The Society of Emergency Medicine Physician Assistants (SEMPA) released updated emergency medicine physician assistant (EMPA) practice guidelines on continuing education, skill competency, and curriculum for postgraduate emergency medicine education programs as well as recommendations for EMPA employers to consider implementing. To learn more about these guidelines, we spoke with SEMPA Immediate Past President Ann Verhoeven, MMSc, PA-C. Ms Verhoeven also serves as chair of the Postgraduate Education Committee. She has been an EMPA for 20 years and works at Regions Hospital in Saint Paul, MN, where she is the program director of the Emergency Medicine Physician Assistant Residency.

Q: What were SEMPA’s goals in issuing these guidelines?

Ms Verhoeven: The founders of SEMPA were brought together in the fall of 1989 when the American College of Emergency Physicians (ACEP) sought to create guidelines on the utilization of physician assistants in the emergency department. ACEP reached out to the director of the EMPA residency at the University of Southern California Los Angeles County Medical Center, who became the first president of SEMPA, for practice recommendations. With the increased utilization of PAs in emergency medicine, subsequent SEMPA leaders established the initial formal EMPA practice guidelines in 2012 to provide a framework for PAs entering the field and for the employers of EMPAs to use at their practice sites. This year, the guidelines were revised to reflect the current practice environment for EMPAs.

Q: What are the key points our readers should know about the guidelines?

Ms Verhoeven: The guidelines were created by EMPAs for EMPAs and their employers as a guide to what are thought to be best practices for the education, continuing education, training, and utilization of PAs in the field of emergency medicine (Table).

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EMPAs should be aware that the emergency medicine physician representative organizations have been expressing concerns about the educational preparation of PAs and NPs for some time and are currently discussing the desire to take measures to limit our scope of practice and to determine our educational training and experience requirement criteria to practice in emergency medicine. SEMPA believes that a PA’s scope of practice should be determined by PA representative organizations, which is one of our goals for outlining the practice guidelines and updating them.

The guidelines outline practices that are already in place at many, if not most, practice sites.

Table. Excerpts of SEMPA Practice Guidelines

Pursue a minimum of 25 hours of Category I continuing education in emergency medicine through SEMPA, ACEP, or AAPA-approved or sponsored educational programs.
PAs newly entering the emergency medicine field should seek education that parallels the curriculum outlined in the SEMPA guidelines
EMPAs practicing in a critical access hospital practice setting should follow recommendations for all PAs in emergency medicine and those outlined in the Rural EMPA Practice Guidelines
Curriculum for postgraduate EMPA programs should:
• Follow The Model of the Clinical Practice of Emergency Medicine (American Board of Emergency Medicine)
• Appoint an emergency physician as medical director and an EMPA as program director
• Follow the 2021 SEMPA Postgraduate Education Program Standards
AAPA, American Academy of PAs; ACEP, American College of Emergency Medicine; EMPA, emergency medicine physician assistant

Q: What is new in the revised guideline?

Ms Verhoeven: The structure and much of the content of the guidelines are unchanged. The revised guidelines include more detail regarding recommended best practices for ensuring that adequate emergency medicine knowledge and experience for EMPAs is achieved and supported by employers. The update also includes recommendations for employers that EMPAs be represented in their leadership structure and involved in developing and maintaining best practices for EMPAs at their clinical sites.

Q: What are the benefits of formal training for EMPAs rather than practice-based training?

Ms Verhoeven: Formal training allows EMPAs to refine their knowledge and skills at an accelerated rate compared with practice-based training. Many postgraduate EMPA programs have rotations in other specialty areas pertinent to emergency medicine practice that are valuable for the complex and often critically ill patients who are encountered in the emergency medicine practice environment. While formal training programs are advantageous, SEMPA is not advocating that postgraduate program completion be a requirement.

Q: Is there anything else you would like to tell our readers?

Ms Verhoeven: Being a member of your specialty organization is one way to remain informed about the important issues that affect your practice and to help advocate for yourself and your colleagues. SEMPA has a seat at the table and is working hard to represent the interests of EMPAs. The more voices we hear from the better we can represent you.


Society of Emergency Medicine Physician Assistants. Emergency Medicine Physician Assistant Practice Guidelines. September 2021. Accessed September 30, 2021.