The Physician Associate Doctorate (an earned degree)

First, understand this is a discussion about academics, NOT the practice of medicine. It seeks to explore the level of degree awarded to the PA on graduation, not how the PA behaves while working in the medical community. State laws and the medical board govern the PA practice, and the PA must abide by those guidelines. However, withholding an appropriate degree for unreasonable fear is simply not right.  So, let’s explore why I believe the PA should be awarded a doctorate upon completion of their graduate program.

Let’s start by identifying the foundation of a college or university degree. The degree level is based on university and institutional accreditation standards, which, in general, use the following guidelines (see SACSCOC or NWCCU doctrine): 

Baccalaureate

The bachelor’s degree is an undergraduate degree which normally represents four years (approximately 120 semester hours or 180 quarter credits) of upper‐ and lower‐division collegiate study, or its equivalent in depth and quality of learning experience.

Masters

A master’s degree is a graduate degree representing approximately 30 semester credits or 45 quarter credits of post‐baccalaureate study, or its equivalent in depth and quality.

Doctorate

A doctorate degree represents three or more years [6 semesters or 90 SH] of graduate study that prepares the recipient to conduct original research, engage in scholarship, create artistic expressions of human emotions, or apply knowledge to practice.

Looking at the Doctorate in more detail shows us that there are two basic pathways. The most well-known doctorate is the Doctor of Philosophy (Ph.D.), which is a research doctorate. Almost all other doctorates fall within the applied doctorate category (application of knowledge), which includes:

• Doctor of Physical Therapy( DPT)
• Doctor of Occupational Therapy (OTD)
• Doctor of Psychology (PsyD)
• Doctor of Pharmacy (PharmD)
• Doctor of Medicine (MD)
• Doctor of Osteopathic Medicine (DO)

Most college or university programs follow the preceding guideline and award the appropriate degree. For example, a typical master’s degree in healthcare averages about 42 credit hours of academic work; a typical healthcare doctorate degree averages about 130 credit hours of academic work. Please see discussion below.

TYPICAL HEALTHCARE MASTERS PROGRAM(S)

In general, a master’s degree requires 30 to 36 credit hours of academic workload. Healthcare degrees, however, can often be more (averaging about 42 credit hours). For example:

• A master’s degree in the acute care nurse practitioner program which averages 37 credit hours (University of South Carolina).
• A master’s degree in the family nurse practitioner program which averages 46 credit hours (Clemson University).
• A master’s degree in a public health program requires an average of 42 credit hours (University of South Carolina).
• A master’s degree in Rehabilitation takes roughly 42 credit hours (Loma Linda University).

TYPICAL HEALTHCARE DOCTORATE PROGRAM(S)

In general, a research doctorate (Ph.D.) requires 90 credit hours of academic work (post-bachelor’s degree). Healthcare doctorates or applied doctorates, however, often require a much higher workload (often 130 credit hours and more). For example:

1. Ph.D. Programs:
   • Requires 90 credit hours beyond a bachelor’s degree, including coursework and dissertation research. For example, Purdue University and University of Cincinnati.
2. Doctor of Physical Therapy (DPT):
   • Requires roughly 100 – 130 credit hours, including clinical rotations. For example, Texas State University (99 credit hours) and George Fox University (127 credit hours).
3. Doctor of Occupational Therapy (OTD):
   • Requires around  100 – 120 credit hours, including clinical rotations. For Example, Southern Illinois University (103 credit hours) and Creighton University (121 credit hours).
4. Doctor of Psychology (PsyD):
   • Requires roughly 120 – 125 credit hours, including clinical rotations. For example, George Fox University (124 credit hours) and Nova Southeastern University (119 credit hours).
5. Doctor of Pharmacy (PharmD):
   • Requires around 120-150 credit hours, including clinical rotations and internships. For example, Campbell University (152 credit hours) and Purdue University (146.5 credit hours).
6. Medical Doctor (MD):
   • Requires about 180 to 200 credit hours, including clinical rotations. For example, Texas A&M (194 credit hours), East Carolina University (192 credit hours),  and University of Michigan (186 credit hours). Note, this relates to the earned Medical Doctor degree only (M1 – M4).

TYPICAL PHYSICIAN ASSOCIATE PROGRAM(S)

Oddly, the physician associate is awarded a master’s degree when most programs meet and far exceed a typical doctoral workload. In fact, many programs require 120 – 150 credit hours of academic workload. For example:

1. Bethel University (147 credit hours)
2. Baylor College of Medicine (135 credit hours), 
3. Methodist University (134 credit hours), and
4. Mercer University (128 credit hours)

Clearly, PA education far exceeds the typical healthcare master’s degree program and fits within the same criteria used for all other healthcare doctorate programs (without adding anything to the existing programs or increasing cost to the student).

SO WHY THE CONFUSION?

So, why is the PA degree limited to a master’s degree? It isn’t the institutional or university accreditation that limits it. Oddly, it’s the PA’s own accreditation body that limits its accreditation to a master’s degree. To change this, at least at that level, PAs will need to take a stance and advocate for accreditation change from their medical accreditation body.

Another reason comes from confusion in the medical community or perhaps how the physician sees this. Confusion comes when people misinterpret the meaning behind the doctorate. Let me explain. The degree earned is based on the institutional accreditation standards, not medical practice. Some believe awarding the doctorate will change how the PA is governed or how they practice medicine.  This is simply not true.  Understand, the physician/PA relationship and PA practice are governed by the state medical board and the state legislature.   Any change in PA practice occurs here, not at the academic level. Laws simply do not allow a PA, regardless of the degree they earned, to identify as a doctor (which implies physician in a clinical setting) while seeing patients.

CLOSING REMARKS

To be clear, awarding a PA doctorate does not impact state laws or medical board mandates that govern PA practice. It simply respects the academic work done and the degree earned.  In closing, please do NOT hold the PA’s academic accomplishments hostage for fear. These words do not and will not compromise the strong and longstanding physician/PA practice or how the PA practices medicine. Bottom line, the PA should be given the degree they earned. Again, it has no impact in how they practice medicine or identify themselves while seeing patients.