Interservice Physician Assistant Program (IPAP) – Military offers a great career path

The Interservice Physician Assistant Program (IPAP) is the Physician Assistant (PA) school for the Army, Navy, Air Force, National Guard, and Coast Guard branches of the military. Located in San Antonio, Texas on Fort Sam Houston, the IPAP works with an educational partnership through the University of Nebraska Medical Center in Omaha, NE.

Becoming a Physician Assistant is a very sought after career as many see healthcare opportunities increasing over the next few years. This along with the excellent compensation students receive while learning makes Interservice Physician Assistant Program a desirable location for many service members and civilians considering other options for obtaining their education.

Applicants to IPAP can be either non-commissioned officers or commissioned officers who attend the school full-time. For the Army, only active duty enlisted soldiers and officers may apply. For other branches, only enlisted soldiers are eligible. These students are then allowed to apply to become commissioned officers once their program is complete.

Get Paid to become a Physician Assistant

While they are going through IPAP, students are paid their normal salary and receive all health benefits. During the 2 years at IPAP, students receive approximately $160,000 in education through the armed services. In exchange for this education, students are required to serve four years in their branch of service once they graduate from IPAP.

Interservice Physician Assistant Program (IPAP)  Admission Requirements

Requirements to apply for the Interservice Physician Assistant Program include having at least 60 hours of college credit, of which 30 must be in residence training. They must also have at least a 2.5 GPA, English credit of 6 hours, Humanities or Social Sciences credit of 6 hours, Chemistry credit of 6 hours, Anatomy credit of 6 hours, Physiology credit of 6 hours, Algebra credit of 6 hours, and Psychology credit of 6 hours.

SAT or ACT scores and complete transcripts for every college attended are also included in their application which is submitted through their branch of service. Military records and letters of recommendation are necessary along with an essay describing why the service member wants to become a Physician Assistant. Desirable candidates are then asked to interview with a current PA.

Every 4 months, the school welcomes 60 new students making entrance into the program very competitive. However, once students are in class, they find a very favorable faculty to student ratio with just one highly-qualified instructor per every 7 students. In addition to classroom teaching, faculty supervise in labs and also in care clinics where students gain hands on experience. During Phase II, or what is also referred to as the Clinical Phases of the school, PA students gain even more valuable experience going through rotations which include areas such as dermatology, neurology, allergy clinic, general surgery, radiology and gynecology.

Once the student graduates from Interservice Physician Assistant Program (IPAP) , they might find themselves working in a wide variety of settings within the military’s medical services. Many PAs work in hospitals or acute care centers alongside doctors while others might work within their units or divisions. As the primary source of medical information when a physician is not available, PAs fill very important roles through the medical communities. They may train medics, provide medical services, or prescribe treatment as necessary. Applying to the Interservice Physician Assistant Program through the armed forces may be an excellent option for many who want to become PAs without carrying loads of student debt.

Overview of Physician Assistant Prescriptive Authority

Physician Assistants usually have the ability to prescribe medications as long as a long list of laws and regulations are complied with.  All states that allow it require a supervising physician that is responsible for oversight. The particular laws and regulations vary by state.  Most states have applications posted with instructions online and you can find them by searching on the state name plus the phrase Physician Assistant prescriptive authority.  Once the application is approved along with the proof of eligibility a certificate to prescribe or a provisional certificate to prescribe is issued.  Proof of eligibility varies by state but always includes proof of educational requirements and a delegated physician as the primary supervising physician.

Prescriptive Authority By State

Below is a map showing the states that allow physician assistants to prescribe medications and the level of authority they are given:

Prescriptive Authority for PA's by State

Source: U.S.Department of Justice, Drug Enforcement Administration

You will notice that in early 2011 there are only 2 states that do not allow PA’s to prescribe medication of any kind. They are Florida and Kentucky. Additionally, many states have classified drugs into 5 categories and have restricted prescription authority given to a certain number of these categories.  Other restrictions which some sates impose on top of these limitations are the amount of medication a physician assistant prescribing to something like a 72 hour supply, or the physician assistnat prescription can have no refills attached to them. These restrictions are shown in the map and are indicated by diagonal lines in addition to the color designation for drug classes allowed.

