PA Announcement Physician Assistant Is a Medical Profession With a Very Bright Future

Mary-Laura Whelihan says that just before starting work toward her master’s degree in Physician Assistant Studies at Springfield College, she jokingly told family members “I’ll see you in two years.”

It hasn’t been that bad, obviously, but Whelihan has been excused from a number of family gatherings over the past 16 months or so, and for good reasons. The Physician Assistant program is a rugged one, she explained, citing lengthy time in the classroom her first year, in addition to long hours of studying. And in this, the so-called clinical year, she’s been getting hands-on training at Mercy Hospital in areas ranging from family medicine to general surgery; from obstetrics to internal medicine. Next on the slate is emergency medicine.

“Let’s just say … it’s intense. You’re living and breathing school,” said Whelihan, who is one of several students due to graduate in May who entered the program several years after earning a bachelor’s degree in Biology at UMass Amherst. The others are in the final few months of what is a five-year program that is becoming increasingly popular. For students in both categories, the physician assistant program is a load.

But for those who endure, it is well worth the time and that aforementioned intensity.

Indeed, all those who graduate have jobs waiting for them, and most will have chosen from several attractive offers, said Charles Milch, chair of the Physician Assistant Program, and a PA himself. He said that one of the unofficial duties on his job description is to help seniors weigh such offers, with their mix of benefits packages and starting salaries ranging from $80,000 to just over $100,000.

And those winning these salaries and accompanying perks certainly earn them, said Milch, noting that PAs handle a number of duties and in a variety of settings. Although they are not doctors, PAs practice medicine and do many of the things that doctors do.

Under the supervision of an MD, and as just part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illness, order and interpret tests, counsel on preventative health, assist in surgery and write prescriptions. In rural areas, PAs provide most of the medical care, with a physician available only one or two days each week.

And demand for PAs is growing, so much so that Money magazine ranked it second, just behind ‘systems engineer’ and just ahead of ‘college professor’ in its annual ranking of the “best jobs in America.”

In its description of the profession, the magazine calls it “MD lite,” but those who do it for a living, or are preparing to do so, say their workload is fairly heavy — but also quite rewarding and exceedingly varied.

“I’ve never been bored,” said Milch, who started out in engineering and made a mid-career shift to physician assistant.

In this, the latest installment of its Career Focus series, The Healthcare News looks at the emergence of the PA and why the prospects for the future are so rosy.

Stitch in Time

Whelihan recalls when she was interviewing for acceptance into the PA program at Springfield College, and, specifically, when she would listen to those in their senior year participating in grand rounds, that ritual of medical education consisting of presenting medical problems and treatment of a particular patient.

“The words they were speaking were not even English to me; these were advanced medical terms, and I was just as scared as anything sitting there,” she explained, adding quickly, “now, I’m giving the presentation, and these words are just flowing out as if you’re talking to your best friend.”

To effectively make that transformation, Whelihan says she has, indeed, had to learn what amounts to another language, and mastering this vocabulary of words, acronyms, and abbreviations is just part of the work that has kept her from some of those family gatherings she mentioned.

Hundreds of students have been learning this new language since Springfield College started its PA program in 1996, a move taken in direct response to growing need for such professionals in the local market.

At that time, said Milch, there was no such program west of Boston, and today, the SC offering is still the only one in Western Mass. and one of only a handful in the state and 148 across the country.

On its Web site (www.aapa.org) the American Academy of Physician Assistants traces the history of the profession. It began in the mid-1960s, the group says, with the realization among physicians and educators that there was a shortage, as well as uneven distribution, of primary-care physicians in the U.S. To expand the delivery of care, Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of PAs in 1965.

Stead selected Navy corpsmen who received considerable medical training during their military service and during the Vietnam War, but who had no civilian employment. The first class graduated two years later.

Today, there are nearly 80,000 graduates of PA programs working in a wide range of health-care settings. In most area hospitals, for example, said Milch, there is something close to a 50-50 mix of MDs and PAs working in the emergency room, and many departments have similar numbers.

The Springfield College program, which graduates about 35 students each year, began as a bachelor’s-degree offering and quickly morphed into a master’s program with those two distinct tracks — five years for undergrads and two years for those with a bachelor’s in a related health field.

Milch said the program, which operates under an unofficial rallying cry of ‘know the medicine,’ is, indeed, intense, and therefore not for those who aren’t really sure if this is what they want to do professionally. Thus, there is a thorough screening process to help minimize the incidence of people getting a few years or even a few months into their studies and concluding that the PA track isn’t for them.

“We wouldn’t want people to get two-thirds of the way through and say, ‘I don’t like this,’” he explained. “We don’t like to fill seats with people who aren’t sure, because there are so many people out there who are sure.”

Still, there is some attrition — due to people with doubts and/or a grade point average below the minimum to continue to the final year or two. And it is these slots that are filled by students, like Whelihan, who come in the door with a bachelor’s.

Whelihan said she knew enough about the position of physician assistant to become intrigued by an article in the local newspaper about an informational session on the Springfield College program. She told The Healthcare News that she was then 25, and considered the route to becoming an MD, which would mean another four years of school followed by a residency and probably a fellowship, to be too long for her.

But she was intrigued by this career that would offer her many of the same opportunities to practice medicine as becoming an MD would, and also provide those much-desired elements of autonomy and variety.

With just one semester to go, Whelihan said she’s already been offered one job, at a clinic in Connecticut. She’s thinking about it, but is in no rush to accept, because like others in her class, she’ll likely have several more offers to weigh.

And she’ll probably turn to Milch for some help in the process of comparing, contrasting, and deciding which is the best to take.

“Students come to me with contracts,” he said, joking that he doesn’t get a percentage for his help weighing the specifics involving wages, hours on call, retirement benefits, and more. “By the time they’re close to graduating, they’ll have three or four solid job offers in hand.”

Test of Wills

Milch told The Healthcare News that all the members of the PA program’s 2009 graduating class passed the national certification exam on their first try, and that three of the past four classes have accomplished that feat.

That will put some amount of pressure on the class of 2010, Whelihan acknowledged, noting quickly that pressure is certainly nothing new for her and her classmates.

“We’ve been under a lot of pressure since the start — we can handle this,” she said with a smile and some nodding.

Time will tell if she’s right, but what is already known is that Whelihan and others will keep Milch busy looking over their many job offers and offering advice on which one to accept.

This is a profession where the current picture is quite attractive, and the future will seemingly only get better.