Erin Crown, MHS, PA-C, Psych-CAQ
NCCPA and nccPA HEALTH FOUNDATION
Meet Erin Crown, MHS, PA-C, Psych-CAQ, a board licensed doctor assistant/affiliate (PA). She turned a psychiatric PA over a decade in the past when the variety of PAs practising in psychiatry was lower than 1% of the physique of licensed PAs. Erin is likely one of the roughly 3000 board licensed PAs practising in psychiatry within the US.1
Crown shares, “My curiosity in psychiatry began throughout my undergraduate years, graduating with a level in well being science and a minor in psychology. I entered my grasp’s program in PA research, with the understanding that I’d graduate having been broadly educated in medication as a PA and eligible to pursue a profession in any space of drugs. It was throughout my scientific clerkship 12 months after I accomplished my psychiatry rotation at a maximum-security males’s penitentiary—SCI-Rockview; I knew the place I wished to be.”
Crown remembers, “over time, I’ve skilled superb career-broadening alternatives in psychiatric follow.” From her early scientific experiences in caring for acutely in poor health sufferers on a psychiatric stabilization unit, to splitting her time between that unit and a number of other rural outpatient psychiatry clinics, “I knew I had discovered my calling.” As a psychiatric PA, Crown’s function has expanded to incorporate co-ownership and administration of a non-public psychiatry follow, supported by her supervising doctor, whereas creating skilled and trade relationships encompassing scientific analysis, skilled training for each lay and medical communities, and continued scientific follow.
Crown shares, “As I’ve traveled and interacted with all kinds of medical and different professionals, I’m typically requested how a PA finds themselves practising psychiatry?” It’s by means of these conversations that I’ve realized that it might be beneficial to introduce the PA career and PAs in psychiatry to the Psychiatric Occasions viewers.
PAs Apply Drugs
PAs are medical suppliers who follow in almost each medical specialty and subspecialty. NCCPA’s 2023 Statistical Profile of Board Licensed PAs by Specialty Annual Report reveals that the majority PA follow specialties have skilled progress over the past 12 months and the previous 5 years. The most important percentages of PAs work in household medication (16.5%), emergency medication (10.8%), orthopedic surgical procedure (10.7%), dermatology (4.3%), and inside medicine-general (4.0%).1 With well being care supplier shortages, there’s a vital demand for PAs in all scientific disciplines.
PAs Present Psychological and Behavioral Well being Companies
Because the US continues to face a psychological well being disaster, PAs are on the forefront of caring for sufferers with psychological and behavioral well being issues. NCCPA Skilled Profile knowledge signifies that 2.4% of PAs (~3,000) determine as Psychiatric PAs and are offering care in office-based non-public practices (46.1%), psychological well being amenities (18.3%), and hospitals (15.7%).1
Desk. Medical Companies Offered by Board Licensed PAs in Psychiatry
As illustrated within the Desk, board licensed PAs in psychiatry present a variety of scientific companies and work collaboratively with a variety of well being professionals (Determine).
Determine. PAs in Psychiatry Work With Different Well being Professionals
Psychological well being care offered by PAs will not be restricted to Psychiatry, with 33.4% of all PAs reporting they encounter sufferers day by day who want therapy for psychological issues.1 Roughly 10.8 million sufferers are seen by PAs every week, throughout all follow disciplines and settings.2 PAs are making a optimistic influence on affected person care nationwide.
Why PAs
The PA career emerged within the mid-Nineteen Sixties from a necessity to supply well being care companies for a rising affected person inhabitants, particularly in rural and underserved communities; a scarcity of main care physicians; and the rising provide of extremely expert former medics and corpsmen getting back from navy service. The primary PA program was established in 1965 by Eugene A. Stead, Jr, MD, at Duke College. Since then, over 300 PA applications throughout the nation have educated greater than 200,000 PAs, who more and more meet present and rising affected person care wants in all specialties and follow settings. Having been based by a doctor, the PA academic mannequin mirrors medical training for physicians.
Earlier than enrolling in one of many 311 accredited PA applications in america, undergraduate college students sometimes full prerequisite programs in biology, chemistry, anatomy, and physiology, amongst different related topics. Pre-PA college students should earn a bachelor’s diploma, typically in a science-related subject, and doc preadmission scientific experiences. PA applications sometimes span 27 months of full-time classroom, laboratory, and scientific coaching experiences, culminating within the award of a grasp’s diploma. The PA curriculum follows the medical faculty mannequin, incorporating graduate-level programs in pathophysiology, medical sciences, pharmacology, interviewing and bodily evaluation, scientific laboratory sciences, simulation, and scientific expertise growth. All applications are required to supply scholar studying experiences in psychological and behavioral well being. Required scientific coaching experiences embody rotations in inside medication, emergency medication, pediatrics, and different specialties. PAs full their academic program with over 2000 hours of scientific rotations.
