PAs are trained in intensive educational programs accredited by the Accreditation Review Commission on Education for the Physician Assistant. The programs are approximately 26 months long and are offered at medical schools, colleges and universities, and teaching hospitals.1
PA education promotes the development of practical skills in clinical problem solving and decision making. The rigorous PA program curriculum consists of classroom and laboratory instruction in basic medical and behavioral sciences, including anatomy, pathophysiology, pharmacology and clinical diagnosis. Classroom work is followed by clinical rotations that include primary care specialties, surgery and surgical subspecialties, psychiatry and emergency medicine. PA students complete, on average, 2,000 hours of supervised clinical practice prior to graduation. PA educational programs, first accredited by the American Medical Association (AMA) in 1972, are now accredited by the Accreditation Review Commission onEducation for the Physician Assistant. There are currently more than 180 accredited programs. More than ninety percent offer master’s degrees.2 Before they can be licensed, PAs take the national PA certifying examination administered by the National Commission on Certification of Physician Assistants (NCCPA).
This certifying exam also functions as a de facto licensing examination; all states require passage of the NCCPA exam as a prerequisite for full licensure as a PA. To maintain national certification, PAs must complete 100 hours of continuing medical education every two years and pass a recertification examination every six years (10 years beginning in 2014).
Each PA's scope of practice is defined at the practice level, consistent with the PA's education, experience and preference, facility policy, and state laws. PAs are free to choose any medical or surgical specialty after graduation. Some PAs work in the specialty of orthopaedics with physicians who are orthopaedic surgeons. These physician assistants are referred to as PAs in orthopaedics.
PAs in orthopaedics perform histories and examinations, order and interpret diagnostic tests and prescribe medications and therapy. In addition to first assisting at surgery, procedures provided by PAs include tendon repairs, wound closures and debridements, injection of joints and fracture management. In the hospital, PAs conduct post-op rounds, write orders, take call and perform admission and discharge work.
Physician assistants (PAs) in orthopedics and "orthopedic physician's assistants" (OPAs) are distinctly different professions. PAs have broad medical training at accredited programs and work with physicians in any specialty, including orthopedics. PAs are licensed in all states and are recognized Medicare and Medicaid providers. Most OPAs are trained on the job and work as orthopedic technologists or surgical assistants. They may be certified, but few states regulate their practice. OPA are not recognized as providers under the Medicare program.
Although the professional titles are similar, PAs and OPAs have significantly different training and responsibilities. Working with physicians in all medical and surgical specialties, PAs diagnose and treat patients, order tests and prescribe medications. OPAs have a limited scope of practice within orthopaedics, working directly with the surgeon in a supportive role
- Physician Assistant Education Association. (2010–2011). Twenty-seventh annual report on physician assistant educational programs in the United States. Alexandria,VA.
- Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). (2013). Accredited Programs. Retrieved December 12, 2013, from
- American Society of Orthopaedic Physician’s Assistants. What is an orthopaedic physician’s assistant? Retrieved February 3, 2009, from www.asopa.org/pdfs/opawhitepaper.pdf.
- American Society of Orthopaedic Physician’s Assistants. (2009). Recognition. Retrieved February 5, 2013, from www.asopa.org/sections/licensure.php.
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