The Accreditation Review Commission on Education for the Physician Assistant in September granted accreditation to the surgical PA postgraduate residency program at Duke University Medical Center in Durham, N.C.

The Duke surgical PA residency is the third postgraduate program accredited by ARC-PA since the commission made the controversial decision in 2005 to begin formally accrediting postgraduate PA programs. In March, ARC-PA granted accreditation to the surgical PA residency at Johns Hopkins Hospital in Baltimore and the oncology PA postgraduate program at M.D. Anderson Cancer Center in Houston.

Duke's 12-month surgical PA residency usually accepts between four and eight PA residents a year (the current class has five) and has separate tracks for cardiothoracic surgery and general surgery.

The program's first month is didactic and includes lectures, online learning modules, simulation training and shadowing. The remaining 11 months involve various clinical rotations at Duke University Medical Center. Duke PA residents generally perform duties similar to those of first-year physician residents. PA residents work 80-hour weeks during the program and receive a stipend and benefits.

"It's a tough program. You really are working 80 hours a week, and you don't know what that's like until you do it," says Duke surgical residency program director Alicia Brown, PA-C. "But the great thing it gives you is experience that I don't think you can get from on-the-job training."

Residents in the cardiothoracic surgery track do spend a one-month rotation in general surgery but focus almost exclusively on CT surgery. The CTS residency includes two months with CTS PAs, two months in the acute coronary care unit and a rotation in the surgical ICU.

General surgery residents do rotations in surgical subspecialties as well as general surgery.

The program attracts recent PA graduates as well as experienced PAs who seek experience in surgery.

"We get a combination of everyone," Brown says. "We get a lot of new graduates, but we also get people who have been working as PAs for a long time and decide to come back and get surgical training. We get a lot of applicants from internal medicine and family medicine and people at all different levels (of experience)."

Completing the surgical residency gives PAs an edge when seeking jobs in competitive surgical fields, Brown says. That's particularly true in cardiothoracic surgery, a demanding specialty that requires a unique skill set.

"It depends what (graduates) are looking for," Brown says. "When we have jobs available (at Duke University Medical Center), we encourage people to stay. People who are flexible tend to find what they are looking for."

Although the process of obtaining ARC-PA accreditation was arduous, Brown thinks it was worth it for the program. Accreditation also can be helpful for prospective students who want assurance that the residency provides quality education. Twelve of the Association of Postgraduate Physician Assistant Programs' 41 members are surgical programs.

"I knew that we had a good program here, and I wanted to document that," Brown says.