First group of paramedic physician assistants to graduate course today

After years of strong opposition from the Health Ministry, the Israel Medical Association and others, 30 paramedics will graduate Monday from a ministry course to become Israel’s first physicians’ assistants. The training course included lectures, simulation exercises and work in hospital emergency rooms.

A law passed about three years ago, as a result of the work of a steering committee, initially allowed paramedics with a bachelor’s degree to become physicians’ assistants (PAs). Today’s graduates, however, are the first ones to actually become PAs based on that law.

The law also did not allow PAs from abroad to practice here, whether they had graduated with a master’s degree or had worked for years in the medical profession abroad, even if they would undergo additional training here.

Dr. Idit Segal, acting deputy head of the ministry’s Medical Authority, who is a strong supporter of PAs, told The Jerusalem Post on Sunday that the PA law has been amended.

“It will now allow licensed PAs from abroad who are not paramedics to work as PAs – but at present only in hospital emergency rooms, in pathology and giving anesthesia,” she said. “They will not earn the very large sums that they got in the US, some $100,000 a year, but they will earn salaries similar to Israeli paramedics. With master’s degrees, they could eventually earn more, and their responsibilities will expand.”

But now that there is less opposition and the severe shortage of physicians has increased the demand for PAs, the ministry has become an advocate of expanding paramedics’ responsibilities. Even the Israel Medical Association and medical specialty societies are becoming more supportive, on condition that they do not harm the interests of physicians.

The idea had met with some initial opposition from Magen David Adom, which would lose some paramedics, and from the Anesthesiologists Society, which worries about nonphysicians endangering their jobs, Segal noted.

In North America, PAs study a few years less than full-fledged MDs and can perform many medical tasks under a physician’s supervision. They admit patients, examine them, send them for tests and even give emergency care.

Segal has been in close touch with Nefesh B’Nefesh, the voluntary organization that encourages and eases aliya and integration into Israel from North America, which is promoting aliya among PAs abroad.

Seventeen general hospitals all over the country have hired the PA graduates after they passed an exam. The 30 paramedics graduating Monday have already started work. The hospitals funded the participation of the new PAs in the course and hired them to fill manpower slots they received via the ministry.

After passing the test, said Segal, the PAs have to work for a year in hospital emergency rooms under supervision, but “this does not hurt them; they get paid during this period.” The immigrant PAs do not have to take a Hebrew-language test, which immigrant nurses have to do, but their Hebrew should be adequate to communicate with patients and colleagues, she added. If it isn’t, they are sent to ulpan.

The ceremony will be held at the ministry’s headquarters, with Health Minister Ya’acov Litzman and director-general Moshe Bar Siman Tov attending.

Asked whether geriatric and psychiatric hospitals would also be permitted to hire PAs, Segal said the subject has not yet come up, but that it was a good idea.

When it was suggested that the ministry organize a conference on PAs for paramedics, Western immigrant PAs, doctors and hospital directors to increase awareness and promote contacts, Segal said that the idea was definitely worth pursuing.

Sixty additional job slots have been approved for PAs to work in additional places.

“We hope to open another PA course in about two months,” she said.