Medical Review By: Dr. Ted Schiff
When you make an appointment with a dermatologist, there’s a chance you may see the provider’s dermatology physician assistant (PA) instead. If you do, you may find yourself wondering what qualifications PAs have and what kinds of services they can provide. You may have even considered becoming a PA yourself.
Below are answers to some of the most commonly asked questions about dermatology PAs.
What is a dermatology physician assistant?
Certified dermatology PAs, or PA-Cs (physician assistant-certified), are medical professionals who are licensed to practice medicine in collaboration with a dermatologist. While they don’t have a medical degree, they do have to complete a rigorous education program and attain thousands of hours of clinical experience.
Dermatology PAs can perform many of the same services a dermatologist provides, but they do so under the direction and supervision of a dermatologist. An experienced PA sees patients on their own, but they may consult with a dermatologist on more complicated cases or ask the dermatologist to take over.
What services can a dermatology PA provide?
The duties dermatology PAs are permitted to carry out depending on the setting in which they work, level of experience, and state laws. PAs may be able to:
- Take medical histories
- Perform physical exams, including skin cancer screening exams
- Diagnose and treat skin conditions, such as acne, eczema, and rosacea
- Order and interpret tests
- Perform biopsies, wide excisions, and cryotherapy
- Develop treatment plans
- Prescribe medication
- Provide information about preventive care
- Perform certain minimally and non-invasive cosmetic procedures, such as Botox injections, laser skin resurfacing, and mild or moderate chemical peels
- Assist in surgeries, such as Mohs surgery
Services that only a dermatologist can provide include deep chemical peels and invasive surgeries.
What level of education and training must a PA have?
Candidates who apply to PA programs need a bachelor’s degree, ideally in a scientific field such as biology or chemistry. They may need to take an additional year to complete prerequisite courses. Even people who have a scientific undergraduate degree may have to attend classes that weren’t required in their bachelor’s program, such as physics, ethics, and statistics.
The next step is to gain experience working with patients. PAs must have patient care experience (PCE), in which they are directly responsible for a patient’s care, or healthcare experience (HCE), in which they are indirectly responsible for a patient’s care. Most PA programs require at least 1,000 hours of PCE or HCE. They can get them through jobs such as:
- Registered nurse
- Certified nursing assistant
- Medical assistant
- Emergency medical technician
- Surgical technician
- Emergency room technician
- Lab assistant/phlebotomist
- Medic or medical corpsperson
- Peace Core volunteer
PA programs typically last approximately 26 months (three academic years). Graduates must take the Physician Assistant National Certifying Exam, which is administered by the National Commission on Certification of Physician Assistants. Once they pass the exam, they can begin practicing medicine.
PAs receive a general medical and surgical education. They can choose a specialty such as dermatology once they become certified. They learn more about the specialty through on-the-job training provided by a doctor. PAs are free to change specialties throughout their career.
After a PA is certified, they must complete 100 hours of continuing medical education (CME) credits every two years and take a recertification exam every 10 years.
What training does a PA program consist of?
Students take a variety of classes, including anatomy, pharmacology, physical diagnosis, behavioral science, and medical ethics. Similar to medical students, PA students must complete clinical rotations, typically in physician offices, ambulatory clinics, and acute or long-term care facilities. Types of rotations required typically include family medicine, internal medicine, obstetrics and gynecology, and psychiatry and dermatology.
How does someone apply to a PA program?
Most candidates apply to an accredited PA program through the Centralized Application Service for Physician Assistants, which allows them to apply to multiple PA programs with one application. Candidates are expected to submit undergraduate/post-graduate transcripts, letters of recommendation, a list of PCE or HCE hours and a personal statement that explains why they want to be a PA and why they’re a good candidate for the program. An interview is required.
Article Written By: Jessica Brown, a health and science writer/editor based in Brooklyn, New York. She has written for Prevention magazine, jnj.com, BCRF.org, and many other outlets.