Hospital medicine is a medical specialty focused on the care of hospitalized patients. Physicians and physician assistants (PAs) play crucial roles within this field.

PAs in hospital medicine work alongside physicians to provide comprehensive medical care to patients admitted to hospitals. Their responsibilities may include conducting patient assessments, diagnosing illnesses, developing treatment plans, ordering and interpreting diagnostic tests, prescribing medications, and coordinating patient care with other healthcare professionals.

PAs in hospital medicine often serve as integral members of interdisciplinary healthcare teams, collaborating with physicians, nurses, specialists, and other staff to ensure optimal patient outcomes and continuity of care throughout hospital stays.

Hospital Medicine Overview

Working as a physician assistant (PA) in a hospital setting entails a dynamic and multifaceted role that involves various responsibilities aimed at providing high-quality patient care. Patient in Hospital BedPAs in hospitals typically work under the supervision of attending physicians, but they often have a considerable degree of autonomy in their day-to-day practice. They are trained to handle a wide range of medical conditions and emergencies, from managing acute illnesses to providing ongoing care for chronic conditions.

In a hospital setting, PAs are involved in all stages of patient care, from admission to discharge. They conduct thorough assessments of patients, which may involve taking medical histories, performing physical examinations, and interpreting diagnostic tests.

Based on their findings, PAs collaborate with the medical team to develop and implement appropriate treatment plans. This may include prescribing medications, ordering additional tests or procedures, and coordinating with other healthcare professionals to ensure comprehensive care.

One of the key aspects of working as a PA in a hospital is the fast-paced and often unpredictable nature of the environment. PAs must be able to think quickly on their feet, make critical decisions under pressure, and effectively prioritize tasks to provide timely and efficient care to patients. They also play a vital role in patient education, ensuring that individuals and their families understand their conditions, treatment options, and discharge instructions.

Furthermore, PAs in hospital medicine are often involved in various administrative tasks, such as documenting patient encounters, communicating with other members of the healthcare team, and participating in quality improvement initiatives to enhance patient care outcomes.

Overall, working as a PA in a hospital setting requires a blend of clinical expertise, strong communication skills, and the ability to adapt to ever-changing circumstances to deliver exceptional care to patients in need.

Definition of Hospital Medicine

Hospital medicine is a specialized medical field primarily focused on the care of patients within hospital settings. Physicians and advanced practice providers like physician assistants and nurse practitioners play pivotal roles in hospital medicine, managing the treatment of acutely ill patients admitted to hospitals.

This specialty encompasses a broad spectrum of responsibilities, including conducting initial assessments, overseeing patient care plans, coordinating with specialists and other healthcare professionals, and ensuring continuity of care throughout hospital stays.

Hospital medicine practitioners are adept at managing complex medical conditions, providing acute interventions, and facilitating transitions of care, ultimately aiming to optimize patient outcomes and improve the overall quality of care within hospital settings.

Scope of Practice for Hospitalist PAs

Hospitalist physician assistants (PAs) have a diverse scope of practice within hospital medicine, tailored to the acute care needs of hospitalized patients. Their responsibilities span various facets of patient care, including conducting comprehensive assessments, diagnosing and treating acute medical conditions, and managing complex cases under the supervision of attending physicians.

PAs in hospital medicine often perform procedures such as inserting central lines, suturing wounds, and managing ventilator support for critically ill patients. They collaborate closely with multidisciplinary teams, including physicians, nurses, and specialists, to provide coordinated and holistic care to patients.

Additionally, hospitalist PAs play a vital role in patient education, ensuring that individuals and their families understand their conditions, treatment plans, and post-discharge instructions.

Their scope of practice may also encompass administrative tasks, such as documenting patient encounters, participating in quality improvement initiatives, and contributing to interdisciplinary rounds to optimize patient outcomes and enhance the overall efficiency of hospital care delivery.

Differences Between Hospital Medicine and Primary Care

The role of a physician assistant (PA) differs significantly between hospital medicine and primary care, reflecting the distinct focus and responsibilities of each specialty.

In hospital medicine, PAs primarily care for patients who are acutely ill and require immediate medical attention within a hospital setting. Their focus is on managing acute conditions, coordinating care during hospital stays, and facilitating transitions of care as patients move through different levels of treatment. Hospitalist PAs often perform procedures, interpret diagnostic tests, and collaborate closely with multidisciplinary teams to provide comprehensive care to hospitalized patients.

On the other hand, in primary care, PAs typically engage in long-term relationships with patients, focusing on preventive care, health maintenance, and management of chronic conditions in outpatient settings.

