Editing Physician assistant (section)

=== United States ===
====Nomenclature (US)====
In accordance with the [[American Academy of Physician Associates]] (AAPA), the official title of the profession in the United States is "Physician Associate".<ref name=aapa/><ref>{{citation |title=AAPA House of Delegates Votes to Change Profession Title to Physician Associate |url=https://www.aapa.org/news-central/2021/05/aapa-house-of-delegates-votes-to-change-profession-title-to-physician-associate/ |access-date=2023-01-02 |publisher=American Academy of Physician Associates |date=2021-05-24}}</ref> While this is the official title used by the national organization, utilization of this title may vary on the state and local level based on state and local bylaws and policies.<ref>{{citation |title=General FAQs |url=https://www.aapa.org/title-change/general-faqs/ |work=American Academy of Physician Associates |access-date=2023-01-02}}</ref> Many hospital and healthcare systems still use physician assistant as titles, with some just resorting to using "PA" to avoid confusion with [[physician]]s.<ref>{{Cite web |last=Science |first=Mayo Clinic College of Medicine and |title=Physician Assistant - Explore Health Care Careers - Mayo Clinic College of Medicine & Science |url=https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/physician-assistant/ |access-date=2024-04-06 |website=Mayo Clinic College of Medicine and Science |language=en}}</ref>

A physician assistant may use the initials "PA", "PA-C", "APA-C", "RPA" or "RPA-C", where the "-C" indicates "Certified" and the "R" indicates "Registered".{{Citation needed|date=April 2023}} The "R" designation is unique to a few states, mainly in the [[Northeastern United States|Northeast]]. APA stands for aeromedical physician assistant and indicates that a physician assistant successfully completed the US Army Flight Surgeon Primary Course.<ref>{{cite web|title="Aeromedical Physician Assistant" Army Regulation 40–501, 6-2.h|url=http://www.apd.army.mil/pdffiles/r40_501.pdf#page=74&zoom=auto,-193,380|archive-url=https://web.archive.org/web/20040119110228/http://www.apd.army.mil/pdffiles/r40_501.pdf#page%3D74%26zoom%3Dauto%2C%2D193%2C380|url-status=dead|archive-date=January 19, 2004|access-date=5 February 2019|website=Apd.army.mil}}</ref> During training, PA students are designated PA-S.{{Citation needed|date=April 2023}} The use of "PA-C" is limited to certified PAs who comply with the regulations of the National Commission on Certification of Physician Assistants and who have passed [[Physician Assistant National Certifying Exam|PANCE]].{{Citation needed|date=April 2023}}

Students undertaking physician assistant or associate training may refer to themselves as a physician assistant student, physician associate student, student physician assistant or student physician associate.{{Citation needed|date=April 2023}} PA students may add "S" at the end of their student designation (PA-S).{{Citation needed|date=April 2023}} Students may also use the corresponding year of their training in their student designation.{{Citation needed|date=April 2023}} For example, students in the second year of their physician assistant or physician associate training may use (PA-S2) as their student designation.{{Citation needed|date=April 2023}}

The American Academy of Physician Associates has spent over $22 million since 2018 campaigning to change the word "assistant" to "associate" in the title of physician assistant. The campaign has been heavily criticized by physicians, but advocates argue that the revised title more accurately reflects the clinician's role on the patient care team.<ref>{{Cite news |last=Rau |first=Jordan |date=December 3, 2021 |title=Physician assistants want to be called physician associates, but doctors cry foul |work=[[NPR]] |url=https://www.npr.org/sections/health-shots/2021/12/03/1059916872/physician-assistants-want-to-be-called-physician-associates-but-doctors-cry-foul |access-date=October 20, 2023}}</ref>

In the United States, the profession is represented by the [[American Academy of Physician Associates]]. All PAs must graduate from a nationally accredited ARC-PA{{Clarify|date=May 2021}} program as well as passing the national certification exam.<ref>{{cite web|title=PA Information|url=http://www.westliberty.edu/physician-assistant/about/|access-date=2013-05-23|publisher=West Liberty University}}</ref> In 1970 the [[American Medical Association]] passed a resolution to develop educational guidelines and certification procedures for PAs.<ref name="Carter 2001">{{cite journal|last1=Carter|first1=R.|date=Spring 2001|title=Physician Assistant History|url=http://www.pahx.org/pdf/Military%20Ranks.pdf|journal=Perspective on Physician Assistant Education|volume=12|pages=130–132|doi=10.1097/01367895-200107000-00011|number=2}}</ref> The [[Duke University Medical Center]] Archives had established the Physician Assistant History Center, dedicated to the study, preservation, and presentation of the history of the profession. The PA History Center became its own institution in 2011, was renamed the PA History Society, and relocated to [[Johns Creek, Georgia]].<ref>{{cite web|title=Who we are:The Society for the Preservation Of Physician Assistant History|url=http://www.pahx.org/who-are-we|access-date=6 April 2016|website=Pahx.org}}</ref>

