This job description is designed to provide a basic guideline for the Physician Assistant in Urology. In general, PAs are authorized to perform any duties delegated to them by their supervising physician that they feel comfortable performing. Since all state laws are not identical, please check with your state medical board regarding restrictions unique to your state. The job description for PAs in Urology includes, but is not limited to:

1. General duties: Performing complete evaluations on patients of all ages (pediatric through geriatric). Ordering and interpreting appropriate lab, x-ray, and special studies. Establishing a working diagnosis based upon acquired data and developing a treatment plan for urological conditions in accordance with current urology practice and in conjunction with the urologist. Implement therapeutic intervention and provide appropriate follow-up care. Exercise judgment on conditions requiring consultation, referral, or evaluation by the supervising urologist or other healthcare professionals.
2. Hospital duties: Perform complete pre-operative H & Ps on all surgical patients, identifying and alerting the surgeon to any disqualifying conditions that present. First Assist in all surgical procedures to include nephrectomies, nephrostomies, radical prostatectomies, cystectomies, orchiectomies, penile prosthetic implantations, urological trauma procedures, transurethal procedures, artificial urethral sphincter implantations, stent procedures, and various other urological procedures as they present. Conduct hospital rounds on a daily basis of all ward and ICU patients. Evaluate care and order appropriate labs, special studies, IVs, diet, and therapeutic interventions required. In conjunction with the surgeon, formulate and implement discharge planning and clinical follow-up, and dictate discharge summaries. Evaluate and provide appropriate intervention (in conjunction with supervising surgeon) for ER and nursing home patients consulted for urological conditions. Be able to identify need and catheterize patients with appropriate catheters for their condition.
3. Office duties: See new and follow-up patients and provide intervention that is problem oriented for their urological conditions. Present patients, when appropriate, to the supervising surgeon and assist in care, treatment, and follow-up as needed. Perform and/or assist in office procedures to include transrectal ultrasound (TRUS) volume studies, urodynamics, cystoscopies, post-void residual (PVRs) evals, difficult catheterizations, post-op voiding trails, and other necessary procedures. Order and interpret lab, x-ray, special studies, and clinical procedures and provide appropriate care and follow-up. Provide phone consultation for patient complaints and prescription refills. Perform on-call duties for urology.
4. Evaluate, screen and counsel patients on health maintenance and promote utilization of community resources. Design, conduct, and/or participate in research studies, manage databases, and perform quality assurance.

As with any specialty, a strong background in family practice or internal medicine is helpful for any PA seeking specialty work. This foundational knowledge is invaluable in both the clinical and hospital settings. Many surgeons seek well-rounded PAs so they can augment their own specialty knowledge with current generalized practice skills. The necessary skills and expertise needed to perform in the urology field requires time and training. Expect six to twelve months of intensive OJT before feeling comfortable in performing many of these functions. As the PAs comfort level grows, the urologist will find great benefit in having a PA who can take care of many routine urological problems, freeing the surgeon to concentrate on more complex patients. As always, the PA works under the supervision of the urologist. It is the urologist who should be the judge of the capabilities, skills, and limitations of the physician assistant. 

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