A career as a physician assistant used to involve working in a primary discipline, such as primary care or surgery. But now physician assistants can be found in virtually every medical setting from psychiatry to emergency medicine to home health care to research to geriatrics. "Because we do clinical rotations in so many different areas, we can move from specialty to specialty without any additional training," says Jennifer Hixon, a physician assistant for 25 years and dean of the School of Physician Assistant Studies at the Massachusetts College of Pharmacy and Health Sciences (MCPHS).
At the same time, a physician shortage, healthcare reform, and an aging population have made physician assistant one of the nation's fastest growing professions. In 2008, Money Magazine ranked physician assistant one of the top careers to have in a recession, because of its rare combination of high pay and high security. Moreover, US News recently named physician assistant one of the Best Careers of 2009. This is no surprise to Hixon who says, "We are poised to be part of the solution to our country's healthcare problems, because we help make physicians and medical practices more efficient and effective."
Fueling demand is a 2003 Accreditation Council for Graduate Medical Education policy that limits the number of hours a resident physician can work to 80 per week. "The workload and need for patient care continues to expand, so many health care institutions are turning to physician assistants to fill the gap," explains Rosann Ippolito, program director and clinical professor at Northeastern University's Physician Assistant Program.
Physician assistants practice medicine under the supervision of physicians and surgeons. Unlike medical assistants, who perform routine clinical and clerical tasks, physician assistants are formally trained to provide diagnostic, therapeutic, and preventive health services. They take medical histories, examine and treat patients, order and interpret laboratory tests and x-rays, and make diagnoses. They also treat minor injuries, counsel patients, and prescribe medications.
Because physician assistant programs like the one at MCPHS and Northeastern train students to do much of what a physician does after only two years of study, these programs are competitive, condensed, and intense. Students take courses in biochemistry, pathology, human anatomy, physiology, microbiology, physical diagnosis and patient evaluation, clinical pharmacology, clinical medicine, surgery, primary care, geriatric and home health care, disease prevention, and medical ethics.
In other words, in two years the coursework mirrors that of medical school.
Students also undergo supervised clinical training in several areas, including family medicine, internal medicine, surgery, prenatal care and gynecology, geriatrics, emergency medicine, psychiatry, and pediatrics. "This patient care experience gives the applicant a familiarity with the language of medicine and the complex health care delivery system," says Ippolito. "This is key because physician assistant educators build upon that experience in the classroom."
"People always ask, 'How can you fit that all into two years?'" she adds. But she says that while the education is all consuming, given the fact that previous patient care experience is required of the applicants, this allows programs to sharpen their educational focus.
Hixon adds, "Certainly, it is very difficult. But it is preparing us for an intense position. The pace helps physician assistants manage the pace of the medical community and the job they end up doing."
Hixon is continually impressed by how much information students can absorb and put to use in such a short time, she says. "It is an incredible challenge for them-and it was for me. But with passion and drive you can do it. It's like climbing Mt. Everest. You just get there. And you reach the summit as a group."
It can be inspiring to witness this evolution year after year, Hixon says. "In an instant, the students are speaking a different language. They look different. They stand taller. Their white coats are starched. And they are ready to do their job."