TOPIC:AN Research and Education, Chennai.Email: [email protected], Mob: 7299972060Dr.

TOPIC:AN EMERGING PROFESSION WITH NEW VISION: INDIAN PHYSICIAN ASSISTANTS SINCE 1992Authors: A.S. Princy¹, Research scholar, School of Management studies, Hindustan University, Padur, Chennai & Assistant Professor, Chettinad Academy of Research and Education, Chennai.Email: [email protected], Mob: 7299972060Dr. M. Rajeswari², Associate Professor, School of Management studies, Hindustan University, Padur, Chennai. Email: [email protected] ABSTRACT:Purpose: Literature review was done to know closely about the history, growth and different roles of Physician Assistant profession.Methods: Literatures from year 1960 to 2017 was analyzed which is available in internet database in English literature is taken in to account. Survey and discussions methods are also used to get the updated data from healthcare team. Findings: Physician Assistant profession started with the strength of three member workforce and now the work force reached the status as 1300 and 1200 students of Physician Assistant are there in India.Conclusions: Review concluded that role of Physician Assistant can be utilized in Indian healthcare sector to compensate the deficiency of physicians in the healthcare outreach areas. New opportunities for young generation as the medical graduates can concentrate more on their postgraduate programme in medical field and PA can support the Make in India project.Keywords: Physician Assistant, roles, responsibilities, healthcare, ProfessionBACKGROUNDThe concept of Physician Assistant came from United States of America. Physician Assistant profession started in India 20years ago. This paper focuses on the literatures available in Indian context and publications from USA. Physician Assistants literature related to role, transition, policy, etc are also available in other countries like Canada, UK, Netherland and Taiwan. In this paper mainly key areas are growth of PA professional, expansion of PA programme, role expansion and future expansion.INTRODUCTIONAccording to Indian Association of Physician Assistants “Physician Assistant is a skilled healthcare professional who is qualified with academic and clinical training to provide healthcare services under the supervision of a specialist Physician” Dr. K.M Cherian is the pioneer of Physician Assistant program in India. The idea of Physician Assistant emerged to support a busy physician to have an improved healthcare delivery.  He got trained in cardiac surgery from University of Alabama. He worked under John W. Kirklin, MD, who was a pioneer in the development of one of the earliest American Cardiac Surgical PA programs. When he came back to India he developed same scenario as US. Junior doctors who have bachelor degree in medicine used to work with specialized surgeons and assist them during the surgeries. But this workforce is not a permanent resource because they often go for sabbaticals to prepare for competitive higher education entrance exams. Dr. Cherian tried to fill this gap by introducing new healthcare professionals. GROWTH OF PHYSICIAN ASSISTANT PROFESSIONDr. Cherian tries to fit Physician Assistant program in India in1992. Physician Assistant programme started in Institute of Cardiovascular Disease in Chennai. Initially it was a two year post graduate diploma programme in which fresh science graduates are eligible to join. First batch emerged with three Physician Assistant in1994. Second batch program has been incorporated as two year Master programme and got affiliation from Birla Institute of Technology and Science, Pilani, Rajasthan with the help of Honorary Director of the training centre of ICVD. Prof. Ramakrishnan. Physician Assistant profession got good feedback among the surgeons and they started floating along with the Physicians to different hospitals in India.Few years Physician Assistants are trained in ICVD settings so their job opportunities are limited. Later few changes in the training modules of the programme have done to other field to extent the role of Physician Assistant. Couple of batches came out with Masters and even M. Phil degrees. Then it extends it programme to Bachelor degree with many specialties like neurology, nephrology, gastroenterology and plastic surgery. This profession got recognized among Physicians, human resource teams, etc. Presently there are nearly 1300 PAs and 1200 students of Physician Assistant are there in India.EXPANSION OF PA PROGRAMMEPA profession is expanded in almost all departments in hospitals like Outpatient unit, Operation theatre, Intensive care unit, organ transplant, respiratory medicine, dermatology, nephrology, neurology, radiology, perfusion, anesthesia, emergency and trauma care and medical laboratory. Table 1 Specialty of Physician Assistants in 2017 Sl# Area of Specialties    1. Radiology and Imaging