Physician assistant

A physician assistant or physician associate is a type of non-physician practitioner. 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.
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. 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.
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. They cannot prescribe medications nor request ionising radiation investigations in the UK. 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.

Title and professional identity

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, 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. In Malawi they are called clinical officers. Most of them study clinical medicine at the Malawi College of Health Sciences and other colleges within the country. In 2021, the American Academy of Physician Assistants voted to rename itself the American Academy of Physician Associates and adopted "physician associate" as the preferred professional designation. U.S. state governments such as the one in Oregon have begun to implement statutory changes to reflect the name change in Oregon. The move has been controversial; critics of the name change feel the word "associate" could be misleading for patients trying to understand PAs' scope of practice, while proponents feel it better conveys the profession's collaborative and independent roles.

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 with accompanying state-level certification.
Canada	Canadian Certified Physician Assistant	CCPA	Entry to Practice Examination	Physician Assistant Certification Council of Canada with accompanying provincial certification
United Kingdom	Physician Assistant Physician Associate	PA-R	Physician Associate Registration Assessment from September 2025 Physician Associate National Examination 2007-2025	Royal College of Physicians
Republic of Ireland	Physician Associate	PA	none	none
Kenya	Clinical officer	CO	Clinical Officers Licensing Examination	Clinical Officers Council
South Africa	Clinical Associate			-
Malaysia	Assistant Medical Officer			Malaysia Medical Assistant Board
India	"Physician Assistant"& "Physician Associate" Both are now known as "Physician Associate"	PA	National common Entry and Exit Examination.	.
Germany	Physician Assistant	PA	-	-
China	Assistant Doctor
Papua New Guinea	Health Extension Officer
Former Soviet Union	Feldsher
Israel	Physician Assistant	PA-R

Services

Depending on jurisdiction, a physician assistant or associates may:

conduct patient interviews and take medical histories
conduct physical examinations, including the interpretation of clinical signs
order and interpret diagnostic tests and exams
diagnose illnesses
formulate treatment plans
coordinate and manage care
perform medical procedures
prescribe medications
conduct clinical research
provide patient counselling
offer advice on preventative health care
first assist in surgery
Can serve as a clinical tutor/Demonstrator, assistant professor, associate professor, or professor.
In Administrative sector, can serve as principal/Director, Dean etc. as per experience & Qualifications.
Scope of Practice and Regulation

Physician assistant scope of practice vary by country and state. Physician assistant practice laws in a majority of US states have been updated in recent years to give PAs more autonomy and reduce onerous supervision language. A few states now allow PAs to practice under a "collaborative" agreement rather than with direct physician supervision. In the UK, the General Medical Council has become the official regulator of physician associates in December 2024. England's 2025 Leng Review also recommended standard national policies, including a specific supervision model and a unique PA uniform to distinguish PAs from doctors.

Workplaces

Physician assistants or associates train to work in settings such as hospitals, clinics 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 Health Sciences specialties, including emergency medicine, surgery and cardiology.

Employment Growth and Compensation

Physician assistant job growth in the 21st century has been substantial. In the United States, the U.S. Bureau of Labor Statistics reported that "demand for PAs is expected to grow 27% from 2022 to 2032, much faster than the average for all occupations". Median annual wages for U.S. physician assistants have increased to over $130,000 and are higher still in surgical and emergency medicine subspecialties. A number of sources have reported that the increasing demand for physician assistants is a result of physician shortages in primary care and increased use of team-based models of care.

Training

Physician assistant education is shorter than the medical degree required to become a physician. Most PAs in the United States have completed 4 years of undergraduate training followed by 2–3 years of Master's-level training, including both didactic training and clinical training. The didactic portions usually include microbiology, genetics, clinical anatomy and physiology, clinical pathophysiology, clinical medicine, clinical pharmacology, patient history & physical exam, clinical problem-solving, women's health, and applied clinical skills. The clinical year usually entails of 4-8 week rotations in surgery, family medicine, emergency medicine, OB/GYN, psychiatry, internal medicine, pediatrics, and other rotations depending on the school. In total, most United States PA Master's programs come out to about 100 semester credit hours or 150 quarter hours.
After training and graduation, most PAs in the US take the PANCE for board certification. The PANCE is a 300-question exam covering a wide variety of medical topics, assessing for entry-level competency of a PA. Unlike an MD, a PA's training 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. In the US, many states require PAs to submit CME hours to demonstrate they are staying up to date for licensure renewal. The National Commission on Certification of PAs requires 100 CME hours every 2 years to maintain certification. Every 10 years, the NCCPA requires PAs to take the PANRE or PANRE-LA, an exam that aims to test the competency of practicing PAs.
Some PAs go on to get doctorates. These doctorates are professional doctorates equivalent to a Doctor of Nursing Practice, but are not equivalent to a Physician Doctorate. These doctorates are largely focused in academic research, health administration, and health leadership education. Sometimes these degrees expound upon clinical knowledge, but are not equivalent to their physician counterparts nor are they standardized across all doctorates. Many PAs will not address themselves as "Dr. Smith" or "Doctor Smith," as this can confuse patients and falsely represent themselves as physicians, which could potentially lead to litigation. However, outside of the clinical environment, many PAs in colleges and universities will use the honorific of Doctor.

Diversity and Representation

The PA profession in the United States continues to have recruitment and diversity issues, with the physician assistant workforce remaining predominantly white and male. A 2025 report by the Milbank Memorial Fund discovered that approximately 3.5% of recent PA graduates self-identified as Black, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander, while about 6.4% of recent graduates self-identified as Hispanic.
This was in contrast to the findings of the 2025 AAPA Salary Report, in which over 85% of certified PAs self-identified as White. In response, professional organizations such as the AAPA have developed a diversity award as well as expanded existing programs which allow students from minority groups easier access into the profession.