You do not have permission to edit this page, for the following reasons:
This IP address has been blocked from editing Wikipedia.
This does not affect your ability to read Wikipedia pages.
Most people who see this message have done nothing wrong. Some kinds of blocks restrict editing from specific service providers or telecom companies in response to recent abuse or vandalism, and can sometimes affect other users who are unrelated to that abuse. Review the information below for assistance if you do not believe that you have done anything wrong.

The IP address or range 34.205.0.0/16 has been blocked (disabled) by ‪ST47‬ for the following reason(s):

The IP address that you are currently using has been blocked because it is believed to be a web host provider. To prevent abuse, web hosts may be blocked from editing Wikipedia.
You will not be able to edit Wikipedia using a web host provider because it hides your IP address, much like a proxy or VPN.
We recommend that you attempt to use another connection to edit. For example, if you use a proxy or VPN to connect to the internet, turn it off when editing Wikipedia. If you edit using a mobile connection, try using a Wi-Fi connection, and vice versa. If you are using a corporate internet connection, switch to a different Wi-Fi network. If you have a Wikipedia account, please log in.
If you do not have any other way to edit Wikipedia, you will need to request an IP block exemption.

How to appeal if you are confident that your connection does not use a web host's IP address:
If you are confident that you are not using a web host, you may appeal this block by adding the following text on your talk page: ((unblock|reason=Caught by a web host block but this host or IP is not a web host. My IP address is _______. Place any further information here. ~~~~)). You must fill in the blank with your IP address for this block to be investigated. Your IP address can be determined here. Alternatively, if you wish to keep your IP address private you can use the unblock ticket request system. There are several reasons you might be editing using the IP address of a web host (such as if you are using VPN software or a business network); please use this method of appeal only if you think your IP address is in fact not a web host.

Administrators: The IP block exemption user right should only be applied to allow users to edit using web host in exceptional circumstances, and they should usually be directed to the functionaries team via email. If you intend to give the IPBE user right, a CheckUser needs to take a look at the account. This can be requested most easily at SPI Quick Checkuser Requests. Unblocking an IP or IP range with this template is highly discouraged without at least contacting the blocking administrator.

This block will expire on 05:44, 30 September 2026.

Even when blocked, you will usually still be able to edit your user talk page, as well as email administrators and other editors.

For information on how to proceed, please read the FAQ for blocked users and the guideline on block appeals. The guide to appealing blocks may also be helpful.

Other useful links: Blocking policy · Help:I have been blocked
Your IP address is in a range that has been blocked on all Wikimedia Foundation wikis. The block was made by ‪Jon Kolbert‬. The reason given is Open proxy/Webhost: See the help page if you are affected .
- Start of block: 05:38, 21 February 2024
- Expiry of block: 05:38, 21 February 2029
Your current IP address is 34.205.141.108. The blocked range is 34.205.0.0/16. Please include all above details in any queries you make. If you believe you were blocked by mistake, you can find additional information and instructions in the No open proxies global policy. Otherwise, to discuss the block please post a request for review on Meta-Wiki. You could also send an email to the stewards VRT queue at stewards@wikimedia.org including all above details.
You can view and copy the source of this page:
((distinguish|Assistant physician))
((Multiple issues|
((Factual accuracy disputed|date=April 2023))
((Globalize|article|USA|2name=the United States|date=April 2023))
))
((Short description|Mid-level health care provider))

A '''Physician Assistant''' or '''Physician Associate''' ('''PA''') is a type of [[healthcare professional]]. While these job titles are used internationally, there is significant variation in training and scope of practice from country to country, and sometimes between smaller jurisdictions such as states or provinces. Depending on location, PAs practice semi-autonomously under the supervision of a [[physician]], or autonomously perform a subset of medical services classically provided by physicians.<ref name="auto">((cite web |title=Where PAs and Physician Associates Can Work Internationally |url=https://www.thepalife.com/physician-assistants-pas-and-associates-around-the-world/ |website=The Physician Assistant Life |date=11 December 2018 |access-date=May 10, 2023))</ref>

The educational model was initially based upon the accelerated training of physicians in the United States during the shortage of qualified medical providers during [[World War II]].  Since then, the use of PAs has spread to at least 16 countries around the world.<ref name="auto"/><ref>((Cite web |title=History of the PA Profession|publisher=[[American Academy of Physician Assistants]] |date=n.d. |access-date=13 June 2022 |url= https://www.aapa.org/about/history/ ))</ref> In the US, PAs may diagnose illnesses, develop and manage treatment plans, prescribe medications, and serve as a principal [[healthcare provider]]. In many states PAs are required to have a direct agreement with a [[physician]].<ref>((Cite web|title=What is a PA? - Frequently Asked Questions|url=https://www.aapa.org/wp-content/uploads/2019/09/FAQs_NewLayout_August2019.pdf|access-date=2021-04-03|publisher=[[American Academy of Physician Assistants]]))</ref> 
In the UK, PAs were introduced in 2003. They support the work of the healthcare team, but are dependent clinicians requiring supervision from a physician.<ref name="sheikh">((Cite news |title=Operose Health: UK's biggest GP chain replacing doctors with less qualified staff |last1=Sheikh |first1=Rahil |last2=Mole |first2=Charlie |last3=Holder |first3=Sam |website=BBC News |date=13 June 2022 |url= https://www.bbc.co.uk/news/health-61759643))</ref> They cannot prescribe medications nor request ionising radiation investigations (e.g., x-ray) in the UK.<ref name=":2" />  PAs are widely used in Canada.  The model began during the [[Korean War]] and transitioned to the present concept in 2002.  Skills and scope of privileges are similar to those in the US.<ref name="auto"/>
((Toclimit|3))

==Nomenclature==

The occupational title of physician assistant and physician associate originated in the United States in 1967 at [[Duke University]]. The role has been adopted in the US, Canada, UK and Ireland, each with their own nomenclature. The role has been adopted in the US, Canada, United Kingdom, Republic of Ireland, Netherlands, Australia, New Zealand, India, Israel, Bulgaria, Myanmar, Switzerland, Liberia, Ghana, and by analogous names throughout Africa, each with their own nomenclature and education structure.

{| class="wikitable sortable mw-collapsible mw-collapsed plainrowheaders"
! Jurisdiction !! Title !! Abbreviation !! Test !! Certifying Authority
|-
| United States || Physician Associate/Physician Assistant || PA-C || Physician Associate National Certification Exam ||National Commission on Certification of Physician Associates<ref name=aapa>((citation|url=https://www.aapa.org/title-change|title=PA Title Change Investigation|work=American Academy of Physician Associates))</ref> with accompanying state-level certification.
|-
| Canada || Canadian Certified Physician Assistant || CCPA || Entry to Practice Examination || Physician Assistant Certification Council of Canada<ref>((Cite web|url=https://capa-acam.ca/paccc/elgibility/|title=Certification Exam Eligibility|website=CAPA - ACAM))</ref> with accompanying provincial  certification
|-
| United Kingdom || Physician Associate || PA-R || Physician Associate National Certification Examination || Royal College of Physicians<ref name=UK>((Cite web|url=https://www.fparcp.co.uk/examinations/overview/|title=The Physician Associate National Examinations|publisher=Faculty of Physician Associates|website=www.fparcp.co.uk))</ref>
|-
| Republic of Ireland || Physician Associate || PA || none || none
|-
| Kenya || [[Clinical officer]] || CO || Clinical Officers Licensing Examination || [[Clinical Officers Council]]
|-
| South Africa || Clinical Associate<ref>World Health Organization. ''Classifying health workers''. Geneva, WHO, 2010.</ref> || ||
|-
| Malaysia || [[Assistant Medical Officer]] || || || Malaysia Medical Assistant Board (Lembaga Pembantu Perubatan Malaysia)
|-
| India || Physician Assistant/Physician Associate || PA || National common Entry and Exit Examination. || NCAHP, Ministry of Health and Family Welfare, Government of India.
|-
| China || [[Assistant doctor (China)|Assistant Doctor]]<ref>((Cite web|title=Archived copy|url=http://www.unhcr.org/refworld/pdfid/4b6fe1b10.pdf|url-status=dead|archive-url=https://web.archive.org/web/20160609200938/http://www.unhcr.org/refworld/pdfid/4b6fe1b10.pdf|archive-date=2016-06-09|access-date=2012-12-05))</ref> || || ||
|-
| [[Papua New Guinea]]||[[Health Extension Officer]]<ref>((cite web|title=Divine Word University|url=http://www.dwu.ac.pg/faculties/fhs/he/bhs.html|url-status=dead|archive-url=https://web.archive.org/web/20101128014328/http://dwu.ac.pg/faculties/fhs/he/bhs.html|archive-date=2010-11-28|access-date=2011-09-07))</ref> || || ||
|-
| Former [[Soviet Union]] || [[Feldsher]]<ref name="isco08">((Cite web|title=ISCO - International Standard Classification of Occupations|url=http://www.ilo.org/public/english/bureau/stat/isco/isco08/index.htm|access-date=2019-02-05|website=Ilo.org))</ref>|| || ||
|-
| Israel || Physician Assistant<ref name=JAAPA-israel/> || PA-R || ||
|}

==Services==
Physician assistants or associates may:
* conduct patient interviews and take medical histories
* conduct physical examinations
* order and interpret diagnostic tests and exams (''in some countries'')
* diagnose illnesses
* formulate treatment plans
* coordinate and manage care
* perform medical procedures
* prescribe medications (''in some countries'')
* conduct clinical research
* provide patient counselling
* offer advice on preventative health care
* first assist in surgery<ref>((cite web|url=http://medicine.yale.edu/pa/profession/index.aspx|title=Physician Associate Program: The PA Profession|date=4 January 2013|publisher=Yale School of Medicine|access-date=23 December 2014))</ref>
* Can serve as a Clinical Tutor,Assistant professor, Associate Professor,Professor(Depending on Academic qualifications along with Experience).

== Workplaces ==
Physician assistants or associates train to work in settings such as [[hospital]]s, [[clinic]]s and other types of health facilities, or virtually via [[telemedicine]]. PAs are commonly found working in teaching and research as well as hospital administration and other clinical environments. PAs may practice in [[primary care]] or medical specialties, including emergency medicine, surgery and cardiology.<ref>((cite web | title = What is a PA? Infographic | publisher = American Academy of PAs | url = https://www.aapa.org/wp-content/uploads/2020/07/WhatIsAPA-Infographic-MAY2020.pdf | access-date = 18 Sep 2020))</ref>

== Training ==
Physician assistant (or associate) education is shorter than a medical degree required to become a physician. It also typically does not involve [[residency training]], although this is increasingly offered in a variety of specialties.

Renewal of certification is usually required every few years, varying by jurisdiction.((Cn|date=April 2023))

== History ==
In 1961, Charles Hudson recommended that the [[American Medical Association]] create new medical provider certifications. [[Eugene A. Stead]] of the [[Duke University]] Medical Center assembled the first class of physician assistants in 1965, composed of four former [[United States Navy|US Navy]] [[Hospital Corpsman|Hospital Corpsmen]].<ref>((cite journal |first1=J A |last1=Braun |first2=D R |last2=Howard |first3=L R |last3=Pondy |title=The physician's associate-a task analysis |journal=[[American Journal of Public Health]] |date=December 1973 |volume=63 |number=12 |pages=1024–1028 |doi=10.2105/AJPH.63.12.1024|pmid=4148535 |pmc=1775358 ))</ref><ref>((cite web |url=http://pahx.org/stead-jr-eugene |title=Eugene A. Stead, Jr., MD |publisher=PA History Society |access-date=19 June 2016))</ref> He based the curriculum of the PA program on his first-hand knowledge of the fast-track training of medical doctors during [[World War II]].<ref name="aapa.org">((cite web |url=http://www.aapa.org/threeColumnLanding.aspx?id=429 |title=History of the PA Profession |publisher=American Academy of Physician Assistants |access-date=26 December 2014 |archive-url=https://web.archive.org/web/20141226234522/http://www.aapa.org/threeColumnLanding.aspx?id=429 |archive-date=2014-12-26 |url-status=dead ))</ref> Two other physicians, Richard Smith at the [[University of Washington]], and Hu Myers at [[Alderson Broaddus University|Alderson-Broaddus College]] launched their own programs in the mid-late 1960s. J. Willis Hurst started the [[Emory University]] Physician Assistant Program in 1967.

