Career as a Physician Assistant

The Ladder

How to Advance as a Physician Assistant

So you have figured out the basics of being a PA (physician assistant), chosen to become one and even settled on a place to work. Now you have to figure out how to advance.

This question is not specific to this career, but the answer isn't either. There is also more than one route up the staircase. Entry- and mid-level PAs have the opportunity to go back to school to specialize or do it the old-fashioned way, by networking within the PA community. The steps to advancement could lead to becoming a high-ranking, highly-respected PA, a hospital administrator position or perhaps a deanship with decision-making power. On your way up, we'll also detail typical workplace hierarchies and related careers.

We're in the era of healtcare teams and health coaches, so challenges will arise: What if, for example, you're a 25-year-old PA advising a registered nurse with 25 years of tenure about patient treatment? How about being a PA of any age or experience level and having to mediate between two doctors with differing opinions for said treatment? It can be a minefield. To understand some of your colleagues, here are related careers to consider:

JobDegreeMedian Salary (2014)Notable
PhysicianProfessional$189,760Supervises physician assistants and other staff... The majority work in offices, not hospitals... Like PAs, they can have a specialization.
Nurse PractitionerMaster's$97,990Registered nurse with specialized graduate education... Often works alongside a PA... Job postings may call for either a PA or a NP.
Registered NurseAssociate's$69,790Goes by the short-form RN... Perhaps even more connected to the patient than the aforementioned professionals.
Medical AssistantPostsecondary Program$31,220One ladder rung above the job of nursing assistant... Many assistants earn a post-high school certificate or receive on-the-job training.

Career Comparison: Physician Assistant versus Nurse Practitioner

The comparison demanding more context pits physician assistants against nurse practitioners. NPs, for short, are actually very similar to their PA colleagues, despite their differences in education. NPs are registered nurses (RNs) who have earned a master's degree in a specialty; the requirement for future NPs will be a doctorate degree. PAs, as we know by now, receive a more generalist education before specializing later, if they like. Their field is transitioning to a master's degree requirement. Another key difference: Nurse practitioners can have more autonomy in the workplace, perhaps opening their own clinic, whereas physician assistants always report to a supervising physician or medical doctor.

Three Steps to Advance

  • 1. Pursue additional education, perhaps specializing in a kind of clinical care.

    The National Commission on Certification of Physician Assistants (NCCPA) launched its certificate of added qualifications (CAQ) program in 2009 to make it easier for PAs to document their level of expertise. Often times, your employer will pay for some or all of your expenses if, say, you're attending a 35-hour conference across the country. Even if you don't want to advance but simply want to transition into a new specialization, this could be the path to reinventing your career.

    American Academy of PAs -- Specialty Organizations

    • Addiction Medicine
    • Neurology
    • Allergy, Asthma and Immunology
    • Neurosurgical
    • Anaesthesia
    • Obstetrics and Gynecology
    • Cardiology
    • Occupational Medicine
    • Cardiovascular Surgery
    • Oncology
    • Caring for the Elderly
    • Orthopaedic Surgery
    • Dermatology
    • Otorhinolaryngology/Head & Neck Surgery
    • Emergency Medicine
    • Pediatrics
    • Endocrine
    • Plastic Surgery
    • Family Practice
    • Psychiatry
    • Gastroenterology
    • Rheumatology
    • Hospice and Palliative Medicine
    • Surgical
    • Nephrology
    • Urological
  • 2. Stick it out.

    Experience and clinical knowledge can lead to a supervisory role with more salary, perhaps your own staff.

  • 3. Network with Other PAs.

    The American Academy of PAs (AAPA), which was founded in 1968, has an annual conference, where it hosts 6,000 PAs. The AAPA also fosters a private online community called “Huddle.” The Student Academy of AAPA has chapters at programs and performs many of the same services for student PAs. Speaking of chapters, there are also AAPA constituent groups by state, one in all 50, plus D.C.

Q&A: PA Career Coach Jennifer Anne Hohman

The former director of the AAPA's professional advocacy department says you should make sure you’re paid what you’re worth.

  • What services do you offer to PAs?

    As a career advisor with over 15 years of PA-specific advocacy experience, I have a passion for helping PAs create healthy careers. Working with PAs one on one, I have seen the concrete benefits of contract negotiation first-hand so many times. I also have insight into the complexities of team practice: It helps to have a sympathetic, savvy ally to navigate the wide-open road of a PA career. My goal in working with clients is to address these concerns:

    My career consultation helps clients refine and improve their CVs and cover letters, online presence and offers guidance along the job search and interview process.

    My contract consultation includes in-depth analysis of a client’s proposed contract with an eye to identifying problem areas, increasing compensation and creating an effective negotiation strategy to lay a foundation for a successful employment relationship.

  • What are common problems that your clients are facing?

    Many of my clients are new graduates new to the “business of medicine,” but I also assist experienced PAs who also seek advocacy before signing employment contracts: Negotiation is a stressful process for many professionals. One thing I’ve learned over the years is that PAs are best able to help patients when they have secured solid employment contracts. With reasonable schedules and positive compensation assured, PAs can focus on patients without stress or distraction. I also help clients with career transitions, whether because they are returning to practice after time away with family or changing specialties or locations.

  • How can PAs advance their careers?

    Advancement can take the form of attaining increasing expertise in a given specialty to take on increasing levels of leadership and compensation in that field. At the same time, one of the most unique and attractive aspects of the PA profession is the ability to move from specialty to specialty as one’s interests change. Thus, advancement can also take the form of building a varied and exciting medical practice that grows laterally into new specialties and practice settings over time. We are also seeing positions of administrative and clinical leadership increasingly available to PAs as the profession comes of age.

  • Beyond hiring you, how can PAs improve their prospects on the job market?

    I suggest that stay active in their professional networks, pursue additional specialty trainings and conferences, moonlight to explore potential new practice areas and make sure their CVs reflect the full scope of their accomplishments.

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