Dedication to Excessive Requirements
All US PA academic applications should reveal compliance with rigorous program requirements as outlined by the Accreditation Evaluate Fee on Training for the Doctor Assistant (ARC-PA).3 Accreditation of PA applications was initially underneath the auspices of the American Medical Affiliation, however the ARC-PA was authorised as an impartial accrediting physique in 2001. The ARC-PA is the US company that protects the pursuits of the general public and PA career by defining the requirements for PA training and evaluating PA academic applications inside the territorial United States to make sure their compliance with these requirements.4 The requirements define institutional duties, curricula elements, scholar scientific coaching experiences, in addition to program and scholar analysis elements that have to be documented to acquire ARC-PA accreditation. Though the grasp’s diploma is at the moment the terminal diploma for the PA career, the ARC-PA doesn’t accredit a tutorial diploma awarded by the sponsoring establishment of the PA program. The rigorous PA academic curriculum and analysis processes reveal a dedication to excessive requirements, as established by the career’s founders.
That dedication to excessive requirements is additional demonstrated by means of nationwide PA certification. PAs are licensed to follow in all 50 states. All states and US territories require that PA graduates cross the Doctor Assistant Nationwide Certifying Examination (PANCE), developed and administered by the Nationwide Fee on Certification of Doctor Assistants (NCCPA), to acquire an preliminary license to follow medication as a PA.
Established as a not-for-profit group in 1974, NCCPA supplies certification applications that mirror requirements for scientific information, scientific reasoning, and different medical expertise {and professional} behaviors required upon entry into follow and all through the careers of PAs. The examination specs are primarily based on the outcomes of a profession-wide follow evaluation, and examination questions are allotted to the vary of medical content material and activity classes related to entry-level PA follow. Solely people who graduate from an entry-level PA program accredited by the ARC-PA are eligible to use to take the PANCE, which is run all year long at greater than 300 safe testing amenities within the US and overseas.5 The generalist nature of the PANCE ensures that graduates reveal a baseline fund of information and expertise crucial for entry into the career.
PAs’ continued competence in core medical information is facilitated by means of recertification, which is achieved by efficiently finishing the Doctor Assistant Nationwide Recertifying Examination (PANRE) each 10 years. Moreover, to keep up NCCPA board certification, PAs should doc a minimal of 100 credit of persevering with medical training (CME) each 2 years. PAs typically full CME credit of their main follow self-discipline. It is very important notice that though solely 17 states require present NCCPA certification for license renewal, 96% of PAs keep NCCPA board certification, year-over-year, demonstrating their dedication to continued skilled growth and lifelong studying (NCCPA, unpublished knowledge, January 2025). NCCPA’s certification upkeep and recertification processes make sure that PAs reveal continued studying and competence in core medical information in addition to their follow self-discipline(s).
Continued Studying
PAs can pursue extra voluntary training resulting in doctoral and different superior levels in medical sciences (DMSc) and different disciplines. The PhD, MD, and DHSc are probably the most steadily acquired superior levels.6 Moreover, PAs could enroll in postgraduate scientific applications of their follow self-discipline. Early findings from NCCPA’s 2024 Statistical Profile of Board Licensed PAs revealed that 5.7% of all PAs indicated that they accomplished a PA postgraduate coaching program (PA residency or fellowship) after graduating from their entry-level PA program. Moreover, amongst these PAs who accomplished a postgraduate program, 3.1% did so in psychiatry.6
The NCCPA additionally presents an non-compulsory Certificates of Added {Qualifications} (CAQ) in 11 follow disciplines, together with psychiatry. The CAQ is a voluntary credential that board licensed PAs could earn to reveal superior experience within the chosen scientific specialty. To earn a CAQ, PAs should keep present NCCPA certification (PA-C), doc completion of prescribed non-exam elements, together with CME credit within the related follow self-discipline, submit a scientific attestation, and efficiently full an goal evaluation. Incomes a CAQ demonstrates a PA’s dedication to superior studying and fervour for well being care within the chosen follow self-discipline.