The Liberian model of PAs was a curriculum intended for graduates to work in areas absent of physicians as physician substitutes.  Advisors for this program included UNICEF, American physicians, and Agnes N. Dagbe, MS, RN, a Liberian nurse educated in the US.  Additional training was done in the USSR.  The Liberian government inaugurated the program in 1965 with Dagbe as PA program.<ref>((cite journal|last1=Oliphant|first1=John|last2=Kennedy|first2=Jallah|title=The PA profession in Liberia: A case study in pioneering innovation and resiliency|doi=10.1097/01.JAA.0000873788.94386.1b|journal=JAAPA|volume=35|issue=10|date=October 2022|pages=56–61|pmid=36165551 |s2cid=252534492 |url=https://journals.lww.com/jaapa/Fulltext/2022/10000/The_PA_profession_in_Liberia__A_case_study_in.14.aspx))</ref>

Beginning in January 1971,<ref>((cite journal |url=http://www.paeaonline.org/index.php?ht=action/GetDocumentAction/i/25103 |title=Military Physician Assistants: Their Background And Education |first1=Judith E. |last1=Colver |first2=J. Dennis |last2=Blessing |first3=Jason |last3=Hinojosa |journal=Journal of Physician Assistant Education |date=2007 |volume=18 |issue=3 |pages=40–45 |doi=10.1097/01367895-200718030-00005))</ref> the US Army produced eight classes of physician assistants, at 30 students per class, through the [[United States Army Medical Department Center and School|Academy of Health Sciences]], [[Brooke Army Medical Center#Brooke Army Medical Center|Brooke Medical Center]] (academically accredited by [[Baylor University]]).

In 2017, approximately 68% of physician assistants in the United States were women and approximately 32% were men.<ref>((Cite web|title=2017 Statistical Profile of Certified Physician Assistants: An Annual Report of the National Commission on Certification of Physician Assistants.|url=https://prodcmsstoragesa.blob.core.windows.net/uploads/files/2017StatisticalProfileofCertifiedPhysicianAssistants%206.27.pdf|url-status=live|archive-url=https://web.archive.org/web/20201222212015/https://prodcmsstoragesa.blob.core.windows.net/uploads/files/2017StatisticalProfileofCertifiedPhysicianAssistants%206.27.pdf|archive-date=2020-12-22|access-date=2021-04-03|website=))</ref>

The profession expanded globally. It can now be found in Afghanistan, Australia, Canada, Germany, Ghana, India, Israel, Liberia, the Netherlands, New Zealand, Saudi Arabia, and the United Kingdom. As a profession, physician assistants have greatly influenced the theory and conceptualization of socially accountable health professional education.<ref>((cite journal |last1=Kerlon |first1=Ando |last2=Forde |first2=Allan |last3=Preston |first3=Robyn |title=Social Accountability of the Physician Assistant: A Fit-for-Purpose Health Workforce |journal=The Journal of Physician Assistant Education |date=March 2016 |volume=1 |issue=27 |pages=43–46 |doi=10.1097/JPA.0000000000000053 |pmid=26894952 |s2cid=9265616 ))</ref>

==Jurisdictions==

=== Australia ===
In 2011, Health Workforce Australia began developing the role of physician assistant throughout the country culminating with registration and a PA Program based out of [[James Cook University]].<ref>((cite web |title=Why James Cook is starting a PA Program |url=https://www.croakey.org/why-james-cook-university-is-starting-a-physician-assistant-program/ |website=Crokey Health Media |access-date=May 13, 2023))</ref> The Australian Society of Physician Assistants in 2011 published a code of practice.<ref>((cite web |title=Table of Contents |url=http://www.aspa-australianpas.org/forms/code_of_practice_may13.pdf |website=Code of Practice))</ref> Despite all initial indicators showing that the new profession would be successfully integrated into the health care system, in 2013 it was reported that the progress had floundered resulting in the majority of PAs in Australia being unemployed.<ref>((Cite web|title=Physician Assistants in Australia: the solution to workforce woes?|url=http://www.amsj.org/archives/3005|access-date=2018-04-17|website=Australian Medical Student Journal|language=en-AU))</ref>

===Canada===
((As of|October 2018)), there are approximately 800 physician assistants working in healthcare settings in Canada.<ref name="auto1">((cite web |url=https://capa-acam.ca/about-pas/ |title=About PAS |publisher=Canadian Association of Physician Assistants |access-date=8 October 2015))</ref> The first formally trained physician assistants graduated in 1984 from the [[Canadian Forces Medical Service|Canadian Forces Medical Services School]] at Borden, Ontario.<ref name="CAPA history">((cite web |url=http://capa-acam.ca/about-pas/history/ |title=About PAs: History |publisher=Canadian Association of Physician Assistants |access-date=8 October 2015))</ref> The [[Canadian Medical Association]] (CMA) recognized physician assistants as a health professional in 2003.<ref name="CAPA history" /> Physician assistants are able to perform medical functions such as ordering tests, diagnosing diseases, prescribing medications, treating patients, educating patients and performing various medical and surgical procedures. Physician assistants are labeled under the federal government national occupational classification code 3124: allied primary health practitioners.<ref>((Cite web|url=https://noc.esdc.gc.ca/Error/ServerError404/2ac8f9140b764c69bd149542760a8e0e|title=Error 404 - Canada.ca|website=noc.esdc.gc.ca))</ref>

==== Education and certification (Canada) ====
((Refimprove-section|date=May 2021))
The first civilian physician assistant education programs were launched in 2008 at the [[University of Manitoba]] and [[McMaster University]].<ref name="CAPA history" /> In 2010, a third civilian program was launched by the consortium of physician assistant education ([[University of Toronto]], [[Northern Ontario School of Medicine]], and [[The Michener Institute]]) while further programmes were added in 2024 at [[Dalhousie University]]<ref>((cite web |url=https://www.newswire.ca/news-releases/new-training-program-at-dalhousie-will-help-address-health-workforce-challenges-867151453.html |title=New Training Program at Dalhousie will help address Health Workforce Challenges |publisher=Cision |access-date=9 January 2024))</ref> and at the [[University of Calgary]].<ref>((cite web |url=https://ca.news.yahoo.com/albertas-first-training-program-physician-192334373.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAFI6sGSl_w7JOLbrfKCrLprWRaRedTMHF72A88UAXwlj765Not7i2QBUhCzQos_2d7_BthX_XP4aN_o9xyCggy8Yo7uZBSD_qs3m0N8yUyJel9IAqfV3L3Q8uOw_vxcEHB9ADG69KKEx_vjPNEzeYElp6wyz3EMtvOm-lvodvETB |title=Alberta's first training program for physician assistants launches in Calgary
 |publisher=Yahoo News |access-date=28 March 2024))</ref>

In Canada, the education of a physician assistant generally consists of three years of professional post-graduate university education. The education is delivered over a two calendar year time-frame by completing fall, winter and summer semesters for both years of the program in either a master level university physician assistant program or post-graduate professional university bachelor level physician assistant program. Physician assistant graduates become eligible for the certification exam by being a graduate of a Canadian physician assistant program that is recognized by the Physician Assistant Certification Council of Canada (Canadian Armed Forces physician assistant program, University of Manitoba, McMaster University and the consortium of physician assistant education all of which are accredited by the Canadian Medical Association).<ref name="auto1"/>

====Scope of practice (Canada)====
As of 2023 PAs in Canada may:
:
Physician assistants resemble and provide many of the functions of Physician Assistants (PA) are academically prepared and highly skilled health care professionals who provide a broad range of medical services. PAs are physician extenders and not independent practitioners; they work with a degree of autonomy, negotiated and agreed on by the supervising physician(s) and the PA. PAs can work in any clinical setting to extend physician services. PAs complement existing services and aid in improving patient access to health care. A relationship with a supervising physician is essential to the role of the PA. "<ref>((cite web |title=Canadian Association of Physician Assistants Association canadienne des adjoints au médecin |url=https://capa-acam.ca/about-pas/ |website=web page |access-date=May 13, 2023))</ref> Physician assistants may be compared to the role of nurse practitioner by the general public and may be confused as the same profession. Nurse practitioners in Canada practice under an advanced nursing model.<ref>((Cite journal|url=https://www.longwoods.com/content/22268/nursing-leadership/a-historical-overview-of-the-development-of-advanced-practice-nursing-roles-in-canada|title=A Historical Overview of the Development of Advanced Practice Nursing Roles in Canada|first1=Sharon|last1=Kaasalainen|first2=Ruth|last2=Martin-Misener|first3=Kelley|last3=Kilpatrick|first4=Patricia|last4=Harbman|first5=Denise|last5=Bryant-Lukosius|first6=Faith|last6=Donald|first7=Nancy Carter and Alba|last7=DiCenso|date=December 1, 2010|journal=Nursing Leadership (Toronto, Ont.)|volume=23 Spec No 2010 |pages=35–60 |doi=10.12927/cjnl.2010.22268 |pmid=21478686 |doi-access=free))</ref> Physician assistants practice under a medical model, similarly modeled after medical school (physician) education.<ref>((Cite web|date=September 2009|title=Canadian Association of Physician Assistants Scope of Practice and National Competency Profile|url=https://capa-acam.ca/wp-content/uploads/2012/12/NCP_en_sept20092.pdf|access-date=2021-04-03|website=capa-acam.ca))</ref> Nurse practitioners practice within their defined specific scope of practice autonomously and sometimes collaboratively. The defined scopes of a nurse practitioner include the areas of (family care, adults and paediatrics). Physician assistants are permitted to practice in all medical specialties by mirroring the practice of a physician with a full range of skills and scope by practicing both autonomously as a clinician and collaboratively with physicians when required. Some examples of practice areas for physician assistants include (emergency medicine, critical care medicine, cardiology, psychiatry, community and family medicine, neurology, surgery, orthopaedics, internal medicine, oncology, gastroenterology, military medicine, respirology, dermatology, women's health and many more specialities). Physician assistants may perform certain roles which have been traditionally only provided by physicians in clinical practice, making the PA's medical training over other providers unique in this regard.((Citation needed|date=April 2023))

((Factual accuracy disputed|date=April 2023))

==== Compensation (Canada) ====
Physician assistant salaries in civilian practice in Canada are relatively new and can range from approximately $80,000 CAD for entry level positions to $142,000 CAD a year for experienced providers which are not on call and up to $178,000 CAD for experienced providers which are on call.<ref>((cite web |url= http://www.pcam.ca/wp-content/uploads/2017/10/Collective-Agreement-between-WRHA-and-PCAM-FULLY-EXECUTED.pdf|title=COLLECTIVE AGREEMENT |date= 2017|website= www.pcam.ca|access-date=2021-04-04))</ref> The physician assistant profession is newer to civilian practice in Canada. The compensation report published in 2019 by the Canadian Association of Physician Assistants outlines the typical salaries across Canada being an entry median salary of approximately $80,000 CAD and an experienced median salary of approximately $105,000 CAD.<ref>((Cite web|date=2019|title=The Canadian Association of Physician Assistants - Compensation Report - 2019|url=https://capa-acam.ca/wp-content/uploads/2019/09/PA-Compensation-2019.pdf|access-date=2021-04-03|website=capa-acam.ca))</ref>

