Job opportunities should be good, particularly in rural and
inner city clinics.
Physician assistants (PAs) practice medicine under the supervision
of physicians and surgeons. They should not be confused with
medical assistants, who perform routine clinical and clerical
tasks. (medical assistants
are discussed elsewhere in the Handbook.) PAs are formally
trained to provide diagnostic, therapeutic, and preventive
health care services, as delegated by a physician. Working
as members of the health care team, they take medical histories,
examine and treat patients, order and interpret laboratory
tests and x rays, and make diagnoses. They also treat minor
injuries, by suturing, splinting, and casting. PAs record
progress notes, instruct and counsel patients, and order or
carry out therapy. In 48 States and the District of Columbia,
physician assistants may prescribe medications. PAs also may
have managerial duties. Some order medical supplies or equipment
and supervise technicians and assistants.
Physician assistants work under the supervision of a physician.
However, PAs may be the principal care providers in rural
or inner city clinics, where a physician is present for only
1 or 2 days each week. In such cases, the PA confers with
the supervising physician and other medical professionals
as needed and as required by law. PAs also may make house
calls or go to hospitals and nursing care facilities to check
on patients, after which they report back to the physician.
The duties of physician assistants are determined by the
supervising physician and by State law. Aspiring PAs should
investigate the laws and regulations in the States in which
they wish to practice.
Many PAs work in primary care specialties, such as general
internal medicine, pediatrics, and family medicine. Other
specialty areas include general and thoracic surgery, emergency
medicine, orthopedics, and geriatrics. PAs specializing in
surgery provide preoperative and postoperative care and may
work as first or second assistants during major surgery.
Although PAs usually work in a comfortable, well-lighted
environment, those in surgery often stand for long periods,
and others do considerable walking. Schedules vary according
to the practice setting, and often depend on the hours of
the supervising physician. The workweek of hospital-based
PAs may include weekends, nights, or early morning hospital
rounds to visit patients. These workers also may be on call.
PAs in clinics usually work a 40-hour week.
|Training, Other Qualifications, and Advancement
All States require that PAs complete an accredited, formal
education program and pass a National exam to obtain a license.
PA programs usually last at least 2 years and are full time.
Most programs are in schools of allied health, academic health
centers, medical schools, or 4-year colleges; a few are in
community colleges, the military, or hospitals. Many accredited
PA programs have clinical teaching affiliations with medical
In 2005, more than 135 education programs for physician assistants
were accredited or provisionally accredited by the American
Academy of Physician Assistants. More than 90 of these programs
offered the option of a master’s degree, and the rest offered
either a bachelor’s degree or an associate degree. Most applicants
to PA educational programs already have a bachelor’s degree.
Admission requirements vary, but many programs require 2
years of college and some work experience in the health care
field. Students should take courses in biology, English, chemistry,
mathematics, psychology, and the social sciences. Many PAs
have prior experience as registered nurses, while others come
from varied backgrounds, including military corpsman/medics
and allied health occupations such as respiratory therapists,
physical therapists, and emergency medical technicians and
PA education includes classroom instruction in biochemistry,
pathology, human anatomy, physiology, microbiology, clinical
pharmacology, clinical medicine, geriatric and home health
care, disease prevention, and medical ethics. Students obtain
supervised clinical training in several areas, including family
medicine, internal medicine, surgery, prenatal care and gynecology,
geriatrics, emergency medicine, psychiatry, and pediatrics.
Sometimes, PA students serve one or more of these “rotations”
under the supervision of a physician who is seeking to hire
a PA. The rotations often lead to permanent employment.
All States and the District of Columbia have legislation
governing the qualifications or practice of physician assistants.
