Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 28;24(1):1660.
doi: 10.1186/s12913-024-12158-7.

Physician assistant/associate career flexibility: factors associated with specialty transitions

Andrzej Kozikowski  1 , Mirela Bruza-Augatis  2 , Dawn Morton-Rias  1 , Kasey Puckett  1 , Colette Jeffery  1 , James F Cawley  3 , Roderick S Hooker  4 , Alicia Quella  1 , Sheila Mauldin  1 , Joshua Goodman  1
Affiliations

Physician assistant/associate career flexibility: factors associated with specialty transitions

Andrzej Kozikowski et al. BMC Health Serv Res. .

Abstract

Background: Physician assistants/associates (PAs), due to their broad medical education and certification, have the flexibility to change specialties throughout their careers. Prior studies suggest that between half and three-quarters exercise this option at some point in their career, and a third do so within the first decade. However, more research is needed to understand the factors associated with PAs changing vs. remaining in the same specialty throughout their professional journey.

Methods: A cross-sectional analysis using a 2023 national dataset was conducted to examine specialty transitions throughout PAs' careers. We analyzed responses (N = 121,947 [81.3% response rate]) to a question asking how many times PAs changed specialties throughout their careers. Our investigation included specialty changes overall and separately within career-stage subgroups. We also explored demographics and practice attributes associated with specialty change patterns.

Results: Most PAs change specialties at least once during their careers, with some making this transition as many as six or more times. The highest proportion of change occurs in the first, followed by the second decade of practice. In the first 10 years, 40.3% of PAs changed specialties. In multivariate analysis, duration of practice was the strongest factor associated with increased odds of transitioning. PAs practicing for 31 or more years had over four-fold higher odds of changing specialties than PAs practicing for 10 or fewer years. Other factors strongly linked to specialty changes included working in critical care medicine or psychiatry, holding two or more clinical positions, practicing in urgent care, being an independent contractor, female gender, serving in the military, and possessing a doctorate. The pattern of significant PA characteristics linked with specialty changes was largely consistent when comparing the overall cross-sectional analysis with separate subgroups of PAs within different career stages.

Conclusion: PAs exhibit a high degree of career flexibility when it comes to changing specialties. Our research demonstrates that by the late-career stage, three-fourths of PAs have transitioned between at least two disciplines; however, most changes occurred in the first decade of practice. This study further substantiates the PA profession's attributes, highlighting its unique characteristics, such as its adaptability and capacity for career flexibility.

Keywords: Adaptability; Career flexibility; Changing specialties; Health workforce; Physician assistants; Physician associates.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Sterling Institutional Review Board (IRB# 10826) approved this study as exempt. This study does not constitute human subject research and is not in the valuation of human subject protection. All methods were carried out in accordance with relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Proportion and number of times PAs changed specialties, mean age, and years of certified
Fig. 2
Fig. 2
Proportion of PAs that changed specialties by years certified
Fig. 3
Fig. 3
Factors associated with decreased and increased odds of PAs having changed specialties
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cawley JF. Physician assistant education: an abbreviated history. J Physician Assist Educ. 2007;18(3):6–15.
    1. Morgan PA, Hooker RS. Choice of specialties among physician assistants in the United States. Health Aff. 2010;29(5):887–92. - PubMed
    1. Hooker RS, Cawley JF, Leinweber W. Career flexibility of physician assistants and the potential for more primary care. Health Aff. 2010;29(5):880–6. - PubMed
    1. Osborn M, Satrom J, Schlenker A, Hazel M, Mason M, Hartwig K. Physician assistant burnout, job satisfaction, and career flexibility in Minnesota. Jaapa. 2019;32(7):41–7. - PubMed
    1. Ward-Lev E, Kuriakose C, Navoa JJ, Halley M. Career flexibility for PAs: What makes switching specialties successful? JAAPA. 2024;37(5):29–34. - PubMed

LinkOut - more resources