Prescription Authority Caveat’s

Even though a physician assistant may be granted prescription drug authority by the state he lives and is licensed to do so there are other factors that might limit their ability to do so. Firstly, the hospital, or medical group for which he works can impose there own rules and restrictions on what they can do, Secondly, the supervising physician may not allow or may place additional restrictions on the authority.  He is ultimately responsible for the PA and may wish to avoid the risk or need to build a period of trust in the abilities of a PA before allowing them to prescribe.  Lastly, a few states require a co-signor or supervising physician to be present at the time of writing the prescripton.

Why some states limit the Prescriptive Authority of PA’s

Many patient advocate groups lobby the legislative bodies that grant these powers to prevent or place limitations on Physician assistants and Nurse practitioners to prescribe medications.

The people who oppose granting prescriptive powers to PA’s argue that the additional training and education a physician receives is lacking in a physician assistant education.  They believe the quality of care will suffer because this lower level of education and training means proper diagnosis will not be made in many cases leading to more prescription related incidents.  They also believe that the advanced knowledge of drug interactions is lacking in the education of a PA especially when it comes to controlled substances. Many controlled substances can mask certain symptoms resulting I serious drug interactions and drug addictions.

Why more Prescription Authority for Physician Assistants is likely

The new healthcare legislation makes accessibility of care for more people not only a desire but also the law. The only way that this can effectively be done is to create more doctors or to expand the scope of practice for advanced nurse practitioners and physician assistants. Many legislatures have exploratory groups looking at this now.  They cite better patient outcomes in many cases compared to the outcomes for care provided by a physician.  Some studies showed that those who saw a physician assistant exclusively for 30% or more of their healthcare needs had fewer visits on average per year.  This in addition to the lower cost per visit when seeing a physician assistant leads to a substantial cost savings.  Innovative solutions that lower costs are going to be necessary to expand coverage and find a way to pay for that expansion.

The scope of practice expansion will make it more lucrative for physician assistants and nurse practitioners to participate n primary care. PA’s have generally tended to specialize because of the lower pay in a primary care environment. These new developments will make for a bright future in the physician assistant career field.

Physician Assistant Specialties

Physician Assistant Specialties

Among  physician assistants–about 51%–work in primary care, although many of them work in physician assistant specialties. In a pediatrics or family practice a physician assistant will typically take medical histories, review tests and administer whatever care is instructed by the physician. Rural health clinics also employee physician assistance on a regular basis as a way to make up for a shortage of doctors.

PAs can also find physician assistant employment in hospitals in the emergency room or in surgical departments. They typically work directly with patients, setting fractures, suturing wounds, ordering medical supplies, ordering tests and x-rays and updating patient charts.
Other PAs choose to work in specialty care.
A 2008 census report showed that physician assistants practiced in these areas of specialization:
·     Gen. internal medicine and its sub specialties (15.6%)
·    General surgery and surgical subs specialties (25.1%)
·    Pediatrics and pediatric subspecialties (4.3%)
·    Emergency medicine (10.5%)
·    Occupational medicine (2.3%)
·    Obstetrics and gynecology (2.3%)
·    Dermatology (3.6%)

Salaries by physician assistant specialties

As you might imagine, salaries for physician assistants and in a specialty practice are generally higher than those in a family practice. They also very from a high of $110,468 to a low of $78,956–depending on the exact specialty.
The American Academy of Physician Assistance reported in its 2008 census the mean total incomes (MTI) for clinically practicing PAs working at least 32 hours per week as follows

Specialty    MTI
Cardiovascular/Cardiothoracic surgery     $110,468
Dermatology     $104,474
Emergency medicine     $99,635
Neurosurgery     $98,024
Critical care medicine     $96,984
Radiology     $95,214
Orthopedics     $94,916
Anesthesiology     $93,370
Plastic surgery     $92,633
Occupational medicine     $92,323
Trauma surgery     $91,417
Urology     $90,462
General surgery     $90,094
Pain management     $89,059
Cardiology     $87,812
Hospital medicine     $87,550
Otorhinolaryngology     $86,856
Geriatrics     $85,973
Psychiatry     $85,361
General internal medicine     $85,076
Addiction medicine     $84,627
Oncology     $84,336
Gastroenterology     $84,268
Family medicine     $84,173
Pediatrics     $83,021
Neurology     $81,762
Allergy/Immunology     $81,557
Public health     $81,387
Rheumatology     $81,224
Nephrology     $80,842
Obstetrics/Gynecology     $79,229
Endocrinology     $78,956

Physician assistants working in outpatient care centers had an annual mean wage of $87,060 and those employed in the Federal Executive Branch showed an annual mean wage of $81,180. Finally, PAs working in colleges, universities, and professional schools have an average mean wage of $82,450.

