F. J. Gianola

The military veteran to physician assistant pathway: building the primary care workforce.

The physician assistant (PA) profession emerged to utilize the skills of returning Vietnam-era military medics and corpsmen to fortify deficits in the health care workforce. Today, the nation again faces projected health care workforce shortages and a significant armed forces drawdown. The authors describe national efforts to address both issues by facilitating veterans’ entrance into civilian PA careers and leveraging their skills. More than 50,000 service personnel with military health care training were discharged between 2006 and 2010. These veterans’ health care experience and maturity make them ideal candidates for civilian training as primary care providers. They trained and practiced in teams and functioned under minimal supervision to care for a broad range of patients. Military health care personnel are experienced in emergency medicine, urgent care, primary care, public health, and disaster medicine. However, the PA profession scarcely taps this valuable resource. Fewer than 4% of veterans with health care experience may ever apply for civilian PA training. The Health Resources and Services Administration (HRSA) implements two strategies to help prepare and graduate veterans from PA education programs. First, Primary Care Training and Enhancement (PCTE) grants help develop the primary care workforce. In 2012, HRSA introduced reserved review points for PCTE: Physician Assistant Training in Primary Care applicants with veteran-targeted activities, increasing their likelihood of receiving funding. Second, HRSA leads civilian and military stakeholder workgroups that are identifying recruitment and retention activities and curricula adaptations that maximize veterans’ potential as PAs. Both strategies are described, and early outcomes are presented.

Assessment of admissions policies for veteran corpsmen and medics applying to physician assistant educational programs.

Purpose: The purpose of this study was to assess the admission policies, experiences, and attitudes of physician assistant (PA) program directors with regard to recruiting, admitting, and training veteran corpsmen and medics. Methods: A descriptive survey consisting of 18 questions was distributed to all 154 PA program directors in the United States. Results: One hundred ten (71.4%) program directors participated in the survey. Veterans were admitted into 83.6% of programs in the years 2008–2010, and accounted for an average of 2.6% of all students. A minority of PA programs accepted college credits earned by veterans for their military training (45.3%) or for their off‐duty education (28.4%). Few PA programs participated in the Yellow Ribbon Program (16%) or actively recruited veterans (16%). Over half of PA programs (56.7%) would be more likely to give special consideration to the admission of veteran corpsmen and medics if it was easier to equate their military education and experience to the programs admission prerequisites. The most frequently reported benefits for educating veteran corpsmen and medics in PA programs are their health care and life experiences, maturity, and motivation. Barriers for educating veterans include veterans’ lack of academic preparedness for graduate education, a lack of time/access for recruiting, and the cost of PA school. Conclusion: Most PA program directors cited multiple benefits for educating veteran corpsmen and medics, but veterans face barriers for admission into PA programs. Approaches are discussed for facilitating the transition of corpsmen and medics from the military to careers as PAs.

Morality, Professionalism, and Clinical Ethics: Part II

INTRODUCTION When Just Ethics made its appearance in 2004, the first column noted a question from a colleague: “Are we as PAs held to a higher moral standard than the general public?”1 The response was “yes,” followed by a rationale. This same colleague recently asked: “Can we really teach morality, professionalism, and clinical ethics?” A related question is: how do we as educators, physician assistant (PA) professionals, and PA colleagues assess our behaviors? More importantly, how do we teach appropriate behaviors to and assess them in our students? Just Ethics provides a forum for discussion of these and similar questions. The name of this feature, Just Ethics, refers not to a narrow ideal, but rather to a broad concept that embraces integrity, moral reasoning, and professional behavior. A variety of factors may contribute to what we summarize as professionalism and medical ethics, and we welcome discussion of the unique details, the wider context, and everything in between. The literature addressing these concerns in medical education has been growing;2 it is a knowledge base to which PA faculty can and should contribute. Following is a brief review of recent literature on morality, professionalism, ethics, and the need to teach these concepts to our students. This overview will provide both a contextual framework and a starting point for PA educators to add their perspectives to this important discussion.

Veterans as physician assistants

ABSTRACTThe physician assistant (PA) profession emerged nearly 50 years ago to leverage the healthcare experience of Vietnam-era military trained medics and corpsmen to fill workforce shortages in medical care. In 2009, the American Recovery and Reinvestment Act Primary Care Training and Enhancement program was established to improve access to primary care. Training military veterans as PAs was again identified as a strategy to meet provider access shortages. However, fewer than 4% of veterans with military healthcare training are likely to apply to PA school and little is known regarding the factors that predict acceptance to training. In 2012, we surveyed all veteran applicants and a stratified random sample of nonveterans applying to PA training. We compare the similarities and differences between veteran and nonveteran applicants, application barriers, and the factors predicting acceptance. We conclude with a discussion of the link between modern veterans and the PA profession.