Physician assistant education: five countries

BACKGROUND: Physician assistant (PA) education has undergone substantial change since the late 1960s. After four decades of development, other countries have taken a page from the American experience and launched their own instructional initiatives. The diversity in how different countries approach education and produce a PA for their nation's needs provides an opportunity to make comparisons. The intent of this study was to document and describe PA programs in Australia, Canada, the United Kingdom, The Netherlands, and the United States.

METHODS: We reviewed the literature and contacted a network of academics in various institutions to obtain primary information. Each contact was asked a set of basic questions about the country, the PA program, and the deployment of graduates. Information on US PA programs was obtained from the Physician Assistant Education Association.

RESULTS: At year's end 2010, the following was known about PA development: Australia, one program; Canada, four programs; United Kingdom, four programs; The Netherlands, five programs; the United States, 154 programs. Trends in program per capita growth remain the largest in the United States, followed by The Netherlands and Canada. The shortest program length was 24 months and the longest, 36 months. Outside the United States, almost all programs are situated in an academic health center ([AHC] defined as a medical university, a teaching hospital, and a nursing or allied health school), whereas only one-third of US PA programs are in AHCs. All non-US programs receive public/government funding whereas American programs are predominately private and depend on tuition to fund their programs.

CONCLUSION: The PA movement is a global phenomenon. How PAs are being educated, trained, and deployed is known only on the basic level. We identify common characteristics, unique aspects, and trends in PA education across five nations, and set the stage for collaboration and analysis of optimal educational strategies. Additional information is needed on lesser-known PA programs outside these five countries.