Physician assistants as primary investigators: options for advancing your career through clinical research

The majority of physician assistants (PAs) utilize their degrees to provide direct patient care in clinical medicine, but there are many other career options for PAs to consider, including those in clinical research. PAs working in clinical research are most frequently assigned the role of sub-investigator (sub-I). The sub-I functions under the supervision of the principal investigator (PI), who is ultimately responsible for all duties related to the clinical trial at their clinical site. The dynamic between sub-I and PI is similar to the relationship between PA and collaborating physicians in a clinical practice setting. Sub-Is and PIs share similar responsibilities related to the clinical aspects of the trial, and sub-Is can be delegated to perform clinical trial tasks including evaluating and consenting study participants, performing interim visits, ensuring the safety of study participants, and providing concise and timely documentation. Beyond these clinical research tasks, the PI has additional responsibilities, including reviewing all documentation, verifying that protocols are being followed, and ensuring patient safety. The role of the PI is typically reserved for physicians, though no regulations mandate this. Experienced research PAs should consider challenging these norms and seek out opportunities to progress into the PI role as an avenue for career development. This article examines the prerequisites required to hold the role of PI and encourages PAs to consider and advocate for this nontraditional career path.