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The rise of the Physician Associate

Physician Associates- Who are they? What do they do? Where are they destined to go??? Senior nurse turned final year PA student Cheryl WIlliams demystifies the role for us...

Physician Associates (PAs) are healthcare professionals with a general medical education, who work alongside doctors as part of the medical team. Physician Associates are dependent practitioners but can work autonomously under the supervision of a fully qualified doctor. They add to the skill mix within teams, providing stable continuity and easing the workload on doctors.

Although new to many clinicians, Physician Associates can already be found working in A&E, GP surgeries and inpatient medical and surgical wards and have been in the UK since 2003.

Physician Associates can:
• Take medical histories
• Carry out examinations
• Manage long term conditions
• Formulate diagnoses and appropriate management plans
• Perform diagnostic and therapeutic procedures
• Request and interpret appropriate diagnostic studies
• Provide health promotion and disease prevention advice

PAs cannot prescribe or request ionising radiation at present currently but this is expected to change when professional regulation is passed in parliament in (hopefully) 2019. To qualify as a PA, students must attend a 2 year post graduate PGDip/MSc from a recognised UK university, after a prior science/healthcare degree. Therefore, a large number of PA students have many years of healthcare experience before qualifying.

The course consists of theory and a prescribed number of clinical placement hours that includes:
• 350 hours of general medicine
• 180 hours of general practice
• 180 hours of front door/emergency medicine
• 90 hours of mental health
• 90 hours of general surgery
• 90 hours of paediatrics
• 90 hours of obs and gynae
While assessment style and schedule slightly vary between Universities, majority of PAs undertake anatomy/physiology exams, clinical case based learning, OSCEs, portfolios, DOPs, MCex, MCQs, group and individual presentations, clinical case reports, and research.

Clearly, qualification as a PA is no mean feat, not to mention the national exam which ensures to standardise and ensure a minimum high quality standard a PA student must meet before being able to practice in the field. The national exams consists of an MCQ and 14 OSCE stations. Revalidation requirements include 40 hours of CPD per year and a recertification exam every 6 years. PAs are currently monitored on a managed voluntary register within the Faculty of Physician Associates through the Royal College of Physicians. Once statutory regulation is approved, PAs will have a full professional register.

There is currently some uncertainty regarding the role from other healthcare professionals who are unsure of how the role will fit in. However, PAs cannot apply for doctor's jobs and are not intended to replace doctors. PAs were implemented to complement the existing team and provide an extra pair of hands. Anyone who has worked within the NHS will be aware that there is plenty of work to go around, and another clinically qualified team member help with rotation handover periods, and freeing up doctors to attend training. As with all new roles, there will always be some suspicion and uncertainty but hopefully you’ll reserve judgement till you’ve worked with a PA. 

Guest Blog: Cheryl Williams, 18.07.2018


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