Primary care PAs emphasize wellness promotion, disease prevention, and continuity of care over time. They conduct routine health assessments, provide screenings and vaccinations, manage chronic illnesses, and offer patient education and counseling to promote healthy lifestyles. Primary care PAs also serve as advocates for their patients, coordinating referrals to specialists and community resources as needed.

Overall, while both hospital medicine and primary care involve the provision of healthcare by PAs, their roles differ significantly in terms of patient population, setting, scope of practice, and focus of care.

Hospitalist PAs prioritize acute care and complex medical management within the hospital, whereas primary care PAs emphasize preventive care, chronic disease management, and long-term patient relationships in outpatient settings.

Education and Training Requirements

Becoming a hospitalist physician assistant (PA) requires a combination of rigorous training and education to prepare for the specialized demands of caring for acutely ill patients in a hospital setting.

The journey typically begins with obtaining a bachelor’s degree, preferably in a health-related field, followed by enrollment in an accredited physician assistant program. These programs typically last about two to three years and include classroom instruction, laboratory work, and clinical rotations in various medical specialties.

Upon completing a physician assistant program, aspiring hospitalist PAs must pass the Physician Assistant National Certifying Examination (PANCE) administered by the National Commission on Certification of Physician Assistants (NCCPA) to obtain initial certification. This examination assesses the knowledge and skills necessary for entry-level practice as a PA.

After obtaining initial certification, PAs interested in specializing in hospital medicine may pursue additional training through postgraduate residency or fellowship programs in hospital medicine or a related field. These programs provide intensive, hands-on experience in managing acute and complex medical conditions in a hospital setting, further refining clinical skills and expertise.

Throughout their careers, hospitalist PAs engage in continuing medical education (CME) to stay abreast of advances in medical knowledge, technology, and best practices in hospital medicine. They may also pursue specialty certifications, such as the Certificate of Added Qualifications (CAQ) in Hospital Medicine offered by the NCCPA, to demonstrate expertise in this field.

Overall, the training and education requirements for becoming a hospitalist PA are rigorous and multifaceted, encompassing formal education, certification, specialized training, and ongoing professional development to ensure competency and excellence in providing acute care to hospitalized patients.

Admission Requirements for PA Programs

Admission requirements for hospitalist PA programs typically involve a combination of educational qualifications, certification, and other criteria. Here’s a breakdown:

Educational Qualifications

Applicants are generally required to have completed a Bachelor’s degree from an accredited institution. Hospitalist Physician Assistant classroomWhile specific majors may not always be specified, a degree in a relevant field such as biology, pre-medicine, or healthcare administration may be advantageous.

Certification Qualifications

Prospective students must typically hold certification as a Physician Assistant (PA-C) by passing the Physician Assistant National Certifying Exam (PANCE). This certification demonstrates a baseline level of competency in the field.

Specialty Focus

Some hospitalist PA programs may prefer or require applicants to have experience or coursework in relevant specialties, such as internal medicine, emergency medicine, or critical care. Demonstrated knowledge or experience in acute care settings is often valued.

Additional Criteria

Letters of Recommendation: Many programs require applicants to submit letters of recommendation, often from healthcare professionals or educators who can speak to the applicant’s aptitude, character, and readiness for advanced training.

Disciplinary History: Applicants may be asked to disclose any history of disciplinary actions or legal issues that could impact their suitability for the program.

Professional Experience

While not always mandatory, many hospitalist PA programs prefer applicants with prior clinical experience as a PA or in a related healthcare role. This experience can demonstrate readiness for the demands of the program.

GPA Requirements

Minimum GPA requirements vary by program but typically range between 3.0 and 3.5 on a 4.0 scale. A strong academic record is often considered indicative of the applicant’s ability to handle the rigors of graduate-level coursework.


Some programs may require applicants to participate in an interview as part of the admissions process. This interview allows the admissions committee to assess the applicant’s communication skills, professionalism, and commitment to the field.

By meeting these admission requirements, candidates can position themselves competitively for admission to hospitalist PA programs, preparing them for a rewarding career in acute care medicine.

Requirements for Becoming a Hospitalist PA

To become a hospitalist Physician Assistant (PA), candidates must fulfill specific educational requirements and obtain relevant certifications. Here’s an overview:

Educational Requirements

The primary educational requirement for becoming a hospitalist PA is to complete a Master’s degree program in Physician Assistant Studies. These programs typically last around two to three years and include both classroom instruction and clinical rotations.

While a Master’s degree in Physician Assistant Studies is the most common path, some programs may accept candidates with a Master’s degree in a related field such as biology, medicine, health sciences, or nursing. However, candidates with degrees in these related fields may need to complete additional coursework to meet the specific requirements of PA programs.


