In January of 2007, The American College of Emergency Physicians issued a "Policy Statement" validating the necessity of additional training for Physician Assistants in the Emergency Department (ED) setting. The policy states all "Physicians Assistants working in ED's should have or acquire specific experience or specialty training in emergency care, should participate in a supervised orientation program, and should receive appropriate training and continuing education in providing emergency care." This is the first time that an organization external to PA organizations has acknowledged the necessity for advanced education of PAs.
Traditionally, entry-level training was either a bachelor's or now, more commonly, a master's degree program. Individuals desiring doctoral degrees had to pursue the traditional academic route of a Doctor of Philosophy (PhD), available only in non-clinical subjects. Those desiring post-professional education emphasizing clinical skills had limited options. The first was to obtain an advanced standing master's degree, none of which were residency based or academically intensive. Most of the current programs are distance learning based with very little faculty oversight of the clinical experience. The other option was to complete a specialized clinical Residency training program which issued a certificate of advanced competency. The only residency based programs aside from the U.S. Army and U.S. Air Force programs are the Medical College of Georgia, the University of Texas Health and Science Center of Texas, and John Hopkins University, which offer a Certificate of Completion. The Doctorate of Science in Physician Assistant Studies specializing in Emergency Medicine (DScPAS-EM) degree is offered in recognition of an exemplary level of training currently being conducted. The introduction of the DScPAS-EM program further benefits the Army by establishing the standard by which other programs will emulate, offering distinguishment in the field and prestige to graduates. The DScPAS-EM is further used as a tool to recruit and retain qualified graduates who wish to further their education but lack a venue to meet this need. While graduates previously incurred a two year active duty service obligation (ADSO) for the 12 month certificate of completion residency, current graduates incur a three and one-half year ADSO with the 18 month DScPAS-EM program. This service obligation is in addition to the four year ADSO incurred after completion of PA school. There is also a mandatory four year experience requirement as a general PA prior to applying to the DScPAS-EM program. Another benefit of the longer program and ultimately a cost savings for the Army is the change in requirement for a utilization tour. The former program was followed by a "two year utilization tour" where the new graduate was placed into a duty assignment where they would continue their "learning curve" and further garner knowledge. After completion of the eighteen month program, this would be unnecessary and the graduate would be ready for any duty assignment, thereby enhancing readiness.
This program intends to distinguish the educational progression between the entry-level Master's degree and the advanced clinical training gained in the proposed program. No other residency-based program requires individual research and many do not have the clinical residency requirements that enhance this curriculum so richly. This program includes an expanded curriculum of eighteen months to allow for more clinical education and experience. This curriculum was selected by the American College of Emergency Physicians (ACEP) as the recommended example curriculum to develop emergency medicine training programs for mid-level providers. The emphasis on individual research and evidence based practice, in combination with a superior clinical curriculum, truly distinguishes this program as unique. Other programs are not able to match these strengths in both areas. The DScPAS-EM degree will further recognize the focus on the science behind emergency medicine by emphasizing evidence based medicine. This academic program is setting the standard as being the first in the country to offer the DScPAS-EM degree for advanced clinical training.