FAQs
What are the duties of an OB/GYN PA?
The duties of an OB/GYN PA include the health care management of women from adolescence onward. Individual PA duties are dependent on the scope of his or her supervising physician's practice and the desire of the physician to delegate certain tasks or responsibilities. The range of duties is as varied as the number of different OB/GYN practices. In a survey sent to members of APAOG in 2000, members reported that their most frequent encounters involved annual pap/pelvic and breast exams, gynecological complaints, family planning, menopause management, and prenatal care. The most frequently performed procedures were ultrasound, colposcopy (including endocervical curretage, LEEP and cryosurgery) and endometrial biopsy, but other procedures also listed included IUD and Norplant insertion and removal, artificial insemination, vulvar/cervical/breast biopsy, pessary fitting, vaginal delivery, abortion, D & C, hysteroscopy, laminar inserts and circumcision. Members also noted that they were able to use their primary care training to manage their patient's medical conditions both during pregnancy and in the non-pregnant state. Duties, again, were usually dependent on the needs of the practice and the interests and training of the OB/GYN PA.
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How do I specialize in OB/GYN?
One of the strengths of the Physician Assistant profession is that all PAs are trained and certified in the primary care model. PAs bring this broad foundation of medical knowledge to any prospective employment situation. Historically, PAs have successfully entered many specialties through an informal mentoring relationship with their supervising physicians. If you have an interest in Ob/Gyn, look for job opportunites that allow you to develop a level of expertise in the area of women's health. As you gain knowledge from working with colleagues, you can also participate in workshops that teach procedures done by PAs (see duties of Ob/Gyn PAs). Along with hands on workshops, expertise is developed by attending continuing medical education conferences focusing on women's health sponsored by PAs, physicians, advanced practice nurses, etc.
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Are there differences between Physician Assistants (PAs), Nurse Practitioners (NPs) and Nurse Midwives (CNMs)?
PAs and NPs practicing in women’s health and CNMs overlap in the scope of clinical practice. They are trained to conduct physical exams, order and interpret tests, diagnose and treat both acute and chronic illnesses. Counseling and patient education are important aspects of their care. In the OB/GYN setting this includes but is not limited to, well woman exams, assessment of breast masses, incontinence, infertility, colposcopy, osteoporosis, management of ovarian cysts, endometriosis and uterine fibroids, family planning and contraceptive provision, prenatal, and postpartum care. They can be trained to perform procedures such as IUD and Implanon insertion, endometrial and vulvar biopsies, ultrasounding, diaphragm and pessary insertion and some assist in surgery.
PAs and NPs can practice in many other specialties of medicine including primary care, family practice, pediatrics, cardiology, endocrinology, orthopedics, emergency care and many other surgical and subspecialties. CNMs specialize in the management of women's health care, focusing particularly on pregnancy, childbirth, the postpartum period, care of the newborn, and the family planning and gynecological needs of women.
CNMs and NPs must complete a Registered Nurse program prior to attending a CNM or NP program, or attend an accelerated program. PAs are required to hold a bachelor’s degree with pre-requisite science courses and health care experience prior to attending a PA program. All are required to pass a national certifying exam and be licensed by the governing board in the state where they practice, and additionally must earn continuing education credits to maintain certification and licensure. NPs and CNMs are considered to have a collaborating relationship with a physician, while physicians are defined as having a supervising relationship with PAs. Regulations may vary from state to state as well.
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Is it legal for PAs to deliver babies?
Women's health and obstetrics are routine components of PA education. State laws, hospital regulations, physician and patient preference and the training and expertise of the PA influence the extent to which PAs provide obstetrical care.
Most state rules and regulations do not address PAs and deliveries. Only four states delineate the specific context of PA participation in obstetrical care. [See the AAPA's "Summary of State Law References to PA Participation in Obstetrical Care and Deliveries".] Barriers to PAs who want to perform deliveries usually occur at the level of hospital regulations.
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Where are some of the hospitals that do utilize PAs in Labor & Delivery?
1. East Georgia Regional Medical
Center, Statesboro, GA
2. Hurley Hospital, Flint, MI
3. St. John's Hospital, Detroit, MI
4. Sinai-Grace Hospital, Detroit, MI
5. Oakwood Hospital , Dearborn, MI
6. Cambridge Health Alliance, Cambridge MA
7. Brooklyn Hospital, NY
8. Coney Island Hospital, NY
9. Lennox Hill Hospital, NY
10. New York Methodist, NY
11. New York Hospital Medical Center of Queens, NY
12. Harlem Hospital, NY
13. Staten Island Hospital, NY
14. Weiler Hospital, Bronx, NY
15. Park Ridge Hospital, Rochester, NY
16. Christiana Hospital, Newark, Delaware
17. Abington Memorial Hospital, Abington, Pennsylvania
18. Arrowhead Regional Medical Center, Colton, CA
19. Riverside County Medical Center Riverside, CA
20.
Albert Einstein Medical Center,
Philadelphia, PA
[Additional hospitals will be listed here as APAOG learns of them. If you are aware of any not listed here, please email APAOG with that information so they can be added to this list.]
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Is it legal for PAs to perform Cesarean deliveries?
PAs may serve as the first assistant in C sections provided they are credentialed to do so at the hospital of interest.
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Is it legal for PA's to perform abortions?
Most state have "physician only" laws which prevent Physician Assistants from performing surgical abortions. The issue of medical abortions is less standardized and needs to be investigated on a state by state basis. The National Abortion Federation assists in questions about these legal issues, as well as providing a list of training programs for PAs in abortion care and management. Many PAs provide reproductive choice care, without performing the actual procedures, by doing pre and post counseling, ultrasound diagnosis, inserting laminaria & paracervical blocks, assisting with procedures, managing care afterwards (including complications), family planning, teaching, and call coverage.
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How do I find an OB/GYN rotation as a PA student?
If the PA program does not have an established
Ob/Gyn rotation site, try applying for A-SCOR (APAOG-sponsored
clinical Ob/Gyn rotation). You can learn more about this
opportunity by going to the student
page on this website.
Professional and personal contacts would
be the next way to obtain a preceptorship. Also contact
sites such as Planned Parenthood or other family planning
clinics which have traditionally been dedicated to midlevels
and education. Teaching institutions might consider training
a PA if you made a personal contact with the OB/GYN staff,
even if they have only accepted medical students in the
past. Also take advantage of personal acquaintances you
have with obstetrician/gynecologists or PA's who might be
able to make contacts for you.
If those avenues are not successful,
the student could write to the potential practitioners in
their desired area explaining their preparation for the
rotation and any support available from their PA program.
A sample of such a letter is available on the members only
section of the APAOG website.
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