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For these reasons, house staff officers for the primary care of inpatients may not be available in large numbers in the future. Alternative staffing will have to be implemented. Many hospitals already have hired non-physician health providers to fill the gap. Nurse practitioners and PAs, whose job was originally designed to serve outpatients in rural communities, are now being employed to perform inpatient duties on surgical and medical floors as well as in emergency rooms. Lately, new curricula in critical care education for PAs have been developed. Many PAs are being trained in the management of acutely ill patients with multiorgan failure. Hospitals, however, may be reluctant to allow physician assistants to take care of such delicate patients. In this study, we evaluated the feasibility and outcome of utilizing PAs in a medical ICU. The period of study ranged for four years, during the initial two of which only residents were assigned to the unit. During the latter two, residents were replaced by PAs. Materials and Methods The Medical Intensive Care Unit The medical intensive care unit at this hospital consists of eight fully monitored beds. The patient population is derived from direct admissions through the emergency department or from transfers from other medical inpatient floors.