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The Eastern Virginia Medical School in downtown Norfolk recently touted its growth in enrollments for programs that provide advanced training for physician assistants and surgical assistants. EVMS now has 432 students in its School of Health Professions, a more than 10 percent growth from the 2009-2010 academic year that school administrators ascribe, in part, to students’ "looking for a job that pays well and gives them a chance to make a real difference in others’ lives."

Physicians assistants and surgical assistant do play large and growing roles in providing health care. In Virginia (VA), licensed PAs can perform physical examinations, prescribe medications and perform any health care procedures that his or her supervising physician can do so long the doctor signs off on a protocol authorizing the PA to do so.

Virginia law does not make a distinction between PAs and surgical assistants, but assisting with surgeries does require a different set of skills. For instance, a partial list of duties for surgical assistants published by a health professionals certification boards includes

  • Determine specific equipment needed per procedure
  • Assist in moving and positioning of patient
  • Insert and remove urinary bladder catheter
  • Confirm procedure with surgeon
  • Drape patient within surgeon’s guidelines
  • Provide retraction of tissue and organs for optimal visualization with regard to tissue type and appropriate retraction instrument and/or technique
  • Assist in maintaining blood pressure by direct pressure, use and application of appropriate surgical instrument for the task
  • Use electrocautery
  • Clamp, ligate (tie off) and cut tissue per surgeon’s directive
  • Dissect common femoral artery and bifurcate per surgeon’s directive
  • Maintain integrity of sterile field
  • Close all wound layers as per surgeon’s directive
  • Insert drainage tubes per surgeon’s directive
  • Select and apply wound dressings
  • Assist with resuscitation of patient during cardiac arrest or other life-threatening events in the operating room

The U.S. Bureau of Labor Statics recorded 91,000 surgical assistant jobs during 2008 and projected a rapid increase in those positions over the next decade. The same federal agency identified nearly 75,000 PAs in 2008 and predicted similar rapid growth in the numbers of health providers to fill the role of nurses and doctors for many rural and inner-city patients.

As patients receive more care and services from physician assistants and surgical assistants, they more and more literally put their lives in the hands of those health professionals. Clinics, hospitals and supervising doctors and surgeons will continue bearing the primary liability for any civil claims resulting errors or negligence, but that won’t provide any immediate comfort to a patient injured by a surgical assistant’s mistake or a PA’s misdiagnosis.

EVMS has pledged to cap its enrollment in PA and surgical assistant programs before the number of students strain the school faculty’s ability to deliver top-quality skills and safety training. I applaud that commitment to producing only the best health professionals.


About the Editors: The Shapiro, Cooper, Lewis & Appleton personal injury law firm, whose attorneys work out of offices in Virginia (VA) and North Carolina (NC), edits the injury law blogs Virginia Beach Injuryboard, Norfolk Injuryboard, Eastern Shore Virginia Injury Attorneys Blog and Northeast North Carolina Injuryboard as pro bono services.


  1. Gravatar for Mark

    Studies show that about 65 percent of Virginia's medical school graduates left the state to practice elsewhere. With this information, and with President Obama's heathcare plan, more medical assistants will be needed to help with the increasing number of people needing medical care.

  2. Gravatar for Shapiro, Lewis & Appleton
    Shapiro, Lewis & Appleton


    I understand how people could ascribe the growth in numbers of physician and surgical assistants to a shrinking in the number of doctors. However, Virginia does not currently suffer from a significant shortage of physicians and surgeons. Projections from state health officials show that Virginia may have 2,000 vacant doctors' positions by 2030. That can seem like a lot, but with 20 years to plan and implement solutions, the problem also seems solvable -- in part by training and hiring more skilled ssistants.

    Better pay and shorter hours seem more likely to be drawing local medical school graduates to practice outside Virginia. It's also worth noting that Virginia's firm caps on medical malpractice awards, though slated to increase some over the next decade, could serve as a draw for some practitioners considering working in this state.

    John Cooper, VA Medical Malpractice Attorney

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