Technology    2. Emergency and trauma care    3. Anesthesia Technology    4. Cath lab Technology    5. Cardiac Technology    6. Dialysis Technology    7. Nephrology Technology    8. Neuroscience Technology    9. Dermatology    10. Respiratory Technology    11. Medical Laboratory Technology    12. Perfusion Technology    13. General Surgery  Demands of Physician Assistants are increasing day by day today, nearly 47 Institutes in India offers Physician Assistant diploma or bachelors degree programme. PA programme are offered by private Institutes only, But Dr. MGR Medical University in Tamil Nadu is the government medical university which has this programme. Geographically PA profession and colleges spread widely in all south Indian states, West Bengal, Gujarat, Delhi, etc. (Table 2 )There is no standardized syllabus. Programme structure is 4- year degree programme, which includes 1 year internship. Eligibility to join this programme is Plus two with Physics, Biology, Chemistry and or Math.Table 2 Sl# Institute/University name State    1. Sri Venkateswara Medical College Andhra Pradesh    2. Micro Info Web Pvt. Ltd Delhi    3. Khatu Shyam Institute of management and Technology Delhi    4. BN Patel Institute of Paramedical Science Gujarat    5. Martin Luther Christian University Meghalaya    6. Jayasree Academy West Bengal    7. JSS medical College and Hospital Karnataka    8. Frontier Lifeline Hospital Tamil Nadu    9. M.M.M College of Health Sciences Tamil Nadu    10. Sri Gokulam College of Nursing Tamil Nadu    11. Surabhi School of Nursing Tamil Nadu    12 Vinayaka Missions University Tamil Nadu    13. Sri Gokulam Institutes of Paramedical Sciences Tamil Nadu    14. Saga Institute of Management Studies Kerala    15. Sri Ramachandra Medical College Tamil Nadu    16. Care Hospitals Andhra Pradesh    17. Amrita Institute Kerala    18. Dr. MGR Medical University Tamil Nadu  Geographic distribution of PA Institutes Figure 1ROLE OF PHYSICIAN ASSISTANTMost Physician Assistants work in private hospitals. In outpatient wing Physician Assistants examines the patient, takes history, summarizes the order, interpret reports like X-rays, ECG, sonogram, treadmill test, etc. They have to counsel the patients and their family also. In wards and critical care areas Physician Assistants takes rounds, meet emergency situations, prepare progress notes, discharge summary, etc. In surgeries Physician Assistants support Physicians as first or second assistants for harvesting saphenous vein for CABG surgery, role as clinical perfusionist, post operative treatment, etc. They even work in non clinical set ups like hospital administration, clinical research and hospital information systems. The scope for Physician Assistant professional is not only limited to hospitals but they can get placed in medical software institutions, pharmaceutical industries, organizations developing sophisticated medical devices, medical tourism and medical insurance. INDIAN ASSOCIATION OF PHYSICIAN ASSISTANTSIndian Association of Physician Assistants formed on 8th April 2008. IAPA was registered under the jurisdiction of Registrar of societies, North Madras with the Institute of cardiovascular Disease, Madras. Main objective of this organization is to support Pas professional and personal development. IAPA conducts National Scientific Meets, so it helps PAs as a platform to present their research papers and to meet all PAs working around the country. IAPA continues to press government to standardize the curriculum and recognize this profession in India. CONCLUSIONSAs population in India is increasing in volume, demand of Physician Assistant professions will be increasing so governing bodies has to recognize and utilized their role in healthcare sector. Government has to take action to curb with the present shortage of Physicians in the health care sector. REFERENCES1. Kuilman L, Sundar G, Cherian KM. Physician assistant education in India. Journal of Physician Assistant Education. 2012;23(3):56-59.2. Sundar G. Physician assistants in India: Triumphs and tribulations. JAAPA. 2014; 27(4):9-11. 3. Antony KR. Awaiting the new foot soldiers of community health care. The Hindu. October 8, 2012. Available at: www.thehindu.com/opinion/op-ed/awaiting-the-new-foot-soldiers-of-community-health-care/article3975089.ece.4. Rao KD, Stierman E, Bhatnager A, et al. As good as physicians: patient perceptions of physicians and non-physician clinicians in rural primary health centers in India. Glob Health Sci Pract. 2013;1(3)397-406.5.http://www.ohsu.edu/xd/education/schools/school-of-medicine/academic-programs/physician-assistant/applicants/policies/pacompetencies.cfm6. Dehn, R. W., Everett, C. M., & Hooker, R. S. (2017). Research on the PA profession: The medical model shifts. Journal of the American Academy of Physician Assistants, 30(5), 33-42. DOI: 10.1097/01.JAA.0000515548.76484.39