Forty years ago, Vietnam War veterans returned home attempting to start new lives as civilians. Among them were medics who looked for a way to turn their skills into a living and ultimately created the demand for a new profession.
The University of Florida supported the new physician assistant profession and, eventually, helped set the pace for public medical schools around the nation.
On June 12, just days before the commencement ceremony for 59 physician assistant studies students, the profession saw another milestone set by the University of Florida’s College of Medicine; the Board of Trustees approved the elevation of the PA program to the School of Physician Assistant Studies.
“This further demonstrates the significant role of the Physician Assistant program at the College of Medicine. It also reflects a tremendous need and demand for physician assistants in the health-care systems of our state and the nation,” said College of Medicine Interim Dean, Michael Good, M.D., during the graduation ceremony on Saturday, June 20.
UF’s first PA program began in 1972 in collaboration with Santa Fe Community College. The 30 students enrolled were awarded with an associate degree after two years of study. The program would find a permanent home at UF just five years later and PA graduates were awarded a bachelor of science degree.
“UF has been a trailblazer in moving the profession to the forefront, answering the growing demand for PAs as health-care reform and spending became top national issues,” said Wayne D. Bottom, PA-C, M.P.H., associate dean and director of the School of Physician Assistant Studies, who has led UF’s PA Program for 27 years.
“I’m not a lightweight,” Bottom said, referring to his longtime commitment to PA studies, which originated in Alabama. During his time there, Bottom successfully lobbied for the creation of the Central Application Service for Physician Assistants, a national application system for PA students that is similar to the American Medical College Application Service for medical students.
Bottom saw UF’s program through instability as it moved from the College of Allied Health Professions (now College of Public Health and Health Professions) back to the College of Medicine in 1993, and he was thrilled a year later when the Florida Legislature earmarked funding to double enrollment to 60 students per class. The Program was upgraded to the master’s degree level in 1996.
When asked about the significance of the recent elevation to a school status, Bottom said, “While this is designated as a school it is the equivalent to a new department within the College of Medicine which means we have the same rights and privileges as every other department … we have a voice and a vote.”
Currently there are 145 PA programs nationwide. UF is the only public university in Florida to offer PA studies as a graduate program. The move to a school has not changed the Program itself, however.
The School of Physician Assistant Studies remains a 24-month-long master’s program that includes 12 months of coursework and 12 months of clinical rotations. Following completion, students must pass the national certifying exam to receive the PA-C designation and to become licensed to practice in all 50 states.
According to labor statistics, this elevated designation as a School parallels the demand for physician assistants. The U.S. Bureau of Labor Statistics report new job opportunities for physician assistants will grow by 50 percent in the next six years, making it the fastest growing occupation in the nation. Bottom says that before graduation, his students have five to seven job offers to choose from with starting salaries between $70,000 and $90,000.
This projected job growth reflects the expansion of health-care industries and an emphasis on reducing costs, which results in increasing use of PAs by many health-care providers. The College of Medicine program has turned out more than 1,400 PA graduates with two-thirds still practicing in Florida.
“As baby boomers begin to retire, there will be a massive increase in patient needs; particularly in Florida,” Bottom said. “If President Obama gets some form of health insurance for the 47 million currently uninsured in the U.S., this will result in another massive hit on the resources of the practice of medicine.”
Today PAs assist physicians in virtually all major specialties and they practice in hospitals and private practices in urban and rural areas across the nation. Most PAs work in family and emergency medicine while others are drawn to internal medicine, obstetrics/gynecology, pediatrics and surgery. PAs have become more prevalent in UF’s own network of health professionals, the UF Faculty Group Practice.
“We have had multiple PAs in gastroenterology, hepatology, and nutrition for many years,” said Christopher E. Forsmark, M.D., professor of medicine.
“The ability of our PAs to work collaboratively with the M.D. faculty allows us the ability to provide state-of-the-art care for our patients with complex gastrointestinal and liver diseases,” Forsmark said. “PAs are essential to the smooth functioning of our clinical enterprise and to our delivery of high-quality care.”
When asked about the future of PA studies, there is always room for progress, said Bottom. He sees the need for increased class size but knows there are some fundamental changes that must happen first.
“In order to keep contributing in terms of the number of PA graduates at this capacity, we need more space,” he said referring to the cramped classrooms and labs currently shared with medical students.
Bottom also feels an expansion of the program would be more likely if the out-of-state tuition was less intimidating. Recently, Florida Legislature voted not to allow out-of-state students to convert to in-state status after a year of study. Currently, out-of-state tuition for the program is $42,000 while in-state is $14,000.
“We need students from many backgrounds and clinical experience,” Bottom said. “The ability to have a diverse group of students will keep UF at the forefront of the PA profession.”