In the 1960s, a shortage of primary care medical doctors in rural and urban areas of the United States. Coinciding with the above problem, returning military servicemen who had delivered medical care in Vietnam but were unqualified to do so in the U.S. became a social problem of medical systems. One solution was to train these men quickly and allow them to work under the supervision of a doctor. This was the basic reason for the U.S. physician assistant (PA) system. For underserved communities, PAs are necessary 1) as the principal care provider in rural area or inner-city urban clinics with a supervising physician and other medical professionals and 2) to reduce the pressure, working hours and intensity of work of junior doctors or to replace junior doctors with a qualified and trained healthcare provider. In Korea, Pas would not help reduce the pressure and intensity of work for primary care providers, but could do so for residents. Therefore, the well-established PA system, including its education and training system, may be appropriate for Korea. To establish the appropriate PA system in Korea, several factors must be considered. The first is the qualifications for PAs. In Korea, medical doctors and nurses are considered medical personnel but medical technicians and nurse aids are not. To be certified to work as clinical assistants, certification as medical personnel is mandatory. The second is education and certification. Independent schools for PA training would require longer training time and an additional education system. The society of medical association authorized by the Ministry of Health and Welfare may be more suitable for education and training of PAs in Korea than an additional independent education system. Finally, for successful PA system in Korea, the thorough inspection and control of the system by hospitals and also by society of medical association is critical.