Certification as a Physician Assistant-Certified (PA-C) is a fundamental requirement for practicing as a PA in any specialty, including hospital medicine. This certification is obtained by passing the Physician Assistant National Certifying Exam (PANCE) administered by the National Commission on Certification of Physician Assistants (NCCPA).

While not always mandatory, certifications in specialties relevant to hospital medicine, such as General Surgery, Emergency Medicine, or Family Medicine, are often highly desirable. These certifications demonstrate additional expertise and may enhance a PA’s qualifications for hospitalist positions.

Clinical Rotations

As part of their Master’s degree program, aspiring hospitalist PAs undergo extensive clinical rotations in various medical specialties, including internal medicine, emergency medicine, and critical care. These rotations provide hands-on experience and exposure to the diverse range of conditions encountered in hospital settings.

Continuing Education

Beyond initial certification and education, hospitalist PAs are encouraged to engage in continuing education to stay current with advances in medical knowledge and best practices. This may include attending conferences, participating in workshops, or pursuing additional certifications or advanced degrees.

By completing a Master’s degree program in Physician Assistant Studies or a related field, obtaining relevant certifications, and gaining clinical experience through rotations, aspiring hospitalist PAs can acquire the necessary skills and qualifications to excel in the dynamic field of acute care medicine.

Fellowship Programs Available for Aspiring Hospitalist PAs

Fellowship programs play a crucial role in enhancing the skillset and knowledge base of aspiring hospitalist physician assistants (PAs). These programs provide an opportunity to gain specialized training in hospital medicine, allowing PAs to excel in this field. One notable program is the University of Missouri School of Medicine’s 12-month postgraduate PA Fellowship in Hospital Medicine.

The University of Missouri’s fellowship program aims to equip PAs with the necessary tools to thrive in a hospitalist role. The 12-month duration allows participants to delve deep into the complexities of hospital medicine while receiving hands-on training from experienced physicians and PAs. During this fellowship, participants have the opportunity to rotate through various specialty areas, gaining exposure to a wide range of patient cases and treatments.

Those who successfully complete the University of Missouri fellowship program are eligible to obtain a Certificate of Added Qualifications (CAQ) in Hospital Medicine. This certification acknowledges the additional expertise and advanced skills acquired through the fellowship program. Having a CAQ in Hospital Medicine distinguishes PAs as highly qualified professionals in hospitalist care.

Core Competencies

Becoming a hospitalist PA (Physician Assistant) can be a rewarding career path for those interested in providing quality healthcare in the hospital setting. As a hospitalist PA, individuals have the opportunity to work alongside physicians, helping manage and treat patients throughout their hospital stay. To excel in this role, certain core competencies are necessary.

1. Strong Medical Knowledge and Skills

To become a hospitalist PA, a solid foundation in medical knowledge is crucial. The ability to understand and interpret complex medical information is vital, as hospitalist PAs often collaborate with physicians in diagnosing and treating patients.

Having a broad knowledge base in various medical fields, such as internal medicine, emergency medicine, and critical care, will allow hospitalist PAs to effectively manage a wide range of conditions. Additionally, honing clinical skills such as physical examination, diagnostic testing interpretation, and treatment planning will further enhance the ability to provide exceptional patient care.

2. Effective Communication and Interpersonal Skills

Hospitalist PAs work closely with patients, families, physicians, and other healthcare professionals. Thus, strong communication and interpersonal skills are essential for success in this role.

As a hospitalist PA, one must be able to effectively communicate complex medical information to patients and their families clearly and compassionately. Good listening skills are also crucial to understanding patients’ concerns and addressing them appropriately.

Furthermore, effective collaboration and teamwork with physicians and other healthcare professionals are vital for providing cohesive and comprehensive care.

3. Critical Thinking and Problem-Solving Abilities

Hospitalist PAs frequently encounter challenging medical cases that require critical thinking and problem-solving abilities. The ability to analyze complex situations, evaluate multiple diagnostic possibilities, and make sound decisions is essential for providing high-quality patient care. Hospitalist PAs must demonstrate strong clinical reasoning skills, using evidence-based practices to formulate treatment plans and make informed decisions that optimize patient outcomes.

4. Adaptability and Flexibility

The hospital environment can be fast-paced and dynamic, with patient conditions rapidly changing. Hospitalist PAs must be adaptable and flexible, able to handle unexpected situations.

Required Clinical Skills for Hospitalist PAs

Hospitalist PAs, or Physician Assistants, play a vital role in the healthcare field by providing comprehensive care to patients in hospital settings. To become a successful hospitalist PA, individuals must possess a range of clinical skills that are essential for effectively diagnosing and treating patients.

