Everything You Need to Know About How to Become a PA in Emergency Medicine

August 8, 2019
So you want to be an emergency medicine physician assistant (EMPA)? Here are some things you should consider when making the decision, what you’ll need to prepare, and resources to help you out (even an emergency medicine PA Qbank).

History of PAs in EM

PAs have practiced in EM and health science since the PA profession was created in the 1960s. A representative body was organized by emergency medicine residency-trained PAs, and in 1990, the Society of Emergency Medicine Physician Assistants (SEMPA) was formed with a mission to advance, protect, and promote the role of EMPAs. According to the 2018 NCCPA Statistical Profile, 13% of PAs currently practice in EM—that’s 12,860 individuals.

Scope of practice and practice settings

PAs practice in all settings of EM, including prehospital care, triage, fast track, and the main emergency department (ED). Similar to an ENP, they also practice patient care in EDs of any type, from urban level I trauma centers, to community hospital EDs, to rural single-provider EDs. PAs are health care team providers and have a supervising physician that is most commonly onsite, but in rural settings, physician supervision may be achieved by telephone or video conferencing. Emergency physician assistants care for patients of all levels of acuity depending on the individual practice setting and state laws.

Procedures? Yes, but it’s not all procedures

As part of their training program, PAs are trained to perform many emergent procedures which also require a knowledge of internal medicine. Some of the more common ones include splinting bone fractures, suturing lacerations, and performing diagnostic procedures like a lumbar puncture. In some physician assistant program settings, PAs perform intubations and insert chest tubes and central venous catheters. However, EM is not only about procedures. Be prepared to care for patients with complex medical concerns, behavioral health concerns, and some not-so-emergent complaints.

Is EM the right fit for you?

EM requires a broad knowledge base covering all specialties in order to manage any patient presentation that comes through the ED doors. EMPAs must be able to make quick decisions, often with incomplete information. Remember your ABCs (airway, breathing, and circulation)! EMPAs must also be comfortable working as part of a team and be able to communicate effectively. They must also be prepared for shift work, which means coming in at all hours of the day.

Preparation for practice
1. Pre-PA experiences
2. PA program rotations
  • Request a second EM rotation
  • Request rotations with experience that will enhance your EM capabilities (e.g., orthopedics, trauma surgery, and critical care)
3. EM postgraduate program
  • A good option for the structured transition to practice and for those desiring to practice at the top of their licensure
  • An especially good option for PAs who desire to practice in settings caring for patients with high levels of acuity and in single-provider rural ED settings
4. EM Resources
    • Become a SEMPA member and enjoy free and discounted access to a multitude of emergency medicine resources
  • Emergency Medicine: A Toolkit for Students
    • A free resource to SEMPA members that includes comprehensive information to help guide you through your EM rotation and into practice
  • Rosh Review EM CAQ Question Bank
    • Once you have obtained a few years of EM experience and you are ready to take the National Council on Certification of Physician Assistants Emergency Medicine Certificate of Added Quality (NCCPA EM CAQ) Exam, Rosh Review’s emergency medicine PA Qbank is a great resource to ensure your success
  • Rosh Review SEMPA “One Step Further” Award
    • Given to a SEMPA EMPA member who has proven to go “one step further” to advance both themselves and the EMPA profession

For more PA content, check out these blogs:
What to do after passing your PANCE
Tips for PANCE review and PANRE review
Pummel the PANCE series
Rock Your Rotation Exam series

By Ann Verhoeven, MMSc, PA-C

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