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PA's for Tomorrow

Statement on Doctorate as PA Terminal Degree

Posted on 10th Mar 2022 21:12:20 in Technical Tutorial

Tagged as: doctorate, pas, physician assistants, terminal degree,

Originally posted September 2014


  PAs for Tomorrow recognizes that in the United States, a degree is used to evaluate and measure many different things. To the public, an educational degree offers reassurance, as it infers some level of professional and clinical competence. To the insurance industry, a degree ensures that the clinician is educated to a level that is reimbursable. To the educator, it demonstrates that the clinician has completed the preparation needed to attain the said degree. To all of those entities, regardless of the profession, the doctorate level degree is a sign of a mature profession and professional. PA education has historically been more clinically than academically or administratively oriented. Our programs have long been standardized and have produced a proven product in the graduate PA. Whether the PA earned a certificate in the 1960s, an associate’s degree in the 1970s, a bachelor’s degree in the 1990s or a master’s degree in the 2000s, PA education has not changed considerably and has remained excellent.


  The Duke PA program model has stood the test of time. While our educational model has remained much the same, the profession has changed considerably. PAs are practicing in more specialties than ever before, practicing in ways never considered and are maturing as clinicians. Part of that evolution and maturation has also been in the administrative and academic realms. In short, our profession is more multifaceted than ever before. The US healthcare market has changed at an unprecedented rate and PA education needs to respond and shift with that pace. It is the belief of PAFT that the clinical component of our education will no longer be enough to shape the full PA of the future regarding their total scope of practice. Our medical model of training affords graduate PAs a tested and tried skillset in the delivery of healthcare services upon graduation. Comparison of PA education and medical school education reveals an interesting similarity in terms of hours, especially given recent proposals to expedite medical school training to a three-year course of study. Given the expedited nature of the PA model, the number of hours a PA graduate spends in their professional program is, on average, a mere 8 weeks less than the typical four-year medical school graduate.


  The hourly comparison does not account for curriculum differences, however; the proposed compressed three-year medical school graduate may likely appear strikingly similar to the curriculum that has produced successful PAs for nearly 50 years. Even without expanding to a doctorate level degree, a present-day PA graduate might theoretically have more hours in their respective program than the three-year medical school graduate of tomorrow. Given the historic resistance of institutionalized medicine to entertain development of a fast–tract PA-to-MD program or to allow PAs entrance into formalized MD residency programs, it seems the most progressive route to expand the PA profession’s graduate-level opportunities will be via our own established and very structured PA educational pathways. As per history, when organized medicine declined our progress, PAs created their own in the form of degree advancement, educational resources created by for the benefit of PAs, and post-graduate development of PA residency training among other self-realized advancements. Nearly all medical professions that were at the bachelor’s or master’s degree level 40 years ago are at the doctorate level today. These professions include pharmacists, psychologists, physical therapists, nurse practitioners, nurse midwives, nurse anesthetists, occupational therapists, audiologists, naturopathists and more. PA training at the masters level includes a number of graduate level hours that meet or exceed many of these disciplines.


  In fact, many of our students will exceed the number of graduate hours that would fulfill a doctorate level degree in many other non-physician professions. PAs function in many capacities in their clinical, personal, and professional worlds. PAs are legislators, hospital board members, employers, educators, military leaders including commanders, VA directors and obviously, PAs hold a meaningful presence in every medical specialty. It is clear that if the PA profession is to advance in all facets of the healthcare industry and realize the ability to practice at our full potential, the doctorate level degree should be an available option for those pursuing an advanced PA degree. It is notable that many other professions have recognized this and PAFT is hopeful that our own profession’s educational leaders will see the importance of embracing doctorate level education for the PA profession. Moreover, legislators have often been quick to question whether PAs – “by our own PA education” – have the capability of fulfilling the needs of patients as they seek solutions that may ease healthcare provider shortages. Our educational depth will be one means by which we are measured and considered as viable providers to meet those shortage needs. Physicians, too, are often unaware of the extent of our didactic and clinical training, despite our presence among them for the past 45 years.


  Developing and expanding an advanced degree program for PAs will only lend to professional credence and viability as capable healthcare providers. PA programs will not only be required to adapt their existing didactic and clinical programs, but it will be important to develop an “add-on” doctorate program for practicing clinicians that already hold advanced degrees. Those degrees should include both a clinical scope and a leadership tract that will enhance the doctorate PA’s ability to interact and function within health systems as well as with business leaders and administrators. It is in these areas that the clinically practicing PA lacks insight, knowledge, and skill, primarily due to limited educational resources. These are also the areas in which other professions are eclipsing PAs and forging ahead of our profession. If PAs are to become leaders in other areas of medicine, it will no longer be acceptable to limit our graduates to the solid clinical components that our present PA degree offers. The PA of the future will require an expanded educational background to become leaders in our profession and to also function at an executive level. This will allow future PA leaders to better self-define the PA profession and to clarify the value that the profession brings to accessible and affordable care while remaining patient-centered in philosophy. PAFT feels that the future of our profession rests on the willingness of our PA educators to embrace the development of a doctorate level terminal degree for all PA graduates.


Our organization hopes that most PA programs will begin to transition to a terminal doctorate degree by 2020. By 2025, the majority of PA programs should have a terminal doctorate level degree in place with many institutions also offering an “add-on” doctorate degree for those who wish to pursue additional training to advance their degree status. This would also allow all PAs who are practicing to pursue part-time degree development while also working clinically. PAs for Tomorrow feels this would be a substantial step in the recognition, development, and evolution of fully advancing the PA profession into the future as well as fully recognize the already existing rigor and hours experienced in PA education.


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