I Have a DMS: Now What?

Aisha Hussein, DMS, PA-C

We are standing at a unique crossroads in the PA world: we are actively participating in our profession's maturity yet witnessing our career pathways struggle to keep pace with that evolution. In an era of artificial intelligence and the expectation to create faster than we can compensate, we feel the challenge of navigating a career that seems entirely tangible, yet structurally elusive at the same time.

Professional equity or parity is something PAs have struggled with since our inception. By design, the PA role was intended to be a collaborative companion within a healthcare team to provide care efficiently. While I contend that we will always struggle with what "parity" should look like, there is a vital premise that needs clarifying: the post-professional doctorate for PAs is not just a title—it is a knowledge fund. It can advance clinical expertise to practice at the top of our license, but it also provides the critical expertise needed to navigate beyond the clinical walls.¹

If you feel that nothing changed the day you added "Doctor" to your badge, it is because the infrastructure is lagging. Advocacy and professional growth are a self-sufficient model: when the workforce builds, the advocacy follows.²

Tangible Strategies for Growth & Return on Investment (ROI)

1.        Academia: The Paved Path

In academia, research shows that doctorally-trained PAs are significantly more likely to hold academic appointments and contribute to the profession through scholarship.³ Here, the path is structured, and the ROI is inherent to the system.

·       The Status: Credentials determine your rank (e.g., Assistant to Associate to Full Professor), which serves as the primary lever for salary increases and long-term job security.

·       The Strategy: Leverage your degree to move beyond teaching and into scholarly publishing and presenting. This active scholarship status justifies rank advancement, making your ROI direct, measurable, and codified in the university’s pay scale.

2.        Clinical: Climbing the Relative Value Unit (RVU) Wall

If you are 100% clinical, you face a value paradox. Despite your higher degree, your RVUs remain the same. Evidence suggests that the doctorate moves workers from “micro-level” patient contributions, toward "macro-level" healthcare system contributions.⁴ To break through the wall, you have two strategic options:

·       Option 1: The 0.2 FTE Maneuver. Identify a quality improvement (QI) problem in your system and present a solution to leadership. Once you have buy-in, negotiate to dedicate 20% of your time (8 hours/week) to lead a committee solving it. Use the resulting metrics (profit margin or social impact) to justify a salary increase and a title that aligns with your leadership output.⁵

·       Option 2: Lateral Leadership. Apply for leadership roles not as a PA with a degree, but as a Doctor of Medical Science (DMS/DMSc) with specialized leadership skills. Doctorally prepared PAs are increasingly sought for administration roles that demand high-level systems thinking.¹ Management is defined by skill and the ability to lead teams—not just clinical background.⁶

3.        Mixed Roles: Defining Your Seat at the Summit

If you are already in a hybrid role, it is time to let your credentials shine. You have already reached the mountain, but now you must define the view.

·       The Status: You are positioned to influence both the clinical and administrative sides of the house simultaneously.

·       The Strategy: Use your degree to develop a specific project that improves hospital efficiency, such as optimizing informatics or revenue cycles. Efficiency earns more than honor; it earns rank and growth potential.³ By opening these doors, you create opportunities for yourself and establish a blueprint for the PAs who follow you.

The Bottom Line

The DMS degree is a tool, but it only works if you pick it up. As clinical leadership demands more sophisticated systems science, our doctorate is our rebuttal to legacy hierarchies. It proves we are capable of managing the very systems in which medicine is practiced. Do not standby and wait for the infrastructure to recognize you—use your knowledge to build the infrastructure.

References

1.             McKenna RE, Hooker RS. The PA postprofessional doctorate. JAAPA Off J Am Acad Physician Assist. 2025;38(5):35-41. doi:10.1097/01.JAA.0000000000000201

2.             Hooker RS, Cawley JF. Physician Assistants/Associates at 6 Decades | AJMC. April 10, 2026. Accessed April 10, 2026. https://www.ajmc.com/view/physician-assistants-associates-at-6-decades

3.             Klein A, Kayingo G, Schrode KM, Soria K. Physician Assistants/Associates With Doctoral Degrees: Where Are They Now? J Physician Assist Educ. 2024;35(1):14-20. doi:10.1097/JPA.0000000000000549

4.             Bernard KS, Derr JN, McMoon M, et al. The Contribution of Postprofessional Doctorates to the Career Development of Healthcare Workers: A Scoping Review. J Allied Health. 2024;53(3):e191-e200.

5.             Hooker RS, Cawley JF. The value of physician assistants in primary care. Published online 2021.

6.             Pickard T. What 3 decades as a PA have taught me about leadership. JAAPA. 2025;38(12):14. doi:10.1097/01.JAA.0000000000000284