorsed PAs as a legit part of the healthcare workforce
Accreditation
Validifies our profession to the public with regards to a minimum
education standard
o The accredidation process was started as a Committee on Allied
Health Education and Accredidation (CAHEA)
o Then became Commission on Accredidation of Allied Health
Educational Programs
o Now it is the: Accreditation Review Commision on Education for
the Physician Assistant (ARC-PA)
o There are seven participating organizations:
o AAFP
o AAP
o AAPA
o PAEA
o AMA
o ACS
o ACP/ASIM
o Also includes public members and commissioners at large
o Website: http://www.arc-pa.org/
Geographic distribution of PA Programs
o South 54
o Northeast 57 fun fact: PA and NY have highest concentration
of PA programs
o Midwest 50
o West 25
o Total 210 and growing

General Program Characteristics:

o As of 2014 93% of the PA programs in the country awarded
Masters degrees.
o 65% are private
o 32.8% public
o 3.2% for profit
Program Length
o Avg Length is 26.9 months w/ 54.2 months of clinical
experience
o Most start and end in August
Enrollment and Class size
o First year class enrollment has risen dramatically since 1985
going from 1,032 to 8,602 (doesnt specifiy what year this went
to)
o The average first year class size is 46
Tuition the tale of the almighty Buck

91% of first year PA students receive financial aid

Have seen a historic annual increase of approximately 8%

Admissions Information Highlights

Required Entrance Exam(s)
o 75.8% require GRE
o 12.5% will accept GRE or MCAT
o 7.5% accept SAT
o 3.3% accept ACT
o 2.5% take just MCAT
o 5.8% use another or combo of exams
o This doesnt total 100% bc programs could choose more
than one answer for this survey
o The big take away- most programs use the GRE or the
MCAT if they award a masters degree

Applicants vs Matriculants

18,510

19,968

21,730

22,687

16,569 Unique Applicants (left axis)

6,828
Number of Matriculants
(left axis)
5,385

5,819

Red = number of matriculants

Applicants per seat

5,360

7,371

3.4

3.23

3.6
3.1

2.77
Applicants per seat

GPA of Applicants vs Matriculants

Applicant

Matriculant

Science

3.23

3.49

Non-Science

3.45

3.62

Overall

3.33

3.55

(This data is through 2014)

Age and Gender of Applicants

Average Age

Applicant

Matriculant

26.0
25.1

Percentage of Female

72.4%
Applicant

Matriculant
71.5%

Take away: Women are more likely to apply and matriculate then men

Ethnicity:
Applicant

Matriculant

.3%

.2%

13.3%

10.2%

6.8%

3.4%

.1%

.1%

Multiple Races

3.4%

3.2%

Hispanic,
Latino

9.7%

7.9%

76.0%

81.9%

American
Indian, Alaskan
Asian
Black, African
American
Native
Hawaiian,
Other Pac
Islander

White

Not really sure what his big take away here was other than the PA
applicant and matriculate pool is primarily white? Nearly 6% more
white students are represented in the matriculant pool than the
applicant pool. Still dont understand how more White people can
matriculate than apply? (Note the last category)
Prereqs:

o Most programs require micro, bio, phys, anatomy, gen chem,

stats, orgo, biochem. Genetics and calculus are the two least
required courses
Healthcare Experience
Some programs allow health care experience. Some do not. How
much most students who enter a PA program is represented in the
graphic below

The most important reasons most students choose the PA career

Calling to healthcare
Desire to care for patients
Excitement of healthcare

Relieve pain and suffering

Work-life balance
The most desirable specialty is Emergency Medicine almost
70%
Most desirable future practice setting? Suburban America
Least desirable future practice setting? Prison System

Faculty Characteristics

Average age = 46.7

Female = 62.5
Hispanic = 3.6%
White = 85%
Three years or less in current 60.8%
Assistant (49.6%), Associate (24.3%), Full (6.5%)
Tenured = 8.4% (about 12% on tenure track)
49% of faculty worked clinically in the past year
Average clinical hours worked per week: 9.3
(n = 439)

PAEA
PA education Priorties are maintained by the PAEA and include:
Maintain & Enhance Quality of Education
Focus on Primary Care
High Quality Clinical Sites
Faculty
Recruitment and retention
Development
Student Services
Diversity
Research
Advocacy
PAEA Student Health Policy Fellows is a new Program just established in
the last 2 years (2014) to address issues and challenges that pertain to
the PA profession. Some of these issues and challenges are:
Preparing PAs for the changing healthcare system
Managing growth
What will be the effects of the gender shift in the profession?
Will PA applicant numbers continue to grow?
Responding to continuing challenges of clinical training site
shortages
Faculty shortages and greying PA faculty
Many Preceptors are not paid and the availability of clinical sites is very
limited and constantly being fought over.
Average cost per student per week= $210

The big take away from this is that increased cost from clinical sites to
accept students causes student tuition rates to increase which will
ultimately cause the salary costs to be higher for PAs that work at
these facilities due to increased student debt. Its a vicious cycle.