The physician assistant profession started in October 1965, when Duke University launched the first PA training program under the direction of Eugene A. Stead, Jr., M.D. The program enrolled four former Navy corpsmen in a two-year curriculum designed to help address a growing shortage of doctors across the United States. Two years later, on October 6, 1967, the first class of three PAs graduated from Duke.
Why the PA Role Was Created
By the early 1960s, the United States was facing what scholars and the press called a national “doctor shortage.” Rising affluence, population growth, and advances in medical treatment were all driving demand for healthcare that the existing physician workforce couldn’t meet, particularly in rural and underserved communities. The problem wasn’t unique to the U.S. Between 1963 and 1979, the country accepted over 60,000 foreign medical graduates just to help fill the gap, and countries like Canada and the United Kingdom were doing the same.
Economists at the time argued that training more doctors was only part of the solution. Rashi Fein, a health economist, suggested that increased reliance on “medical auxiliaries” could do just as much to meet the demand for care. That idea resonated with Dr. Stead, who had already been using former military corpsmen to help run specialty units at Duke’s medical center. These corpsmen had extensive hands-on clinical training from their military service but no civilian credential that reflected their skills. Stead saw an opportunity to formalize their experience into a new medical role.
The First Program at Duke University
Dr. Stead designed a two-year curriculum that built on the clinical knowledge corpsmen already had, expanding it into a broader medical education. The first class consisted of four former Navy corpsmen recruited specifically because their military medical training gave them a strong foundation. The program was housed within Duke’s Department of Medicine, and its structure borrowed elements from both medical school and nursing education.
Of the original four students, three completed the program and graduated on October 6, 1967: Victor H. Germino, Kenneth F. Ferrell, and Richard J. Scheele. They became the first formally trained physician assistants in the country.
How the Profession Gained Legal Standing
In the years after Duke’s first graduates entered practice, the PA model spread quickly. Other universities began developing their own programs, and by the early 1970s the profession was gaining formal recognition. In 1971, the American Medical Association officially recognized the PA profession, and the first six states passed legislation authorizing PAs to practice.
National certification followed shortly after. In December 1973, the first certifying exam was administered to 880 PA candidates. By 1975, those who passed were issued certificates designating them as “Physician Assistant, Certified” (PA-C), a credential that remains the national standard. The National Commission on Certification of Physician Assistants (NCCPA), the organization that still oversees PA certification today, was formally established in 1974 through a collaboration of 14 national organizations convened by the AMA and the National Board of Medical Examiners.
Growth From One Program to Over 300
What started as a single experimental program at Duke has expanded into a major component of the U.S. healthcare system. As of 2025, there are 322 accredited PA programs across the country. The profession has also expanded internationally. Canada graduated its first formally trained PAs in 1984 through its military medical services. The Netherlands introduced the PA role in 2001, and the United Kingdom began recruiting American PAs to work in primary care in 2003, eventually establishing its own training pipeline.
The Shift to “Physician Associate”
The profession’s name is currently in transition. The American Academy of Physician Associates (formerly the American Academy of Physician Assistants) has been advocating for a title change from “physician assistant” to “physician associate,” arguing that the new title better reflects the collaborative, autonomous nature of modern PA practice. Oregon became the first state to officially make the change in 2024, followed by Maine and New Hampshire. The shift is still in its early stages, with most states continuing to use the original title in their licensing laws.