==== Education and certification (US) ====
{{As of|2019|May}}, 243 accredited PA programs operated in the United States, with dozens more in development.<ref name="paeaonline.org">{{cite web|title=PAEA Program Directory|url=http://directory.paeaonline.org/programs|access-date=5 February 2019|website=Directory.paeaonline.org}}</ref> Most educational programs are [[Postgraduate education|graduate programs]] leading to the award of [[master's degree]]s in either Physician Assistant Studies, Health Science ([[Master of Health Science]]), or Medical Science (MMSc), and require a [[bachelor's degree]] and [[Graduate Record Examination]] or [[Medical College Admission Test]] scores for entry. The majority of PA programs in the United States employ the [[CASPA]] application for selecting students.<ref name=paeaonline.org /> Professional licensure is regulated by [[U.S. state|state]] medical boards. PA students train at medical schools and academic medical centers across the country.

[[File:Physician Assistant Program at ODU.jpg|thumb|Physician Assistant Program at ODU]]

PA education is based on medical education;<ref>{{cite web|title="Issue Brief - Physician Assistant Education: Preparation for Excellence" - AAPA|url=http://www.aapa.org/gandp/issuebrief/education.pdf|url-status=dead|archive-url=https://web.archive.org/web/20061113221713/http://www.aapa.org/gandp/issuebrief/education.pdf|archive-date=2006-11-13|access-date=5 February 2019|website=Aapa.org}}</ref> it typically requires 2 to 3 years of full-time graduate study like most master's degrees.<ref>{{cite web|title=Physician Assistant|url=http://www.guidetohealthcareschools.com/degrees/allied-health/physician-assistant|access-date=18 January 2013|publisher=guidetohealthcareschools}}</ref> (Medical school lasts four years plus a specialty-specific residency.) Training consists of classroom and laboratory instruction in medical and behavioral sciences, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine, as well as elective rotations.<ref>{{cite journal|vauthors=Cawley JF|year=2012|title=Physician Assistants and Their Role in Primary Care|url=https://journalofethics.ama-assn.org/article/physician-assistants-and-their-role-primary-care/2012-05|journal=AMA Journal of Ethics|volume=14 |issue=5 |pages=411–414 |doi=10.1001/virtualmentor.2012.14.5.pfor2-1205|pmid=23351209 |access-date=5 September 2020|doi-access=free}}</ref> PAs are not required to complete residencies after they complete their schooling (unlike physicians). Postgraduate training programs are offered in certain specialties for PAs, though these are optional and shorter in length than medical residency.<ref>{{cite web|title=The Association of Postgraduate PA Programs (APPAP)|url=http://www.appap.org/index1.html|url-status=dead|archive-url=https://web.archive.org/web/20080303195642/http://www.appap.org/index1.html|archive-date=2008-03-03|access-date=5 February 2019|website=Appap.org}}</ref>

PA clinical postgraduate programs are clinical training programs that differ from on the job training given their inclusion of education and supervised clinical experience to meet learning objectives.<ref name="Polansky 2007 100–108">{{cite journal|last=Polansky|first=Maura|year=2007|title=A Historical Perspective on Postgraduate Physician Assistant Education and the Association of Postgraduate Physician Assistant Programs.|journal=Journal of Physician Assistant Education|volume=18|issue=3|pages=100–108|doi=10.1097/01367895-200718030-00014}}</ref> Montefiore Medical Center Postgraduate Surgical Physician Assistant Program was established in 1971 as the first recognized clinical postgraduate PA program.<ref name="Polansky 2007 100–108"/> 49 programs address specialties such as Neurology, Trauma/Critical Care and Oncology. 50 programs joined the Association of Postgraduate Physician Assistant Programs to establish educational standards for postgraduate PA programs.<ref name="Polansky 2007 100–108"/><ref name="Polansky 2012 39–45">{{cite journal|last=Polansky|first=Maura|author2=Garver GJ|author3=Wilson LN|author4=Pugh M|author5=Hilton G|year=2012|title=Postgraduate clinical education of physician assistants.|journal=J Physician Assist Educ|volume=23|issue=1|pages=39–45|doi=10.1097/01367895-201223010-00008|pmid=22479907 |s2cid=24895570 }}</ref>

