The Kingdom of Saudi Arabia is the largest Arab state in the Gulf Cooperation Council and makes up 80% of the Arabian peninsula. Of the Gulf Cooperation Council states (the others are Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates), Saudi Arabia has the largest population, with about 6 million citizens and 9 million registered expatriates. As per the Saudi Arabian constitution, the government through the Ministry of Health and its agencies, including the Ministry of Defense Medical Services Directorate, is the primary healthcare provider entrusted with the provision of care through 87 hospitals and a network of 1,925 healthcare centers. Universal health insurance was introduced in Saudi Arabia in 2005, making healthcare free for all citizens and expatriates in Saudi Arabia.
According to the World Health Organization, Saudi Arabian health services have relied heavily on expatriate healthcare professionals during the last 4 decades. Huge efforts had been initiated to educate and train nationals. The country is facing severe health-related challenges especially with obesity, hypertension, and diabetes, along with other chronic diseases due to the shortage and maldistribution of the national healthcare providers.
The Ministry of Defense decided to establish a physician assistant (PA) program to train young Saudis interested in healthcare. These professionals would work in medical field units and other military units. In collaboration with the George Washington University Medical Faculty Associates, the Ministry of Defense established a PA program at the Prince Sultan Military College of Health Sciences in Dhahran. The program opened in September 2010 with faculty and resource personnel from George Washington University Medical Faculty Associates. Amy Keim served as director of international physician assistant development and David Fahringer was appointed as the program director for the first 2 years, with two full-time faculty members serving as academic and clinical coordinators.
Candidates for the PA program must have at least a bachelor's degree in applied sciences. Students must be proficient in English, the language in which the courses are taught. They also should have basic competence in reading, writing, speaking, and listening skills with a Test of English as a Foreign Language score of 500 or an International English Language Testing System score of at least 5.5.
The program is 28 months long. The didactic curriculum operates year-round. Clinical rotations during the second year are offered at the military hospitals and affiliated institutions. Students rotate in emergency medicine, general surgery, orthopedic surgery, internal medicine, psychiatry, field medicine, and family medicine. Graduates are awarded a master's in applied health science. The program's goal is to prepare PAs to function effectively as members of the healthcare team, to work in medical field units and other military units, and to serve the military and civilian communities in the Kingdom of Saudi Arabia. Students also must take military training and serve in the military for 5 years after graduation.
To obtain certification and licensure to begin practice, graduates must pass a comprehensive examination, which includes an objective structured clinical examination and an oral examination. A graduate PA serves as a military medical officer (first lieutenant) in the Ministry of Defense's medical service division after completing a 6-month internship in emergency medicine under physician supervision. Since the program's inception, 15 students have been graduated as PAs and 7 candidates are on clinical rotations.
The PA program has not been recognized by the Ministry of Higher Education (the accrediting body) or the Ministry of Health Specialist (the licensing body). The program demands and deserves recognition by the Ministry of Higher Education and accommodations in the mainstream education system, as well as approval in Saudi Arabia.