CK: What do you think has changed since the 1980s and what role do you see EM PAs having in the future?

TC: The acceptance of PAs as important members of the ED team has grown among emergency physicians and among physicians from other specialties. In the clinical setting, more EM PAs are working in the main emergency department and not exclusively in the fast track or urgent care areas of the department. In some facilities, the EM PA plays an active role in trauma and medical resuscitations. As emergency care is found in non-hospital venues, such as satellite or freestanding emergency departments, there might be a role for EM PAs to work in those settings with close collaboration and input from EM attendings at a tertiary facility. Teaching by EM PAs is an area that is vastly overlooked. Many EM PAs have years of experience working in a variety of EM settings and could be utilized as teaching faculty that contribute to the educational missions of EM residency programs as well as EM PA training programs. Finally, there is a great opportunity for EM PAs to take on administrative and leadership roles, such as managers of emergency departments and EMS administrators, and to participate in research endeavors.

CK: There are currently approximately 30 EM PA post-graduate residency/fellowship training programs. Is that going to be the future for PAs in emergency medicine?

TC: As a graduate of one of the first EM PA residencies and as the current program director of an EM PA fellowship for PAs, I have a bias in favor of these training programs. There are many excellent EM PAs out there who have learned on the job. However, as emergency medicine has grown as a specialty, and as EM PA roles continue to evolve, these training programs provide a solid academic foundation in a supervised, clinical environment that gives EM PAs an advantage going into the job market by providing additional focused training in emergency medicine. Additionally, most of these programs are in institutions with EM residencies, giving EM PAs the opportunity to participate in lectures, simulation, journal clubs, and research projects and to gain procedural competencies alongside EM residents, residents who someday will be EM attendings. In the future, I could foresee these programs adopting a standardized curriculum for training EM PAs that could even result in a PA equivalent to EM board certification.