One of the primary skills required for hospitalist PAs is patient assessment. This involves gathering relevant medical history, performing thorough physical examinations, and assessing the overall condition of patients. By closely observing the symptoms and analyzing the data, hospitalist PAs can accurately diagnose and create personalized treatment plans.

In addition to patient assessment, hospitalist PAs must be skilled in developing treatment plans. They must have a deep understanding of various medical conditions, their causes, and appropriate treatment options. This skill requires good knowledge of evidence-based medicine and the ability to critically evaluate the best course of action for patients.

Another critical clinical skill for hospitalist PAs is the interpretation of diagnostic tests. This involves analyzing laboratory results, radiological findings, and other medical tests to aid in diagnosing and monitoring patients’ conditions. Being able to accurately interpret these tests is crucial in providing appropriate and timely interventions.

Lastly, hospitalist PAs should possess prescribing authority to administer medications when necessary. This skill demands a comprehensive understanding of pharmacology to ensure proper dosage, administration, and potential drug interactions.

Medical Knowledge Needed for Success in Hospital Medicine Practice

Hospital medicine practice is a specialized field that requires a high level of medical knowledge and the necessary skills and competencies. To become a successful hospitalist physician assistant (PA), it is essential to have a strong foundation in general medicine, as well as familiarity with various medical and surgical specialties.

Hospitalists PAs must possess a deep understanding of medical knowledge to effectively diagnose and manage patients in the hospital setting. This includes a comprehensive knowledge of various diseases, including their pathophysiology, clinical presentation, and treatment options. Additionally, PAs should have competence in interpreting diagnostic tests, such as laboratory results and imaging studies.

In hospital medicine practice, it is crucial to have a broad understanding of general medicine. Hospitalists PAs should be proficient in managing common medical conditions, such as pneumonia, heart failure, and diabetes. They should also be familiar with acute care medicine, including the management of critically ill patients in the intensive care unit.

Furthermore, familiarity with various medical and surgical specialties is essential for a hospitalist PA. This includes understanding the unique aspects and management of specialties like cardiology, pulmonology, gastroenterology, and neurology. Collaboration with specialists and effective communication is vital for providing comprehensive care to patients.

In addition to medical knowledge and general medicine, hospitalist PAs should have proficiency in specific procedures and interventions. These may include performing central line insertions, lumbar punctures, joint aspirations, and minor surgical procedures. They should also be skilled in managing respiratory distress, performing bedside ultrasound, and interpreting electrocardiograms.

Didactic Instruction to Prepare for Working in a Clinical Setting

Didactic instruction plays a vital role in preparing individuals to become hospitalist physician assistants (PAs). These instructional sessions are designed to provide the knowledge and skills necessary to excel in a clinical setting.

By incorporating various structured weekly sessions, such as internal medicine education conferences, case and procedure simulations, assigned readings, and certification courses, aspiring hospitalist PAs can acquire the essential information and experience needed to thrive in their role.

One crucial aspect of didactic sessions is the internal medicine education conference. These conferences provide fellows with a platform to stay updated on the latest advancements and guidelines in internal medicine. Through interactive discussions and presentations, fellows can develop a deep understanding of various medical conditions and their management.

Additionally, case and procedure simulations are a key component of didactic instruction. These simulations allow fellows to practice their skills in a controlled environment, mimicking real-life scenarios. By participating in these simulations, aspiring hospitalist PAs can enhance their diagnostic and procedural abilities, ensuring they are well-prepared to handle a wide range of patient cases.

Assigned readings are another essential element of didactic instruction. Fellows are expected to delve into relevant medical literature to gain a comprehensive understanding of various diseases, treatment modalities, and evidence-based practices. These readings serve as a foundation for clinical decision-making and provide fellows with the necessary background knowledge to provide high-quality patient care.

Lastly, certification courses are often incorporated into didactic sessions. These courses cover topics such as advanced cardiac life support (ACLS) and basic life support (BLS), among others. By becoming certified in these courses, aspiring hospitalist PAs demonstrate their commitment to patient safety and acquire the skills needed to respond effectively to medical emergencies.

Experience in Hospital Medicine

Becoming a hospitalist physician assistant (PA) requires a solid background and experience in hospital medicine. Hospitalist PAs work closely with physicians and other healthcare professionals to care for patients admitted to the hospital.

Their role primarily involves diagnosing and treating acute and chronic illnesses, managing complex medical conditions, and coordinating patient care during hospital stays. To embark on the journey of becoming a hospitalist PA, individuals must focus on gaining relevant experience that will prepare them for the demands of this specialized field.

