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How to become a physician assistant (PA)

‘Behind every good physician is a great physician assistant’

While you might expect to see this quote on your friend’s custom printed T-shirt rather than being uttered by a Greek philosopher, it has a grain of truth to it. Physician assistants (PA) are a physician’s right hand (together with nurses) and help fill the void created by an ever increasing demand for well-trained doctors worldwide and by continuous healthcare cuts.

Essential steps to become a physician assistant
Secondary School Focus on natural science subjects like biology, chemistry, and physics, together with mathematics.
Bachelor's Degree Any healthcare related bachelor's degree will suffice, as long as you complete the following essential pre-required subjects: anatomy, physiology, chemistry, microbiology, biology, ethics, statistics, quantitative methods.
Health Work Experience You need a minimum of three years or 2000 clinical hours of hands-on patient care.
Physician Assistant Program It is considered a master's degree that will last 2 years (US) or 3 three years (UK), where the standard medical or healthcare-related subjects are taught, together with patient care.
Registration To become board-certified you need to pass the Physician Assistant National Certifying Exam (PANCE) in the US or the Physician Associate National Certification and National Certification exam if you are in the UK.
Maintain Your Licence You need to complete 100 hours of continuing medical education (CME) every two years and sit the Physician Assistant National Re-certifying Exam regularly.
Specialization Possible fields include ultrasound, neurofeedback, nutrition, vascular access, etc.
Personal Skills Communication, people skills, empathy, bedside manner, the ability to remain calm under pressure, resilience, etc.

However, there are two sides to the coin. Having the word ‘physician’ attached to your job title comes with obvious perks, but also with difficulties like huge responsibilities, a challenging education path and a demand for excellence. It is also quite a niche area that many potential healthcare candidates don’t know enough about. This is where this article comes into play. It will aim to inform you of the ins and outs of this profession, clarify any confusions and, most importantly, show you how to become a great physician assistant.

Physician Assistant Education Requirements

Before diving in head-first, some aspects need to be clarified. The overall path to becoming a physician assistant is quite similar worldwide, but there are some minor but significant differences in requirements between continents. It is important that you familiarize yourself with them in order to have the best shot at joining this profession.

Doctor clutches stethoscope

In addition, the terminology also differs. In the US, the job title is ‘physician assistant’. However, in the UK, the same role is known as a ‘physician associate’. There is such a role as a physician assistant in the UK, but these professionals deal with very different and specific tasks relating to the area of anaesthesia.

Secondary School

For some, it’s too early to know what career they want to pursue at 15-16 years of age, while for others it’s not. In any case, to provide yourself a comfortable bedding for a career in the health sciences, you should choose to study natural sciences like biology, chemistry, and physics, together with mathematics.

You need to realise that while secondary school might feel like ‘early days’, it is the beginning of your physician assistant prerequisites. You need to pick your subjects wisely and study hard in order to finish with the most competitive grades possible in your final exams (A-levels, SATs or APs, etc.).

Students write in books

Bachelor’s Degree

You’ve succeeded to ace your secondary school exams and now you need to climb the next step of the ladder and complete a bachelor’s degree. This is where the real work begins because your degree, subject choices, and results will directly impact your acceptance into a physician assistant program. The competition for this program is usually fierce, often reaching five applications for every spot, so the higher your college grades are, the better your chance will be.

There is no specific physician assistant bachelor’s degree. In both the US and UK you need to first complete a healthcare related bachelor’s degree of at least two years that covers the following subject areas:

  • Anatomy
  • Physiology
  • Chemistry
  • Microbiology
  • Biology
  • Healthcare ethics
  • Statistics
  • Quantitative methods

It feels like you’re applying to medical school or pre-medical course, doesn’t it? Being a physician’s extension is not easy, so you need to build a solid science foundation before facing your future patients.

In the US specifically, there are accelerated physician assistants bachelor’s degrees (BA-PAs), but they are divided into two parts - the first half is an accelerated and compressed bachelor’s degree, while the second part forms the physician assistant training program. In essence, this option is the same as the previous one - just more focused, condensed and shorter in length. Having said that, the most popular choice is to do a separate bachelor’s degree rather than the accelerated program.

Student visualises upwards climb to graduation

Healthcare Work Experience

The physician assistant prerequisites don’t stop here unfortunately. In both the US and UK, most physician assistant admission requirements demand a minimum of three years or 2000 clinical hours worked in a healthcare setting. Basically, you need some sort of hands-on patient care.

This experience can come from many areas, and many physician assistant applicants are already qualified or have spent significant time in one of the following professions:

  • Emergency medical technician
  • Paramedic
  • Lab assistant
  • Phlebotomist
  • Nurse
  • Surgical technician
  • Emergency room technician
  • Midwife

In the US, certain bachelor’s degrees offer a physician assistant shadowing program and internships with the aim of exposing prospective applicants to clinical work and real life patients. You just need to make sure that such programs are recognized and accredited by Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

Doctor prepares needle

Physician Assistant Program

Now you have finally acquired all the admission requirements and can progress further on the physician assistant education path by attending an accredited program. In both the US and UK, the physician assistant specialization program is considered a master’s degree. In addition, the subjects taught to students are also similar in both continents, consisting of the standard medical or healthcare ones such as:

  • Anatomy
  • Physiology
  • Pathology
  • Pharmacology
  • Biochemistry
  • Clinical medicine
  • Microbiology
  • Pathophysiology
  • Medical ethics

However, those programs can differ in duration. For example, in the US it takes two years to complete the physician assistant program while in the UK it takes three years

As you can see, the majority of subjects taught to future physicians must also be mastered by physician assistants. However, because the training of the latter is a lot shorter, physician assistants do not have full autonomy during their day to day work, but rather work under the direct supervision of a qualified physician. They are not independent practitioners. On top of that, this shorter training time means that physician assistants cannot specialize like physicians can, so they are restricted to generalised clinical roles and primary care, similar to a general practitioner. 

