Factors for PAs to Consider When Contemplating an Advanced Degree

LOS ANGELES — Dermatology physician assistants might think that putting in the blood, sweat, and tears to earn one advanced degree is enough, but not Michelle DiBaise, DHSc, PA-C, DFAAPA.

DiBaise, professor and chair of physician assistant studies at A.T. Still University in Mesa, Arizona, already holds a Doctor of Health Science (DHSc) degree, but she’s seriously considering pursuing a second doctorate, or a master’s in public administration or a master’s in public health, “just because I love to constantly learn,” she said. “I am in that bucket.”

During a panel discussion at the annual fall meeting of the Society of Dermatology Physician Assistants, she discussed the pros and cons of obtaining an advanced degree. The most common doctoral degree that PAs are seeking now is the Doctor of Medical Science (DMSc), said DiBaise, who has practiced in the areas of pulmonology, orthopedic surgery, and dermatology. Other available degrees for PAs include the DHSc, Doctor of Philosophy (PhD), and Doctor of Education (EdD) degrees. She recommends the EdD, “if you are going into an academic area, because you’re going to get heavy pedagogy and andragogy training.”

Benefits of an advanced degree include the potential for improving your understanding of quality improvement, health policy/legislation, and administrative functioning. It also may open opportunities to expand your role at work. “Another reason that PAs seek an advanced degree is to have professional parity,” she added. “There’s also a possibility for promotion, either through advancement or increased compensation.”

One key factor to consider is individual preferences on how to study for an advanced degree — for example, learning online or in a classroom in person. “Online is generally asynchronous so you can do it on your own time while you’re working,” DiBaise said. Other questions to consider include the following:

  • What does the advance degree cost?

  • What are the financial aid opportunities?

  • What’s the time commitment?

  • How will this impact family life?

  • What’s the time required to complete the degree?

“Some degrees are 1 year, some are 2 years, and some can be as long as 4 years,” she said. “As for how the doctorate will position you in the workforce, that question may not be as important to you if you just love to constantly learn.”

DiBaise also discussed the benefits and drawbacks of PAs working in academia as a career track, whether they have an advanced degree or not. In the academic setting, “you are content experts, so you can impart your knowledge to future generations, just as others did for you when you were coming up through the ranks,” she said. There is also potential for a more flexible schedule, which depends on the program “and how far up the leadership role you might take in academia,” she added.  

Potential drawbacks to working in academia include the steep learning curve required to apply principles of pedagogy and andragogy in the classroom — “essentially how you teach adult learners,” said DiBaise, who has served as president of the Society of Dermatology PAs in addition to serving as president for the Nebraska, Iowa, and the Arizona state PA associations. “Also, our students can Google anything while they’re sitting in the classroom listening to you talk, and they constantly challenge you, so you have to be prepared for that. You need to develop a thick skin against student criticism. They’ve grown up on social media and are allowed to make biting remarks [on faculty evaluations] because the evaluation tool is an anonymous platform. You have to learn to filter out what is not going to be helpful in changing the curriculum or changing your teaching style.”

Other potential drawbacks to working in academia are the possible requirements to work outside of normal business hours for graduations, white coat ceremonies, and other events, and a level of compensation that is generally less than what can be earned in clinical practice.

For those PAs who have a hunch that academia may be a good fit for them, one way to get a foot in the door is to serve as a preceptor. “You’d be training future PAs, and there is a huge interest in dermatology,” DiBaise said. “Our clinical coordinators are always looking for PAs who would be willing to serve as preceptors. This makes you eligible for category 1 CME from the American Academy of Physician Assistants. Another thing you can do is contact local programs in your area to provide dermatology lectures and to assist in labs, especially biopsying and suturing. Training PAs in the use of dermoscopy is another area of interest.”

Applying for a full-time faculty position in academia is also an option, but DiBaise recommends teaching a course or two as an adjunct first. “Academia is not easier than clinical practice. It’s not better than clinical practice. It’s different than clinical practice. Some people get into it and find out immediately that it’s not for them, and they quit. If you’re not sure, test the waters first.”

DiBaise has disclosed no relevant financial relationships.

Society of Dermatology Physician Assistants (SDPA) 19th Annual Fall Dermatology Conference: Presented November 5, 2021.

Doug Brunk is a San Diego-based award-winning reporter for MDedge and Medscape who began covering healthcare in 1991. He is the author of two books about the University of Kentucky Wildcats men’s basketball program.

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