NEW YORK - The warning from the district attorney was strong:

Be careful if you're considering hiring a physician assistant who recently graduated from Touro College.

A former administrator and nine others were indicted in connection with a scheme to falsify grades and degrees, including for physician assistants.

But officials in the industry offered reassurance on Tuesday, saying that there is a system of checks and balances in place and that someone couldn't just graduate from a PA program and walk into a job.

“Patients should be reassured because it is not a one-step process to becoming a physician assistant,” said Nancy Hughes, vice president of communications and information services for the American Academy of Physician Assistants. “It's a very rigorous process.”

There are more than 60,000 physician assistants in the country. To become one, a person has to be accepted to one of the 136 accredited programs in the country, which run anywhere from 26 months to four years, Hughes said.

While in school, students are exposed to a wide variety of medical training, from surgery to gynecology.

Once they graduate, students must pass a national certification exam and then be licensed by their states.

Physician assistants work in a range of medical fields, but always under the supervision of a practicing physician.

They can do everything from perform exams to write prescriptions to help in surgeries.

On Monday, Manhattan District Attorney Robert Morgenthau announced that Touro College's former director of admissions, the former director of the school's computer center, three former students and three public school teachers were involved in a plot to tamper with the college's computer system to change grades and create fake degrees in exchange for money.

A search of the home of one of the defendants turned up around 50 blank certification forms for physician assistants, prosecutors said.

At a news conference, Morgenthau said, “One dangerous thing they did was give degrees to physicians' assistants,” and he recommended a careful check of any job applicant who got a PA degree from Touro. But every state requires those who would be licensed PAs to pass an exam, and that exam has its own safeguards, said Tiffany Flick, communication manager for the National Commission on Certification of Physician Assistants, which administers the tests.

At every certified school, the director for the PA program must twice confirm the students' eligibility to take the test - before they graduate and then again three days after.

Without that second confirmation, “they're not eligible to sit for the exam,” she said.

If they pass the exam, they must be licensed by their states. They must complete 100 hours of continuing medical education every two years and take a re-certification exam every six years.

The organization that gives programs accreditation is waiting to see if any steps need to be taken at Touro, said John McCarty, executive director of the Accreditation Review Commission on Education for the Physician Assistant. “The whole process is based on trust,” he said, acknowledging that people can try to skirt around the system. But he said the organization has never had to remove a school's accreditation for reasons of fraud.

Touro attorney Franklyn Snitow said the school had been reviewing records to detect any fraud.

He pointed out that the school, a multi-campus city institution with 21,000 students, had instigated the investigation by going to the authorities with concerns over bogus grades.

He said people could feel secure in Touro's PA program.

“I'm confident that people can continue to have faith in the program and our graduates and that we will root out anyone who has abused the system,” he said.