Students assemble anatomy model

Registration

Hold your horses, you’re not done just yet! Before you start practicing your dream job you need to register and become a board-certified physician assistant, similar to any medical profession. If you study in the US, you need to pass the Physician Assistant National Certifying Exam (PANCE) which turns your brain to mush with 300 multiple choice questions during a period of five hours. What happens if luck is not on your side that day? You may take the test five more times up to a maximum of six times in six years. What happens if Mercury is retrograde every time and you fail? You need to do the physician assistant program again. 

If you study in the UK, you need to pass two exams. The first one is the Physician Associate National Certification which consists of 14 OSCE stations and a written exam of 200 single best answer questions. The second one you need to take is the National Certification exam and only if you succeed in both of them you can become a board-certified physician assistant.

Happy student holds a graduation certificate

Unluckily for you, but fortunately for your patients, obtaining your licence is not a one-off thing. It merely opens the door for you, but to stay in the game you need to prove that you keep up with the ever expanding field of science and medicine. As such, you need to complete 100 hours of continuing medical education (CME) every two years and sit the Physician Assistant National Re-certifying Exam every ten years in the US, and every six years in the UK.

Career Advancement

If you are not happy about your current level of knowledge, you can advance it even more. Some physician assistants specialize even more in various fields and maneuvers such as ultrasound, neurofeedback, nutrition, vascular access, etc. There are a ton of opportunities for you to become the best of the best, so just take the bull by its horns and run with it. 

Personal Skills   

Paperwork, certification, and knowledge only go so far. Although they are essential, they don’t complete the entire puzzle. The last missing piece are personal skills, an umbrella term encompassing communication, people skills, empathy, bedside manner, the ability to remain calm under pressure, resilience (and so on) that are mandatory for any good physician assistant.

Doctor holds hands with patient

It might sound cliche and repetitive, but it’s true. You can name all the world’s medications for every disease, but if you don’t know when and how to provide a comforting touch or words to your patient, they will not cooperate with you, causing all your up-to-date and scientifically backed advice to get flushed down the drain.

So there you have it, the physician assistant education requirements spelled out word for word. It’s certainly not easy and no-one claims that it is, but it is certainly a rewarding profession in the long run and one in which you can really make a difference in people’s lives.

Highlights

  • In the US, the profession is called 'physician assistant', but in the UK it is known as a 'physician associate'.
  • Throughout your education path, you should focus on natural science subjects, ever since secondary school. Similar to medical school, you will need to complete a bachelor's degree (preferably in a closely related area), acquire three years of work experience, and then apply to an accredited physician assistant program.
  • The program itself takes anywhere between two and three years, depending on your chosen location.
  • Before you can start practicing, you will need to pass some standardized, national exams. For example, in the US you need to get through the Physician Assistant National Certifying Exam (PANCE), while in the UK you need to succeed in two exams: Physician Associate National Certification and a National Certification exam.
  • In order to keep your licence, you will need continuous medical education as well as to pass the Physician Assistant National Re-certifying Exam. Luckily, you can also advance your career further on by specialising in various health-related fields.
  • Personal skills such as communication, people skills, good bedside manner, and so on, are critical for a physician assistant.
Show references

References:

  • American Academy of Physician Assistants: Become a PA, https://www.aapa.org/career-central/become-a-pa/
  • Learn How To Become: How To Become A Physician Assistant; Physician Asistant Programs & Careers, https://www.learnhowtobecome.org/physician-assistant/
  • National Health Service UK, Health Career Centres: Physician Associate, https://www.healthcareers.nhs.uk/explore-roles/medical-associate-professions/roles-medical-associate-professions/physician-associate
  • British Medical Association: Physician associates in the UK, https://www.bma.org.uk/collective-voice/policy-and-research/education-training-and-workforce/physician-associates-in-the-uk
  • Royal College of Physicians, Faculty of Physician Associates: The Recertification exam, http://www.fparcp.co.uk/examinations/recertification
  • Mittman DE, Cawley JF, Fenn WH. Physician assistants in the United States. BMJ : British Medical Journal. 2002;325(7362):485-487.

Author, Review, Layout:

  • Adrian Rad
  • Molly Smith

Illustrators - from top to bottom, in order:

  • 'Doctor clutches stethoscope' - megaflopp/Shutterstock.com
  • 'Students write in books' -  Syda Productions/Shutterstock.com
  • 'Student visualises upwards climb to graduation' - alphaspirit/Shutterstock.com
  • 'Doctor prepares needle' - OTAKUPHOTO/Shutterstock.com
  • 'Students assemble anatomy model' - nd3000/Shutterstock.com
  • 'Happy student holds a graduation certificate' - Syda Productions/Shutterstock.com
  • 'Doctor holds hands with patient' - Andrei_R/Shutterstock.com
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