UNLOCKING THE POTENTIAL OF THE HEALTH SYSTEM BY CREATING OPPORTUNITIES FOR SPECIALISATION FOR PHYSICIAN ASSISTANTS

Authors

  • G. Stoilchev Medical Faculty, Trakia University, Stara Zagora, Bulgaria Author
  • B. Parashkevova Medical Faculty, Trakia University, Stara Zagora, Bulgaria Author
  • M. Baev Department of Healthcare & Social Work, New Bulgarian University, Sofia, Bulgaria Author

DOI:

https://doi.org/10.15547/tjs.2025.4.004

Keywords:

physician assistant, feldsher, specialization

Abstract

This review article explores the opportunities for specialization of physician assistants (PA) in various medical specialties in an international context. The profession of PA plays an increasingly important role in healthcare, especially in systems with limited resources. The specialization (residency) of these professionals allows for higher quality of medical care and more effective distribution of responsibilities in multidisciplinary teams. The main emphasis is placed on the system in the United States, where the opportunities for residency are best developed through accredited programs in areas such as cardiology, surgery and others. The United Kingdom and Germany are still developing the profession and its specialized areas. Australia is also taking steps in this direction, albeit with a limited scope. Bulgaria, compared to these countries, is taking the first steps in the establishment and qualification of these specialists. Through a comparative analysis, good practices and the potential for adapting successful models in different healthcare systems are outlined. The conclusions of the review emphasize the need for regulation, standardization, and investment in the education of physician assistants with the aim of their broader engagement and specialization in clinical practice, including with the aim of alleviating the healthcare workforce crisis in Bulgaria and Europe.

References

Physician Assistant History Society, Inc.Eugene A. Stead, Jr, M.D., [online] Available at: https://pahx.org/bios/stead-jr-eugene/ [Accessed 31.03.2025]

AAPA (n.d.) Become a PA. [online] Available at: https://www.aapa.org/career-central/become-a-pa/ [Accessed 22.03.2025].

Barton Associates (n.d.) Specialties for Physician Assistants: What's the Cost to Primary Care? [online] Available at: https://www.bartonassociates.com/blog/specialties-for-physician-assistants-whats-the-cost-to-primary-care/ [Accessed 22.03.2025].

ACC (n.d.) Certified Cardiovascular Knowledge Examination for NPs and PAs. American College of Cardiology. [online] Available at: https://www.acc.org/Membership/Sections-and-Councils/Cardiovascular-Team-Section/Features/Certified-Cardiovascular-Knowledge-Examination-NP-PA [Accessed 22.03.2025].

Coursera (n.d.) What is a Physician Assistant? [online] Available at: https://www.coursera.org/gb/articles/physician-assistant [Accessed 22.03.2025].

Hopkins Medicine (n.d.) Emergency Medicine PA Residency Program [online] Available at: https://www.hopkinsmedicine.org/emergency-medicine/emergency-medicine-physician-assistant-residency-program [Accessed 22.03.2025].

Mayo Clinic (n.d.) Physician Assistant Career Profile. [online] Available at: https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/physician-assistant/ [Accessed 22.03.2025].

My PA Resource (n.d.) PA Residency Program. [online] Available at: https://myparesource.com/pa-program-residency/ [Accessed 22.03.2025].

ARC-PA (n.d.) Currently Accredited Graduate Programs. Accreditation Review Commission on Education for the Physician Assistant. [online] Available at: https://www.arc-pa.org/postgraduate-accreditation/currently-accredited-postgraduate-programs/ [Accessed 22.03.2025].

PCOM (2023) Physician Assistant Specialties. Philadelphia College of Osteopathic Medicine. [online] Available at: https://www.pcom.edu/academics/programs-and-degrees/physician-assistant-studies/news/physician-assistant-specialties.html [Accessed 22.03.2025].

APPAP (2024) Postgraduate Training Programs for APPs [online PDF] Available at: https://www.apppostgradtraining.com/wp-content/uploads/2024/04/CAPP_PostgradSpecProgShts_0424_R1.pdf [Accessed 22.03.2025].

Faculty of Physician Associates at: https://www.fparcp.co.uk/ [Accessed 30.03.2025].

RCOphth (2023) Launch of Physician Associate Pilot. Royal College of Ophthalmologists. [online] Available at: https://www.rcophth.ac.uk/news-views/launch-of-physician-associate-pilot/ [Accessed 22.03.2025].

Regulating physician associates and anaesthesia associates, General Medical Council, [online] Available at: https://www.gmc-uk.org/about/what-we-do-and-why/regulating-physician-associates-and-anaesthesia-associates [Accessed 31.03.2025].