The PA career is supported by 2 nationwide membership organizations that advocate for the career and PA patient-centered care, in addition to present persevering with training alternatives and plenty of extra companies for PAs, PA college, and college students. Based in 1968, the American Academy of Doctor Associates (AAPA) is the nationwide skilled society for PAs. It represents the PA career throughout all medical and surgical specialties in all 50 states, the District of Columbia, US territories, and the uniformed companies. AAPA advocates and educates on behalf of the career and the sufferers PAs serve. AAPA works to make sure skilled progress, private excellence, and recognition of PAs. AAPA additionally enhances PAs’ capacity to enhance the standard, accessibility, and cost-effectiveness of patient-centered well being care.7
The PA Training Affiliation (PAEA) is the one nationwide group representing PA academic applications in america. PAEA supplies growth companies for college at its member applications, in addition to help companies for PA candidates, scholar evaluation instruments, and a variety of extra companies for its stakeholders. Based in 1972 because the Affiliation of Doctor Assistant Applications, the PAEA adopted its present title in 2022.8
PAs are a Win-Win
Since its founding in 1965, the PA career and PAs like Crown have expanded entry to well being care and training in lots of disciplines. With 123 million People residing in psychological well being career scarcity areas,9 the rising variety of PAs in psychiatry represents one other such instance of these efforts. From 2019-2023, the variety of PAs practising in psychiatry had the best proportion change of any PA follow space.1
Extra indicators underscore the expansion of PAs as companions in psychological and behavioral well being care. By 2030, the Well being Assets and Companies Administration has forecasted an 86% improve within the variety of PAs within the subject of psychiatry.10 As alternatives emerge, the PA career can be prepared: Greater than 12,000 new graduates be a part of the workforce yearly, which represents a 40% improve over the past 5 years,6 and greater than 30 new applications are within the accreditation pipeline (NCCPA, unpublished knowledge, January 2025).
PAs are aided of their endeavors by (1) the nationwide methods and buildings that help rigorous program accreditation and certification in addition to training and follow growth; (2) their training within the medical mannequin and dedication to steady skilled growth, which helps their capacity to emphasise whole-person care and their readiness, together with prescriptive authority, to look after comorbid bodily and psychological well being circumstances; and (3) the career’s dedication to adapting to fulfill affected person, follow, and system wants.
To assist help the PA career’s psychological and behavioral well being initiatives, the nccPA Well being Basis leads the PArtners in Psychological Well being Initiative,11 an intraprofessional, collaborative effort devoted to advancing the function of all board licensed PAs and strengthening partnerships to handle psychological well being and substance use dysfunction wants. Led by a steering committee that features representatives from the nationwide PA organizations, particular person PA champions, and interprofessional companions, this effort leverages a collective influence technique that amplifies the career’s dedication to enhancing academic approaches, strengthening the follow setting, and elevating consciousness of psychological well being wants and the contributions of board licensed PAs.
PAs throughout disciplines are ready and prepared to answer the rising demand for psychological and behavioral well being companies, bridging gaps in entry to psychiatric care and offering a win-win for sufferers and practices.
Dr Morton-Rias is the president/CEO of the NCCPA and the nccPA Well being Basis.
References
1. 2023 Statistical Profile of Board Licensed PAs by Specialty: An Annual Report of the Nationwide Fee on Certification of PAs. Nationwide Fee on Certification of Doctor Assistants. Accessed June 23, 2025. https://www.nccpa.internet/wp-content/uploads/2024/07/2023-Statistical-Profile-of-Board-Licensed-PAs-by-Specialty-Annual-Report.pdf
2. 2023 Statistical Profile of Board Licensed Doctor Assistants, Annual Report. Nationwide Fee on Certification of Doctor Assistants. Accessed June 23, 2025. https://www.nccpa.internet/wp-content/uploads/2024/05/2023-Statistical-Profile-of-Board-Licensed-PAs5_3_24.pdf
3. Accreditation Requirements for PA Training, Fifth Version. Accreditation Evaluate Fee on Training for the Doctor Assistant. September 2019. Accessed June 23, 2025. https://www.arc-pa.org/wp-content/uploads/2024/07/Requirements-Fifth-Ed-July-2024.pdf
4. Accreditation evaluate fee on training for the doctor assistant. Accreditation Evaluate Fee on Training for the Doctor Assistant. Accessed June 23, 2025. https://www.arc-pa.org/about/
5. About NCCPA. Nationwide Fee on Certification for Doctor Assistants. Accessed June 23, 2025. https://www.nccpa.internet/about-nccpa/#who-we-are
6. 2024 Statistical Profile of Board Licensed PAs, Annual Report. Nationwide Fee on Certification of Doctor Assistants. Accessed June 23, 2025. https://www.nccpa.internet/wp-content/uploads/2025/05/2024-Statistical-Profile-of-Board-Licensed-PAs.pdf
7. About AAPA. American Academy of Doctor Associates. Accessed June 23, 2025. https://www.aapa.org/about/
8. About us. PA Training Affiliation. Accessed June 23, 2025. https://paeaonline.org/our-work/about-us
9. Well being workforce scarcity areas. Well being Assets and Companies Administration. Accessed June 23, 2025. https://knowledge.hrsa.gov/matters/health-workforce/shortage-areas
10. Behavioral Well being Workforce Projections, 2017-2030. Well being Assets and Companies Administration Well being Workforce. Accessed June 23, 2025. https://bhw.hrsa.gov/websites/default/recordsdata/bureau-health-workforce/data-research/bh-workforce-projections-fact-sheet.pdf
11. Collective Influence. nccPA Well being Basis. Accessed June 23, 2025. https://nccpahealthfoundation.internet/our-causes/mental-health/#collective-impact
