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The intention was to select individuals who have had adequate exposure to inpatient care and were familiar with hospital-based medical care. Second, prior experience in a hospital setting is desirable. The PAs employed in this study had experience in surgical, anesthesia or cardiology services and were capable of recognizing emergencies and dealing with them. Third, formal training in the delivery of intensive care should be offered. This is best accomplished by inviting the PAs to participate in rounds in an intensive care unit under the supervision of qualified physicians. After a period of observation, they may be assigned patient care duties, starting with simple histories, physical examinations and chart reviews and gradually increasing to performance of invasive procedures under direct supervision. As shown in Table 1, some reduction in the number of admissions and a slight increase in the duration of stay may occur. In our study, these alterations remained within what is expected in an intensive care setting. In any case, the results indicate that the supervising physicians were being more cautious in admitting and discharging patients. Such caution is probably among the more favorable outcomes of utilizing PAs in the medical intensive care unit.