There are more PA students than ever-about 12,000 are enrolled at an all-time high of 142 accredited programs. Many existing programs are planning to expand, and about 20 colleges are developing new PA programs.
The demand for clinical preceptors for PA students has never been greater, and supply simply isn't keeping pace. Many PA programs face a critical shortage of preceptors and clinical sites.
"It's nuclear. The number of PA programs seems to be enlarging again, and with this increase the number of clinical sites becomes even more stretched," says Physician Assistant Education Association (PAEA) president Dana Sayre-Stanhope, EdD, PA-C, who is the PA program director at Emory University in Atlanta.
"It's always been accepted in the physician community that physicians will educate their own. With 72,000 PAs, it's disappointing to me that only one-third of practicing physician assistants precept students and are sharing their expertise."
The United States faces a shortage of health care providers, and many PA programs would like to increase enrollment to help meet the demand for more PAs. But they can't expand without training sites and preceptors. Quality clinical rotations are essential to PA education. Without adequate preceptors, programs cannot prepare students to enter clinical practice following graduation.
In PAEA's 2006 survey of PA program expansion plans, limited clinical training sites was the No. 1 barrier to expansion identified by respondents (49.4%). and limited preceptors was a close second (48.7%).
The shortage is nationwide and affects most PA programs, Sayre-Stanhope says, not just those in areas with a high concentration of programs.
"I don't think (location) makes a difference," she says. "I've been a program director in the Northeast, Southeast, Midwest and Far West, and in all of these programs we had a struggle. Let me put it this way: No amount of money would (convince) me to become a clinical coordinator. It's a tough job."
PAEA recognizes that the situation is grave and has made efforts to recruit preceptors. PAEA past president Anita Glicken, MSW, appealed to the 2007 AAPA House of Delegates for help in recruiting more PA clinical preceptors, and Sayre-Stanhope repeated the message in the 2008 HOD. Also, PAEA staffed a booth to educate PAs about the shortage and recruit preceptors at the 2008 AAPA conference in San Antonio in May.
Although the preceptor shortage is common knowledge in PA education circles, the matter has gotten little publicity, and the average PA probably does not realize the extent or the significance of the problem.
PAs at the conference generally were receptive to PAEA's message, but Sayre-Stanhope was surprised when PAs responded to questions about not precepting students with, "Nobody asked me."
PAs practicing near a program should not wait to be approached, she says. They automatically should identify themselves to the program and ask how they can help.
"Organized medicine has always been good at instilling in physicians that they have an obligation to inform (future students)," she says. "We have never sent that message-not effectively-to PA students, and I think it is hurting us."
Serving as a PA preceptor is significant responsibility and can be challenging, Sayre-Stanhope says, but it doesn't have to be an overwhelming burden. PAs with as little as one year of clinical practice experience can precept students successfully, and PAEA and individual programs can provide resources to help PAs learn to teach effectively.
Practicing PAs don't need to take a constant stream of PA students into their practices. They can help alleviate the preceptor shortage by taking "one student a month, or one every two months, or even one a year," Sayre-Stanhope says.
Click here for ADVANCE editor Michael Gerchufsky's interview with PAEA president Dana Sayre-Stanhope.