St. Scholastica starting physician assistant program

The launch of a physician assistant graduate program in Duluth "is going to be part of the solution" to a shortage of doctors, particularly in remote areas, a rural health expert said.

"There certainly is a need," said Kate Dean, executive director of the Essentia Institute of Rural Health. "We're very excited to have this program off the ground and running."

The College of St. Scholastica will welcome its first class of 30 students to the two-year program in September, said Bruce Loppnow, dean of the college's School of Health Sciences. It will be housed in the school's Health Science building, which opened last year in the BlueStone development, about a mile from the main campus.

The program's inauguration is to be officially announced on Friday.

It's one response to an acute shortage of doctors, said Dr. Kim Kruger, who was named in 2014 to direct the St. Scholastica program. Physician assistants, with a training time of two years - compared with four years plus a three-year residency for physicians - can be brought into the field much faster, she said.

But there aren't enough physician assistants to fill the gap.

"There are about 60 PA positions open in northern Minnesota right now," she said. "And that growth is going to continue. It's a 40 percent growth rate annually."

Median salary for a physician assistant in 2016 was a little more than $100,000 per year, according to the U.S. Department of Labor's "Occupational Outlook Handbook."

Three other Minnesota schools offer physician assistant programs - Augsburg College, St. Catherine University and Bethel University, all in the Twin Cities metro area. The students accepted to St. Scholastica's program - out of about 200 applicants - were chosen with rural northern Minnesota in mind, Kruger said.

"We look at students who are from Minnesota, northern Wisconsin, they come from rural communities, they have a long history of service in their own lives up to this point, they're interested in the servanthood of medicine," she said. "We know those are the students that end up going back to those communities to practice."

Serving her home area was one of the things cited by Natalie Castle, who grew up in Bovey and will be in the first class.

"I knew the shortage of providers there, and it'd take a while for me to be an MD and go back," said Castle, 23. "And I kind of want to get into the field to make a difference now."

Like some of the other students, Castle already had been accepted when it was planned that the program would open in 2016.

The decision to wait a year before seeking accreditation was difficult but right, Kruger said.

"We had to be real about it," she said. "We can't afford to not do it well. ... We just had to be sure that we had it right."

That included overhauling the original curriculum to focus on rural medicine, primary care and being "practice-ready" immediately upon graduation, she said.

Grand Rapids native Patrick Nelson, who previously worked as a paramedic and as a research fellow at the National Cancer Institute, also had an extra year to wait before beginning his physician assistant training. He was philosophical about the wait.

"I never had any question that if it's going to start it's going to be a good program from the get-go," he said.

The class size will grow to 34 next year and 38 the following year, Kruger said. Students will experience intensive classroom and lab training during the fall, spring and summer semesters of the first year and then will be assigned to monthlong clinical rotations the second.

St. Scholastica already has a nurse practitioner program. The two careers are similar, but different, Kruger said. Nurse practitioners are trained under the nursing model, which is focused toward a holistic patient approach. Physician assistants, like physicians, are trained under the medical model, "which means you have a problem or a pathology, and you need to fix it."

Nurse practitioners can work independently, Kruger added, whereas physician assistants always work under a doctor's supervision. But that doesn't mean the PA is in the same room as the doctor.

"You may have one physician in Brainerd but then five PAs in the surrounding communities that that physician is responsible for," she said. "Those communities still can get the access and care that they need."

Both physician assistants and nurse practitioners are essential in helping to fill the health provider gap, said Terry Hill, senior adviser to the Duluth-based National Rural Health Resource Center.

"Physician assistants and nurse practitioners become an extremely important part of these medical teams," he said. "In many cases, without them we simply would see the collapse of the local (health) system."