Economic Implications of Postgraduate Training for Physician Assistants/Associates: A Comparative Analysis

The entry-level physician assistant/associate (PA) education offers a solid foundation for general medical knowledge and clinical skills. Yet, there has been an increasing trend for PAs to complete a postgraduate (PG) fellowship/residency to gain specialized expertise in specific medical disciplines. We analyzed national data and compared PAs' annual income, educational attainment, background, and professional attributes with a PG fellowship/residency and those without. Descriptive and bivariate statistics, along with quantile regression, were conducted. We found distinct differences in demographic/practice characteristics of the two groups (all p<0.001). PAs with PG fellowship/residency vs those without were older (median age, 42 vs 38), identified as male (42.4% vs 29.4%), Black/African American (4.8% vs 3.3%), and Hispanic/ Latino(a/x) (8.0% vs 6.6%). Most PAs completed their PG fellowship/residency in emergency medicine and worked in hospitals. Furthermore, income levels between PAs with a PG fellowship/residency and those without, revealed a significant gap of $10,000 in favor of those with a fellowship/residency. However, after adjusting for confounders, quantile regression analysis estimated a narrowed gap ($1,500.60). These findings indicate that additional education may not be associated with a substantial income increase. Further research should investigate the income growth trajectory of a PG fellowship/residency, providing a deeper understanding of the economic implications.