In the United States, a graduate from an accredited PA program must pass the NCCPA-administered Physician Assistant National Certifying Exam ([[PANCE]]) before becoming a PA-C; this certification is required for licensure in all states.<ref>{{cite web|title="Physician Assistant National Certifying Exam (PANCE)" - National Commission on Certification of Physician Assistants (NCCPA)|url=http://www.nccpa.net/EX_pance.aspx|url-status=dead|archive-url=https://web.archive.org/web/20071217013701/http://www.nccpa.net/EX_pance.aspx|archive-date=2007-12-17|access-date=5 February 2019|website=Nccpa.net}}</ref> The content of the exam is covered in the PANCE BLUEPRINT. In addition, a PA must log 100 [[Continuing medical education|Continuing Medical Education]] hours and reregister his or her certificate with the NCCPA every two years. Every ten years (formerly six years), a PA must also recertify by successfully completing the Physician Assistant National Recertifying Exam ([[PANRE]])<ref>{{cite web|title=About CME Requirements|url=http://www.nccpa.net/ContinuingMedicalEducation|access-date=5 February 2018|website=National Commission on Certification of Physician Assistants|publisher=NCCPA}}</ref>
There is a growing number of doctoral programs for certified PAs leading to a [[Doctor of Medical Science]] (DMSc) but there is no requirement for one to have a doctorate in order to practice.
"National Physician Assistant Week" is celebrated annually in the US from October 6 through October 12. This week was chosen to commemorate the anniversary of the first graduating physician assistant class at Duke University on October 6, 1967.<ref>{{Cite web|title=PA Week|url=http://www.aapa.org/newsroom/pa-week.html|url-status=dead|archive-url=https://web.archive.org/web/20081202045954/http://www.aapa.org/newsroom/pa-week.html|archive-date=2008-12-02|access-date=2012-08-09}}</ref> October 6 is also the birthday of the profession's founder, Eugene A. Stead Jr., MD.<ref>{{Cite web|url=https://www.aapa.org/pas-go-beyond/spread-the-word/|title=Spread the Word}}</ref>

====Scope of practice (US)====
Physician assistants have their own licenses with distinct scope of practice.<ref>{{cite web|date=7 November 2013|title=Professional issues: Scope of practice|url=http://www.aapa.org/workarea/downloadasset.aspx?id=583|url-status=dead|archive-url=https://web.archive.org/web/20140729111325/http://www.aapa.org/WorkArea/DownloadAsset.aspx?id=583|archive-date=29 July 2014|access-date=23 December 2014|publisher=American Academy of Physician Assistants}}</ref> Each of the 50 states has different laws regarding the prescription of medications by PAs and the licensing authority granted to each category within that particular state through the [[Drug Enforcement Administration]] (DEA).<ref>{{Cite web|title=DEA Diversion Control Division|url=http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html|url-status=dead|archive-url=https://web.archive.org/web/20110616214301/http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html|archive-date=2011-06-16|access-date=2011-06-11}}</ref> PAs in Kentucky and Puerto Rico are not allowed to prescribe any [[controlled substance]]s.
Several other states place a limit on the type of [[Controlled Substances Act|controlled substance]] or the quantity that can be prescribed, dispensed, or administered by a PA.<ref>{{cite web |title=Mid-Level Practitioners Authorization by State |url=https://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf |website=US Department of Justice Drug Enforcement Administration Diversion Control Division |access-date=18 September 2021}}</ref>
Depending upon the specific laws of any given state board of medicine, the PA must have a formal relationship on file with a [[collaborative]] physician. The collaborating physician must also be licensed in the state in which the PA is working, although he or she may physically be located elsewhere. Physician collaboration can be in person, by [[telecommunication|telecommunication systems]] or by other reliable means (for example, availability for consultation). In [[emergency department]]s the laws governing PA practice differ by state, generally allowing a broad scope of practice and limited direct supervision.<ref>{{cite journal|last1=Wiler|first1=JL|last2=Ginde|first2=AA|date=February 2015|title=State laws governing physician assistant practice in the United States and the impact on emergency medicine.|journal=Journal of Emergency Medicine|volume=48|issue=2|pages=e49-58|doi=10.1016/j.jemermed.2014.09.033|pmid=25453855}}</ref>

