How to Become a Psychiatric PA: Career Guide
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With mental health needs continuing to climb across the U.S., many Physician Assistants (PAs) are looking to specialize in psychiatry as a way to provide meaningful support in an underserved area of care. This path blends general medical expertise with deeper knowledge in psychiatric assessment, medication management, and long-term behavioral health support. If you’re already a practicing PA or preparing to become one, here’s how you can pursue a focused career in psychiatry
What Psychiatric PAs Do
Psychiatric PAs work alongside psychiatrists and other mental health professionals to diagnose and treat a wide range of behavioral health conditions. They play a hands-on role in both inpatient and outpatient care, helping evaluate patients, prescribe medications, and oversee treatment progress over time.
A typical day might include assessing a patient’s mental and physical history, identifying symptoms of psychiatric conditions, and helping rule out other medical causes that could be contributing to behavioral changes.
Most physician assistants in psychiatry can prescribe psychiatric medications, including controlled substances. This prescribing authority is grounded in their expertise in psychopharmacology — the study of indications, actions, risks, and side effects of psychiatric drugs, both when used independently and in combination with others. With this specialized training, psychiatric PAs are able to manage medications used to treat depression, anxiety, bipolar disorder, schizophrenia, and more, ensuring safe and effective care tailored to each patient’s unique needs.
Increasing Mental Health Access
Psychiatric PAs are key contributors to care planning, coordination with other providers, and communication with families. Their presence increases capacity in mental health systems that are often short-staffed and overburdened. In a landscape where mental health services are stretched thin and physician shortages are a painful reality, especially in underserved areas, psychiatric PAs help bridge critical gaps in care. By working alongside psychiatrists and other members of the mental health team, they enhance access to high-quality treatment for patients who might otherwise struggle to receive timely support. Their advanced training allows them to deliver comprehensive care while also helping to ease the workload on psychiatrists, ensuring that more patients can be reached without sacrificing the quality of care.
Where Psychiatric PAs Work
Psychiatric PAs serve in a wide variety of clinical environments, such as:
- Behavioral health clinics and private practices
- Psychiatric units in hospitals
- County and state mental health facilities
- Emergency rooms and psychiatric crisis units
- Correctional facilities such as jails and prisons
How Job Duties Vary by Setting
Depending on the care environment, the day-to-day responsibilities of psychiatric PAs can look quite different. In hospitals and inpatient psychiatric units, PAs function as vital extensions of the psychiatric team. Their daily agenda might include conducting comprehensive patient histories, handling psychiatric assessments, and rounding with the team. PAs frequently respond to behavioral health emergencies, order and interpret labs or imaging, and collaborate closely with psychiatrists to fine-tune medication regimens and ongoing care plans.
Shift gears to an outpatient setting, think community mental health clinics or private practices and the workflow is a bit different. Here, psychiatric PAs often focus on new patient intakes, follow-up psychiatric evaluations, and managing treatment plans over time. They take the lead on physical exams, order necessary diagnostic tests, establish medication protocols, and may coordinate referrals to subspecialists when extra support is needed.
Work in correctional facilities takes on yet another twist. In jails and prisons, psychiatric PAs might perform initial psychiatric intakes, manage psychiatric medications for individuals in custody, and develop diagnoses for new mental health concerns that arise. The patient population in these environments is unique, with a mix of chronic behavioral health conditions and acute presentations.
Psychiatric PAs can also carve out niches working with specific populations—pediatrics, geriatrics, or those struggling with post-traumatic stress — tailoring their assessments and care models to the needs of each particular group.
Education Requirements
Before pursuing a psychiatric specialty, you must complete a graduate-level Physician Assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). After graduation, they must pass the Physician Assistant National Certifying Examination (PANCE), offered by the National Commission on Certification of Physician Assistants (NCCPA).
After obtaining your general Physician Assistant certification, from there psychiatric specialization involves gaining practical experience, pursuing optional fellowships, and, for some, obtaining advanced certification.
Optional Postgraduate Psychiatry Fellowships:
While not required, some PAs choose to complete a post-graduate fellowship. These programs usually last about a year and allow PAs to receive an additional 300 to over 500 hours of classroom instruction and between 1,500 and 2,000 hours of hands-on clinical training focused on assessing, diagnosing, and treating a wide range of psychiatric conditions.
Examples of clinical experiences during a fellowship might include:
- Geriatric psychiatry
- Child and adolescent psychiatry
- Substance abuse and mental health unit (dual diagnosis)
- Mood and psychotic disorders
Certificate of Added Qualifications (CAQ) in Psychiatry:
For PAs who want to formalize their psychiatric expertise, the NCCPA offers a Certificate of Added Qualifications (CAQ) in Psychiatry. To obtain this certification PAs must meet the following requirements:
- Hold a current PA-C credential
- Be licensed to practice in at least one U.S. Jurisdiction
- Log a minimum of 2,000 hours of experience working as a PA in psychiatry
- Complete 150 Category I Continuing Medical Education (CME) credits in psychiatry, with at least 50 earned in the past two years
- Submit an attestation from a supervising psychiatrist verifying your competencies
- Pass the Psychiatry CAQ exam, which covers topics such as psychiatric pharmacology, diagnostic interviewing, risk management, and specific mental health disorders
Once a candidate’s submitted requirements have been approved, they must take and pass the Psychiatry Specialty Exam, which consists of 120 multiple choice questions targeted for physician assistants with experience in the practice of psychiatry.
The CAQ exam content is designed to reflect real-world psychiatric practice and includes a comprehensive range of topics such as:
- Mood disorders
- Psychotic disorders
- Substance-related disorders
- Anxiety disorders
- Personality disorders
- Delirium, dementia, and cognitive disorders
- Life cycle and adjustment disorders
- Childhood disorders that persist into adolescence and adulthood
- Somatoform and factitious disorders
- Eating disorders
- Sexual and gender identity disorders
- Dissociative disorders
- Impulse control disorders
- Sleep disorders
- Ethics and forensic issues
According to the NCCPA, Physician Assistants have experienced the following after receiving their CAQ:
- Over 75% found or anticipated finding a new job
- 60% achieved or expect to increase their job responsibilities
- Over 75% found the CAQ useful in documenting qualifications required for external accreditation
- Over 33% achieved or anticipate a broadening of their eligibility for reimbursement
- Almost 75% have received greater recognition or regard from physicians or other health care professionals
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Professional Resources and Associations for Psychiatric PAs
For those looking to deepen their knowledge, build professional connections, or stay up to date on the latest best practices, several leading organizations offer invaluable resources, information, and networking opportunities. Consider connecting with:
- Association of Physician Assistants in Psychiatry
- American Psychiatric Association
- American Association of Community Psychiatrists
- American Association for Geriatric Psychiatry
- American Academy of Child and Adolescent Psychiatry
- Association of Medicine and Psychiatry
Membership or participation in these organizations can open doors to continuing education, clinical guidelines, conferences, and a supportive professional community dedicated to improving mental health care.
Searching for new Physician Assistant opportunities? Explore Physician Assistant opportunities on PracticeSeeker Here.
Sources:
Specialty Certificates - NCCPA. (2025, April 22). NCCPA. https://www.nccpa.net/specialty-certificates/#psychiatry
Specialty Certificates - NCCPA. (2025, April 22). NCCPA. https://www.nccpa.net/specialty-certificates/#psychiatry
