Postgraduate physician assistant (PA) programs designed to train individuals for the workplace have existed since the advent of the profession itself. These residency programs continue to grow in number despite the lack of outcome data supporting improvements in PA learning, effects on career development, or improved patient care. Leadership bodies of the PA profession in the US have been at odds regarding the meaning and ramifi cation of postgraduate programs on specialty credentialing, accreditation standards, insurance reimbursement, and employment. Using Bourdieu's cultural confl ict theory as a framework, we analyze the issues confronting postgraduate PA training programs. Our paper discusses implications related to shifts in power amongst the different stakeholders concluding that, although formal postgraduate PA training can be benefi cial to both the PA and the medicine, considerations related to underlying agendas need attention.