Physician assistants are eligible to work after completing their degree at a physician assistant school, passing the PANCE, and obtaining a state license. Internships and residencies are voluntary. However, postgraduate residency programs are available for physician assistants specializing in surgery, orthopedic surgery, neuroscience, acute/critical care medicine or emergency medicine, rural emergency medicine, trauma, dermatology, psychiatry, urology, obstetrics/gynecology, rheumatology, and oncology. Residency improves knowledge base and technical skills, builds industry contacts, and improves job offers. Alternatively, some schools offer specialized programming in surgery, pediatrics, and public health for physician assistants who wish to specialize. There is no separate licensing exam for specialization.
Physician assistant schools and colleagues are good resources for residency information. The best online reference is the Association of Postgraduate PA Programs (APPAP). Residency programs are generally one year in length, though some are as long as 18 months, with some remuneration, generally a relatively low salary, perhaps $50,000, and benefits. Benefits may include vacation time, health care coverage, and licensing fee payment.
Applications are made directly to individual residency programs. Programs require physician assistant certification, a passing score on the PANCE, and references. Some residencies will accept applications from physician assistant students waiting to sit for the PANCE.
One example of a surgical residency program is the Arrowhead Regional Medical Center’s Orthopaedic Surgery Physician Assistant Residency Program in California. This 12-month training program demands an average 70-hour work week and offers experience working in the clinic, emergency room, and surgery along with up to 50 CME credits.
The Bassett Medical Center in New York, a leader in rural medicine, offers a Rural Emergency Postgraduate Residency Program of 12-month duration. Students gain certifications and EMS training along with clinical and didactic training. The program is modeled after emergency medicine physician residencies.
In New York, Montefiore offers a 12-month physician assistant postgraduate residency in obstetrics and gynecology. Southwestern Medical Center in Texas offers a fellowship in rheumatology that provides 12 months of additional clinical and classroom experience. The APPAP tracks 49 residency programs for physician assistants.