During the COVID-19 pandemic, several state  governments changed regulations regarding PA scope of practice, including:
* On May 21, 2020, the law S.B. 1915 was signed by Oklahoma Governor [[Kevin Stitt]]. This law allows Physician Assistants to become primary care providers and receive direct pay from insurers. The reference of "supervision" was changed to "delegating" in regards to physician responsibility. This law also allows PAs to legally volunteer in the case of disaster or emergency.<ref>{{cite web|author=<!--Not stated-->|date=June 15, 2020|title=Oklahoma Bill Brings New Opportunities for PAs|url=https://www.cmfgroup.com/blog/pa/oklahoma-bill-brings-new-opportunities-for-pas/|access-date=July 13, 2020|website=cmfgroup.com|publisher=CMF Group}}</ref>
* On May 27, 2020, Governor [[Tim Walz]] signed into Minnesota law the Omnibus Healthcare Bill S.F. 13. This law removes references to physician responsibility of supervision and delegation of care provided by PAs. The law also removes delegated prescriptive authority.<ref>{{cite web|author=<!--Not stated-->|date=June 5, 2020|title=Minnesota Bill Brings New Opportunities for PAs|url=https://www.cmfgroup.com/blog/pa/minnesota-bill-brings-new-opportunities-for-pas/|access-date=July 13, 2020|website=cmfgroup.com|publisher=CMF Group}}</ref>

==== Employment (US) ====

The first employer of PAs was the then-Veterans Administration, known today as the [[United States Department of Veterans Affairs|Department of Veterans Affairs]]. Today it is the largest single employer of PAs, employing nearly 2,000.{{Citation needed|date=September 2021}}

According to the AAPA, as of 2020 there are more than 148,560 certified PAs in the United States, up from 115,547 in 2016.<ref>{{cite web |title=Statistical Profile of Certified PAs - Annual Report 2020 |url=https://www.nccpa.net/wp-content/uploads/2021/07/Statistical-Profile-of-Certified-PAs-2020.pdf |website=NCCPA.net |access-date=18 September 2021}}</ref>

''Money'' magazine, in conjunction with Salary.com, listed the PA profession as the "fifth best job in America" in May 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49.65%.<ref>{{cite web|title=50 Best Jobs in America - May 1, 2006|url=https://money.cnn.com/magazines/moneymag/moneymag_archive/2006/05/01/8375749/index.htm|access-date=5 February 2019|website=Money.cnn.com}}</ref> In 2010, CNN Money rated the physician assistant career as the number two best job in America.<ref>{{cite web|title=Physician Assistant ranked No. 2|url=https://money.cnn.com/magazines/moneymag/bestjobs/2010/snapshots/2.html|access-date=5 February 2019|website=Money.cnn.com}}</ref>
In 2012, Forbes rated the physician assistant degree as the number one master's degree for jobs.<ref>{{cite news|last=Smith|first=Jacquelyn|date=8 June 2012|title=The Best And Worst Master's Degrees For Jobs|work=Forbes|url=https://www.forbes.com/sites/jacquelynsmith/2012/06/08/the-best-and-worst-masters-degrees-for-jobs-2/|access-date=19 February 2017}}</ref>
In 2015, Glassdoor rated physician assistant as the number one best job in America.<ref>{{Cite web|title=25 Best Jobs in America for 2015 &#124; Glassdoor Blog|url=http://www.glassdoor.com/blog/jobs-america/|url-status=dead|archive-url=https://web.archive.org/web/20150128202233/http://www.glassdoor.com/blog/jobs-america/|archive-date=2015-01-28}}</ref>
In 2021, U.S. News & World Report rated physician assistant as the number one best job in America.<ref>{{cite web |title=2021's 100 Best Jobs in America - US News Rankings |url=https://money.usnews.com/careers/best-jobs/rankings/the-100-best-jobs |website=money.usnews.com |access-date=18 September 2021}}</ref>