==== Regulation (Canada) ====
Physician assistants are currently practicing across Canada in the Canadian Armed Forces as commissioned officers in domestic and international environments and have been in practice since the 1960s.<ref>((Cite web|url=https://www.canada.ca/en/department-national-defence/news/2016/06/canadian-armed-forces-creates-new-officer-occupation-for-physician-assistants.html|title=Canadian Armed Forces creates new officer occupation for Physician Assistants|first=National|last=Defence|date=June 3, 2016|website=gcnws))</ref> Physician assistants outside of the Canadian Armed Forces practice usually in the public health care system in the provinces of Manitoba, Ontario, New Brunswick, Nova Scotia, and Alberta.((citation needed|date=June 2021)) Physician assistants have been regulated in Manitoba since 1999 and in New Brunswick since 2009<ref>((cite web |url= https://capa-acam.ca/wp-content/uploads/2017/10/Historical-Events_Sept_2017_FINAL.pdf|title= Canada's Physician Assistant Historical Timeline|date=2017 |website=capa-acam.ca |access-date=2021-04-04))</ref> and are registrants of their respective provincial college of physicians and surgeons. In Ontario, Alberta and Nova Scotia the profession is not regulated at this time.((Citation needed|date=April 2023)) Physician assistants in Ontario were introduced in 2007 to the public health system as a joint venture between the Ontario Ministry of Health and the Ontario Medical Association.<ref>((Cite web|url=https://www.healthforceontario.ca/en/Home/Health_Providers/Physician_Assistants?_ga=2.196839212.1021625597.1593876282-472451766.1593876282|title=Physician Assistants|website=www.healthforceontario.ca))</ref> In Alberta, a registry has been established for physician assistants under the [[College of Physicians and Surgeons of Alberta]] with future regulation underway.<ref>((cite web |url=https://www.albertahealthservices.ca/medstaff/Page8754.aspx#:~:text=PAs%20are%20nationally%20represented%20by,in%20Alberta%20is%20still%20underway |title= Medical Staff |website=www.albertahealthservices.ca|access-date=2021-04-04))</ref> In Ontario, future regulation has been discussed by the Ontario Ministry of Health in which physician assistants would be members of the [[College of Physicians and Surgeons of Ontario|College of Physicians and Surgeons of Ontario.((Citation needed|date=April 2023))]] Physician assistants are represented by the Canadian Association of Physician Assistants, which originally was formed in October 1999.<ref name="CAPA history" />
As of 2023, PAs scope of practice in Canada is described at their website:
:The PA's scope of practice is determined on an individual basis and formally outlined in a practice contract or agreement between the supervising physician(s), the PA and often the facility or service where the PA will work. Activities may include conducting patient interviews, histories and physical examinations; performing selected diagnostic and therapeutic interventions or procedures; and counseling patients on preventive health care.((cn|date=May 2023))

=== Germany ===
Physician Assistants / Associates were established in Germany as a degree course in 2005. (''[[:de:Arztassistent]]'' <ref>((Cite web|url=https://www.gesundheit-studieren.com/berufe/arztassistent/|title=Arztassistent|date=January 4, 2024|website=www.gesundheit-studieren.com))</ref>). Recruitment had initially been slow, but as of 2019 there were said to be several hundred ''[[:de:Arztassistenten]]'' in Germany.

=== India ===
The first PA program in India was established in 1992 with a focus on expanding cardiovascular surgery. Since then, eight additional programs have developed (in total seven baccalaureate and four master's level programs).<ref>((cite journal |title=Physician assistant education in India |first1=Luppo |last1=Kuilman |first2=Gomathi |last2=Sundar |last3=Cherian |first3=KM |journal=J Physician Assist Educ |date=January 2012 |volume=23 |issue=3 |pages=56–9 |doi=10.1097/01367895-201223030-00010|pmid=23072073 ))</ref> The profession is regulated by the [[National Commission for Allied and Healthcare Professions]], Ministry of Health & Family Welfare, Government of India.

=== Ireland ===
Physician Associates were introduced by the [[Health Service Executive]] in the mid-2010's. The [[Royal College of Surgeons in Ireland|Royal College of Surgeon]]s has offered a PA [[postgraduate degree]] since 2016,<ref>((Cite news |date=2018-07-03 |title=Physician associate role has 'a lot to offer' — HSE HR chief |language=en-US |url=https://www.medicalindependent.ie/physician-associate-role-has-a-lot-to-offer-hse-hr-chief/ |access-date=2021-06-26 |website=[[Medical Independent]]))</ref> with 28 graduating by ((as of|2021|1|alt=January 2021)).<ref name="MedIndoSoFar.ie"/> PAs may not write [[Medical prescription|prescriptions]].<ref name="MedIndoSoFar.ie">((Cite news |last=Reilly |first=Catherine |date=2021-01-11 |title=Introducing physician associates to Ireland: The story so far |language=en-US |website=[[Medical Independent]] |url=https://www.medicalindependent.ie/introducing-physician-associates-to-ireland-the-story-so-far/ |access-date=2021-06-26))</ref>

=== Israel ===
Physician Assistants were introduced in Israel in May 2016 to help augment a shrinking physician workforce. The initial training programs have been overseen by the ministry of health directly, but transition to academic training is planned.((Citation needed|date=April 2023)) Israeli PA education is modeled after United States' and Netherlands' approaches, and has focused on former paramedics with bachelor's degrees.((Citation needed|date=April 2023)) As of 2022, the 100 or so PAs in Israel work exclusively within Emergency Departments. While PA scope of practice includes many emergency procedures, Israeli PAs are not currently allowed to prescribe or administer medicine in non-emergency settings.<ref name=JAAPA-israel>((cite journal|title=The PA profession in Israel: A half-decade perspective|last=Ozer|first=Roi|journal=[[JAAPA]]|volume=35|issue=11|date=November 2022|url=https://journals.lww.com/jaapa/pages/articleviewer.aspx?year=2022&issue=11000&article=00012&type=Fulltext|accessdate=December 25, 2022|pages=57–61|doi=10.1097/01.JAA.0000885172.21571.8b|pmid=36282580 |s2cid=253108293 ))</ref>

=== New Zealand ===
In February 2015, Health Workforce New Zealand completed a Phase-2 trial of PAs who worked for a period of two years (2013–2015) in four clinical settings.<ref name=":0">((Cite book|last=Sarah|first=Appleton-Dyer|title=Phase II of the physician assistant demonstrations, evaluation report : report for Health Workforce New Zealand|others=Field, Adrian, 1966-, Dale-Gandar, Linden,, Boswell, Angela,, Wright, Matthew (Doctor),, Mahoney, Faith,, Hanham, Grant (Consultant)|year=2015 |isbn=9780478448665|location=Auckland|oclc=919088530))</ref> Specifically, the sites included one rural emergency department and three primary care settings (two rural and one urban) located on the North and South Islands of New Zealand.<ref name=":0" /> At conclusion of the trial, several clinics continued to employ PAs while the process of health regulation makes its way through the government bureaucracy.((Citation needed|date=April 2023))

=== United Kingdom ===
The position of physician assistant was established in the United Kingdom in 2005. It evolved from that of physician assistant, developed in the US in the 1960s.((Citation needed|date=April 2023)) In 2012, a group of physician assistants voted to change the name to ''physician associate'', this title is however exceedingly close to the title ''Associate Physician'', which represents a senior medical doctor. [[Hillingdon Hospitals NHS Foundation Trust]] was asked to manage the recruitment of 200 physician associates who are expected to come from the US for 40 [[NHS trust]]s in September 2015.<ref>((cite news|date=11 September 2015|title=London trust to recruit 200 physician associates for 40 providers|publisher=Health Service Journal|url=http://www.hsj.co.uk/hsj-local/acute-trusts/the-hillingdon-hospitals-nhs-foundation-trust/london-trust-to-recruit-200-physician-associates-for-40-providers/5090211.article#.ViqxBEpup1A|url-access=subscription|access-date=23 October 2015))</ref>

Physician Associates are not regulated and are therefore not registered healthcare professionals. They are not able to prescribe or order tests which require ionising radiation. Legally, Physician Associates cannot work autonomously, as the provision of treatment is regulated by the Health and Social Care Act, which explicitly legislates the protected professional titles of the registered healthcare professionals that can undertake the regulated activities of providing treatment.

In 2022 it was reported that private company Operose Health, owned by US company [[Centene Corporation]], which had acquired many UK [[National Health Service]] (NHS) GP practices, was using many PAs—at less than half the cost of a GP<ref name=wakefield/><ref>((Cite news |title=Britain's biggest chain of GP surgeries accused of 'profiteering' |last=Campbell |first=Denis |newspaper=The Guardian|date = 13 June 2022 |url= https://www.theguardian.com/society/2022/jun/13/britains-biggest-chain-of-gp-surgeries-accused-of-profiteering))</ref>—and allowing them essentially to act as GPs, without required supervision. A [[BBC]] reporter worked undercover at an Operose practice for six weeks, reporting on many problems.<ref name=wakefield>((Cite news |title=Operose Health: What I saw working undercover at a GP surgery |last=Wakefield |first=Jacqui |website=BBC News |date=13 June 2022 |url= https://www.bbc.co.uk/news/health-61759641))</ref>  A senior GP said that the company was prioritising profit, putting patients at risk.<ref name=sheikh/>

In July 2023, the death of Emily Chesterton raised questions about the naming of physician associates in the UK. Emily died from a [[pulmonary embolism]] after seeing a physician associate twice in the weeks proceeding her death, who had misdiagnosed her and asked for her to be given anxiety medication. Emily was under the impression she was seeing her GP, and not a physician associate. After her death, Emily's mother and her local MP, [[Barbara Keeley]], called for more regulation around physician associates and for the role to be renamed to avoid confusion.<ref>((Cite news |date=2023-07-12 |title=Misdiagnosis: Bereaved mum calls for physician associate role clarity |language=en-GB |work=BBC News |url=https://www.bbc.com/news/uk-england-manchester-66168798 |access-date=2023-07-12))</ref><ref>((Cite web |title=House of Commons 6th July 2023 Debate: Physician Associates, Question by Barbara Keeley |url=https://hansard.parliament.uk/Commons/2023-07-06/debates/D98F2ABE-7B33-4748-B88E-ED7243469131/details |website=UK Parliament Hansard))</ref>

In July 2023 a motion was brought forward for discussion by the [[British Medical Association]] to rename PAs clearly as Physician Assistants in the U.K. to avoid role confusion with Physicians and for them to be registered with the [[Health and Care Professions Council]].<ref>((Cite web |date=2020-06-12 |title=Call for alternative regulator of – and to rename – physician associates |url=https://www.bma.org.uk/news-and-opinion/call-for-alternative-regulator-of-and-to-rename-physician-associates |access-date=2023-08-10 |website=The British Medical Association is the trade union and professional body for doctors in the UK. |language=en-gb))</ref>

