How To Become A Physician Assistant: A Step-By-Step Guide

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To someone with minimal understanding of the health sector, the title of “physician assistant” may conjure up an image of someone whose job involves running professional errands for doctors. However, physician assistants (PAs) are highly trained professionals qualified to diagnose, monitor and prescribe medication to patients.

PA duties often overlap with doctors’, yet both medical experts have varying levels of autonomy at work. Doctors are legally allowed to practice independently, but PAs typically need a physician’s supervision to treat patients.

The rising demand for PAs goes to show that medical school and nursing school aren’t the only paths to an advanced career in healthcare. In this article, they discuss how to become a physician assistant, including common specializations and salary and job outlook data for these professionals.

Also called physician associates, PAs are licensed healthcare personnel who support physicians in providing medical care. They work alongside doctors, giving treatment and monitoring patients’ health.

Although some states allow physician assistants to work independently, most require them to work under doctors’ supervision. PAs administer tests, prescribe medication and conduct physical examinations. Other PA responsibilities include:

Physician assistants work in various settings such as hospitals, medical offices, outpatient clinics and surgery wards. Outside of from medical environments, PAs also work in educational facilities, military organizations and sports settings.

Most PAs work full time, with varying work schedules that may include weekends and holidays. Like doctors, they may be on call, having to work on short notice for long periods. Interacting with patients and colleagues for hours can become fatiguing, so PAs should have good stamina and interpersonal skills.

Obtaining a bachelor’s degree from an accredited college is the first step to becoming a physician assistant. PA programs typically accept applicants from various backgrounds, but they recommend a science-focused major, which will help you apply credits from your undergraduate coursework toward your PA prerequisites.

The American Academy of Physician Associates recommends that prospective PAs gain healthcare or patient care experience before applying to graduate school. HCE refers to paid or unpaid work where you’re not directly responsible for patient care, but you may still interact with patients. PCE, on the other hand, requires hands-on involvement in treating patients.

Most PA programs require at least 1,000 HCE or PCE hours, typically earned after working for about a year in the health sector. Roles that meet clinical experience requirements include paramedic, medical technician, surgical assistant, hospice worker, dental assistant, physical therapy aide and phlebotomist.

In a PA graduate program, you’ll gain the advanced knowledge needed to pass the national certifying exam and begin your physician assistant career. A PA program involves coursework in clinical anatomy, histology, clinical therapeutics and medicine principles. You may also undergo clinical rotations or clerkships, which involve shadowing licensed PAs.

Several colleges offer online PA programs, for distance learners. Such PA programs often offer concentrations, allowing students to tailor their degrees to suit their career goals. Common PA specializations include family medicine, geriatrics, women’s health, psychiatry, pediatrics and general internal medicine.

Students can apply for admission via the Centralized Application Service for Physician Assistants (CASPA). CASPA requires PA applicants to submit college transcripts, recommendation letters, résumés, personal statements, and HCE and PCE records.

Ensure your chosen program is approved by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) before applying.

Graduates from programs that hold accreditation from ARC-PA qualify to sit for the Physician Assistant National Certifying exam (PANCE). The exam is administered by the National Commission on Certification of Physician Assistants (NCCPA).

The PANCE is a five-hour, multiple-choice exam that assesses candidates’ medical and surgical knowledge. Passing the PANCE is required to earn PA licensure in all U.S states. Other specific licensing requirements may vary by state.

Completing all of the above steps often takes at least seven years. You can expect to spend four years in your undergraduate program, one year gaining healthcare experience and two years completing a PA program. The path to becoming a PA may take longer if you spend more time gaining experience between undergrad and grad school or if you need extra time to study for and pass the PANCE.

According to the U.S Bureau of Labor Statistics (BLS), physician assistants earned a median annual salary of $126,010 as of May 2022. Individual salaries vary based on industry, experience level and geographical location. For example, PAs in Washington earn $145,390 per year on average, whereas Florida PAs average $110,930 yearly.

Physician assistants are highly sought-after in certain parts of the U.S., including Connecticut, New York, North Carolina, Nebraska and Montana, which sport the highest concentrations of PA jobs. The BLS projects employment for these professionals to increase by 28% from 2021 to 2031—three times the projected job growth rate for other health practitioners nationwide, and nearly six times the projected growth rate for all U.S. jobs.

Physician assistants, just like nurses and clinicians, can specialize in various areas of healthcare according to their strengths and interests. PAs’ specialties largely determine their salary range and the kind of patients they’ll work with.

Most PA programs offer elective options, and some require students to complete supervised clinical experience in multiple specialty areas. They recommend deciding your PA specialization before enrolling in graduate school so you can choose a program offering in-depth training in your area of interest.

Below they list some common specializations for PA students and professionals.

This specialty teaches prospective PAs how to triage, stabilize and manage patients experiencing urgent health problems. In the emergency medicine specialty, students also learn how to present cases to doctors and develop skills to work with urgent care teams.

This concentration equips PA students with extensive knowledge on childbirth, midwifery and the female reproductive system in general. They learn to provide prenatal and postpartum care to women and offer counseling on family planning.

Pediatric PAs support pediatricians by caring for infants and children in ambulatory settings. Students in this concentration learn to evaluate common pediatric problems, offer preventive care and interpret treatment plans to their patients’ guardians.

The surgery specialization prepares PA students to evaluate and monitor surgical patients. They learn how to provide preoperative and postoperative care to surgical patients.

This specialization focuses on caring for and supporting patients living with psychiatric challenges. Students in this specialty learn how to conduct psychiatric evaluations, monitor patients’ progress and refer people to behavioral health specialists.