Physician associates support doctors in the diagnosis and management of patients, NHS, [online] Available at: https://www.healthcareers.nhs.uk/explore-roles/medical-associate-professions/roles-medical-associate-professions/physician-associate [Accessed 31.03.2025].

Wikipedia (n.d.) Arztassistent. [online] Available at: https://de.m.wikipedia.org/wiki/Arztassistent [Accessed 22.03.2025].

Arztassistent / Arztassistentin werden in Deutschland, [online] Available at: https://life-in-germany.de/arztassistent-arztassistentin-werden-in-deutschland/, [Accessed 31.03.2025].

Health Workforce Australia 2012. The potential role of Physician Assistants in the Australian context - Final Report. In: Health Workforce Australia, ed. Vol 1. Adelaide: Health Workforce Australia; 2012:46.

Ando Kerlen, Medicine from Down Under: Physician Assistants in Australia, Social Innovations Jnl, Vol.8 (2021).

Ho P, Maddern G. Physician Assistants: employing a new health provider in the South Australian health system. Medical Journal of Australia. 7 March 2011;194(5):256-258 [online] Available at: https://onlinelibrary.wiley.com/doi/pdf/10.5694/j.1326-5377.2011.tb02959.x.

Chelsea Heaney, 'It devalues us': Physician assistant roles raising concerns, 18.07.2024, NewsGP, The Royal Australian College of General Practitioners, [online] Available at: https://www1.racgp.org.au/newsgp/professional/it-devalues-us-physician-assistant-roles-raising-c [Accessed 31.03.2025] .

Elise Witter, Physician assistants: help or harm?, InSight+ by Australasian Medical Publishing Company, [online] Available at: https://insightplus.mja.com.au/2024/37/physician-assistants-help-or-harm/ [Accessed 31.03.2025].

Trakia University-Stara Zagora, Bachelor's Program "Physician Assistant", [online] Available at: https://trakia-uni.bg/bg/admission/admission-after-secondary-education/specialties/medical-assistant/ [Accessed 22.03.2025].

Trakia University-Stara Zagora, Master's Program in Nursing Care Management, [online] Available at: https://trakia-uni.bg/bg/admission/admission-after-higher-education/masters-programs/managment-healthcare/ [Accessed 22.03.2025].

Medical University-Sofia, Faculty of Public Health, Master's Program in Public Health and Health Management, [online] Available at: https://foz.mu-sofia.bg/%D1%81%D0%BF%D0%B5%D1%86%D0%B8%D0%B0%D0%BB%D0%BD%D0%BE%D1%81%D1%82%D0%B8/%D1%81%D0%BF%D0%B5%D1%86%D0%B8%D0%B0%D0%BB%D0%BD%D0%BE%D1%81%D1%82-%D0%BE%D0%B7%D0%B7%D0%BC-%D0%BC%D0%B0%D0%B3%D0%B8%D1%81%D1%82%D1%8A%D1%80/ [Accessed 22.03.2025].

The Act on the Associations of Nurses, Midwives and Allied Health Professionals, Physician Assistants, Dental Technicians and Assistant Pharmacists, [online] Available at: https://lex.bg/laws/ldoc/2135504377 [Accessed 22.03.2025].

Official website of the Bulgarian Association of Physician Assistants and Feldshers, [online] Available at: https://bslaf.bg/za-nas/ [Accessed 22.03.2025].

The PA Life (n.d.) Physician Assistant Specialties [online] Available at: https://www.thepalife.com/physician-assistant-specialties/ [Accessed 22.03.2025 ].

Teach.com (n.d.) Physician Assistant Specialties. [online] Available at: https://teach.com/online-ed/healthcare-degrees/online-pa-programs/physician-assistant-specialthttps://www.coursera.org/gb/articles/physician-assistanties/ [Accessed 22.03.2025].

Regulation No. 1 of 22.01.2015 on acquiring a specialty in the healthcare system by the Minister of Health, available at: https://lex.bg/laws/ldoc/2136417712 [Accessed 10.10.2025]

Vracheva P., Marinova J., Parashkevova B., The challenge of acquiring a clinical qualification with master's degree for physician assistants in Bulgaria - a real perspective or a chimera, Science & Technologies, volume XIII, 2023, Number 1, Medical biology studies, social medicine and health care, p. 175- 180.

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Published

2025-12-05

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Section

Original Contributions

How to Cite

UNLOCKING THE POTENTIAL OF THE HEALTH SYSTEM BY CREATING OPPORTUNITIES FOR SPECIALISATION FOR PHYSICIAN ASSISTANTS. (2025). TRAKIA JOURNAL OF SCIENCES, 23(4), 9. https://doi.org/10.15547/tjs.2025.4.004

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