Physician assistants in obstetrics and gynecology serve as valuable members of physician-led teams, managing a broad range of patient care issues in both inpatient and outpatient OB/GYN settings. The patient-centered care that physician assistants provide increases patient satisfaction and ensures continuity of care. The education and training these healthcare practitioners have gained allows them to perform a wide range of diagnostic and therapeutic procedures.
According to a brief issued by the American Academy of Physician Assistants (AAPA) and the Association of Physician Assistants in Obstetrics and Gynecology, PAs evaluate and manage common gynecological conditions and provide patient education and counseling on OB/GYN issues.
The work of physician assistants in obstetrics and gynecology encompasses the management of women’s health from adolescence onward. As with other PA specialties, the scope of their work depends largely on the settings in which they work.
Physician Assistants in Outpatient OB/GYN Settings
According to APA census data, 88 percent of PAs work in outpatient obstetrics and gynecology settings, while 33 percent manage the care of inpatients. Physician assistants in obstetrics and gynecology in outpatient settings perform gynecological and obstetrics examinations and evaluate common gynecological conditions.
Physician assistants may provide obstetrical and gynecological care in a number of outpatient settings, including:
- OB/GYN practices
- Family practices
- General internal medicine practices
- Family planning centers
- Urban and rural community health clinics
- Urgent care centers
- Multispecialty physician groups
The most frequent patient encounters among physician assistants in outpatient settings involve:
- Performing annual pap/pelvic and breast exams
- Addressing gynecological complaints
- Addressing menopause management issues
- Providing family planning services
- Providing pre-natal and post-natal care
Many physician assistants are part of teams that evaluate and treat infertility, and many more provide prenatal, intrapartum, and postpartum care. Patient counseling includes counseling on a broad number of issues, such as:
- Breast self-examination
- Prenatal care
- Postnatal care
Other issues commonly addressed by physician assistants in outpatient OB/GYN settings include:
- Breast masses
- Ovarian cysts
- Uterine fibroids
Physician Assistants in In-Patient Obstetrics and Gynecology Settings
Physician assistants providing inpatient care typically fit into one of two models. Either they are employed outside the hospital and have privileges to provide inpatient care, or they are employed by the hospital and work on staff within the OB/GYN unit.
In hospital-based obstetrics and gynecology, physician assistants may perform a number of procedures, such as:
- Internal monitor placement
- Fetal monitor strip interpretation
- Intrauterine device insertion and removal
- Vulvar and endometrial biopsies
- Loop excision electrocoagulation procedures (LEEP)
Physician assistants employed in private practices with hospital privileges may also assist in deliveries. (Note: Most hospitals have regulations in place limiting or preventing physician assistants from performing deliveries.) They also assist during surgeries, such as cesarean sections, hysterectomies, and post-partum tubal ligations.
Physician assistants working with gynecology-oncology surgeons assist in procedures and surgeries such as:
- Radical hysterectomies
- Radical vulvectomies
- Removal of pelvic masses
They also monitor the patient recovery process, order lab work, and provide pre- and post-operative education.
Physician assistants serve as vital links between patients and other clinicians, ensuring continuity of care and maintaining close communication between the surgeon, the patient, and the patient’s family.
How to Become a PA Specialized in Obstetrics and Gynecology
All physician assistants must complete a physician assistant graduate program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), take and pass the National Commission on Certification of Physician Assistants’ (NCCPA) Physician Assistant National Certifying Examination (PANCE), and earn state licensure to practice as a certified physician assistant.
Accredited physician assistant programs, which are about 26 months in duration, include about 2,000 hours of clinical experiences, which must include experiences in obstetrics and gynecology.
Many physician assistant graduates with interest in obstetrics and gynecology complete a post-graduate residency offering intensive training in obstetrics and gynecology. These programs, which include about 12 months of full-time training, provide graduates with opportunities to work alongside OB/GYN physicians in a variety of settings and circumstances. Physician assistants in these programs can expect to complete rotations in antepartum, intrapartum, and postpartum services, as well as gynecological oncology services.
The NCCPA offers the certificate of added qualifications (CAQ) program for physician assistants who want to earn a specialty certification to set themselves apart from other professionals in their field. Although the NCCPA does not offer a CAQ in obstetrics/gynecology, physician assistants working in this field may choose to pursue a CAQ in:
- Hospital medicine CAQ
- Emergency medicine CAQ
To qualify for a CAQ designation, physician assistants must hold a PA-C designation and a valid, unrestricted license to practice as a physician assistant in at least one U.S. jurisdiction. They must also pass a specialty exam and complete the following requirements:
- At least two years of experience
- A Category I specialty CME
- The procedures and patient case experience appropriate for the specialty for which they are applying
Resources for Physician Assistants in Obstetrics/Gynecology
Becoming a member of a physician assistant professional association provides professionals in the field with an abundance of networking and continuing education opportunities:
- Association of Physicians in Obstetrics and Gynecology
- Association of Family Practice Physician Assistants
- American Association of Surgical Physician Assistants
- Society of Emergency Medicine Physician Assistants