The US Department of Labor Bureau of Labor Statistics report on PAs states, "...Employment of physician assistants is projected to grow 37 percent from 2016 to 2026, much faster than the average for all occupations..."<ref>{{cite web|date=19 July 1997|title=Physician Assistants|url=http://www.bls.gov/oco/ocos081.htm|url-status=dead|archive-url=https://web.archive.org/web/19970719214236/http://www.bls.gov/oco/ocos081.htm|archive-date=19 July 1997|access-date=5 February 2019}}</ref> This is due to several factors, including an expanding health care industry, an aging [[baby boomer|baby-boomer]] population, concerns for cost containment, and newly implemented restrictions to shorten physician [[Residency (medicine)|resident]] work hours.

In the 2008 AAPA census, 56 percent of responding PAs worked in physicians' offices or clinics and 24 percent were employed by [[hospital]]s.<ref>{{cite web|title=2008 AAPA Physician Assistant Census Report|url=http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|url-status=dead|archive-url=https://web.archive.org/web/20090325055738/http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|archive-date=2009-03-25|access-date=5 February 2019|website=Aapa.org|page=2}}</ref> The remainder were employed in [[public health]] clinics, nursing homes, schools, prisons, home [[health care]] agencies, and the [[United States Department of Veterans Affairs]]<ref>which also was the first employer of PAs. Mr. Vic Germino one of the first three graduates was employed by the VA and he remained with the VA for over 25 years.l [http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] {{Webarchive|url=https://web.archive.org/web/20090325055738/http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|date=2009-03-25}} Table 3.4: Number and Percent Distribution of Clinically Practicing Respondents by Primary Work Setting</ref> Fifteen percent of responding PAs work in counties classified as non-metropolitan by Economic Research Service of the [[United States Department of Agriculture]];<ref>[http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf 2008 AAPA Physician Assistant Census Report.] {{Webarchive|url=https://web.archive.org/web/20090325055738/http://www.aapa.org/research/Highlights08/2008AAPACensusNationalReport.pdf|date=2009-03-25}} Table 3.13: Number and Percent Distribution of Clinically Practicing Respondents by Metropolitan Status and Degree of Rurality of County of Primary Work Site</ref> approximately 17% of the US population resides in these [[County (United States)|counties]].<ref>{{Cite web|title=USDA ERS - Rural-Urban Continuum Codes|url=https://www.ers.usda.gov/data-products/rural-urban-continuum-codes.aspx|access-date=2019-02-05|website=Ers.usda.gov}}</ref>

For PAs in primary care practice, [[malpractice]] insurance policies with $100,000–300,000 in coverage can cost less than $600 per year; premiums are higher for PAs in higher-risk specialties.<ref>{{cite web|title="Malpractice Consult: Liability insurance for a physician assistant" - Modern Medicine|url=http://medicaleconomics.modernmedicine.com/memag/Medical+Malpractice:+Insurance/Malpractice-Consult-Liability-insurance-for-a-phys/ArticleStandard/Article/detail/118626|url-status=dead|archive-url=https://web.archive.org/web/20080528191605/http://medicaleconomics.modernmedicine.com/memag/Medical+Malpractice:+Insurance/Malpractice-Consult-Liability-insurance-for-a-phys/ArticleStandard/Article/detail/118626|archive-date=28 May 2008|access-date=5 February 2019|website=Medicaleconomics.modernmedicine.com}}</ref>

==== Compensation (US) ====

According to Bureau of Labor Statistics, in 2020 the median pay for physician assistants working full-time was $115,390 per year or $55.48 per hour, and the highest 10 percent earned more than $162,470.<ref>{{cite web|title=Physician Assistants" Occupational Outlook Handbook|url=https://www.bls.gov/ooh/healthcare/physician-assistants.htm#tab-5/|access-date=17 September 2021|website=bls.gov}}</ref> Physician assistants in emergency medicine, dermatology, and surgical subspecialties may earn up to $200,000 per year.<ref>{{cite web|title=2008 AAPA Physician Assistant Census Report - Specialty Reports|url=http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?cc=188720|url-status=dead|archive-url=https://archive.today/20120716142058/http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?cc=188720|archive-date=16 July 2012|access-date=5 February 2019|website=Physician-assistant.advanceweb.com}}</ref>