One crucial step towards building experience in hospital medicine is pursuing a Bachelor’s degree. Many aspiring hospitalist PAs choose to major in a science-related field, such as biology or chemistry, to ensure a strong foundation in the sciences. Throughout their undergraduate education, students can also take advantage of volunteer opportunities or internships in hospitals or healthcare settings to gain exposure to clinical environments.

After completing a Bachelor’s degree, the next step is to enroll in an accredited PA program. These programs typically require applicants to have completed prerequisite courses in the sciences, as well as have a significant number of patient care experience hours.

During PA school, individuals learn a broad range of medical knowledge and skills, including clinical rotations in various specialties. To gain specific experience in hospital medicine, students can seek out rotations in internal medicine or emergency medicine, where they will have the opportunity to work closely with hospitalists and observe their practice.

Once PA school is completed, new graduates may choose to pursue a residency or fellowship program to further specialize in hospital medicine. These programs provide additional training and hands-on experience in managing complex medical conditions commonly encountered by hospitalists. It is during these post-graduate programs that aspiring hospitalist PAs can refine their skills, gain confidence, and build a strong foundation in the field.

In addition to formal education and training, individuals can also gain experience in hospital medicine through employment in healthcare settings that offer exposure to inpatient care. Working as a medical assistant, nurse, or other healthcare provider in a hospital or a clinic can provide valuable insights into the unique challenges and dynamics of hospital medicine. This experience can also give aspiring hospitalist PAs the opportunity to work alongside hospitalists and observe their practice firsthand.

Continuous professional development is crucial for individuals seeking to excel in hospital medicine. Participating in relevant continuing medical education (CME) courses, attending conferences, and joining professional organizations focused on hospital medicine can help hospitalist PAs stay updated on the latest advancements and best practices in their field. Additionally, seeking out mentorship opportunities with experienced hospitalist PAs can provide invaluable guidance and support throughout one’s career.

Importance of Gaining Experience in a Hospital Setting

Gaining experience in a hospital setting is of utmost importance for individuals aspiring to become a Hospitalist Physician Assistant (PA). This experience not only provides a better understanding of hospitalist pay but also allows for enhanced patient care.

Working in a hospital setting provides firsthand knowledge of hospital operations, patient dynamics, and financial considerations that directly impact hospitalist pay. By being immersed in this environment, individuals can gain a comprehensive understanding of the unique challenges and opportunities that come with being a hospitalist PA.

One of the key benefits of working in a hospital setting is the exposure to diverse patient cases and medical conditions. This exposure allows PAs to develop clinical skills and expertise that are vital for providing effective patient care. Being exposed to a variety of cases also helps in expanding the PAs’ knowledge base, making them more well-rounded healthcare professionals.

Furthermore, experience in the hospital setting also provides insights into the intricacies of hospital operations. PAs can learn about the administrative and logistical aspects of patient care, such as hospital protocols, coordinating with other healthcare professionals, and navigating electronic health records systems.

Finally, firsthand experience in a hospital setting is crucial for understanding the financial considerations that impact hospitalist pay. PAs can gain insights into billing and coding practices, resource allocation, and the financial challenges faced by hospitals. This knowledge can be instrumental in negotiating salaries and advocating for fair compensation as hospitalist PAs.

Gaining experience in a hospital setting is vital for those aspiring to become hospitalist PAs. It offers a unique opportunity to understand the complexities of hospital operations, patient dynamics, and the financial considerations that impact hospitalist pay. By immersing themselves in this environment, individuals can develop the skills and expertise necessary for providing exceptional patient care as hospitalist PAs.


How important is the Hospitalist CAQ Exam? Think of the CAQ as a Physician would being Board Certified.  It is not necessary for every job, but it can really help you. Aristotle once stated, “The roots of education are bitter, but the fruit is sweet.”  As you advance your Hospitalist career, the CAQ will help you obtain more opportunities and rewards.

Can Hospitalists PAs still specialize? Yes, many opportunities arise for the Hospitalist PAs to refine his or her skills to a specialty.  Sometimes the specialty is dictated by the setting such as a Pediatric Hospitalist.  Other times, larger practices employ hospitalists to cover patients such as Cardiology, GI, or Oncology Hospitalist to name a few.

What are the best rotations to start your career as a Hospitalist PA?  Most Hospitalist PAs are employed either by Hospitals or by large multi-specialty groups.  If you want to start your career as a hospitalist PA try to perfrom as many rotations with hospitals or medical practices that employ Hospitalists.  Your first job may not be as a Hospitalists, but becoming a PA for a hospital or large multi-specialty practice allows you to grow your medical knowledge and personal brand so you are ready when the opportunity comes available.

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