PA Continuum of Competence

1. PA Continuum of Competence Additional Resources Clinical Doctorate? Further Training Residency Additional Certifications Specialty Focus Pre-PA Education Entry Level PA Education Early Career ~0-6 Years Mid-Career ~6-18 Years Late Career ~18+ Years Retirement Career Choice Decision PreparatoryEducation Didactic Clinical CME Credentialing PreparatoryEducation Licensure Certification Non-Clinical Roles Administration Research Teaching Academic Pursuits Non-Clinical Roles Professional Involvement Leadership Roles

2. Pre-PA Education Phase Pre-PA Education Entry Level PA Education Early Career ~0-6 Years Mid-Career ~6-18 Years Late Career ~18+ Years Retirement Career Choice Decision PreparatoryEducation Didactic Clinical PreparatoryEducation • Stakeholders in Phase • Primary Education • Secondary Education • Undergraduate Institutions • AAPA • SAAAPA • PAEA • Undergraduate advisors • State chapters • Mentors • PA programs • Employers • Social network • Issues • Difference between traditional college and “pre-health” • Key Questions for Session • What are pipeline implications on Quality, Diversity, Quantity, Financial Impact? • Does potential applicant pool (target audience) change? • How does the reputation of the PA profession change? • How would a doctorate influence preparation for PA programs?

3. Entry Level PA Education Phase Entry Level PA Education Pre-PA Education Early Career ~0-6 Years Mid-Career ~6-18 Years Late Career ~18+ Years Retirement Career Choice Decision PreparatoryEducation Didactic Clinical PreparatoryEducation • Stakeholders in Phase • NCCPA Prep • PAEA • Program/faculty • Educational institution • Grant agencies (HRSA, etc.) • ARC-PA (42 programs) • Preceptors • PA employers • AAPA/SAAAPA • State Boards • PAF • Foundations • Issues • Less work experience • Younger population • Pipeline • Diversification of professors • Accreditation • Lack of standard prerequisites • Cost & Financial Aid • Overwhelming content • Lack of faculty • Lack of clinical sites & remuneration • Diversity of membership (degrees) • Insufficient data • Funding • Issues (cont) • Diversity • Faculty Development & Retention • Lack of understanding of PA role & education process • Advising challenges • Balancing program mission with institution’s motivations • Regulation • Lack of standard credential • Supply of grads • Lack of representation at university and policy levels • Key Questions for Session • What are implications for PA programs and institutions • Doctoral-level faculty • Accreditation • Program length • Curriculum • Quality of clinical practice • What are implications on costs and tuition? • How do we justify another doctorate in the domain of medicine?

4. Early Career Phase Early Career ~0-6 Years Pre-PA Education Entry Level PA Education Mid-Career ~6-18 Years Late Career ~18+ Years Retirement Career Choice Decision PreparatoryEducation Didactic Clinical PreparatoryEducation • Stakeholders in Phase • Employers • NCCPA • State boards • Physicians • Other PA’s • Other HC Professionals • Institutions • SAAAPA • AAPA • State chapters • Specialty Orgs • CME providers • Issues • Finding employment • Licensing & credentialing • Demonstrating competence • Liability insurance • Contracts & legal issues • Evolving competence • Appropriate confidence • Personal transitions • Accountability • Professional identification • Departure rate • Managing expectations for PA roles • Specialty choice • “Dual citizenship” – generalist vs. specialist knowledge • Key Questions for Session • What are implications for • PA Preparation • Clinical outcomes • Patient Care • System-wide & population-wide results • Recruitment & distribution (specialty, geography) • Earning potential • Debt burden • Departure rates • PA/Physician relationship • PA Reputation & Attitude • Practice of Medicine • Economics of Medicine • Relations with other HC professions

5. Mid-Career Phase Mid-Career ~6-18 Years Pre-PA Education Entry Level PA Education Early Career ~0-6 Years Late Career ~18+ Years Retirement Career Choice Decision PreparatoryEducation Didactic Clinical PreparatoryEducation • Stakeholders in Phase • Physicians • Other PA’s • Other HC Professionals • Professional associations • Academic institutions & grad schools • Employers • PA Programs • PAEA • CME providers • NCCPA • AAPA • ARC-PA • Specialty organizations • Issues • Need for recognition of content expertise • Assuming other (non-clinical) roles (leadership, administrative, preceptor, teaching, etc.) • Acknowledged success in practice area • Advanced degrees important • Acuity of “dual citizenship” • Job transitions – new proof of competence to new employers • 2nd & 3rd Recertifications more painful • PA/MD relationship strained when PA has more knowledge • Key Questions for Session • How to deal with existing PA’s? “Grandfathering”? • What are implications for • Need for recognition and status • Career advancement • Policy in 3rd party payers/reimbursement • Licensing & certification • Legislative & Regulatory • Patient perceptions & expectations

6. Late Career Phase Late Career ~18+ Years Pre-PA Education Entry Level PA Education Early Career ~0-6 Years Mid-Career ~6-18 Years Retirement Career Choice Decision PreparatoryEducation Didactic Clinical PreparatoryEducation • Stakeholders in Phase • Physicians • Other PA’s • Other HC Professionals • Professional associations • Academic institutions & grad schools • Employers • PA Programs • PAEA • CME providers • NCCPA • AAPA • ARC-PA • Specialty organizations • Issues • Transition from full-time clinical to other options • Don’t wait until too late to gain transition skills • Need a hobby, other interests, a life! • Key Questions for Session • What is the viability of a bridge program for PA’s to become MD’s or DO’s?

7. PA Continuum of Competence Retirement Pre-PA Education Entry Level PA Education Early Career ~0-6 Years Mid-Career ~6-18 Years Late Career ~18+ Years Career Choice Decision PreparatoryEducation Didactic Clinical PreparatoryEducation • Stakeholders in Phase • Family • Social Network • Profession & professional organizations • Issues • Planning for retirement • Meaningful contributions to profession • Key Questions for Session • Implications for retirement age