Educational decentralization and deployment of physician’s assistants

A community-based educational network was established to improve the deployment of physician’s assistants away from the original site of training in California’s San Francisco Bay Area. The philosophy underlying the program decentralization, lessons learned during its implementation, and outcomes of the decentralization are discussed. The graduates’ practice locations for a seven-year period are compared before and after the decentralization of the program. Before decentralization, 58 percent of the graduates established their first practice outside of the Bay Area. Following decentralization, 100 percent of the students trained entirely within community settings took their first jobs away from the Bay Area. Unique aspects of this decentralization experience compared with those reported previously included the lack of a required student-preceptor match at the time of entry into the program, the provision of clinical training in or near the site of student residence, and the opportunity to compare before and after effects of decentralizing educational components other than preceptorships.