september 2015. in 2022 it was reported that private company operose health, owned by us company centene corporation, which had acquired many uk national health service (nhs) gp practices, was using many pas—at less than half the cost of a gp—and allowing them essentially to act as gps, without required supervision. a bbc reporter worked undercover at an operose practice for six weeks, reporting on many problems. a senior gp said that the company was prioritising profit, putting patients at risk. faculty of physician associates, royal college of physicians (uk) the faculty of physician associates is the professional body for physician associates working in the united kingdom. a joint venture between the royal college of physicians of london and the previous professional body, the united kingdom associate of physician associates, the faculty officially launched in july 2015, taking over all professional responsibilities. the faculty oversee the managed voluntary register, which all practising associates are encouraged to join, as well as setting and running the national assessment examination and national recertification examination. scope of practice (uk) in the united kingdom, pas are dependent practitioners, and they must practice under the supervision of a physician. physician associates/assistants are trained under the medical model, similarly to physicians, to deliver medical care in primary, secondary, and tertiary care settings. upon graduation, they can specialize in any area of medicine, typically including primary care, emergency medicine, surgery, and psychiatry. pas are held to the same standards of care as physicians. they perform tasks including diagnosis, taking medical histories, ordering and interpreting labs, treatment, and complex medical procedures. pas cannot request ionising radiation investigations such as a ct scan or radiograph, they also cannot prescribe any medications. voluntary register (uk) the title physician associate is not a protected medical profession. pas in the u.k. are not able to prescribe or request ionising radiation imaging. no regulatory body governs pas. since june 2010, physician associates have been able to obtain membership of the managed voluntary register for physician associates. this database, run by pas for pas, aims to identify all qualified pas who are able to practise. its intent is to maintain high standards. to remain on the register, physician associates are required to re-certify every 5–6 years and maintain up-to-date practice through accumulating continuous professional development hours, which must be completed on an annual basis. in 2018 matt hancock announced a plan regulate pas, details of which have not been announced. the general medical council agreed to be the regulatory body for pas, with regulation beginning in 2022. training (uk) training is through a two-year training programme (msc or postgraduate diploma) in physician associate studies. as of 2017 at least 32 universities offered these programs: university of bolton university of hertfordshire queen mary university of london university of aberdeen university of bradford anglia ruskin university university of birmingham canterbury christ church university university of east anglia hull york medical school university of leeds manchester medical school university of liverpool university of central lancashire newcastle university plymouth university university of reading sheffield hallam university st george's, university of london university of surrey university of wolverhampton university of worcester entry requirement vary; barts and the london school of medicine and dentistry, queen mary university of london requires candidates to hold a minimum of 2:2 or above in a life science, biomedical science, or healthcare subject. aberdeen requires a science-based degree with a minimum 2:1 grade achieved while st george's requires a science-based degree with a minimum 2:2 grade. this includes sport science, biology, psychology and biomedical degrees. applicants should preferably have healthcare experience. applications from other professionals such as nurses, radiographers and paramedics will also be considered. university of bradford requires a 2:1 (or above) undergraduate degree in a life science, biomedical science, or healthcare subject. under exceptional circumstances, extensive experience in healthcare practice may contribute/compensate absent the above requirements. compensation (uk) the average starting salary of a pa-r is band 7 (£37,000), and can vary based on locations. in london, the average salary is around £43,000 and goes up to 50k with experience, particularly with lead pas. pas are also able to do locum shifts on top of their full-time job. compensation of physician associates in the united kingdom remains lower than in the united states and canada. however, compensation of physician associates is on the same pay band as other advanced care providers such as nurse practitioners. nomenclature (us) in accordance with the american academy of physician associates (aapa), the official title of the profession in the united states is "physician associate". while this is the official title nationally, utilization of this title may vary on the state level based on state bylaws and policies. a physician assistant may use the initials "pa", "pa-c", "apa-c", "rpa" or "rpa-c", where the "-c" indicates "certified" and the "r" indicates "registered". the "r" designation is unique to a few states, mainly in the northeast. apa stands for aeromedical physician assistant and indicates that a physician assistant successfully completed the us army flight surgeon primary course. during training, pa students are designated pa-s. the use of "pa-c" is limited to certified pas who comply with the regulations of the national commission on certification of physician assistants and who have passed pance. students undertaking physician assistant or associate training may refer to themselves as a physician assistant student, physician associate student, student physician assistant or student physician associate. pa students may add "s" at the end of their student designation (pa-s). students may also use the corresponding year of their training in their student designation. for example, students in the second year of their physician assistant or physician associate training may use (pa-s2) as their student designation. the american academy of physician associates has spent over $22 million since 2018 campaigning to change the word "assistant" to "associate" in the title of physician assistant. the campaign has been heavily criticized by physicians. there are opposing views which see this change more accurately reflects the clinician’s role on the patient care team physician assistants