How to Become a PA Specialized in Emergency Medicine

The demand for physician assistants (PAs) in emergency medicine continues to rise. According to a study published in Academic Emergency Medicine, the number of emergency departments employing physician assistants and nurse practitioners increased from about 28 percent in 1997 to more than 77 percent in 2006.

Their expertise in all aspects of emergency medicine makes them a valuable asset to emergency departments across America, easing the burden of emergency room physicians, who handled more than 136 million ER visits in 2011 alone.

Job Duties and Work Settings for Physician Assistants in Emergency Medicine

Physician assistants aren’t anything new to emergency departments, as they have been practicing in this setting since the profession began in the mid-1960s. Today, about 10 percent of all practicing PAs work in emergency medicine, in the following settings:

  • Pre-hospital patient care
  • Ground/air transport of patients
  • Patient triage
  • Fast track and urgent care settings
  • Main emergency department/critical care units
  • Administrative functions

The Society of Emergency Medicine Physician Assistants (SEMPA) publishes guidelines for physician assistants in emergency medicine, which include performing the following duties:

  • Taking patient histories
  • Instructing and counseling patients
  • Referring patients to appropriate community resources
  • Obtaining patient management consults
  • Performing physical examinations
  • Recording information into the patient chart
  • Performing or assisting in laboratory procedures
  • Performing or assisting in patient screening procedures
  • Performing diagnostic and therapeutic studies
  • Ordering and interpreting diagnostic laboratory tests and radiological studies
  • Ordering medications and other therapies

PAs specialized in emergency medicine perform a number of therapeutic and diagnostic procedures, such as:

  • Laceration repair
  • Wound care
  • Cast and splint application
  • Abscess incision and drainage
  • Procedural sedation
  • Regional block anesthesia
  • Arthrocentesis
  • Lumbar puncture
  • Thoracentesis
  • Urethral catheterization
  • Establishing venous access
  • Arterial puncture
  • Blood gas sampling

Although PAs in emergency medicine practice under the supervision of an attending physician, these medical providers often work as independent practitioners, exercising considerable autonomy regarding clinical decision-making.

How to Become a Physician Assistant Specialized in Emergency Medicine: Education and Certification Requirements

In all cases, becoming a physician assistant starts with completing a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

Only those graduates of ARC-PA-accredited programs may take the national certification examination through the National Commission on Certification of Physician Assistants’ (NCCPA), a requirement for state licensure in all U.S. jurisdictions.

Physician assistant programs are master’s level programs that take about 26 months to complete and require the completion of specific undergraduate requirements for admission. Most students prepare for these programs by focusing their bachelor’s degree on one of the biological or behavioral sciences.

One of the major components of a PA program is the clinical rotations, which encompass about 2,000 hours in a number of medical specialties, including emergency medicine.

Post-Graduate Fellowships

Paid, post-graduate fellowships are a common pursuit among physician assistants in emergency medicine, allowing new graduates to achieve an intensive course of training in their chosen medical specialty.

Many PA post-graduate programs are modeled after the physician residency curriculum, allowing PAs to work alongside physician residents while completing clinical rotations in:

  • Trauma
  • Pediatric emergency medicine
  • Orthopedics
  • Toxicology

Professional Certification

Like post-graduate fellowships, professional certification is not required to practice as a physician assistant in emergency medicine, but it may prove worthwhile for PAs seeking to advance their career. The NCCPA’s certificate of added qualifications (CAQ) program allows PAs to achieve professional recognition of their advanced qualifications in a specific area of medicine, including emergency medicine.

To qualify to take the Emergency Medicine CAQ specialty exam and receive board certification in emergency medicine, candidates must possess the following:

  • A PA-C designation and a current license to practice as a physician assistant in at least one U.S. jurisdiction
  • At least 150 credits of Category I CME in emergency medicine
  • At least 18 months of full-time experience in emergency medicine within the last 6 years

Attestation from a physician that can prove the candidate possesses experience and/or knowledge in the following areas of emergency medicine:

  • Airway adjuncts: Invasive airway management
  • Anesthesia
  • Advanced wound management
  • Diagnostic/therapeutic procedures
  • Hemodynamics techniques
  • Radiographic interpretation
  • Resuscitation

The specialty examination consists of the following components:

  • Abdominal and gastrointestinal disorders
  • Cardiovascular disorders
  • Dermatologic disorders
  • Endocrine, metabolic, and nutritional disorders
  • Environmental disorders
  • Head, eye, ear, nose, and throat disorders
  • Hematologic disorders
  • Immune system disorders
  • Systemic infectious disorders
  • Musculoskeletal disorders (non-traumatic)
  • Nervous system disorders
  • Obstetrics and gynecology
  • Psycho-behavioral disorders
  • Renal and urogenital disorders
  • Pulmonary disorders
  • Toxicologic disorders
  • Traumatic disorders
  • Procedures and skills

Resources for Physician Assistants in Emergency Medicine

Physician assistants in emergency medicine benefit from remaining active in professional associations, which serve as resources for professional networking events, continuing education activities, and the latest developments in the industry:

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