In February 2024 a story broke about make up artist [[Christopher Tucker]] receiving a cystoscopy despite symptoms of a urinary infection.  He received no antibiotics for the infection or as prophylaxis after the procedure.  He died less than 48 hours later. The Physician Associate involved then took part into the investigation of their own practice in the case.<ref>((Cite news |last=team |first=Investigations |date=2024-02-24 |title=Family of film make-up artist call for inquest after treatment by physician associate |url=https://www.telegraph.co.uk/news/2024/02/24/family-make-up-artist-call-for-inquest/ |access-date=2024-02-24 |work=The Telegraph |language=en-GB |issn=0307-1235))</ref>

==== Faculty of Physician Associates, Royal College of Physicians (UK) ====
The [[Faculty of Physician Associates]] is the professional body for Physician Associates working in the United Kingdom.((Cn|date=February 2024)) A joint venture between the [[Royal College of Physicians]] of London and the previous professional body, the United Kingdom Association of Physician Associates, the Faculty officially launched in July 2015, taking over all professional responsibilities.((Citation needed|date=April 2023)) The Faculty oversees the managed voluntary register, which all practising associates are encouraged to join, and sets and runs the National Assessment Examination and National Recertification Examination which is optional for PAs.<ref name=fparcpfaq/>

====Scope of practice (UK)====
In the United Kingdom, PAs are dependent practitioners, and they must practice under the supervision of a physician.<ref name=":2">((Cite web |title=Becoming a PA ((!)) Faculty of Physician Associates - quality health care across the NHS |url=https://www.fparcp.co.uk/becoming-a-pa |access-date=2023-04-10 |website=www.fparcp.co.uk))</ref> Physician Associates/Assistants are trained under the medical model, similarly to physicians, to deliver medical care in primary, secondary, and tertiary care settings.((Cn|date=February 2024))  They perform some tasks relating to diagnosis, taking medical histories, ordering and interpreting laboratory tests.<ref>((cite web|date=2015-03-26|title=Physician associate|url=http://www.nhscareers.nhs.uk/explore-by-career/doctors/careers-in-medicine/physician-associate/|access-date=22 October 2017|website=Nhscareers.nhs.uk))</ref> PAs cannot legally request ionising radiation investigations such as a [[CT scan]] or radiographs,<ref name=":2" /> they also cannot legally prescribe any medications.

There is no nationally agreed upon scope of practice for Physician Associates in the United Kingdom as of 2024, despite them working in the United Kingdom for over a decade.

In early 2024, the [[British Medical Association]] published their recommendations for doctors supervising PAs<ref>((Cite book |title=Safe scope of practice for Medical Associate Professionals (MAPs) |publisher=British Medical Association |location=https://www.bma.org.uk/media/tkcosjt1/maps-scope-of-practice2024-web.pdf |publication-date=2024))</ref> in an effort to formulate a scope of practice aligned to the education received by PAs. 

The six core principles of this guidance are:<ref>((Cite web |last=Parr |first=Eliza |date=2024-03-07 |title='First of its kind' guidance sees BMA set out PA 'scope of practice' |url=https://www.pulsetoday.co.uk/news/workforce/first-of-its-kind-guidance-sees-bma-set-out-pa-scope-of-practice/ |access-date=2024-03-08 |website=Pulse Today |language=en-gb))</ref><ref>((Cite web |title=BMA sets out first national guidance for the role and responsibilities of physician associates in major intervention for patient safety - BMA media centre - BMA |url=https://www.bma.org.uk/bma-media-centre/bma-sets-out-first-national-guidance-for-the-role-and-responsibilities-of-physician-associates-in-major-intervention-for-patient-safety |access-date=2024-03-08 |website=The British Medical Association is the trade union and professional body for doctors in the UK. |language=en-gb))</ref><blockquote>
# This is an assistant role to doctors helping with simple practical procedures, administrative tasks, and working with patients in a supportive and specified role.
# This does not extend to seeing undifferentiated patients in any situation.
#* In a hospital setting, this means that they should not work in an [[emergency department]] setting unless a supervisor reviews each patient in person
#* In a GP setting, a GP should first triage all the patients and decide which ones a PA can see for some protocolised reviews in stable patients
# When seeing differentiated patients (those already triaged by a doctor as appropriate, or already assessed, diagnosed, and on a treatment plan by a doctor), MAPs must be directly and closely supervised.
# PAs/AAs/SCPs must not make independent management decisions for patients nor be responsible for initial assessments of patients and diagnosis.
# MAPs must make it clear in all communication to patients and to other staff members that they are not doctors and be clear about their specific role.
# Statements such as 'I am one of the medical team' must not be used unless also stating their own title.
</blockquote>Points five and six are aligned to the existing guidance from the Faculty of Physician Associates.<ref name=":3">((Cite web|url=https://www.fparcp.co.uk/file/image/media/651ed4c3228ed_FPA_Physician_Associate_Titles_and_Introductions_Guidance_FINAL_5_10_23.pdf|title=Physician associate title and introduction guidance for PAs, supervisors, employers and organisations))</ref> Who advise that Physician Associates should not use any title that may confuse patients, giving some specific examples: 'GP physician associate', 'GP PA', 'PA surgeon'. The Faculty is also clear that "PAs must not use the prefix 'Dr' or title 'doctor' in any clinical environment or interaction with patients."<ref name=":3" />  the faculty highlight that a PA could use the title Dr if they hold a recognised [https://www.gov.uk/what-different-qualification-levels-mean/list-of-qualification-levels Level 8] qualification when in an academic context/environment, but not in the clinical setting.

The [[British Medical Association]] highlighted a number of activities that they felt PAs should not be undertaking.
{| class="wikitable mw-collapsible mw-collapsed"
|+
!Procedures
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
Perform, train in, or consent others for invasive or life-threatening procedures including:
* Any procedure under a general anaesthetic (GA), under sedation, or regional anaesthesia (including spinal, nerve, Bier)
* Giving a GA except in the case of an AA giving it under the direct and immediate supervision of an anaesthetic consultant
* Endoscopy (any)
* Surgical procedures under GA, spinal anaesthesia, or local anaesthesia (LA), including caesarean section.
* Diagnostic and therapeutic abdominal paracentesis
* Angiography, echocardiography, pacemaker insertion or valvular intervention
* Pleural procedures
* Interventional radiology procedures
* Vaginal delivery of a baby, including
* instrumental delivery of a baby
* Lumbar punctures
* ABGs with lidocaine (therefore, excluding most ABGs)
|-
|'''Assessments'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Undertake outpatient work in clinics unless this is within a predictable, protocol-led role within the department (e.g., surgical pre-op assessment) where no diagnosis or medical decision making is expected and there is a clear pathway for escalation of unwell or unstable patients
* Assess, diagnose, or manage undifferentiated patients (this includes areas such as ED, the acute medical take, and general practice)
* Make independent decisions regarding initial management or ongoing care of patients
* Have input into DNACPR decisions/ ceiling of care/or escalation decisions (other than as a supportive role) nor sign DNACPR/RESPECT forms
* Perform medication reviews
* Be consulted for, or provide, specialty specific advice unless documenting on behalf of a consultant/senior registrar in that specialty (it must be clearly stated/ documented as such)
* Triage or vet referrals received to the specialty/department/practice in which they are employed
* Issue a formal radiology report
* Undertake Mental Health Act assessments, diagnose or manage any mental health condition for which inpatient care is required
* Accept devolved responsibility for the physical health of patients under the inpatient care of a psychiatrist
* Use any 'workarounds' to get access to credentials for prescribing or requesting ionising radiation
|-
|'''Communication with Patients and Colleagues'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Clinical documentation must not include prefixes such as 'Dr' or 'Mr/Miss/ Ms' that could imply status as a medical practitioner (or surgeon)
* Direct/instruct a doctor or other professional to prescribe a medication or to alter an existing [[Medical prescription|prescription]]
* Direct/instruct a doctor or other professional to request an investigation or procedure
* Direct/instruct a doctor to perform any task based on the PA's sole assessment
* Be involved in end-of-life discussions, except as a source of information or in a supportive role. The decision-making and related paperwork must be completed by doctors
* Be involved in giving specialty advice (unless repeating a consultant/senior registrar's advice and making it clear who the advice has come from)
* Take consent for procedures that they themselves do not perform
* Notify public health in cases of notifiable infectious diseases nor make any public health decisions regarding infectious disease unless specifically instructed to by a doctor or public health specialist working in health protection
|-
|'''Daily Work'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Cover, share, or participate in a rota designed for doctors at any level
* Sign a death certificate or [[cremation]] form
* Make any independent treatment decisions
* Attend, prepare, or give any teaching or seminars to doctors as part of their specialty or foundation teaching. PAs or AAs are not eligible to attend doctor teaching of any specialty unless offered to the wider MDT
* Be the sole person taking PICU/[[Intensive care unit|ICU]] step-down or transport handovers without a doctor present
* Discharge patients independently
|-
|'''Clinical Governance'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Publish or be involved in publishing research about the effectiveness of the PA/AA/SCP role without declaring this as a conflict of interest
* Operate in any supervisory or leadership role in which oversight is given over medical staff (e.g., clinical or medical director, clinical or educational supervisor, responsible officer)
* Be involved in revalidation of medical staff except as a colleague giving feedback
* Be involved in disciplinary or fitness to practice investigations at departmental, Trust, Board or MPTS level other than as a witness
* Prepare reports for coronial inquests / procuratorial inquests or act as an [[expert witness]] in a civil or criminal trial (though it is permissible to act as a material witness like any other member of the public)
|-
|'''Anaesthetics and Intensive Care Unit'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Formulate anaesthetic management plans or lead the brief for the anaesthetic team
* Assist in any paediatric anaesthesia (<18 years)
* Assist in any emergency or trauma anaesthesia
* Assist in anaesthetising any patients in remote environments (i.e., outside of main operating theatre suites)
* Assist in anaesthetising any patients outside of normal working day hours (0800-1800) Monday to Friday
* Administer any medicines by any route to patients
* Induce [[Anesthetic|anaesthesia]]
* Undertake laryngoscopy or endotracheal intubation
* Undertake any advanced airway procedure
* Conduct emergence of a patient from anaesthesia without direct supervision by a consultant anaesthetist
* Undertake Rapid Sequence Induction, or advanced airway procedures
* Anaesthetise any patients with a known or predicted difficult airway (such as previous grade 3 or grade 4 Cormack-Lehane view)
* Anaesthetise patients for any high-risk elective surgery, including any cardiac, thoracic, neuro-surgical, and obstetric surgery
* Perform total intravenous anaesthesia
* Undertake neuraxial or regional anaesthesia
* Perform conscious sedation
* Perform central venous or arterial cannulation
* Percutaneous drainage or needle aspiration of contents of any body cavity
* Undertake any anaesthetic work with less than a 1:1 supervision ratio, except where the supervising consultant is supervising a senior (post-FRCA) anaesthetic trainee or SAS doctor in an immediately adjacent operating theatre and 1:1 recommended for all but the most experienced (10 years plus)
* Undertake any anaesthetic work with less than a 1:2 supervision ratio under any circumstances
* Cover any vacancy on an anaesthetic or intensive care doctors' rota
* Hold a specialty bleep, take specialist referrals of any kind, nor be involved in vetting referrals
* Discharge patients independently
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|-
|'''Clinical Radiology'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
Formally report imaging in any modality including:
* Plain film
* Computed tomography (CT)
* Magnetic resonance imaging (MRI)
* Nuclear medicine
* Ultrasound

Approve, vet, or protocol imaging in any modality including:
* Plain film
* CT
* MRI
* Nuclear medicine
* Ultrasound

Perform, train in, or consent for invasive of life-threatening procedures including:
* Fluoroscopic procedures
* CT-guided procedures
* Ultrasound guided procedures
* Any endovascular intervention