All jurisdictions require physician assistants to pass the
Physician Assistant National Certifying Examination, administered
by the National Commission on Certification of Physician Assistants
(NCCPA) and open only to graduates of accredited PA education
programs. Only those successfully completing the examination
may use the credential “Physician Assistant-Certified.” In
order to remain certified, PAs must complete 100 hours of
continuing medical education every 2 years. Every 6 years,
they must pass a recertification examination or complete an
alternative program combining learning experiences and a take-home
Some PAs pursue additional education in a specialty such
as surgery, neonatology, or emergency medicine. PA postgraduate
educational programs are available in areas such as internal
medicine, rural primary care, emergency medicine, surgery,
pediatrics, neonatology, and occupational medicine. Candidates
must be graduates of an accredited program and be certified
by the NCCPA.
Physician assistants need leadership skills, self-confidence,
and emotional stability. They must be willing to continue
studying throughout their career to keep up with medical advances.
As they attain greater clinical knowledge and experience,
PAs can advance to added responsibilities and higher earnings.
However, by the very nature of the profession, clinically
practicing PAs always are supervised by physicians.
Physician assistants held about 62,000 jobs in 2004. The
number of jobs is greater than the number of practicing PAs
because some hold two or more jobs. For example, some PAs
work with a supervising physician, but also work in another
practice, clinic, or hospital. According to the American Academy
of Physician Assistants, about 15 percent of actively practicing
PAs worked in more than one clinical job concurrently in 2004.
More than half of jobs for PAs were in the offices of physicians.
About a quarter were in hospitals, public or private. The
rest were mostly in outpatient care centers, including health
maintenance organizations; the Federal Government; and public
or private colleges, universities, and professional schools.
A few were self-employed.
Employment of PAs is expected to grow much faster than average
for all occupations through the year 2014, ranking among the
fastest growing occupations, due to anticipated expansion
of the health care industry and an emphasis on cost containment,
resulting in increasing utilization of PAs by physicians and
health care institutions.
Physicians and institutions are expected to employ more PAs
to provide primary care and to assist with medical and surgical
procedures because PAs are cost-effective and productive members
of the health care team. Physician assistants can relieve
physicians of routine duties and procedures. Telemedicine—using
technology to facilitate interactive consultations between
physicians and physician assistants—also will expand the use
of physician assistants. Job opportunities for PAs should
be good, particularly in rural and inner city clinics, because
those settings have difficulty attracting physicians.
Besides the traditional office-based setting, PAs should
find a growing number of jobs in institutional settings such
as hospitals, academic medical centers, public clinics, and
prisons. Additional PAs may be needed to augment medical staffing
in inpatient teaching hospital settings as the number of hours
physician residents are permitted to work is reduced, encouraging
hospitals to use PAs to supply some physician resident services.
Opportunities will be best in States that allow PAs a wider
scope of practice.
Median annual earnings of physician assistants were $69,410
in May 2004. The middle 50 percent earned between $57,110
and $83,560. The lowest 10 percent earned less than $37,320,
and the highest 10 percent earned more than $94,880. Median
annual earnings of physician assistants in 2004 were $70,310
in general medical and surgical hospitals and $69,210 in offices
According to the American Academy of Physician Assistants,
median income for physician assistants in full-time clinical
practice in 2004 was $74,264; median income for first-year
graduates was $64,536. Income varies by specialty, practice
setting, geographical location, and years of experience. Employers
often pay for their employees’ liability insurance, registration
fees with the Drug Enforcement Administration, State licensing
fees, and credentialing fees.
Other health care workers who provide direct patient care
that requires a similar level of skill and training include
audiologists, occupational therapists, physical therapists, registered
nurses, and speech-language
For information on a career as a physician assistant, including
a list of accredited programs, contact:
- American Academy of Physician Assistants Information Center,
950 North Washington St., Alexandria, VA 22314-1552. Internet:
For eligibility requirements and a description of the Physician
Assistant National Certifying Examination, contact:
- National Commission on Certification of Physician Assistants,
Inc., 12000 Findley Rd., Suite 200, Duluth, GA 30097. Internet:
- Source: Bureau of Labor Statistics,
U.S. Department of Labor, Occupational Outlook Handbook,