Transformative Education
for Health Professionals

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Physician Assistants in India

Ebin V Abraham, M.Sc.AHS(PA-CVTS), Gomathi Sundar ,PG Dip (PA), Nadia Cobb MS, PA-C

It is more than two decades since the first Physician Assistant (PA) profession was started in India from which three PAs graduated. The PA programme in India is the third US type model in the world following Canada. Dr. K.M. Cherian, a cardiac surgeon of international repute, successfully introduced the PA programme in India at a private healthcare institute in 1992.  He witnessed the PA model during his visits to the US and realized the potential of replicating the programme in his homeland. PAs in India predominantly work in tertiary care private healthcare institutions in various specialties. 

Full project description: 

India is the second most populous country in the world. It is confronted with the dual challenges of combating communicable disease and also non-communicable ‘life-style’ related diseases.The healthcare sector needs to face the big public health challenge of eradicating communicable diseases while at the same time keeping the rapidly rising incidence of non-communicable diseases under check.

India’s healthcare is unbalanced. At one end of the spectrum lies the largely neglected rural health and the health of the urban poor and at the other end is the booming private sector in urban areas with technology and expertise even attracting medical tourists. 

The PA programme in India took its birth in the year 1992 at a private, tertiary healthcare institute in Chennai, India. It was born out of the necessity to fulfil the vacancies due to the constant exodus of resident doctors in pursuit of higher education. Inspired by the PA profession in the United States, Dr. K. M. Cherian believed that a similar profesion might mitigate the problem of the floating population of the resident doctors.  The profession trained PAs in general medical curriculum with a special focus in cardiology and cardiac surgery. The trained PAs were employed in clinical evaluation of patients, cardiovascular diagnostics, cardiac surgery and post-operative care. Impressed by the utility of PAs in focused care, the PA training was adopted in many other centers. With just three graduates in 1994, the PAs have grown in strength to 1,300 (2012 statistics) with almost an equal number pursuing education.

As of October 2014, ten Universities offer  PA training in collaboration with 47 Institutes. The duration of the training varies among Universities; from three or four year bachelor programme to two or three year post graduate programme.  PAs are employed in various healthcare institutions across the country, predominantly in cardiac care settings. The PA programme is a highly job-oriented programme with the PAs finding employment in reputed healthcare institutes soon after the completion of education.

The curriculum of the PA training in India is very intense. Along with medical subjects, the curriculum also includes computer education, biomedical instrumentation, technical report writing, research methodology and statistics. Depending on the nature of the institution offering the training, specialty subjects are included in the curriculum like Obstetrics and Gynecology, Cardiology, Cardiac surgery, Neurology, Gastroenterology, and Orthopedics. Due to this inclusive curriculum, PAs have branched into more than 15 specialties. Training involves class room education, laboratory work and clinical rotations.  The latter is introduced from day 1 of the programme. Trained PAs evaluate patients, perform and interpret diagnostic tests and play a key role in decision making for the care of the patient. They write progress and discharge notes, operation notes, counsel patients and operate as first or second assistant in surgeries. They are involved in research activities also and have published in National and International journals. Due to the broad based curriculum, PAs find employment in Contract Research Organizations, Medical Tourism, Medical Insurance,Telemedicine, Medical Writing etc.,

PAs have a tremendous role to play in the field of public health. They have the potential to take on any role ranging from field workers to policy makers. The Indian Government has planned to form an Allied Health Council in the near future and PAs are expected to find a place there. Though PAs are clinical cadres like doctors and nurses and not allied health professionals, the recognition of the cadre in one of the Government’s Health Council might be a good turning point in the PA profession in India. It might pave ways for new frontiers in exploring expanding roles for PAs.


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