Lead or coordinate MDT meetings Interpret imaging for MDT meetings.
* Hold a radiology referral bleep or mobile device
* Take specialist referrals of any kind or give specialist advice
* Be on the radiologist rota at any level or be used interchangeably with radiologists in any way

Auxiliary roles within an intervention theatre:
* Diagnostic radiography
* Radiation planning
* Radiotherapy delivery
* MDT coordination
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|-
|'''General Practice'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* See undifferentiated patients*
* Consult with any paediatric patient (<16 years)
* Be sole practitioner on call or duty clinician
* Be sole practitioner in the premises
* Be responsible for clinical triage
* Undertake direct supervision of GP registrars, FY2s or medical students
* Undertake teaching of doctors
* Undertake debriefs for GPRs/FYs/medical students
* Undertake EoLC discussions and documentation (DNACPR or RESPECT forms)
* Complete cremation forms
* Undertake home visits involving undifferentiated patients
* Perform minor surgery, IUS/IUD/Nexplanon insertion
* Undertake 6/8-week baby checks
* Steroid injections or any intra-articular injection
* Do referrals to secondary care (scheduled) or advice & guidance, unless reviewed by a GP
* See any patient that has not a) been clearly informed at the point of booking that the appointment is with a PA rather than a GP b) subsequently consented to the appointment with a PA
* Use the titles 'generalist practitioner' or 'registrar' or other titles that imply equivalence to a doctor  *''Unless the patient is also reviewed by a GP, immediately and in person''
|-
|'''Medicine'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Lead a ward round
* Provide specialty advice other than when documenting or communicating advice from a consultant or registrar in that specialty
* Hold a med reg bleep or equivalent
* Clerk, triage or accept referrals for acute medical take, unless relating to protocolised assessment on a defined pathway under direct supervision

Perform, train in, or consent for:
* Endoscopy
* Cathlabs
* Pacing
* DCCV even protocolised

Respiratory:
* Change NIV settings
* Undertake pleural procedures including pleurodesis, drain insertion, or pleural aspiration
* Perform and interpret thoracic ultrasound imaging
* Perform thoracoscopy

Clinical oncology:

Should not perform any of the following auxiliary roles within an intervention theatre:
* Diagnostic radiography
* Radiation planning
* Radiotherapy delivery
* MDT coordination
* Be on the doctor rota at any level or used interchangeably with doctors in any way
* Hold referral bleeps, be involved in vetting referrals, or be acting in a way where they need to give specialist advice
* Discharge patients independently
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|-
|'''Ophthalmology'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Consent patients for surgery
* Perform any intraocular or extraocular surgery under any circumstances (not including non-emergency intravitreal injections)
* Consent patients for or perform any laser procedure
* Triage, review or examine any undifferentiated patients in eye casualty
* Review or examine any undifferentiated patients in outpatient clinics
* Independently request investigations or ionising radiation imaging
* Cover any trainee/registrar shifts during absence/sickness of doctors
* Review patients independently on ward rounds
* Discharge inpatients independently
* Be on the doctor rota at any level or used interchangeably with doctors in any way
* Hold referral bleeps, be involved in vetting referrals, or be acting in a way where they need to give specialist advice
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|-
|'''Paediatrics'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Hold a referral bleep for any specialty or be part of any referral triage or vetting role
* Act as a registrar or senior doctor in any capacity
* Take any PICU step-down or transport handovers as the sole receiver of the handover without a doctor present
* Do the first post-operative review
* Perform any UAC/UVC or long line insertion in an infant or any other central venous or arterial lines in any age
* Carry the crash bleep on the NNU or children's wards
* Attend deliveries as the SHO or registrar or as anything other than an observer or assistant role
* Be on a transport rota in the role of a doctor
* Intubate infants with endotracheal tubes, nasal endotracheal tubes, or apply NPA
* Give any routine immunizations
* Decide that a child is fit to undergo chemotherapy
* Undertake an LP for ICP or sepsis, or any neonatal indication
* Make any changes to any medications or direct any doctor to do so
* Undertake any part of safeguarding reviews or NAI assessments
* Be involved in any palliative care decisions or end of life conversations with parents, unless there in a supportive role only to parents
* Attend any outpatient clinics or participate in any outpatient work in clinics, unless assisting under the direct supervision of doctors e.g., taking bloods
* Lead any ward rounds
* Be on the doctor rota at any level or used interchangeably with doctors in any way
* Hold the referral bleep in any capacity nor be responsible for giving any specialty advice at any level.
* Discharge patients independently
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|-
|'''Psychiatry'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Undertake Mental Health Act assessments, diagnose or manage any mental health condition for which inpatient care is required
* Accept devolved responsibility for the physical health of patients under the inpatient care of a psychiatrist
* Be a substitute for doctors when a patient presents with physical symptoms
* Consent for or initiate treatment
* Make decisions that deprives a person of their liberties (MHA/MCA/DOLS/LPS)
* Be involved in decision making or delivery of experimental (psychedelics, rTMS, etc.) or invasive treatments (ECT, or similar therapies)
* Be on the doctor rota at any level or used interchangeably with doctors in any way
* Hold referral bleeps, be involved in vetting referrals, or be acting in a way where they need to give specialist advice
* Discharge patients independently
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|-
|'''Surgery'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Perform, train in, or consent for invasive or life-threatening procedures including:
*# Endoscopy (any)
*# Surgical procedures under GA, spinal  anaesthesia, or LA (local anaesthesia)
*# Chest drain insertions
*# Cystoscopy
* Act as first assistant in the operating theatre
* Have their own theatre list
* Removing cholecystostomies
* Removing or flushing neurosurgical drains including but not limited to external ventricular drains and post-operative drains following the evacuation of a subdural haematoma' from/in any space within the central nervous system
* Lead ward rounds
* Review or clerk new acute patients in the ED, Surgical triage units, surgical admissions units etc.
* Be on the doctor rota at any level or used interchangeably with doctors in any way
* Hold referral bleeps, be involved in vetting referrals, or be acting in a way where they need to give specialist advice
* Discharge patients independently
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|-
|'''Women's Health'''
|-
|Physician associates (PAs), anaesthesia associates (AAs), and surgical care practitioners (SCPs) MUST NOT:
* Undertake outpatient work in clinics unless in an assistant role (e.g., ANC, PMB clinic)
* Assess women for labour, PPROM, SROM, APH, HTN/PET, or reduced foetal movements, or any acute presentation in pregnancy
* Have any role in maternity triage
* Be involved in surgical management of miscarriage, surgical termination of pregnancy, medical management of miscarriage, medical termination of pregnancy unless taking an assistant role under the direction of a doctor
* Act as first assistant in the operating theatre  Perform, train in, assist with, or consent for invasive or life-threatening procedures including:
* Caesarean section, Instrumental delivery, Perineal repair, Cervical cerclage, Hysteroscopy, Hysterectomy, Laparoscopy, Salpingo-oophorectomy, Prolapse repair, Colposcopy
* Vaginal examination including speculum and bimanual examination (in inpatient and outpatient settings)
* Ultrasonography of the pelvis, either transabdominal or transvaginal
* Insertion or counselling in long-acting contraceptive methods, including IUS, IUD, implants, and injectables
* Administration or counselling in methods of hormone replacement therapy (HRT)
* Initial fitting of vaginal pessaries for organ prolapse
* Be on the doctor rota at any level or used interchangeably with doctors in any way
* Hold referral bleeps, be involved in vetting referrals, or be acting in a way where they need to give specialist advice
* Discharge patients independently
* Use the titles 'consultant', 'registrar', 'specialist', 'resident' or 'senior house officer'
|}
In March 2024, the [[Royal College of General Practitioners]] issued a statement<ref>((Cite web |last=RCGP |title=Physician associates |url=https://www.rcgp.org.uk/representing-you/policy-areas/physician-associates |access-date=2024-03-08 |website=www.rcgp.org.uk |language=en))</ref> about the activites suitable for a Physician Associate when working in Primary Care. They stated that:
* Physician Associates working in general practice must <u>always</u> work under the supervision of qualified [[General practitioner|General Practitioners]].
* Physician Associates must be considered ''additional'' members of the team; rather than substitutes for General Practitioners.
* Physician Associates <u>do not</u> replace General Practitioners nor mitigate the need to urgently address the shortage of General Practitioners in the United Kingdom.
* Physician Associates <u>must</u> be regulated as soon as possible.
* There <u>must</u> be an improvement to public awareness and understanding of the Physician Associate role.
* Training, induction and supervision of Physician Associates within [[general practice]] <u>must</u> be properly resourced and designed.
* At a time of significant workforce challenges in general practice, funding allocations, resources and learning opportunities within general practice <u>must</u> be prioritised for the training and retention of medical doctors (i.e., General Practitioners).
* The significant responsibility and skills required for supervision of a Physician Associate <u>must</u> be appropriately recognised and resourced; with General Practitioners able to choose whether or not they are willing to undertake supervision of Physician Associates.
* Physician Associates should not be employed unless sufficient supervision is provided.

==== Voluntary register (UK) ====
The title physician associate is not a protected one. PAs in the U.K. are not able to legally prescribe or legally request ionising radiation imaging.<ref name=fparcpfaq>((cite web|title=FAQs|url=https://www.fparcp.co.uk/about-fpa/who-are-physician-associates|url-status=live|archive-url=https://web.archive.org/web/20160630070918/http://www.fparcp.co.uk/faqs|archive-date=2016-06-30|publisher=Faculty of Physician Associates, Royal College of Physicians)) Click "FAQs" tab</ref> No regulatory body governs PAs. Since June 2010, physician associates have been able to obtain membership of the Managed Voluntary Register for physician associates.<ref>((cite web|title=History of the PAMVRegister|url=http://www.fparcp.co.uk/new-page-1/|url-status=dead|archive-url=https://web.archive.org/web/20160628053359/http://www.fparcp.co.uk/new-page-1|archive-date=2016-06-28|access-date=19 June 2016|publisher=Faculty of Physician Associates, Royal College of Physicians))</ref> This database, run by PAs for PAs, aims to identify all qualified PAs who are able to practise. Its intent is to maintain high standards.<ref>((cite web|title=Physician Associate Managed Voluntary Register (PAMVR)|url=http://www.fparcp.co.uk/pamvr-home/|url-status=dead|archive-url=https://web.archive.org/web/20160622192424/http://www.fparcp.co.uk/pamvr-home/|archive-date=2016-06-22|access-date=19 June 2016|publisher=Faculty of Physician Associates, Royal College of Physicians))</ref> To remain on the voluntary register, physician associates are required to re-certify every 5–6 years.<ref>((cite web|title=Recertification|url=http://www.fparcp.co.uk/recertification/|url-status=dead|archive-url=https://web.archive.org/web/20160609080400/http://www.fparcp.co.uk/recertification|archive-date=2016-06-09|access-date=19 June 2016|publisher=Faculty of Physician Associates, Royal College of Physicians))</ref>

In 2018 [[Matt Hancock]] announced a plan regulate PAs.  The General Medical Council agreed to be the regulatory body for PAs, with regulation aiming to begin in 2022, this was pushed back to 2024.((Citation needed|date=April 2023))

==== Training (UK) ====
Training is through a two-year training programme (MSc) in Physician Associate Studies, although some PAs in the United Kingdom only hold a PgDip in Physician Associate Studies. ((As of|2017)) at least 32 universities offered these programs:

((div col|colwidth=15em))
* [[University of Bolton]]
* [[University of Hertfordshire]]
* [[Queen Mary University of London]]
* [[University of Aberdeen]]<ref>((cite web|url=https://www.abdn.ac.uk/smmsn/postgraduate/taught/physician-associate/|title=Physician Associate Studies - The School of Medicine, Medical Sciences and Nutrition |publisher=[[University of Aberdeen]]|website=Abdn.ac.uk|access-date=5 February 2019))</ref>
* [[University of Bradford]]<ref name="Bradford.ac.uk">((cite web|url=https://www.bradford.ac.uk/health/|title=Faculty of Health Studies - University of Bradford|website=Bradford.ac.uk|access-date=5 February 2019))</ref><ref>((Cite web |url=http://www.bradford.ac.uk/life-sciences/medical-sciences/our-staff/dr-sertip-zangana.php |title=Our People|publisher=University of Bradford|archive-url=https://web.archive.org/web/20160809021026/http://www.bradford.ac.uk/life-sciences/medical-sciences/our-staff/dr-sertip-zangana.php |archive-date=2016-08-09 |url-status=live))</ref>
* [[Anglia Ruskin University]]
* [[University of Birmingham]]<ref>((cite web|url=https://www.birmingham.ac.uk/postgraduate/courses/taught/med/physician-associate.aspx|title=Physician Associate Studies Diploma - Postgraduate degree programme study - Institute of Clinical Sciences - University of Birmingham|website=Birmingham.ac.uk|access-date=5 February 2019))</ref>
* [[Canterbury Christ Church University]]
* [[University of East Anglia]]
* [[Hull York Medical School]]<ref>((cite web|url=https://www.hyms.ac.uk/postgraduate-taught-degrees/msc-in-physician-associate-studies|title=MSc in Physician Associate Studies|website=Hyms.ac.uk|access-date=2 July 2020))</ref>
* [[University of Leeds]]
* [[Manchester Medical School]]
* [[University of Liverpool]]
* [[University of Central Lancashire]]
* [[Newcastle University]]
* [[Plymouth University]]<ref>((Cite web |url=https://www.plymouth.ac.uk/courses/postgraduate/msc-physician-associate-studies|title=MSc Physician Associate Studies|access-date=2014-08-23 |archive-url=https://web.archive.org/web/20140826114123/http://www1.plymouth.ac.uk/peninsula/postgraduate/Pages/Taught-postgraduate-programmes.aspx |archive-date=2014-08-26 |url-status=live ))</ref>
* [[University of Reading]]<ref>((cite web|url=http://www.reading.ac.uk/|title=University of Reading|website=University of Reading|access-date=5 February 2019))</ref>
* [[Sheffield Hallam University]]
* [[St George's, University of London]]<ref>((cite web|url=https://www.sgul.ac.uk/study/courses/physician-associate-studies|title=Physician Associate Studies MPAS|website=Sgul.ac.uk|access-date=2 July 2020))</ref>
* [[University of Surrey]]<ref>((Cite web |url=https://www.surrey.ac.uk/postgraduate/physician-associate-studies-pgdip|title=Postgraduate courses - Physician Associate Studies PGDip|archive-url=https://web.archive.org/web/20160405120304/http://www.surrey.ac.uk/postgraduate/physician-associate |archive-date=2016-04-05 |url-status=live))</ref>
* [[University of Wolverhampton]]<ref>((cite web|url=https://www.wlv.ac.uk/courses/pgdip-post-graduate-diploma-physician-associate-studies/|title=Post Graduate Diploma Physician Associate Studies |publisher=[[University of Wolverhampton]]|website=Wlv.ac.uk|access-date=2 July 2020))</ref>
* [[University of Worcester]]<ref>((cite web|url=https://www.worc.ac.uk/courses/physician-associate-msc.aspx|title=Physician Associate MSc - University of Worcester|website=Worc.ac.uk|access-date=5 February 2019))</ref>
((div col end))

Entry requirement vary, especially in terms of required first degree subject.((Cn|date=March 2024))  For example, [[University of Bradford]] requires a 2:1 (or above) undergraduate degree in a Life Science, Biomedical Science, or Healthcare subject. Under exceptional circumstances, experience in healthcare practice may contribute/compensate absent the above requirements.<ref name="Bradford.ac.uk" />

=== United States ===
====Nomenclature (US)====
In accordance with the [[American Academy of Physician Associates]] (AAPA), the official title of the profession in the United States is "Physician Associate".<ref name=aapa/><ref>((citation |title=AAPA House of Delegates Votes to Change Profession Title to Physician Associate |url=https://www.aapa.org/news-central/2021/05/aapa-house-of-delegates-votes-to-change-profession-title-to-physician-associate/ |access-date=2023-01-02 |publisher=American Academy of Physician Associates |date=2021-05-24))</ref> While this is the official title used by the national organization, utilization of this title may vary on the state and local level based on state and local bylaws and policies.<ref>((citation |title=General FAQs |url=https://www.aapa.org/title-change/general-faqs/ |work=American Academy of Physician Associates |access-date=2023-01-02))</ref> Many hospital and healthcare systems still use physician assistant as titles, with some just resorting to using "PA" to avoid confusion with [[Physician|physicians]].<ref>((Cite web |last=Science |first=Mayo Clinic College of Medicine and |title=Physician Assistant - Explore Health Care Careers - Mayo Clinic College of Medicine & Science |url=https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/physician-assistant/ |access-date=2024-04-06 |website=Mayo Clinic College of Medicine and Science |language=en))</ref>

A physician assistant may use the initials "PA", "PA-C", "APA-C", "RPA" or "RPA-C", where the "-C" indicates "Certified" and the "R" indicates "Registered".((Citation needed|date=April 2023)) The "R" designation is unique to a few states, mainly in the [[Northeastern United States|Northeast]]. APA stands for aeromedical physician assistant and indicates that a physician assistant successfully completed the US Army Flight Surgeon Primary Course.<ref>((cite web|title="Aeromedical Physician Assistant" Army Regulation 40–501, 6-2.h|url=http://www.apd.army.mil/pdffiles/r40_501.pdf#page=74&zoom=auto,-193,380|access-date=5 February 2019|website=Apd.army.mil))</ref> During training, PA students are designated PA-S.((Citation needed|date=April 2023)) The use of "PA-C" is limited to certified PAs who comply with the regulations of the National Commission on Certification of Physician Assistants and who have passed [[Physician Assistant National Certifying Exam|PANCE]].((Citation needed|date=April 2023))

Students undertaking physician assistant or associate training may refer to themselves as a physician assistant student, physician associate student, student physician assistant or student physician associate.((Citation needed|date=April 2023)) PA students may add "S" at the end of their student designation (PA-S).((Citation needed|date=April 2023)) Students may also use the corresponding year of their training in their student designation.((Citation needed|date=April 2023)) For example, students in the second year of their physician assistant or physician associate training may use (PA-S2) as their student designation.((Citation needed|date=April 2023))

The American Academy of Physician Associates has spent over $22 million since 2018 campaigning to change the word "assistant" to "associate" in the title of physician assistant. The campaign has been heavily criticized by physicians, but advocates argue that the revised title more accurately reflects the clinician's role on the patient care team.<ref>((Cite news |last=Rau |first=Jordan |date=December 3, 2021 |title=Physician assistants want to be called physician associates, but doctors cry foul |work=[[NPR]] |url=https://www.npr.org/sections/health-shots/2021/12/03/1059916872/physician-assistants-want-to-be-called-physician-associates-but-doctors-cry-foul |access-date=October 20, 2023))</ref>

In the United States, the profession is represented by the [[American Academy of Physician Associates]]. All PAs must graduate from a nationally accredited ARC-PA((Clarify|date=May 2021)) program as well as passing the national certification exam.<ref>((cite web|title=PA Information|url=http://www.westliberty.edu/physician-assistant/about/|access-date=2013-05-23|publisher=West Liberty University))</ref> In 1970 the [[American Medical Association]] passed a resolution to develop educational guidelines and certification procedures for PAs.<ref name="Carter 2001">((cite journal|last1=Carter|first1=R.|date=Spring 2001|title=Physician Assistant History|url=http://www.pahx.org/pdf/Military%20Ranks.pdf|journal=Perspective on Physician Assistant Education|volume=12|pages=130–132|doi=10.1097/01367895-200107000-00011|number=2))</ref> The [[Duke University Medical Center]] Archives had established the Physician Assistant History Center, dedicated to the study, preservation, and presentation of the history of the profession. The PA History Center became its own institution in 2011, was renamed the PA History Society, and relocated to [[Johns Creek, Georgia]].<ref>((cite web|title=Who we are:The Society for the Preservation Of Physician Assistant History|url=http://www.pahx.org/who-are-we|access-date=6 April 2016|website=Pahx.org))</ref>

==== Education and certification (US) ====
((As of|2019|May)), 243 accredited PA programs operated in the United States, with dozens more in development.<ref name="paeaonline.org">((cite web|title=PAEA Program Directory|url=http://directory.paeaonline.org/programs|access-date=5 February 2019|website=Directory.paeaonline.org))</ref> Most educational programs are [[Postgraduate education|graduate programs]] leading to the award of [[master's degree]]s in either Physician Assistant Studies, Health Science ([[Master of Health Science]]), or Medical Science (MMSc), and require a [[bachelor's degree]] and [[Graduate Record Examination]] or [[Medical College Admission Test]] scores for entry. The majority of PA programs in the United States employ the [[CASPA]] application for selecting students.<ref name=paeaonline.org /> Professional licensure is regulated by [[U.S. state|state]] medical boards. PA students train at medical schools and academic medical centers across the country.

[[File:Physician Assistant Program at ODU.jpg|thumb|Physician Assistant Program at ODU]]

PA education is based on medical education;<ref>((cite web|title="Issue Brief - Physician Assistant Education: Preparation for Excellence" - AAPA|url=http://www.aapa.org/gandp/issuebrief/education.pdf|url-status=dead|archive-url=https://web.archive.org/web/20061113221713/http://www.aapa.org/gandp/issuebrief/education.pdf|archive-date=2006-11-13|access-date=5 February 2019|website=Aapa.org))</ref> it typically requires 2 to 3 years of full-time graduate study like most master's degrees.<ref>((cite web|title=Physician Assistant|url=http://www.guidetohealthcareschools.com/degrees/allied-health/physician-assistant|access-date=18 January 2013|publisher=guidetohealthcareschools))</ref> (Medical school lasts four years plus a specialty-specific residency.) Training consists of classroom and laboratory instruction in medical and behavioral sciences, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine, as well as elective rotations.<ref>((cite journal|vauthors=Cawley JF|year=2012|title=Physician Assistants and Their Role in Primary Care|url=https://journalofethics.ama-assn.org/article/physician-assistants-and-their-role-primary-care/2012-05|journal=AMA Journal of Ethics|volume=14 |issue=5 |pages=411–414 |doi=10.1001/virtualmentor.2012.14.5.pfor2-1205|pmid=23351209 |access-date=5 September 2020|doi-access=free))</ref> PAs are not required to complete residencies after they complete their schooling (unlike physicians). Postgraduate training programs are offered in certain specialties for PAs, though these are optional and shorter in length than medical residency.<ref>((cite web|title=The Association of Postgraduate PA Programs (APPAP)|url=http://www.appap.org/index1.html|url-status=dead|archive-url=https://web.archive.org/web/20080303195642/http://www.appap.org/index1.html|archive-date=2008-03-03|access-date=5 February 2019|website=Appap.org))</ref>

