Physician assistants (PAs) are licensed clinicians authorized to practice medicine under the supervision of doctors. As a PA, you can examine patients, order lab tests and make diagnoses. You are also able to prescribe medication and create treatment plans, and do not have to have these treatment plans approved by a doctor.
The level of autonomy you have as a PA does depend on state laws and how they govern the PA practice environment, but many states are recognizing the benefits of allowing PAs to work independently. In a small number of states, you may need to collaborate with a supervising physician—however, the vast majority of PAs are independent advanced practice providers and can work with patients without a physician on-site.
Like physicians, PAs can choose specialties. After general training, you can specialize in areas like internal medicine, emergency medicine or surgery. Your specialty can also affect your earning potential as a PA.
Here’s a deeper look at some of the main focus areas for PAs.
Primary Care
In this specialty, you serve as the primary source for patients needing basic medical care, examinations or preventative medicine services. You’ll spend your days diagnosing illnesses, running lab tests and helping patients manage chronic conditions.
Primary care PAs can work in health centers or hospitals. You’ll find most opportunities in private and community clinics or urgent care facilities.
You can start a career as a primary care PA by passing the PANCE exam. Primary care PAs, like their peers in other specialties, need to complete 100 hours of continuing medical education (CME) every two years. This requirement is necessary for license renewal.
Emergency Care
Emergency care physician assistants work with emergency room (ER) doctors. As an emergency PA, your duties focus on assessing patients with injuries or illnesses and stabilizing them. You may collaborate with doctors to respond to the time-sensitive needs of patients. You will likely find work in hospitals or other medical facilities that treat patients requiring immediate care.
After obtaining a master’s degree, passing the PANCE and getting a license, you can specialize in emergency medicine.
According to the Society of Emergency Medicine PAs, you can enroll in an emergency medicine residency program or pursue a certificate of added qualifications (CAQ) in Emergency Medicine from the NCCPA. Though not required, this additional accreditation can be helpful for specialization. To qualify, you need 3,000 hours of experience in emergency medicine and a reference from an overseeing physician. You must also pass an exam.
Psychiatric Care
PAs specializing in psychiatry treat patients with mental health disorders and can work in settings such as hospitals, private clinics or government-run facilities. You also have the option of working in both in-patient and out-patient settings and with a variety of different patient populations, including children and adults, as well as individuals with substance abuse, sleep, anxiety or mood disorders, among many others.
In addition to providing physical care for patients, PAs in this specialty can also prescribe psychiatric medications and diagnose patients. However, if you choose to work in this specialty, you will not be providing talk therapy to patients—instead, you will most likely work alongside a larger medical team of psychologists and psychiatrists to help patients get the care that they need. Pursuing this specialty allows you to play a part in meeting the high demand for mental health care providers.
Surgery
Surgical physician assistants assist physicians during surgical procedures. You’ll work in a perioperative environment. This means you need skills to work on every aspect of surgery, from intake and preoperative preparations to surgery and recovery.
In addition to assisting surgeons during procedures, you may monitor patients before or after the procedure and handle follow-up exams to ensure proper healing.
You can pursue this specialty through a surgical residency after obtaining your PA license. It’s also possible to specialize in a type of procedure. For instance, the NCCPA offers CAQs in cardiovascular and thoracic surgery and orthopedic surgery.
Pediatric
Pediatric PAs work with patients under the age of 18. You can focus on different aspects of care within the pediatrics. For instance, you might offer primary care for children and adolescents in an outpatient clinic or work with infants in a neonatal department at a hospital.
As a pediatric specialist, you also have to focus on health care education. Your duties include educating parents on their children’s conditions and care needs. You may serve as their primary contact if they have questions.
You can seek a CAQ in pediatrics or enroll in a residency program that allows you to specialize in a specific area of pediatric medicine.
Internal Medicine
Internal medicine PAs focus on treating adult patients. In this specialty, you may provide primary care services. You might also work with patients needing ongoing care to manage diseases or chronic conditions.
Internal medicine specialists can provide acute care for patients needing treatment for illnesses or injuries requiring non-emergency care. You will also have to deal with diverse health needs—from addiction to psychological conditions. Similar to primary care PAs, internal medicine specialists work in medical clinics, hospitals or other medical facilities.
After completing clinical rotation and other licensing requirements, you can enroll in a residency program or begin gaining experience in internal medicine.
Pursuing Your Desired PA Specialty
If you are starting on your physician assistant career path, you do not need to make specialization requirements. Like all PAs, you first need to obtain a Master of Science in Physician Assistant Studies.
Programs typically take 24 to 26.5 months to complete and include classroom work and clinical rotations. Once you graduate and meet the requirements, you can take the PANCE exam. You can sit for the test three times per year, but you are limited to six tests in the six years following graduation.
After meeting any additional state requirements, you are qualified to work as a PA. You can use a residency program or gain clinical experience and pursue a CAQ certificate. These steps will help you gain the skills and accreditations necessary to work in your chosen medical specialty as a PA.