As of 2019, the adoption of PAs has spread globally across a variety of health systems and at least fifteen countries have been in various stages of expansion of PA-like medical workers (nonphysician clinicians) that function under the supervision of a doctor.
For a more complete and updated review of this topic please see my latest post: Physician Assistants (PAs) and Associates Around The World
- Canada Physician Assistants
- United Kingdom Physician Associates
- The Netherlands Physician Assistants
- Liberia Physician Assistants
- India Physician Associates
- Ghana PA Medical (Medical Assistant)
- South Africa Clinical Associates
- Australia Physician Assistants
- Saudi Arabia Assistant Physicians
- Germany Physician Assistants
- New Zealand Physician Associates
- Afghanistan Physician Assistants
- Israel Physician Assistants
- Bulgaria Physician Assistants
- Ireland Physician Associates
Many of these countries have American-trained PAs working as expatriates, and most are developing educational programs that produce a health care provider functioning as an addition to the doctor.
Each country has made it's PA a distinct entity, with cultural and educational influences shaping their roles. Common denominators of these PAs are: they function as semi-autonomous clinicians under the direct supervision of a doctor and have roles that tend to complement those of the doctor.
Historical observations suggest the development of the PA profession in different countries tends to follow a similar path and that lessons learned from these nations may be useful in further expansion of the profession.
Those countries mentioned above are just some of the countries that have recently recognized the progress of PAs and have developed their own PA programs. Yet, assistants to doctors and prototypes of PAs are not new.
Eastern European countries such as Russia and Ukraine; Asian countries such as China and Malaysia; much of Oceania (eg, Australia, New Guinea, Micronesia, Melanesia, and Polynesia); as well as parts of Africa and South America have employed medical aides for decades.
Even in the United States, the Alaskan Community Health Aides project, inaugurated during World War II and continuing today, produces what can be referred to as prototype PAs.
Excluding the Netherlands, every country falls short of the desired 3/1,000 doctor-to-population ratio that is recommended by the World Health Organization (WHO). All use English in the classroom, although for the Netherlands, English is a secondary language. Table 1 shows the population and doctor-to-population ratios of these countries, as well as those of the United States for comparison.
Canada, Australia, South Africa, have remote and/or widely separated and sparse populations. In some countries, the size or dispersal of rural populations presents formidable challenges to health care delivery.
Education programs have developed in different ways and by different means in the nations described here. The established PA programs in these countries range from 2 to 3 years in length, with a didactic component followed by a clinical component.
Please see my full article with a breakdown of practice and education requirements in each of the above countries: Physician Assistants (PAs) and Associates Around The World
You can also download and view a beautiful infographic of this comparison here.