Physician assistants are an integral component in the management and delivery of care for cardiothoracic surgery patients. Physician assistants round out any cardiovascular and thoracic surgery practice, deftly attending to all aspects of perioperative care, performing daily rounds, and assisting in invasive surgical procedures.
According to the American Association of Surgical Physician Assistants, physician assistants in cardiovascular and thoracic surgery serve as the first assistant in adult and pediatric cardiac cases, often working in operating rooms, post-operative acute care units, step-down units, and regular hospital units.
Cardiovascular and thoracic surgery physician assistants possess extensive knowledge of artificial cardiac devices, ventilator management, and vasoactive/cardiotonic drugs, making them highly respected and trusted members of the surgeon-led medical team.
The Job Scope and Responsibilities of PAs in Cardiovascular and Thoracic Surgery
Cardiovascular and thoracic surgery physician assistants meet the specific needs of the attending surgeon. Their familiarity with the surgeon and exacting knowledge of the medical model expedites procedures, limits patient mortality and morbidity, and promotes a synergistic relationship with the surgeon.
Their work alongside the surgeon includes:
- Performing patient histories and physical exams
- Performing daily rounds, including discharge summaries and patient education
- Performing invasive procedures, such as:
- Chest tube insertions
- Placement of central venous and dialysis catheters
- Placement of arterial lines and intra-aortic balloon pumps
- Retrieval of vascular tissues for use as a bypass conduit
- Endoscopic retrieval
Although the job duties of cardiothoracic physician assistants tend to vary, in general, these medical professionals provide care for the patient before, during, and after a surgical procedure:
- Pre-surgery, they explain the procedure to the patient and the patient’s family, answering any question and addressing concerns. They also perform routine pre-operative tests.
- During the surgery, physician assistants assist the surgeon in a number of ways. They may perform certain procedures, such as placing IV lines or drawing blood.
- Post-surgery, physician assistants in cardiothoracic surgery care for patients by monitoring their recovery, ordering and reviewing lab tests, and addressing any problems or issues with the surgeon. Often times, they oversee the patient’s discharge process, which may include explaining discharge instructions, follow-up care, and writing prescriptions.
How to Become a PA Specialized in Cardiovascular and Thoracic Surgery
Individuals interested in learning how to become a physician assistant specialized in cardiovascular and thoracic surgery must complete a physician assistant program accredited by Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). These master’s programs, which are about 26 months in duration, require candidates to possess a bachelor’s degree with specific undergraduate courses in biology, anatomy, and chemistry. A few physician assistant programs combine the coursework of both a bachelor’s and master’s degree.
In addition to a rigorous curriculum and related lab experiences, students of physician assistant programs must complete about 2,000 hours of clinical rotations in various areas of medicine, including general surgery, emergency medicine, and internal medicine.
Upon graduating from a physician assistant program, graduates must take and pass the Physician Assistant National Certifying Examination (PANCE) and apply for state licensure in order to qualify to practice as a physician assistant in the U.S.
New graduates often choose to complete a physician assistant post-graduate program in cardiothoracic surgery. Some cardiothoracic surgeons hire graduates and personally train and mentor them, although post-graduate residencies are more typical. Post-graduate programs are paid residences, lasting about 12 months. They provide new graduates with intensive training and education. The Associate of Postgraduate PA Programs recognizes 48 of these programs in the U.S.
The Society for Thoracic Surgeons supports the use of physician assistants in cardiovascular and thoracic surgery, as well as post-graduate programs in educational institutions or private practice, noting that they should prepare students to:
- Procure conduit for coronary artery bypass surgery
- First assist in surgery
- Place arterial lines
- Place central lines
- Place Swan Ganz catheters
- Perform thoracentesis
- Place and remove intra-aortic balloons
- Place and remove chest tubes
- Provide pre- and postoperative care
Professional Recognition in Cardiovascular and Thoracic Surgery
Experienced physician assistants in cardiothoracic surgery often choose to pursue professional recognition in the field via the National Commission on Certification of Physician Assistants (NCCPA) certificate of added qualifications (CAQ) program in Cardiovascular and Thoracic Surgery.
To qualify for the Cardiovascular and Thoracic Surgery CAQ, candidates must:
- Possess PA-C certification
- Possess a current PA license in at least one U.S. jurisdiction
- Possess at least two years of experience
- Possess at least 150 credits of Category I CME focused on cardiovascular and thoracic surgery
- Possess at least two years of full-time experience working as a PA in cardiovascular/thoracic surgery within the last 6 years
- Pass a specialty exam
- Submit an attestation from a physician who can indicate that the PA has performed patient management relevant to cardiothoracic surgery or has an understanding of how and when to apply the appropriate techniques and methods in the following areas:
- Advanced wound management
- Diagnostic/therapeutic procedures
- Diagnostic radiographic/other modalities
- Operative/perioperative care
- Cardiopulmonary resuscitation
Resources for Physician Assistants in Cardiovascular and Thoracic Surgery
Professional associations serve as a valuable resource for continuing education and networking opportunities for physician assistants in cardiothoracic surgery:
- American Association for Thoracic Surgery
- Society of Thoracic Surgeons
- Association of Physicia n Assistants in Cardiovascular Surgery
- American Association of Surgical Physician Assistants