The certified physician assistant (PA-C) credential is the primary certification for PAs, earned only after passing the physician assistant national certifying exam. The PANCE is a five-hour exam comprising 300 multiple choice questions, administered in five blocks of 60 questions. Candidates are allowed to take 45-minute breaks between sessions.

Before sitting for the PANCE, candidates must graduate from a program accredited by the ARC-PA. Prospective PAs can apply for the exam within 180 days of their graduation date, but they can only sit for the exam starting seven days after graduation. You must submit a $550 fee and an application, after which you’ll receive an acknowledgement email from NCCPA with further instructions. If you fail the first attempt, you can retake the exam after 90 days.

Aside from the PA-C, NCCPA offers voluntary credentials for 10 PA specialties:

These credentials are called certificates of added qualifications (CAQs). They provide PAs with recognition for their specialized skills.

Although not required, joining a professional organization can boost a PA’s credibility and expand their opportunities for career development. Below they highlight two professional organizations created to support physician assistants.

PAs are not equal to doctors because doctors have more extensive training in the medical field and the authority to treat patients autonomously. In most states, PAs can only provide medical care according to doctors’ instructions.

PAs and MDs undergo different training experiences. While it takes about seven years to become a PA, MDs require 10-14 years of training. MDs also typically earn more salary than PAs.

A PA typically has more training and clinical experience than a registered nurse. PAs, like physicians, can diagnose illnesses and prescribe medication. RNs cannot.

Medical education providers say law ‘misused’ to force them out of business

Five years after the promulgation of the Medical Education Act, nursing and other non-university medical education providers are on continuous protests for the past few weeks saying that the government has misused the law forcing them to halt their services.

United under the umbrella of the Medical Education Concern and Struggle Committee, the medical education providers have been staging street protests on a daily basis. They accuse the Medical Education Commission of misinterpreting a provision in the Act to target them.

Clause 11 of the Medical Education Act envisions that each college teaching nursing and dental courses must set up a 100-bed hospital. Those, who are offering medical courses of the Council for Technical Education and Vocational Training, argue the provision applies only to the colleges providing university education.

However, the Commission has been claiming all institutions offering medical education fall under its jurisdiction. The commission in 2018 had given nursing colleges two years to build their own hospitals. But the colleges couldn't build the hospitals. As a result, the commission stopped them from taking new admissions. Not just the institutions under the CTEVT lack their own hospitals, but even nursing colleges affiliated with universities also do not have hospitals.

Nirmal Sapkota, general secretary of the Forum for Health and Technical Sciences who also is a coordinator of Medical Education Concern and Struggle Committee, said, as the Medical Education Act doesn’t replace the Council for Technical Education and Vocational Training Act, their colleges don't fall under the commission's jurisdiction.

"However, the commission overstepped its jurisdiction and stopped admission in the colleges that don’t have their own hospitals," he said. A total of 228 colleges including 136 offering pre-diploma-level health education, 73 providing diploma-level staff nurse courses and 18 colleges providing bachelors in nursing and bachelors in nursing science have ceased their operation due to the commission's decision, according to the struggle committee. "Our investment of some Rs15 billion is at risk," said Sapkota.

The medical education providers citing government estimates say it costs around Rs10 million (including fixed and operating costs) to develop one hospital bed. This means they will have to spend at least one billion rupees to set up a 100-bed hospital, which they say is beyond their capacity. "Even if they build their own hospitals there wouldn’t be sufficient flow of patients to make them economically viable," said Sapkota.

Currently, nursing colleges have been partnering with government hospitals for practical training of their students.

Netra Raj Chataut, chairperson of the Forum for Health and Technical Science, said some 4,000 students would enrol on nursing courses until 2021. "But now only 1,200 seats are available for the nursing courses with a decline of 2,800," he said. The nursing college operators say though over 10,000 students sit entrance exams, most of them are deprived of studying the courses of their choice in Nepal. "They go to India to study. Dozens of nursing colleges have sprung up in the Indian cities bordering Nepal," he said.

Washtenaw Community College named center of excellence in nursing education

ANN ARBOR, Mich. – The nursing program at Washtenaw Community College is one of nine programs across the United States to be honored by the National League for Nursing for its excellence in nursing education.

The Ann Arbor school is the only community college to be recognized this year. Around 120 nurses graduate each year, many of whom either immediately begin their healthcare careers or continue their medical education at the University of Michigan and Eastern Michigan University.

“This prestigious national designation offers a lifetime career boost for their students. They are honored that the dedication and hard work of WCC’s nursing faculty and staff, along with their exceptional nursing program, are recognized by the National League for Nursing,” said WCC President Dr. Rose B. Bellanca in a release.

The National League for Nursing bestows the title of Centers of Excellence based on faculty development, student learning, professional development, academic progression in nursing and nursing education research.

Students study in teaching hospitals, at clinical sites and with a simulation lab. They can receive an Associate in Applied Science through four different nursing programs.

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“Having gone through the nursing program at WCC, I would not expect less than a national excellence recognition,” said program graduate Ana Andrade in a release. “All instructors look for a better way to deliver content and share their knowledge while preparing students for the NCLEX licensure exam and getting students into many different clinical rotations for more practice. As soon as a hospital knows you graduated from WCC, they understand you are well-prepared, with much hands-on experience and theory knowledge,”

Faculty and staff noted that the school offers student support, clinical partnerships with local healthcare providers and a quality education reflective of the school’s commitment to lifelong learning and innovation.

WCC and other “Center of Excellence” schools will be recognized on Saturday, Sept. 30 during the 2023 NLN Education Summit.

Learn more about WCC’s nursing programs here.

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