want to be called physician associates, but doctors cry foul. in the united states, the profession is represented by the american academy of physician associates. all pas must graduate from a nationally accredited arc-pa program as well as passing the national certification exam. in 1970 the american medical association passed a resolution to develop educational guidelines and certification procedures for pas. the duke university medical center archives had established the physician assistant history center, dedicated to the study, preservation, and presentation of the history of the profession. the pa history center became its own institution in 2011, was renamed the pa history society, and relocated to johns creek, georgia. education and certification (us) as of may 2019, 243 accredited pa programs operated in the united states, with dozens more in development. most educational programs are graduate programs leading to the award of master's degrees in either physician assistant studies, health science (master of health science), or medical science (mmsc), and require a bachelor's degree and graduate record examination or medical college admission test scores for entry. the majority of pa programs in the united states employ the caspa application for selecting students. professional licensure is regulated by state medical boards. pa students train at medical schools and academic medical centers across the country. physician assistant program at odu pa education is based on medical education; it typically requires 2 to 3 years of full-time graduate study like most master's degrees. (medical school lasts four years plus a specialty-specific residency.) training consists of classroom and laboratory instruction in medical and behavioral sciences, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, emergency medicine, and geriatric medicine, as well as elective rotations. pas are not required to complete residencies after they complete their schooling (unlike physicians). postgraduate training programs are offered in certain specialties for pas, though these are optional and shorter in length than medical residency. pa clinical postgraduate programs are clinical training programs that differ from on the job training given their inclusion of education and supervised clinical experience to meet learning objectives. montefiore medical center postgraduate surgical physician assistant program was established in 1971 as the first recognized clinical postgraduate pa program. 49 programs address specialties such as neurology, trauma/critical care and oncology. 50 programs joined the association of postgraduate physician assistant programs to establish educational standards for postgraduate pa programs. in the united states, a graduate from an accredited pa program must pass the nccpa-administered physician assistant national certifying exam (pance) before becoming a pa-c; this certification is required for licensure in all states. the content of the exam is covered in the pance blueprint. in addition, a pa must log 100 continuing medical education hours and reregister his or her certificate with the nccpa every two years. every ten years (formerly six years), a pa must also recertify by successfully completing the physician assistant national recertifying exam (panre) there is a growing number of doctoral programs for certified pas leading to a doctor of medical science (dmsc) but there is no requirement for one to have a doctorate in order to practice. "national physician assistant week" is celebrated annually in the us from october 6 through october 12. this week was chosen to commemorate the anniversary of the first graduating physician assistant class at duke university on october 6, 1967. october 6 is also the birthday of the profession's founder, eugene a. stead, jr., md. scope of practice (us) physician assistants have their own licenses with distinct scope of practice. each of the 50 states has different laws regarding the prescription of medications by pas and the licensing authority granted to each category within that particular state through the drug enforcement administration (dea). pas in kentucky and puerto rico are not allowed to prescribe any controlled substances. several other states place a limit on the type of controlled substance or the quantity that can be prescribed, dispensed, or administered by a pa. depending upon the specific laws of any given state board of medicine, the pa must have a formal relationship on file with a collaborative physician. the collaborating physician must also be licensed in the state in which the pa is working, although he or she may physically be located elsewhere. physician collaboration can be in person, by telecommunication systems or by other reliable means (for example, availability for consultation). in emergency departments the laws governing pa practice differ by state, generally allowing a broad scope of practice and limited direct supervision. during the covid-19 pandemic, several state governments changed regulations regarding pa scope of practice, including: on may 21, 2020, the law s.b. 1915 was signed by oklahoma governor kevin stitt. this law allows physician assistants to become primary care providers and receive direct pay from insurers. the reference of "supervision" was changed to "delegating" in regards to physician responsibility. this law also allows pas to legally volunteer in the case of disaster or emergency. on may 27, 2020, governor tim walz signed into minnesota law the omnibus healthcare bill s.f. 13. this law removes references to physician responsibility of supervision and delegation of care provided by pas. the law also removes delegated prescriptive authority. employment (us) the first employer of pas was the then-veterans administration, known today as the department of veterans affairs. today it is the largest single employer of pas, employing nearly 2,000. according to the aapa, as of 2020 there are more than 148,560 certified pas in the united states, up from 115,547 in 2016. money magazine, in conjunction with salary.com, listed the pa profession as the "fifth best job in america" in may 2006, based both on salary and job prospects, and on an anticipated 10-year job growth of 49.65%. in 2010, cnn money rated the physician assistant career as the number two best job in america. in 2012, forbes rated the physician assistant degree as the number one master's degree for jobs. in 2015, glassdoor rated physician assistant as the number one best job in america. in 2021, us news & world report rated physician assistant as the number one best job in america. the us department of labor bureau of labor statistics report on pas states, "...employment of physician assistants is projected to grow 37 percent from 2016 to