Kozikowski Andrzej, Bruza-Augatis Mirela, Morton-Rias Dawn, Puckett Kasey, Jeffery Colette, Cawley James F, Hooker Roderick S, Quella Alicia, Mauldin Sheila, Goodman Joshua
National Commission on Certification of Physician Assistants, 12000 Findley Road, Suite 200, Johns Creek, Georgia, 30097, USA.
Graduate School, University of Maryland Baltimore, Baltimore, MD, USA.
BMC Health Serv Res. 2024 Dec 28;24(1):1660. doi: 10.1186/s12913-024-12158-7.
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.
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.
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.
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.
医师助理(PAs)由于其广泛的医学教育和认证,在整个职业生涯中具有改变专业的灵活性。先前的研究表明,一半到四分之三的医师助理在职业生涯的某个阶段会选择这一选项,三分之一的人会在头十年内这样做。然而,需要更多的研究来了解与医师助理在整个职业生涯中改变专业与保持同一专业相关的因素。
使用2023年全国数据集进行横断面分析,以研究医师助理职业生涯中的专业转换情况。我们分析了对一个问题的回答(N = 121947[81.3%的回复率]),该问题询问医师助理在其职业生涯中改变专业的次数。我们的调查包括总体专业变化以及在职业阶段亚组中的单独变化。我们还探讨了与专业变化模式相关的人口统计学和实践属性。
大多数医师助理在其职业生涯中至少改变一次专业,有些人进行这种转换多达六次或更多次。专业变化比例最高的发生在第一个十年,其次是第二个十年。在头10年,40.3%的医师助理改变了专业。在多变量分析中,执业时间是与转换几率增加相关的最强因素。执业31年或更长时间的医师助理改变专业的几率比执业10年或更短时间的医师助理高出四倍多。与专业变化密切相关的其他因素包括从事重症医学或精神病学工作、担任两个或更多临床职位、在紧急护理领域执业、作为独立承包商、女性、在军队服役以及拥有博士学位。当将总体横断面分析与不同职业阶段的医师助理亚组进行比较时,与专业变化相关的重要医师助理特征模式在很大程度上是一致的。
在改变专业方面,医师助理表现出高度的职业灵活性。我们的研究表明,到职业生涯后期,四分之三的医师助理至少在两个学科之间进行了转换;然而,大多数变化发生在执业的第一个十年。这项研究进一步证实了医师助理职业的属性,突出了其独特特征,如适应性和职业灵活性。