What training does a PA-C have?
A PA-C has graduate-level medical training, a national certification and a state license. According to the Bureau of Labor Statistics, physician assistants typically earn a master’s degree from an accredited program, usually at least two years of study after a bachelor’s degree, with supervised clinical training across several specialties. Applicants usually come in with hands-on patient care experience.
The “C” means certified. A PA must pass a national exam to be licensed and use the PA-C title, then keep it through continuing education and a recertification exam. California adds its own renewal rules on top.
A physician’s path is longer. The BLS physicians page describes four years of medical school after college, followed by a residency of 3 to 9 years depending on the specialty.
| PA-C | Physician (MD) | |
|---|---|---|
| Core training | Master’s program, usually 2+ years | 4 years of medical school |
| Training after school | Clinical rotations within the program | Residency, 3 to 9 years |
| National exam | Certification exam for the PA-C title | National licensing exams |
| California license | Physician Assistant Board | Medical Board of California |
| Practice basis | A practice agreement with a supervising physician | Own license |
How does supervision work in California?
In California, every PA practices under a written practice agreement with one or more physicians. Since January 1, 2020, under SB 697, that agreement replaced the older delegation of services agreement. The Physician Assistant Board’s SB 697 bulletin explains that it must spell out:
- the types of medical services the PA may perform;
- policies that ensure adequate supervision, including communication, consultation and referral;
- how the PA’s competency is evaluated over time;
- which medications the PA may furnish or order, and under what circumstances.
Supervision means a licensed physician oversees and accepts responsibility for the PA’s medical services. The physician does not have to be in the room, but must be available by phone or another electronic method when the PA examines a patient. The current California PA laws and regulations booklet also limits each physician to supervising no more than eight PAs at a time.
Does it matter for testosterone care?
For testosterone therapy, the process matters more than the title on the badge. Good TRT care means confirming low testosterone with two early-morning tests and fitting symptoms, ruling out other causes, choosing a formulation, then monitoring hematocrit, PSA and testosterone on schedule. A PA-C who does this work every day is well placed to run it.
Testosterone is a Schedule III medication, and California allows a PA to furnish or order it when the practice agreement says so. What you should look for is a clear path to physician input when a case gets complicated.
When should a physician be directly involved?
Some situations call for physician input or a specialist, whoever you see first. Examples include a PSA that keeps rising, a hematocrit that stays high despite dose changes, a past blood clot, recent heart problems or a pituitary finding on labs. A practice agreement is built to handle exactly these moments, with set ways to consult and refer.
If you are weighing different ways to get care, our comparison of online TRT and an in-person clinic covers what changes when exams and blood draws happen on site.
Who will you see at Ultimate Male?
Your consultation is one-on-one with a PA-C or an MD. Matthew A. Schafer, PA-C, is Clinical Director and Lead Provider, a former EMT and paramedic with more than 15 years in medicine; you can read more on Matthew Schafer’s profile. David A. Nyberg, MD, a Stanford graduate and former Professor of Radiology, serves as Medical Director and oversees medical care at the clinic, so a physician stands behind every care plan, in line with California’s practice agreement rules. His background is on Dr. Nyberg’s profile.
The path into care is the same either way: a free 10-minute call, same-day labs on site in San Gabriel or Downey, then a TRT consultation to review results. A consultation is an evaluation, and testosterone therapy is offered only when your labs and symptoms support it.
How can you check a provider’s license?
Any California PA or physician license can be looked up in minutes. The Department of Consumer Affairs license search shows the license type and whether it is current. It is a good habit before any new clinic visit, and our page on what happens at a first TRT consultation explains what to bring and ask once you book.
