What Exactly is a PA?
After I got accepted into PA school, someone congratulated me on getting into school in Pennsylvania. It was sweet, but not quite the right idea. Technically, there are PA schools in PA. But I attended a program in Miami Shores, Florida.
PA, short for Physician Assistant, is quite the misnomer.
People assume I’m an assistant to a physician (false). They say I’m a doctor, a nurse, a nurse practitioner, a medical assistant, etc. False, false, false, false. And I don’t blame them. Physician Assistant studies is a baby in the world of medicine. But before I get into what we actually are, here’s little of what we’re not.
“You’re a nurse, right?”
Nope. We work alongside with nurses, but we do different things. There are a number of skills nurses are trained in that I don’t know how to do. Think of nurses as your bedside angles, for real. Whatever you do, do NOT underestimate your nurse. On the other end of things, think of Physician Assistants as trying to figure out a puzzle: Why you’re here, what we see examining you, what labs we need to order, what to do with that information, etc.
“Okay, so you’re a doctor.”
Not exactly. I can’t take credit for the extra years of school/training that doctors do. My program is 28 months long for a Master’s in Clinical Medical Science. That includes classroom work and one year out on clinical rotations.
Doctors do two years in the classroom and the other two years include clinical rotations and interviewing for residency programs after they graduate. Residents are your working doctors in a program lasting an average of 4 years. Some will further go onto fellowships for even more specialized training. Doctors have “MD” on their white coats; PAs have “PA-C.” (C means you have passed the boards and are nationally Certified.) So instead of “Dr._____” I am referred to as, well, Carlie.
I’m not sure the accuracy behind this statement, but this is how our training was explained to us in school: “As PA students, you will learn 75% of what doctors learn but in 50% of the time.”
“So you’re a doctor’s assistant.”
Nope! Here’s where the big confusion lies, the title Physician Assistant. But to change the name means spending millions of dollars and changing decades of work. Although you will see in other countries they have adopted the term Physician Associate. Medical assistants are the team members that you typically see in medical offices who take you back to get your vitals, draw labs, understand billing, etc. Seeing the difference here? Good, carry on.
“So you’re a nurse practitioner.”
Getting much close, but not that either. Both Physician Assistants (PAs) and Nurse Practitioners (APRNs) are considered Advanced Level Practitioners. To be fair, in a lot of settings, PAs and APRNS are doing the same thing. They diagnose, treat, and prescribe. Both are “figuring out the puzzles” per say. The difference lies in the training model. Truthfully, I can’t specifically tell you what the nursing model is other than a large part of it is based on nursing theory. I have the utmost respect for anyone who has trained in nursing to any degree. I don’t know if I could do what they do and am incredibly thankful for them on the healthcare team. Under a different approach, PAs study under the medical model that doctors train under. Remember, “75% of the information in 50% of the time.”
Some other differences: APRNs get their nursing degree first and have experience working as a nurse before going back to school. PAs have their Bachelor’s in a variety of fields (mine = psychology) and can get their patient care experience from a number of ways before applying to PA school.
APRNs have the option of going to school part-time while maintaining their job. PA programs operate differently in that it is full time straight through. Not one of the 50 people in my class had a job during the 28 months of school (hellllooooo student loans).
Enough of what we’re not. Here’s a little of how PAs started:
- Back in the 1960s, the shortage of providers to patients was increasing.
- At that time, soldiers were coming home from the war and had experience in dealing with trauma and treating medical and surgical conditions.
- Duke University was the first to establish an accelerated medical program in 1965 consisting of four ex-navy corpsmen.
- Initially seen as physician substitutes, they could provide service in underserved areas under physician supervision.
Currently, there are 229 accredited PA programs across the States, but that number is certainly rising (80 of those programs have started in just the last decade). While writing this post, I also learned that there is now an international presence of PAs, which is incredibly exciting. Countries have endorsed the field and have started PA programs including Canada, Netherlands, Australia, South Africa, United Kingdom, Ireland, Isreal, Germany, Saudi Arabia and India. The Physician Assistant History Society has a great timeline you can check out here.
In summary, the traditional PA applicant has healthcare experience before applying to an accelerated version of medical school so they can diagnose, prescribe, and treat under physician supervision. In short, when people ask me what I went to school for, I say I studied medicine. At my job, I see and manage the patients, but have physicians around me to collaborate with given certain circumstances.
You will find PAs in every type of setting.
- At your primary care office (many people see their PA instead of their doctor)
- In hospitals after you’ve been admitted
- In the Emergency Room before you’re admitted
- They’re in surgery, gynecology, psychiatry, dermatology. Shall I go on?
It’s a field where you’re going to cross privacy borders and know us on a different level than any other professional you work with. In my schooling alone, I’ve done plenty of pelvic exams and I’ve assisted in delivering babies. I’ve done CPR on a soldier and I’ve explored the passageways of patients’ lungs. I’ve done rectal exams and I’ve counseled both a mother and teenage daughter on STD prevention (interesting scenario but had to be done).
This field gives me purpose. And even when we’re met with what feels like defeat with death or in the inability to cure, we are there through the process to give patients a fighting chance at disease or trauma and to improve their quality of life.
It comes with immense work and we were all warned about that before we got into school. Notably, it’s a jam-packed, wild lifestyle for those who crave adrenaline rushes and have a purpose in life of helping and healing. It’s for those who find out that being stretched to the limit is part of the game, and who can walk across a tightrope of academic life with medical books being thrown at your head, figuratively of course.
PA school was a journey like no other. I feel ever as fortunate to have been given the opportunity to be a part of this field.
Hopefully, I have cleared up some confusion with the name. If not, then you’re on your own… Until you’re sick or you need a checkup. Then you’re probably with us. 😉
Much love y’all ♥ Carlie
PS. Don’t hesitate to reach out if you’re considering applying to PA school and have questions, or if you have comments in general. I’d love to connect!