Presented By: Mirela Bruza-Augatis, National Commission on Certification of Physician Assistants
Co-Authors: Joshua Goodman, National Commission on Certification of Physician Assistants
Roderick Hooker, Northern Arizona University
Andrzej Kozikowski, National Commission on Certification of Physician Assistants
Dawn Morton-Rias, National Commission on Certification of Physician Assistants
Kasey Puckett, National Commission on Certification of Physician Assistants

Background/Purpose
The number of postgraduate (PG) fellowship/residency programs for physician associates/assistants (PAs) has rapidly grown. These programs provide PAs with the opportunity to gain specialized expertise in various medical disciplines. However, the number of PAs who complete these programs and their specific characteristics remain unknown. Therefore, we aimed to explore this important topic.

Methods
We analyzed 2021 data from the National Commission on Certification of PAs, comparing demographics and practice characteristics of PAs who completed PG fellowship/residency vs. those who did not. Analyses consisted of descriptive and bivariate statistics, along with quantile regression.

Results
In 2021, 113,510 of 158,470 board-certified PAs provided their PG fellowship/residency status. Of those, 5,859 (5.2%) completed a PA PG fellowship/residency. Our analyses revealed several significant differences (all p<0.001) between the two groups. PAs who had completed a PG fellowship/residency, in comparison to those who had not, were more likely to be older (median age of 42 years vs. 38 years), male (42.4% vs. 29.4%), Black/African American (4.8% vs. 3.3%), and Hispanic/Latino(a/x) (8.0% vs. 6.6%). Furthermore, PAs with a PG fellowship/residency were more likely (all p<0.001) to hold a doctorate (9.1% vs. 1.9%), work in hospitals (51.0% vs. 40.8%), and have been certified for 21 or more years (29.6% vs. 17.0%). The unadjusted analysis revealed that PAs who had completed a PG fellowship/residency earned a median income of $10,000 more than those without (p<0.001). However, after adjusting for demographics and practice characteristics, the income difference was reduced to $1,501 (p=0.003).

Conclusions
Our research suggests that a significant number of PAs undertake a PG fellowship/residency and sheds light on their unique characteristics. While our analysis did reveal a marginal income difference, favoring those with a PG fellowship/residency, future research should explore the income growth trajectory across these two groups to better understand the financial implications of completing a PG fellowship/residency.