Differential Certification of Physician's Assistants

The National Board of Medical Examiners is in the process of preparing an evaluation technique for "Type A physician's assistants," which was defined by the Board of Medicine of the National Academy of Sciences as "distinguished by his ability to integrate and interpret findings on the basis of general medical knowledge and to exercise a degree of independent judgment."1 It appears to this writer that there is a great deal of variability in the training and utilization of what is now broadly characterized as the "Type A physician's assistant." In order to be assured that people are properly qualified for tasks that they are performing, without instituting undue pressures on individual training programs to conform with a standard training policy, it would appear necessary to devise a means of certification that takes into consideration the varied training and utilization practices of these individuals. The writer therefore presents a challenge to