Physician Assistant Course : A career with tremendous scope

Zooming to the PA program in India

When the Central and the State Governments are busy with launching new schemes and projects to create more job opportunities, a promising health care programme that offers immense employment chances, especially for youngsters, is remaining unnoticed in India.

 ”Physician Assistant (PA) programme is an American concept. This profession came into existence in USA in the mid-1960s due to the shortage and uneven geographic distribution of primary care physicians,” says Dr Philomena Mariadoss, Dean, Madras Medical Mission, Chennai.

Renowned Cardiac Surgeon Dr K M Cherian brought the concept of PA to India 17 years ago. But still it is unknown to the public due to various reasons, says Farida Farzana, PA Programme Coordinator, Frontier Lifeline Hospital and Dr K M Cherian Heart Foundation at Chennai. “Though there are several job offers from various institutions, the number of PA graduates to take up the jobs is less here,” she said.

Who is a PA?

A PA is a skilled health care professional who is qualified in academic

and clinical training to provide health care services under the supervision of a specialist. “They undertake all the matters of a patient

beginning from preparing medical histories, examining patients, writing case summaries, ordering laboratory tests like X-rays, ECGs, ultra-sonogram, counselling patients etc. The doctors who have busy

practice may not get time to take care the problems of a patient. At this juncture the role of the PAs becomes vital,” Farida said.

The PAs work in different departments such as Out-Patient wing, Operation theatre, Dept of Anesthesia, Catheterization labs, Coronary care units, Intensive care units, Organ Transplant units, Reproductive Medicine, Orthopaedics, trauma care, Nuclear Medicine and so on.

Scope

“The scope of this course is tremendous in our country. Apart from working as PA, they get placements in medical software institutions, pharmaceutical industry and organizations developing and marketing

sophisticated medical devices, medical tourism, and medical insurance.

Besides, they will be appointed as coordinators for various clinical

trials. While abroad they can work as medical technologists/scientist/cardiac technician/case managers/research assistants with some additional qualification as required by the respective country’s regulations. The programme has gained wider recognition among cardiologists and cardiac surgeons,” says Dr Gomathi Sundar, Vice-President, Indian Association of Physician Assistants (IAPA).

 ``The salary structure at the time of joining ranges anywhere from Rs 15,000 to 22,000 along with special perks like free accommodation,” says Gomathi who is also faculty and medical writer at Care foundation at Hyderabad.

Challenges

Though the benefits are aplenty, not many students get attracted to this programme. Dr Philomena Mariadoss cites lack of recognition from the government sector, lack of accreditation body to regulate the various aspects of the PA program, unstandaridized course curriculum etc as some of the reasons. “Though we had contacted the Tamil Nadu Ministry for Health, Medical Education and Family Welfare in October 2009 regarding this, we have not received any response so far,” Dr Philomena Mariadoss said.

Another draw back is only few universities in India offer higher degree in PA programme. “Only BITS–Pilani offers M.Phil in PA program. After that they can enroll for PhD. If the students from India want to do higher studies abroad, they should study the course ordered by the respective country’s rules and regulations,” says Farida.

Affirming that lack of publicity is one of the reasons, M Manesh, final year student at AIMS, Kochi said that he came to know this course, as he was so passionate in pursuing a career in medical field. “I wanted to study a novel course in medical field and found PA program sound interesting. Though I spend lot of time to get details of this course, now I’m very satisfied,” said Manesh who did degree in Biotechnology.

However, it is learnt that neither the universities that run the programme nor the institutions that have tie-up with the universities have shown sincere interest in seeking recognition from the Government. Dr M G R Medical University at Chennai plans to adopt the PA program. In this manner other universities also should take initiatives to enhance the course and seek recognition before they start the course.

Course

“This is a 4-year degree program, which includes one-year internship. The course structure is designed in such a way that the PA graduates would fit into various fields like clinical (patient care) research, teaching, management /administration /functional consultant in a software industry to develop hospital information system, rural medicine, preventive healthcare etc,” says Dr Philomena Mariadoss.

Apart from the United States, this course is available in Canada, England, Australia, Netherlands and Scotland. In England and Australia it was started recently.

Eligibility: +2 in Science stream.

The duration of the programme: 4 years (3 years + 1 year of Internship)

Fee structure: Normally it is Rs 10,000 to 20,000 per semester.

Universities offering the PA programme

1. Birla Institute of Technology and Science, Pilani in collaboration with Madras Medical Mission and Frontier Life Line, Chennai (4 yrs)

2. Sri Ramachandra Medical College, Chennai (3 yr BSc)

3. Avinashalingam University in collaboration with G.Kuppuswamy Naidu Memorial Hospital, Coimbatore (4yrs)

4. Kanchi Kamakoti Hospitals, Kacheepuram, Tamil Nadu.

5. Netaji Subhas Chandra University, Kolkatta in collaboration with CARE Hospital, Hyderabad and Rabindranath Tagore Institute of Medical Sciences, Kolkata (3yrs).

6. Sri Venkateswara Institute of Medical Sciences, Tirupathi (3 yrs).

7. Amrita Institute of Medical Sciences, Kochi

Role of a PA in a hospital

In the outpatient wing:

Take medical histories

Examine patients

Write case summaries

Order and interpret laboratory tests like X-rays, ECGs, ultra sonogram, Echocardiogram, Treadmill tests, pulmonary function tests etc.,

Make diagnosis

Counsel patients

In the wards and critical care units:

Take rounds

Manage emergency situation until the arrival of the specialist

Record progress notes

Order or carry out therapy under the supervision of a specialist

Prepare discharge summaries

In surgery:

Work as first or second assistants of whom one of the important tasks is to harvest saphenous vein for CABG surgery.

Establishing Cardiopulmonary Bypass as a Clinical Perfusiionist.

     

Prepare operation notes 

Involves in postoperative management of the patients

Involves in wound management.