==== Federal government, uniformed services, and US armed forces (US) ====
PAs are employed by the [[State Department|United States Department of State]] as ''foreign service health practitioners''. PAs working in this capacity may be deployed anywhere in the world where there is a State Department facility.{{Citation needed|date=April 2023}} They provide primary care to US government employees and their families in American embassies and consulates around the world.{{Citation needed|date=April 2023}} An important part of their jobs is to get to know what resources are available locally that they can count on in an emergency. They have other important roles, such as advising their ambassadors on the health situation in the country and provide health education to the diplomatic community. In order to be considered for the position, these PAs must be licensed and have at least two years of recent experience in primary care.<ref>{{Cite web|title=U.S. Department of State {{!}} Home Page|url=https://www.state.gov/|access-date=2019-02-05|website=State.gov}}</ref>

[[File:Physician Assistants DVIDS31599.jpg|thumb|Physician Assistant in the US Army]]

Military PAs serve in the [[White House Medical Unit]], where they provide care to the president and vice president and their families as well as White House staff.{{Citation needed|date=April 2023}}

They are employed by several organizations with the intelligence community, specifically the Central Intelligence Agency.<ref name=":1">{{Cite web|title=Physician Assistant / Nurse Practitioner — Central Intelligence Agency|url=https://www.cia.gov/careers/search-jobs/support-professional/physician-assistant.html|archive-url=https://web.archive.org/web/20180628204919/https://www.cia.gov/careers/search-jobs/support-professional/physician-assistant.html|url-status=dead|archive-date=June 28, 2018|access-date=2018-06-05|website=Cia.gov|language=en}}</ref> While much of the job description is classified, they work under the Directorate of Support and are deployed to "austere environments" where they provide medical care, including trauma stabilization, and teach in the fields of survival, field medicine, and tactical combat casualty care.<ref name=":1" />

[[United States Army]] PAs serve as [[Army Medical Department (United States)#Medical Specialist Corps (SP)|Medical Specialist Corps]] [[Officer (armed forces)|officer]]s, typically within Army combat or combat support [[battalion]]s located in the [[continental United States]], [[Alaska]], [[Hawaii]], and overseas.<ref>{{cite web|title=U.S. Army Recruiting Command|url=https://recruiting.army.mil/|access-date=5 February 2019|website=Recruiting.army.mil}}</ref> These include [[infantry]], [[armor]], [[cavalry]], [[airborne forces|airborne]], [[artillery]], and (if the PA qualifies) [[special forces]] units. They serve as the "front line" of Army medicine and along with [[combat medic]]s are responsible for the total health care of soldiers assigned to their unit, as well as of their family members.{{Citation needed|date=April 2023}}

PAs also serve in the [[United States Air Force|Air Force]] and [[United States Navy|Navy]] as clinical practitioners and [[aviation medicine]] specialists, as well as in the [[United States Coast Guard|Coast Guard]] and [[United States Public Health Service|Public Health Service]]. The skills required for these PAs are similar to that of their civilian colleagues, but additional training is provided in advanced casualty care, medical management of chemical injuries, [[aviation medicine]], and [[military medicine]].{{Citation needed|date=April 2023}} In addition, military PAs are also required to meet the officer commissioning requirements, and maintain the professional and physical readiness standards of their respective services.<ref>{{Cite web|title=Becoming an Army Physician Assistant (PA)|url=https://recruiting.army.mil/armypa/becomePA/|access-date=2019-10-17|website=recruiting.army.mil}}</ref>

The marine physician assistant is a US Merchant Marine staff officer. A certificate of registry is granted through The United States Coast Guard National Maritime Center located in Martinsburg, West Virginia.<ref>{{cite web|title=Code of Federal Regulations|url=http://cfr.regstoday.com/46cfr11.aspx#46_CFR_11p807|url-status=dead|archive-url=https://web.archive.org/web/20160201080824/http://cfr.regstoday.com/46cfr11.aspx#46_CFR_11p807|archive-date=2016-02-01}}</ref> Formal training programs for marine physician assistants began in September, 1966 at the Public Service Health Hospital located in Staten Island, N.Y.<ref>{{cite journal|vauthors=DeMaria WJ, Cherry WA, Treusdell DH|year=1971|title=Evaluation of the marine physician assistant program|journal=HSMHA Health Rep|volume=86|issue=3|pages=195–201|doi=10.2307/4594129|jstor=4594129|pmc=1937084|pmid=4396133}}</ref>