Conducting global research, IAPAE has identified seventy plus countries around the world that have PA and PA Analogue education programs. There are more than thirty-five different country practice titles for these clinical practitioners including asociado médico, assistant medical officer, clinical associate, clinical health officer, clinical officer, community health officer, emergency surgical officer, feldsher, medical assistant/associate, medical licentiate, medical extension officer, physician assistant/associate, techniques paramédicales, técnicos de cirurgia and técnicos de medicina.

Their history can be traced back to Peter the Great in the 17th century utilising feldshers in his Russian army to treat battlefield soldiers. In the late 18th century, Malaysia began training a medical assistant, which is still providing medical care today. In the 19th century, France utilised the officier de santé, Puerto Rico trained the practicantes for primary healthcare and Sri Lanka educated the apothecaries. In 1896, Africans were educated as medical dressers and hospital assistants, which evolved to medical assistants and later became the title used today in much of Africa as clinical officer. In 1965 the physician assistant profession started in the United States and in the beginning of the 21st century PA education started in Europe and the United Kingdom using the title physician associate.

Per the International Labour Organisation, these clinical practitioners are under the category of Health Professional Paramedical Practitioner. The International Standard Classification of Occupations 2008 describes their scope of practice as:

“conducting physical examinations of patients; performing medical and surgical procedures, including prescribing and administering treatments, medications and other preventive or curative measures, especially for common diseases and disorders; administering or ordering diagnostic tests, such as X-ray, electrocardiogram and laboratory tests; performing therapeutic procedures and infection management; assisting medical doctors with complex surgical procedures; monitoring patients’ progress and response to treatment, and identifying signs and symptoms requiring referral to medical doctors; advising patients and families on prevention or treatment of disease and disorders; identifying and referring complex or unusual cases to medical doctors, hospitals or other places for specialized care.”

Read the ILO Report – International Standard Classification of Occupations ISCO-08