Given the fact that the median annual wage of all physician assistants was $81,230 in May of 2008, you can see that it definitely pays to choose one of the physician assistant specialities. The best paying of these are cardiovascular/cardiothoracic practices, but dermatology and emergency medicine are not far behind.

What it takes to become a Physician Assistant specialist

If you decide you want to become a specialist in some area, you will most likely need to go through a residency program. For example to become an OPA (Orthopedic Physician Assistant) requires classroom didactics, lectures, conferences, academic subjects, clinical applications, journal club meetings, practical exercises, demonstrations, seminars, grand rounds, research and operating room experience. The goals and objectives of the training are to fulfill professional requirements associated with an Orthopedic Surgery Residency.

A physician assistant career can take many directions, make sure you explore many different specialties before you decide which is best for you. Other physician assistant specialties such as emergency medicine, occupational health physician assistant, cardiothoracic surgery perfusion test physician assistant have similar requirements.

Physician Assistant Certification

Physician Assistant Certification

All 50 states, plus the District of Columbia, have legislation that governs physician assistant certification. While the qualification to be a PA may vary in small degrees from state to state, they all require PAs to pass the “Physician Assistant National Certifying Examination” (PANCE) as administered by the “National Commission on Certification of Physician Associates” (NCCPA).

Physician Assistant Certification Exam Questions

physician assistant certification examThe physician assistant exam requires six hours and is comprised of 360 multiple-choice questions. It is administered at more than 300 Prometric testing centers offering testing services throughout the U.S. and if an applicant fails to answer at least 162 questions here she will not receive a score report. To pass requires a scaled score of 75 or better.

Before you can take this test, you must graduate from a program that’s approved by the “Accreditation Review Commission on Education for the Physician Assistant” (ARCPA). In fact, even if you have a medical degree from another country you must still graduate from one of these accredited PA programs in order to take the PANCE. There are currently 157 accredited colleges and schools that offer accredited programs.

What the program consists of

These programs require two or three years of study and are considered masters level programs. You must have appropriate GRE scores and a bachelors degree for admission to one of the programs. They include classroom and laboratory instruction in subjects such as human anatomy, critical care medicine, biochemistry, clinical pharmacology, pathology, clinical medicine, medical ethics and physical diagnosis. These programs may also include clinical training with a supervising attendant in several areas, which includes family medicine, prenatal care, internal medicine, emergency medicine, geriatrics, and internal medicine. Sometimes, physician assistant students work in one of more of these areas under the watchful eye of a supervising physician who is seeking to hire a PA.

Most physician assistant programs are offered at medical schools, four-year colleges, academic health centers and allied health schools. A few programs are offered as part of the military, at community colleges or at hospitals. Many accredited physician assistant programs are affiliated with medical schools.

To enter one of these programs normally requires a college degree and some health-related work experience. All states require PAs to complete an accredited, formal education and pass the national exam in order to get a license. Once youare complete on your training and pass the PANCE (Physician Assistant National Certifying Examination), you can apply for physician assistant certification.

Other qualifications

To be a physician assistant you must have a desire to see patients and must be self-motivated. In addition, a PA should have a good bedside manner, the ability to make decisions in times of emergency, and emotional stability. Last but not least, you should have an enthusiasm for lifelong learning because their eligibility to practice depends on continuing education.

To remain certified

Once a physician assistant is certified, after a period of 2 years the PA must have demonstrated professional and ethical conduct, completed 100 hours of continuing education units from approved medical curriculum. In addition to the two year re-certification requirements they must also do one of the two following requirements within a six year period: 1) pass an exam or 2) Complete a take home exam and display a certain level of proficiency demonstrated by work related learning experience. It really is not much different from other professional careers that addiditonal and ongoing education is required to maintain the physician assistant certification.