Academic leadership in physician assistant/associate medical education: a cross-sectional analysis of the association with doctoral degree, gender, and minority status

Abstract

Background There is a critical need for a diverse pool of academic leaders to increase the number and diversity of the medical workforce. Physician Assistant/Associate (PA) is a growing medical profession. Although the master’s degree is the terminal degree for PAs, a growing number of PAs obtain a variety of doctoral degrees. However, there is no standardized training for academic PA leaders. The purpose of this study was to identify factors associated with PA academic leadership. Specifically, this study explored the following factors: doctoral degree credentials, gender and underrepresented minority status. Methods Using the 2019 Physician Assistant Education Association Faculty and Directors survey, we assessed the relationship between academic leadership groups [Program Director (PD), Academic Director (AD), and Clinical Director (CD)] doctoral degree, gender, and underrepresented minority in medicine (URIM) status. Multivariable logistic regression models were used to determine the predictors of being in a leadership role. Results with p < 0.05 were considered statistically significant. Results Of the 956 participants, 71% were female, 4% Hispanic, 86% White, 4% Black, 2% Asian, and 1% Native Hawaiian/Pacific Islander/American Indian/Alaska Native. Overall, 9% were URIM. Mean age was 45.6 (SD = 10.2) years. Average time in PA education was 2.9 years (SD = 1.4). Approximately 50% (n = 472) had a leadership role (PD-24%, AD-10%, CD-16%). Of all leaders, 68% were female, 9% were URIM, and 19% had a doctoral degree. Having a doctoral degree increased the odds of being a PD [AOR 2.38, CI [1.57–3.59], p = < 0.0001, AD and CD = non-significant]. More time in PA education increased the odds of being a PD [AOR 1.10, CI [1.07–1.12, p = < 0.0001] and AD [AOR 1.06, CI [1.03–1.09], p = < 0.0001], but not a CD. Gender and URIM status were not significantly associated with leadership roles. URIMs had doctorate degrees at higher rates than non-URIMs. Conclusion PA academic leaders differ by doctoral degree attainment but not by gender and URIM status. URIM faculty are grossly underrepresented in the PA professorate, but disproportionately have doctoral degrees. Academic training opportunities for all PA academic leaders and strategies to increase URIM faculty are needed.

PAs' perspective on leadership in medicine

“…Nonclinical PAs often desire more leadership training because fulfilling leadership roles such as a program director in academia requires advanced training 20. Additionally, nonclinical PAs are expected to pursue research and are required to participate in doctoral training to be tenured 20…”

Physician Assistants/Associates With Doctoral Degrees: Where Are They Now?

“…The association between having a doctorate degree and race may be attributed to the pressure of non-White PAs to hold more education to achieve similar leadership positions. 16 …”

“…14 Physician assistants/associates are well-situated to be leaders in their field and are a growing voice in leadership as they take on leadership roles in education, research, and administration. 15,16 Physician assistants/associates practice medicine in a large array of settings and specialties. The most common practice areas and positions for PAs are surgical (18.7%), family medicine/general practice (17.7%), emergency medicine (11.8%), and internal medicine (9.7%) subspecialties.…”

“…Comparatively, higher percentages of PAs in academia hold doctoral degrees. 16,17 The purpose of this study was to describe demographic characteristics and practice patterns of PAs who have doctoral degrees. We hope this work may shed more light on the potential impacts of doctoral degrees for PAs and provide needed evidence for the ongoing debate on whether the PA profession should move to doctoral-level training.…”

“… 14 Physician assistants/associates are well-situated to be leaders in their field and are a growing voice in leadership as they take on leadership roles in education, research, and administration. 15 , 16 …”