PA clinical postgraduate programs are clinical training programs that differ from on the job training given their inclusion of education and supervised clinical experience to meet learning objectives.<ref name="Polansky 2007 100–108">((cite journal|last=Polansky|first=Maura|year=2007|title=A Historical Perspective on Postgraduate Physician Assistant Education and the Association of Postgraduate Physician Assistant Programs.|journal=Journal of Physician Assistant Education|volume=18|issue=3|pages=100–108|doi=10.1097/01367895-200718030-00014))</ref> Montefiore Medical Center Postgraduate Surgical Physician Assistant Program was established in 1971 as the first recognized clinical postgraduate PA program.<ref name="Polansky 2007 100–108"/> 49 programs address specialties such as Neurology, Trauma/Critical Care and Oncology. 50 programs joined the Association of Postgraduate Physician Assistant Programs to establish educational standards for postgraduate PA programs.<ref name="Polansky 2007 100–108"/><ref name="Polansky 2012 39–45">((cite journal|last=Polansky|first=Maura|author2=Garver GJ|author3=Wilson LN|author4=Pugh M|author5=Hilton G|year=2012|title=Postgraduate clinical education of physician assistants.|journal=J Physician Assist Educ|volume=23|issue=1|pages=39–45|doi=10.1097/01367895-201223010-00008|pmid=22479907 |s2cid=24895570 ))</ref>

In the United States, a graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam ([[PANCE]]) before becoming a PA-C; this certification is required for licensure in all states.<ref>((cite web|title="Physician Assistant National Certifying Exam (PANCE)" - National Commission on Certification of Physician Assistants (NCCPA)|url=http://www.nccpa.net/EX_pance.aspx|url-status=dead|archive-url=https://web.archive.org/web/20071217013701/http://www.nccpa.net/EX_pance.aspx|archive-date=2007-12-17|access-date=5 February 2019|website=Nccpa.net))</ref> The content of the exam is covered in the PANCE BLUEPRINT. In addition, a PA must log 100 [[Continuing medical education|Continuing Medical Education]] hours and reregister his or her certificate with the NCCPA every two years. Every ten years (formerly six years), a PA must also recertify by successfully completing the Physician Assistant National Recertifying Exam ([[PANRE]])<ref>((cite web|title=About CME Requirements|url=http://www.nccpa.net/ContinuingMedicalEducation|access-date=5 February 2018|website=National Commission on Certification of Physician Assistants|publisher=NCCPA))</ref>
There is a growing number of doctoral programs for certified PAs leading to a Doctor of Medical Science (DMSc) but there is no requirement for one to have a doctorate in order to practice.
"National Physician Assistant Week" is celebrated annually in the US from October 6 through October 12. This week was chosen to commemorate the anniversary of the first graduating physician assistant class at Duke University on October 6, 1967.<ref>((Cite web|title=PA Week|url=http://www.aapa.org/newsroom/pa-week.html|url-status=dead|archive-url=https://web.archive.org/web/20081202045954/http://www.aapa.org/newsroom/pa-week.html|archive-date=2008-12-02|access-date=2012-08-09))</ref> October 6 is also the birthday of the profession's founder, Eugene A. Stead, Jr., MD.<ref>((Cite web|url=https://www.aapa.org/pas-go-beyond/spread-the-word/|title=Spread the Word))</ref>

====Scope of practice (US)====
Physician assistants have their own licenses with distinct scope of practice.<ref>((cite web|date=7 November 2013|title=Professional issues: Scope of practice|url=http://www.aapa.org/workarea/downloadasset.aspx?id=583|url-status=dead|archive-url=https://web.archive.org/web/20140729111325/http://www.aapa.org/WorkArea/DownloadAsset.aspx?id=583|archive-date=29 July 2014|access-date=23 December 2014|publisher=American Academy of Physician Assistants))</ref> Each of the 50 states has different laws regarding the prescription of medications by PAs and the licensing authority granted to each category within that particular state through the [[Drug Enforcement Administration]] (DEA).<ref>((Cite web|title=DEA Diversion Control Division|url=http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html|url-status=dead|archive-url=https://web.archive.org/web/20110616214301/http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html|archive-date=2011-06-16|access-date=2011-06-11))</ref> PAs in Kentucky and Puerto Rico are not allowed to prescribe any [[controlled substance]]s.
Several other states place a limit on the type of [[Controlled Substances Act|controlled substance]] or the quantity that can be prescribed, dispensed, or administered by a PA.<ref>((cite web |title=Mid-Level Practitioners Authorization by State |url=https://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf |website=US Department of Justice Drug Enforcement Administration Diversion Control Division |access-date=18 September 2021))</ref>
Depending upon the specific laws of any given state board of medicine, the PA must have a formal relationship on file with a [[collaborative]] physician. The collaborating physician must also be licensed in the state in which the PA is working, although he or she may physically be located elsewhere. Physician collaboration can be in person, by [[telecommunication|telecommunication systems]] or by other reliable means (for example, availability for consultation). In [[emergency department]]s the laws governing PA practice differ by state, generally allowing a broad scope of practice and limited direct supervision.<ref>((cite journal|last1=Wiler|first1=JL|last2=Ginde|first2=AA|date=February 2015|title=State laws governing physician assistant practice in the United States and the impact on emergency medicine.|journal=Journal of Emergency Medicine|volume=48|issue=2|pages=e49-58|doi=10.1016/j.jemermed.2014.09.033|pmid=25453855))</ref>

During the COVID-19 pandemic, several state  governments changed regulations regarding PA scope of practice, including:
* On May 21, 2020, the law S.B. 1915 was signed by Oklahoma Governor [[Kevin Stitt]]. This law allows Physician Assistants to become primary care providers and receive direct pay from insurers. The reference of "supervision" was changed to "delegating" in regards to physician responsibility. This law also allows PAs to legally volunteer in the case of disaster or emergency.<ref>((cite web|author=<!--Not stated-->|date=June 15, 2020|title=Oklahoma Bill Brings New Opportunities for PAs|url=https://www.cmfgroup.com/blog/pa/oklahoma-bill-brings-new-opportunities-for-pas/|access-date=July 13, 2020|website=cmfgroup.com|publisher=CMF Group))</ref>
* On May 27, 2020, Governor [[Tim Walz]] signed into Minnesota law the Omnibus Healthcare Bill S.F. 13. This law removes references to physician responsibility of supervision and delegation of care provided by PAs. The law also removes delegated prescriptive authority.<ref>((cite web|author=<!--Not stated-->|date=June 5, 2020|title=Minnesota Bill Brings New Opportunities for PAs|url=https://www.cmfgroup.com/blog/pa/minnesota-bill-brings-new-opportunities-for-pas/|access-date=July 13, 2020|website=cmfgroup.com|publisher=CMF Group))</ref>

==== Employment (US) ====

The first employer of PAs was the then-Veterans Administration, known today as the [[United States Department of Veterans Affairs|Department of Veterans Affairs]]. Today it is the largest single employer of PAs, employing nearly 2,000.((Citation needed|date=September 2021))

According to the AAPA, as of 2020 there are more than 148,560 certified PAs in the United States, up from 115,547 in 2016.<ref>((cite web |title=Statistical Profile of Certified PAs - Annual Report 2020 |url=https://www.nccpa.net/wp-content/uploads/2021/07/Statistical-Profile-of-Certified-PAs-2020.pdf |website=NCCPA.net |access-date=18 September 2021))</ref>

''Money'' magazine, in conjunction with Salary.com, listed the PA profession as the "fifth best job in America" in May 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49.65%.<ref>((cite web|title=50 Best Jobs in America - May 1, 2006|url=https://money.cnn.com/magazines/moneymag/moneymag_archive/2006/05/01/8375749/index.htm|access-date=5 February 2019|website=Money.cnn.com))</ref> In 2010, CNN Money rated the physician assistant career as the number two best job in America.<ref>((cite web|title=Physician Assistant ranked No. 2|url=https://money.cnn.com/magazines/moneymag/bestjobs/2010/snapshots/2.html|access-date=5 February 2019|website=Money.cnn.com))</ref>
In 2012, Forbes rated the physician assistant degree as the number one master's degree for jobs.<ref>((cite news|last=Smith|first=Jacquelyn|date=8 June 2012|title=The Best And Worst Master's Degrees For Jobs|work=Forbes|url=https://www.forbes.com/sites/jacquelynsmith/2012/06/08/the-best-and-worst-masters-degrees-for-jobs-2/|access-date=19 February 2017))</ref>
In 2015, Glassdoor rated physician assistant as the number one best job in America.<ref>((Cite web|title=25 Best Jobs in America for 2015 &#124; Glassdoor Blog|url=http://www.glassdoor.com/blog/jobs-america/|url-status=dead|archive-url=https://web.archive.org/web/20150128202233/http://www.glassdoor.com/blog/jobs-america/|archive-date=2015-01-28))</ref>
In 2021, US News & World Report rated physician assistant as the number one best job in America.<ref>((cite web |title=2021's 100 Best Jobs in America - US News Rankings |url=https://money.usnews.com/careers/best-jobs/rankings/the-100-best-jobs |website=money.usnews.com |access-date=18 September 2021))</ref>

The US Department of Labor Bureau of Labor Statistics report on PAs states, "...Employment of physician assistants is projected to grow 37 percent from 2016 to 2026, much faster than the average for all occupations..."<ref>((cite web|date=19 July 1997|title=Physician Assistants|url=http://www.bls.gov/oco/ocos081.htm|url-status=dead|archive-url=https://web.archive.org/web/19970719214236/http://www.bls.gov/oco/ocos081.htm|archive-date=19 July 1997|access-date=5 February 2019))</ref> This is due to several factors, including an expanding health care industry, an aging [[baby boomer|baby-boomer]] population, concerns for cost containment, and newly implemented restrictions to shorten physician [[Residency (medicine)|resident]] work hours.

In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by [[hospital]]s.<ref>((cite web|title=2008 AAPA Physician Assistant Census Report|url=http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|url-status=dead|archive-url=https://web.archive.org/web/20090325055738/http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|archive-date=2009-03-25|access-date=5 February 2019|website=Aapa.org|page=2))</ref> The remainder were employed in [[public health]] clinics, nursing homes, schools, prisons, home [[health care]] agencies, and the [[United States Department of Veterans Affairs]]<ref>which also was the first employer of PAs. Mr. Vic Germino one of the first three graduates was employed by the VA and he remained with the VA for over 25 years.l [http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] ((Webarchive|url=https://web.archive.org/web/20090325055738/http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|date=2009-03-25)) Table 3.4: Number and Percent Distribution of Clinically Practicing Respondents by Primary Work Setting</ref> Fifteen percent of responding PAs work in counties classified as non-metropolitan by Economic Research Service of the [[United States Department of Agriculture]];<ref>[http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] ((Webarchive|url=https://web.archive.org/web/20090325055738/http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|date=2009-03-25)) Table 3.13: Number and Percent Distribution of Clinically Practicing Respondents by Metropolitan Status and Degree of Rurality of County of Primary Work Site</ref> approximately 17% of the US population resides in these [[County (United States)|counties]].<ref>((Cite web|title=USDA ERS - Rural-Urban Continuum Codes|url=https://www.ers.usda.gov/data-products/rural-urban-continuum-codes.aspx|access-date=2019-02-05|website=Ers.usda.gov))</ref>

For PAs in primary care practice, [[malpractice]] insurance policies with $100,000–300,000 in coverage can cost less than $600 per year; premiums are higher for PAs in higher-risk specialties.<ref>((cite web|title="Malpractice Consult: Liability insurance for a physician assistant" - Modern Medicine|url=http://medicaleconomics.modernmedicine.com/memag/Medical+Malpractice:+Insurance/Malpractice-Consult-Liability-insurance-for-a-phys/ArticleStandard/Article/detail/118626|url-status=dead|archive-url=https://web.archive.org/web/20080528191605/http://medicaleconomics.modernmedicine.com/memag/Medical+Malpractice:+Insurance/Malpractice-Consult-Liability-insurance-for-a-phys/ArticleStandard/Article/detail/118626|archive-date=28 May 2008|access-date=5 February 2019|website=Medicaleconomics.modernmedicine.com))</ref>

