A hospitalist postgraduate training program for physician assistants

Abstract

Many hospitalist groups are hiring physician assistants (PAs) to augment their physician services. Finding PAs with hospitalist experience is difficult. Employers often have to recruit PAs from other specialties or hire new graduates who have limited hospital experience. Furthermore, entry‐level PA training focuses on primary care, with more clinical rotations centered in the outpatient setting. In light of these challenges, our institution created a 12‐month postgraduate training program in Hospital Medicine for 1 PA per year. It is the first reported postgraduate PA hospitalist fellowship to offer a certificate of completion. The program's curriculum is based on the Society of Hospital Medicine (SHM) “Core Competencies,” and is comprised of 12 one‐month rotations in different aspects of hospital medicine supplemented by formal didactic instruction. In addition, the PA fellow completes “teaching modules” on various topics not directly covered in their rotations. Furthermore, this postgraduate physician assistant training program represents a model that can be utilized at almost any institution, academic or community‐based. As the need for hospitalists increases, so will the need for trained physician assistants in hospital medicine. Journal of Hospital Medicine 2010;5:94–98. © 2010 Society of Hospital Medicine.

Learning needs of physician assistants working in hospital medicine

“…The curriculum was developed based on the Core Competencies in Hospital Medicine, and the authors explained that after 12 months of training, their first graduate functioned at the level of a PA with 4 years of experience under her belt. 7 Several articles describe experiences using midlevel providers (including PAs) in general surgery, primary care medicine, cardiology, emergency medicine, critical care, pediatrics, and hospital medicine settings. 5,[8][9][10][11][12][13][14][15][16][17][18][19][20] Many of these articles reported favorable results showing that using midlevel providers was either superior or just as effective in terms of cost and quality measures to physician-only models.…”

“…Structured and focused postgraduate training in hospital medicine seems like a reasonable solution to prepare newly graduating PAs that are interested in pursuing hospitalist careers, but such opportunities are very limited. 7 To date, there is no available information about the learning needs of PAs working in hospital medicine settings. We hypothesized that understanding the learning needs of PA hospitalists would inform the development of more effective and efficient training programs.…”

Effective use of physician extenders in an outpatient otolaryngology setting

“…There are trends for greater level of autonomy and additional postgraduate training. Residency programs are available for advanced care practitioners who desire additional training in subspecialized areas; however, no current programs are available in otolaryngology 8, 17. Although postgraduate training is not necessary for advanced practice providers to work in an otolaryngology clinic, a comfort level must be obtained before the physician extender transitions to partial or near complete independent practice 2.…”

Hospital medicine workforce: The impact of nurse practitioner and physician assistant providers

“…When compared with a traditional 3‐year medical residency at the same institution, the PA training program had similar outcomes on patient care including similar number of adverse events, readmissions, and patient satisfaction scores. A more formal postgraduate training program for PAs has been established at the Mayo Clinic Arizona . This 12‐month program, based on the Society of Hospital Medicine's (SHM) Core Competencies, consists of general medicine and inpatient medical subspecialty rotations, didactic instruction, and self‐directed teaching modules to learn systems‐based practices.…”

“…A more formal postgraduate training program for PAs has been established at the Mayo Clinic Arizona. 13 This 12-month program, based on the Society of Hospital Medicine's (SHM) Core Competencies, consists of general medicine and inpatient medical subspecialty rotations, didactic instruction, and self-directed teaching modules to learn systems-based practices. The Adult Hospital Medicine Boot Camp, sponsored by the SHM and the American Academy of Physician Assistants, is another training opportunity for both NPs and PAs who currently work in or are planning to practice hospital medicine.…”