Leveraging Doctoral Education to Advance Physician Associate Leadership in Clinical Research and Expand Trial Access in Underserved Communities.

Abstract

Recent federal initiatives, including the Food and Drug Omnibus Reform Act, have emphasized improving diversity in clinical trial enrollment and expanding research into community and underserved settings. However, investigator shortages and administrative burden continue to limit clinical trial capacity and site availability. Physician associates (PAs) typically serve as sub-investigators (sub-Is) with responsibilities focused on clinical care for enrolled participants. National survey data demonstrate limited advanced practice provider (APP) involvement in trial leadership: Among 271 practices surveyed, only 15% reported APP participation in trial selection, 5% had an APP serving as a primary investigator, and 3% reported APP involvement in protocol development. These findings highlight underutilization of PAs in research leadership roles. Postprofessional PA doctoral programs provide advanced training in research design, biostatistics, evidence-based practice, leadership, and scholarly communication. These competencies are directly applicable to clinical trial oversight, regulatory coordination, and site-level operations. Doctoral-educated PAs may continue serving as sub-Is while assuming expanded responsibilities in study management and protocol development within established collaborative practice frameworks. Integrating clinical trial-focused tracks into PA doctoral curricula may strengthen research workforce capacity, reduce physician administrative burden, and expand trial access in community settings. Creating structured leadership pathways for doctoral-educated PAs aligns with federal goals to improve equitable trial representation and offers a practical strategy to enhance clinical research infrastructure.