==== Compensation (US) ====

According to Bureau of Labor Statistics, in 2020 the median pay for physician assistants working full-time was $115,390 per year or $55.48 per hour, and the highest 10 percent earned more than $162,470.<ref>((cite web|title=Physician Assistants" Occupational Outlook Handbook|url=https://www.bls.gov/ooh/healthcare/physician-assistants.htm#tab-5/|access-date=17 September 2021|website=bls.gov))</ref> Physician assistants in emergency medicine, dermatology, and surgical subspecialties may earn up to $200,000 per year.<ref>((cite web|title=2008 AAPA Physician Assistant Census Report - Specialty Reports|url=http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?cc=188720|url-status=dead|archive-url=https://archive.today/20120716142058/http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?cc=188720|archive-date=16 July 2012|access-date=5 February 2019|website=Physician-assistant.advanceweb.com))</ref>

==== Federal government, uniformed services, and US armed forces (US) ====
PAs are employed by the [[State Department|United States Department of State]] as ''foreign service health practitioners''. PAs working in this capacity may be deployed anywhere in the world where there is a State Department facility.((Citation needed|date=April 2023)) They provide primary care to US government employees and their families in American embassies and consulates around the world.((Citation needed|date=April 2023)) An important part of their jobs is to get to know what resources are available locally that they can count on in an emergency. They have other important roles, such as advising their ambassadors on the health situation in the country and provide health education to the diplomatic community. In order to be considered for the position, these PAs must be licensed and have at least two years of recent experience in primary care.<ref>((Cite web|title=U.S. Department of State ((!)) Home Page|url=https://www.state.gov/|access-date=2019-02-05|website=State.gov))</ref>

[[File:Physician Assistants DVIDS31599.jpg|thumb|Physician Assistant in the US Army]]

Military PAs serve in the [[White House Medical Unit]], where they provide care to the president and vice president and their families as well as White House staff.((Citation needed|date=April 2023))

They are employed by several organizations with the intelligence community, specifically the Central Intelligence Agency.<ref name=":1">((Cite web|title=Physician Assistant / Nurse Practitioner — Central Intelligence Agency|url=https://www.cia.gov/careers/search-jobs/support-professional/physician-assistant.html|archive-url=https://web.archive.org/web/20180628204919/https://www.cia.gov/careers/search-jobs/support-professional/physician-assistant.html|url-status=dead|archive-date=June 28, 2018|access-date=2018-06-05|website=Cia.gov|language=en))</ref> While much of the job description is classified, they work under the Directorate of Support and are deployed to "austere environments" where they provide medical care, including trauma stabilization, and teach in the fields of survival, field medicine, and tactical combat casualty care.<ref name=":1" />

[[United States Army]] PAs serve as [[Army Medical Department (United States)#Medical Specialist Corps (SP)|Medical Specialist Corps]] [[Officer (armed forces)|officer]]s, typically within Army combat or combat support [[battalion]]s located in the [[continental United States]], [[Alaska]], [[Hawaii]], and overseas.<ref>((cite web|title=U.S. Army Recruiting Command|url=https://recruiting.army.mil/|access-date=5 February 2019|website=Recruiting.army.mil))</ref> These include [[infantry]], [[armor]], [[cavalry]], [[airborne forces|airborne]], [[artillery]], and (if the PA qualifies) [[special forces]] units. They serve as the "front line" of Army medicine and along with [[combat medic]]s are responsible for the total health care of soldiers assigned to their unit, as well as of their family members.((Citation needed|date=April 2023))

PAs also serve in the [[United States Air Force|Air Force]] and [[United States Navy|Navy]] as clinical practitioners and [[aviation medicine]] specialists, as well as in the [[United States Coast Guard|Coast Guard]] and [[United States Public Health Service|Public Health Service]]. The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in advanced casualty care, medical management of chemical injuries, [[aviation medicine]], and [[military medicine]].((Citation needed|date=April 2023)) In addition, military PAs are also required to meet the officer commissioning requirements, and maintain the professional and physical readiness standards of their respective services.<ref>((Cite web|title=Becoming an Army Physician Assistant (PA)|url=https://recruiting.army.mil/armypa/becomePA/|access-date=2019-10-17|website=recruiting.army.mil))</ref>

The marine physician assistant is a US Merchant Marine staff officer. A certificate of registry is granted through The United States Coast Guard National Maritime Center located in Martinsburg, West Virginia.<ref>((cite web|title=Code of Federal Regulations|url=http://cfr.regstoday.com/46cfr11.aspx#46_CFR_11p807|url-status=dead|archive-url=https://web.archive.org/web/20160201080824/http://cfr.regstoday.com/46cfr11.aspx#46_CFR_11p807|archive-date=2016-02-01))</ref> Formal training programs for marine physician assistants began in September, 1966 at the Public Service Health Hospital located in Staten Island, N.Y.<ref>((cite journal|vauthors=DeMaria WJ, Cherry WA, Treusdell DH|year=1971|title=Evaluation of the marine physician assistant program|journal=HSMHA Health Rep|volume=86|issue=3|pages=195–201|doi=10.2307/4594129|jstor=4594129|pmc=1937084|pmid=4396133))</ref>

== References ==
((reflist))

== External links ==
((Commons category|Physician assistants))
* [http://www.aapa.org/ American Academy of Physician Associates (AAPA)]
* [http://www.paeaonline.org/ Physician Assistant Education Association]
* [http://nccpa.net/ National Commission on Certification of Physician Assistants (NCCPA)]
* [http://www.arc-pa.org/ Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)]
* [http://www.capa-acam.ca/ Canadian Association of Physician Assistants CAPA]
* [https://www.fparcp.co.uk/ The Faculty of Physician Associates at the Royal College of Physicians (FPA)]
* [https://web.archive.org/web/20130622024612/http://physicianassistant.co.il/ Israeli Association of Physician Assistants]

((Portal bar|Medicine))

((DEFAULTSORT:Physician Associate))
[[Category:Health care occupations]]
Pages transcluded onto the current version of this page (help):
Physician assistant (edit)
Template:Ambox (view source) (template editor protected)
Template:As of (view source) (template editor protected)
Template:Category handler (view source) (protected)
Template:Citation (view source) (protected)
Template:Citation needed (view source) (protected)
Template:Cite book (view source) (protected)
Template:Cite journal (view source) (protected)
Template:Cite news (view source) (protected)
Template:Cite web (view source) (protected)
Template:Clarify (view source) (template editor protected)
Template:Cn (view source) (template editor protected)
Template:Commons category (view source) (template editor protected)
Template:DMCA (view source) (template editor protected)
Template:Dated maintenance category (view source) (template editor protected)
Template:Dated maintenance category (articles) (view source) (template editor protected)
Template:Delink (view source) (protected)
Template:Disputed (view source) (template editor protected)
Template:Distinguish (view source) (template editor protected)
Template:Div col (view source) (template editor protected)
Template:Div col/styles.css (view source) (template editor protected)
Template:Div col end (view source) (template editor protected)
Template:FULLROOTPAGENAME (view source) (template editor protected)
Template:Factual accuracy disputed (edit)
Template:Fix (view source) (protected)
Template:Fix-span (view source) (template editor protected)
Template:Fix/category (view source) (protected)
Template:Globalize (view source) (template editor protected)
Template:Globalize/name (view source) (template editor protected)
Template:MONTHNAME (view source) (template editor protected)
Template:MONTHNUMBER (view source) (template editor protected)
Template:Main other (view source) (protected)
Template:More citations needed (view source) (template editor protected)
Template:More citations needed section (view source) (template editor protected)
Template:Multiple issues (view source) (template editor protected)
Template:Multiple issues/styles.css (view source) (template editor protected)
Template:Ns has subpages (view source) (protected)
Template:Pagetype (view source) (protected)
Template:Plainlist/styles.css (view source) (protected)
Template:Portal bar (view source) (template editor protected)
Template:Refimprove-section (view source) (semi-protected)
Template:Reflist (view source) (protected)
Template:Reflist/styles.css (view source) (protected)
Template:Replace (view source) (protected)
Template:SDcat (view source) (protected)
Template:Short description (view source) (protected)
Template:Short description/lowercasecheck (view source) (protected)
Template:Side box (view source) (template editor protected)
Template:Sister project (view source) (template editor protected)
Template:Sp (view source) (template editor protected)
Template:TOC limit (view source) (template editor protected)
Template:TOC limit/styles.css (view source) (template editor protected)
Template:Toclimit (view source) (template editor protected)
Template:Webarchive (view source) (template editor protected)
Template:Yesno (view source) (protected)
Module:Arguments (view source) (protected)
Module:Category handler (view source) (protected)
Module:Category handler/blacklist (view source) (protected)
Module:Category handler/config (view source) (protected)
Module:Category handler/data (view source) (protected)
Module:Category handler/shared (view source) (protected)
Module:Check for unknown parameters (view source) (protected)
Module:Citation/CS1 (view source) (protected)
Module:Citation/CS1/COinS (view source) (protected)
Module:Citation/CS1/Configuration (view source) (protected)
Module:Citation/CS1/Date validation (view source) (protected)
Module:Citation/CS1/Identifiers (view source) (protected)
Module:Citation/CS1/Utilities (view source) (protected)
Module:Citation/CS1/Whitelist (view source) (protected)
Module:Citation/CS1/styles.css (view source) (protected)
Module:DecodeEncode (view source) (template editor protected)
Module:Delink (view source) (protected)
Module:Disambiguation/templates (view source) (protected)
Module:Distinguish (view source) (template editor protected)
Module:Format link (view source) (template editor protected)
Module:Hatnote (view source) (template editor protected)
Module:Hatnote/styles.css (view source) (template editor protected)
Module:Hatnote list (view source) (template editor protected)
Module:Message box (view source) (protected)
Module:Message box/ambox.css (view source) (protected)
Module:Message box/configuration (view source) (protected)
Module:Namespace detect/config (view source) (protected)
Module:Namespace detect/data (view source) (protected)
Module:Ns has subpages (view source) (protected)
Module:Pagetype (view source) (protected)
Module:Pagetype/config (view source) (protected)
Module:Pagetype/disambiguation (view source) (protected)
Module:Pagetype/setindex (view source) (protected)
Module:Pagetype/softredirect (view source) (protected)
Module:Portal (view source) (template editor protected)
Module:Portal/images/m (view source) (template editor protected)
Module:Portal bar (view source) (template editor protected)
Module:Portal bar/styles.css (view source) (template editor protected)
Module:SDcat (view source) (protected)
Module:Side box (view source) (template editor protected)
Module:Side box/styles.css (view source) (template editor protected)
Module:String (view source) (protected)
Module:TableTools (view source) (protected)
Module:Unsubst (view source) (protected)
Module:Webarchive (view source) (template editor protected)
Module:Webarchive/data (view source) (template editor protected)
Module:WikidataIB (view source) (template editor protected)
Module:WikidataIB/nolinks (view source) (template editor protected)
Module:WikidataIB/titleformats (view source) (template editor protected)
Module:Wikitext Parsing (view source) (protected)
Module:Yesno (view source) (protected)
Return to Physician assistant.
Retrieved from "https://en.wikipedia.org/wiki/Physician_assistant"