The Globalization of Physician Assistants

As of 2019, the adoption of PAs has spread globally across a variety of health systems and at least fifteen countries have been in various stages of expansion of PA-like medical workers (nonphysician clinicians) that function under the supervision of a doctor. For a more complete and updated review of this topic please see my latest post:Physician Assistants (PAs) and Associates Around The World CanadaPhysician Assistants United KingdomPhysician Associates The NetherlandsPhysician Assistants LiberiaPhysician Assistants IndiaPhysician Associates GhanaPA Medical (Medical Assistant) SouthAfricaClinical Associates AustraliaPhysician Assistants Saudi ArabiaAssistant Physicians GermanyPhysician Assistants New ZealandPhysician Associates AfghanistanPhysician Assistants IsraelPhysician Assistants BulgariaPhysician Assistants IrelandPhysician Associates Many of these countries have American-trained PAs working as expatriates, and most are developing educationalprograms that produce a health care provider functioning as an addition to the doctor. Each country has made it's PA a distinct entity,with cultural and educational influences shaping their roles. Common denominators of these PAs are: they function as semi-autonomousclinicians under the direct supervision of a doctor and have roles that tend to complement those of the doctor. Historical observations suggestthe development of the PA profession in different countries tends to follow a similar path and that lessons learned from these nationsmay be useful in further expansion of the profession. Those countries mentioned above are just some of the countriesthat have recently recognized theprogress of PAs and have developedtheir own PA programs. Yet, assistantsto doctors and prototypes ofPAs are not new. Eastern Europeancountries such as Russia and Ukraine; Asian countries such asChina and Malaysia; much ofOceania (eg, Australia, New Guinea,Micronesia, Melanesia, andPolynesia); as well as parts of Africaand South America have employedmedical aides for decades. Even inthe United States, the AlaskanCommunity Health Aides project,inaugurated during World War II andcontinuing today, produces what canbe referred to as prototype PAs. Common Denominators Excluding the Netherlands, everycountry falls short of the desired3/1,000 doctor-to-population ratiothat is recommended by the WorldHealth Organization (WHO). Alluse English in the classroom,although for theNetherlands, English is a secondarylanguage. Table 1 shows the populationand doctor-to-population ratiosof these countries, as well as those ofthe United States for comparison. Canada, Australia, South Africa, have remote and/orwidely separated and sparse populations.In some countries, the size ordispersal of rural populations presentsformidable challenges to health caredelivery. Educational Development Education programs have developedin different ways and by differentmeans in the nations described here.The established PA programs in thesecountries range from 2 to 3 years inlength, with a didactic componentfollowed by a clinical component. Please see my full article with a breakdown of practice and education requirements in each of the above countries:Physician Assistants (PAs) and Associates Around The World You can also download and view a beautiful infographic of this comparison here. Resources:The Globalization of Physician Assistant's (PDF) You may also like -Physician Assistants (PAs) and Associates Around The World The contemporary physician assistant/associate (PA) movementbegan in North America and Africa in the mid-1960s. As of 2018, the adoption of PAs has spread globally across a variety of health systems and at least fifteen countries []The 10 Best Cities For PAs to Move to in 2018 In its 2018 ranking of best health care jobs,U.S. News and World Reportranked physician assistant second in best health care jobs and third in best jobs overall. PAs are undoubtedly in high demand. As of 2017, the U.S. Bureau of []Make a Difference Train the Next Generation of PAs in Sub-Saharan Africa as a Clinical Associates MentorNote:The Clinical Associates twinning partnerships in South Africa are made possible through the support of the US Presidents Emergency Plan for AIDS Relief (PEPFAR) and the US Centers for Disease Control and Prevention (CDC) in South []