The University of Florida is among a handful of educational institutions nationwide offering a specialized surgery residency for physician assistants, or PAs.
“Students might graduate from physician assistant school and want to practice in surgery, but it’s a daunting prospect. They might have done a six-week surgical rotation during their entire training as a physician assistant,” said Steven J. Hughes, M.D., a professor of surgery and chief of the division of general surgery at the UF College of Medicine.
UF’s PA surgical residency is an intensive 12-month program that accepts four physician assistants each year. Residents complete six- to seven-week clinical rotations through several divisions — acute care, cardiothoracic, general, pediatric, transplant and vascular surgery, as well as an elective rotation in any division within the department of surgery, or neurosurgery, otolaryngology or urology. Clinical teaching is augmented with an intensive didactic and simulation curriculum.
“There is a challenge in bringing PAs on board in surgery. Many are still in need of training, and it can take at least six months to gain on-the-job experience,” said George Sarosi, M.D., the Robert H. Hux Professor in the UF College of Medicine’s division of general surgery. “Graduates from a PA surgical residency come on board with the crucial training and skills.”
PA programs successfully train physician assistants, but the students receive a generalist education, said Ralph Rice, DHSc, P.A.-C., director of the UF School of Physician Assistant Studies.
“UF’s PA surgical residency affords interested students an opportunity to learn the art and science behind the surgery,” he said.
Students gain exposure assisting in the operating room and treating patients in the hospital and outpatient clinics.
“They become an integral part of our surgical teams,” said Atif Iqbal, M.D., an assistant professor of general surgery in the UF College of Medicine and the program director of the UF PA residency.
PA residents are inserted “shoulder to shoulder” with first-year surgical residents, Hughes noted. “Both handle a significant amount of day-to-day patient management — minute-to-minute assessment of patient well-being and disposition and care planning. They play vital roles in treatment consistency,” he said.
Christa Campbell, P.A.-C., who completed her residency in March 2016, now works on the surgical critical care unit at UF Health Shands Hospital.
“I liked that I was able to independently perform procedures and participate in the interdisciplinary collaboration with all of the teams in order to take care of these complex patients,” she said. “I gained the confidence, skill set and knowledge base to succeed as a PA in the surgical ICU.”
Additionally, PAs — and their nurse practitioner, or NP, colleagues — can help fill a crucial gap in patient care, Iqbal said. He hopes that UF will expand the PA residency program to accommodate the increasing number of applicants.
“Residents have growing restrictions on their work hours, but their responsibilities and training requirements are increasing. Faculty are also working harder, but are limited by the number of hours in a day. Increasing focus on health care expenditure and decreasing resources and reimbursements nationally means that everyone has to work more each year to maintain productivity,” Iqbal noted. “With that crunch, we need more clinicians to fill the widening gap. We want to ensure that they are well positioned, educated and poised to be an integral part of the team.”