Essential Functions Required for Admission, Continuation and Graduation

A candidate for the Master of Medical Science (MMS) degree in Physician Assistant Studies must be able to demonstrate intellectual-conceptual, integrative and quantitative abilities; skills in observation, communication and motor functions; and mature behavioral and social attributes.

Technological compensation can be made for some handicaps in certain areas, but a candidate should be able to perform in a reasonably independent manner without a trained intermediary. (The use of a trained intermediary means that a candidate’s judgment must be mediated by someone else’s power of selection and observation.)

Observation

The candidate must be able to observe demonstrations and experiments in the basic sciences, including but not limited to physiologic and pharmacologic demonstrations in animals, microbiologic cultures and microscopic studies of microorganisms and tissues in normal and pathologic states.

A candidate must be able to observe a patient accurately at a distance and close at hand. Observation necessitates the functional use of the sense of vision and somatic sensation. It is enhanced by the functional use of the sense of smell.

Communication

A candidate should be able to speak, hear and observe patients in order to elicit information; describe changes in mood, activity, and posture; and perceive nonverbal communications.

A candidate must be able to communicate effectively and sensitively with patients. Communication includes speech, as well as reading and writing. The candidate must be able to communicate effectively in oral and written form with all members of the health care team.

Motor

Candidates should have sufficient motor function to elicit information from patients by palpatation, auscultation, percussion and other diagnostic maneuvers. A candidate should be able to execute motor activities reasonably required to provide general care, to perform diagnostic procedures and to provide emergency treatment to patients.

Examples of emergency treatment reasonably required of physician assistants are cardiopulmonary resuscitation (CPR), the administration of intravenous medication and the application of pressure to stop bleeding. Such actions require coordination of both gross and fine muscular movements, equilibrium, and functional use of the senses of touch and vision.

Intellectual-Conceptual, Integrative and Quantitative Abilities

Intellectual-conceptual, integrative and quantitative abilities include measurement, calculation, reasoning, analysis and synthesis. Problem-solving, the critical skill demanded of physician assistants, requires all of these intellectual abilities. In addition, the candidate should be able to comprehend 3-dimensional relationships and to understand the spatial relationships of structures.

Behavorial and Social Attributes

A candidate must possess the emotional health required for full utilization of intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive, and effective relationships with patients.

Candidates must be able to tolerate physically taxing workloads and to function effectively under stress. They must be able to adapt to changing environments, display flexibility and learn to function in the face of uncertainties inherent in the clinical problems of many patients.

Commitment to excellence, service orientation, goal-setting skills, academic ability, self-awareness, integrity and interpersonal skills are all personal qualities that are assessed during the admission and education process. Because the nature of medical education is based on a mentoring process, candidates are expected to be able to accept criticism and respond by appropriate modification of behavior.

Addendum to the Technical Standards

In addition to the existing text incorporated within the Essential Functions Required for Admission, Continuation and Graduation, there are specific needs that are relevant to successful completion of curriculum requirements. This addendum provides specific examples to enhance the interpretation of the Technical Standards, particularly within the “Motor” and “Behavioral and Social Attributes” categories.

During the pre-clinical year, students are required to master the skills of a complete physical examination. They must complete Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) instruction and certification processes.

They are required to attend a variety of clinical observational sessions that may involve some patient interaction. These sessions are scheduled at a variety of times and days not limited to 8 am to 5 pm, Monday through Friday. They must be available to meet when sessions are available for the mastery of the curriculum objectives. This includes evening and weekend obligations.

During the clinical year, several mandatory rotations, such as Surgery, OB/Gyn, Emergency Medicine and Inpatient Medicine require extended hours, with start times as early as 5 am. Evening, night and weekend shifts are common and can usually extend into 12- to 14-hour days.

Specifically, the OB/Gyn rotation necessitates daytime and over-night shifts (totaling 24 or more hours) to expose the student to the full spectrum of care for patients in the Labor and Delivery suites. As a result, students must be able to physically and psychologically perform capably and competently with moderate degrees of sleep deprivation.

Physical needs within the surgical rotations are fairly strenuous, particularly with respect to responsibilities in the Operating Room or Suite. Many surgical procedures last for 3-5 hours or more and a student may be required to stand in one place for that entire time with minimal rest or breaks.

In emergency situations, patients may need to be moved, turned or resuscitated, and the PA student may be in situations that necessitate short periods of bending, lifting or partial lifting, reaching, squatting or straining.

In hospital rotations, students may be required to cover large areas of space (different patient-care floors, different wings or sections within institutional building structures). They must be able to transport themselves from one location to another in a timely fashion in order to facilitate patient care responsibilities and to receive educational training (such as in morning rounds).