Careers mindset

Hey
So my ultimate dream is to become surgeon and I have done a lot of research on it and I am aware it can be extremely stressful, and the idea that I have to study medicine has been drilled into my head as it was aapparently the only route.

However, I have discovered a new route and a postgraduate degree called Physician Associate-it's new, and it teaches the main areas you learn from a medical degree and with that I could become a first assistant surgeon
So my plan is: study a science degree (maybe anatomy and human biology) and study physician associate degree (2 years), then apply for ODP (operating department practitioner-you can apply if you're a nurse or physician associate!) and then become a first assistant surgeon. That is what I gathered from research, including the website Royal Society of Surgeons which explicitly mentions physician associate and talks about it.

Should I go for it? Or should I fuss about trying to get a medical degree as it has loads of specialities, even though it's extremely competitive? Cos I hear stories how people change their minds as they go older and end up doing something entirely different.
I'm really not into research or that kind of stuff anyway.
What do you think?

x

If you want to be a surgeon, do medicine! The route you've described is extremely convoluted. Why have you put ODP at the end? A. you can become an ODP straight from school and b. it would allow you to scrub and assist in that way, but it wouldn't make you a surgeon.

Physicians Associates are still very controversial and new. I think the role is still very much in its infancy in this country (its much more established in the US) and at the moment no one is really sure how they will fit in in the long run. IMO its something that won't last, not in its current form (a 50k salary is not really sustainable in the NHS) but we shall see.

But medicine is extremely competitive and I don't want to be in a situation of being rejected lol. I will try though, but physician associate seems to be my back-up plan. The information about physician associate on the internet is limited, and it seems that you have to do ODP to become first assistant surgeon? A first assistant surgeon can also do surgery without doing at least 8 years studying and training, no? And look: https://www.rcseng.ac.uk/patients/the-surgical-team/whos-who

So far there's a 100% employment rate.

Also, to answer your other questions: What is it about surgery that appeals? What do you want out of your career?
Well, I've always wanted to help and treat people directly, and the satisfaction from treating someone is huge, like it would be incredible to make someone see or hear again, that stuff would have been impossible to do back then! I really admire surgeons, the effort they put in, the concentration they have, the great determination they have to save someone's life, the manual dexterity, oh it's endless. To participate in an operation and actually operate with them would be an honour. If I was a surgeon, I really love the idea of going to different countries and saving people from third world countries, like the charity 2020. I feel like diagnosing isn't enough, plus a surgeon's job is very varied, practical and exciting-which is what I look for.

I'm not entirely sure what you mean by 'first assistant surgeon'. Do you mean the surgical assistants/surgical care practitioners bit under other healthcare professionals in the link you gave?

To be honest, fear of rejection is not necessarily a reason to look for other, very convoluted, ways of being involved in surgery. Odds are, you will be rejected first time. 60% of applicants get no offers. But you take a gap year and reapply, work on your application with work experience and good entrance examination scores.

I still think that the route you've suggested is over long and complicated. I also think that you're confusing the ODP course (which produces theatre practitioners who can scrub/assist the anaesthetist or work in recovery and are on the same pay banding as nurses) with post graduate surgical qualifications that may allow other healthcare professionals (nurses, ODPS ... not doctors) to have a more active/advanced role in surgery. You certainly won't just be able to leap from course to course, you will be expected to gain significant experience in your chosen role (ODP/PA etc) before you would be allowed to undertake a more advanced surgical role.

Have you had any work experience in theatres? To actually see the different roles and what they do? It sounds like that would be a good option for you.

I guess so, although I was referring to the "Associate specialist surgeons", but they both seem to do the same thing, looks like it. I haven't had any work experience in theatres, and isn't that very hard to do?

And okay, thank you for your very useful information, I'll try gather work experience, especially in theatres if I get any luck.

Associate specialist surgeons are doctors. And no, that certainly isn't the same thing.

For any AHP (nurse, odp etc) to do surgery on their own/as an assistant they will have had extensive experience within their own role previously. It is not a easy thing to get in to, nor is there a huge amount of jobs doing this (currently). For example, Advanced nurse practitioners may perform minor surgery, say carpal tunnel decompressions, on their own. But thats because they are very experienced in that operation and will have limited scope to perform any other surgery. It is also very Trust dependent as to how much AHP specialists are utilised or trained.

If you want to perform surgery, realistically the only straightforward way to do that is as a Doctor.

But medicine is extremely competitive and I don't want to be in a situation of being rejected lol. I will try though, but physician associate seems to be my back-up plan. The information about physician associate on the internet is limited, and it seems that you have to do ODP to become first assistant surgeon? A first assistant surgeon can also do surgery without doing at least 8 years studying and training, no? And look: https://www.rcseng.ac.uk/patients/the-surgical-team/whos-who

So far there's a 100% employment rate.

Also, to answer your other questions: What is it about surgery that appeals? What do you want out of your career?
Well, I've always wanted to help and treat people directly, and the satisfaction from treating someone is huge, like it would be incredible to make someone see or hear again, that stuff would have been impossible to do back then! I really admire surgeons, the effort they put in, the concentration they have, the great determination they have to save someone's life, the manual dexterity, oh it's endless. To participate in an operation and actually operate with them would be an honour. If I was a surgeon, I really love the idea of going to different countries and saving people from third world countries, like the charity 2020. I feel like diagnosing isn't enough, plus a surgeon's job is very varied, practical and exciting-which is what I look for.

Hi

I'm a Physician Associate student in my first year. I know that the info we get online about PAs is very limited so I'm open to answer any questions you might have about the course or the career (as far as my knowledge goes since I have not graduated yet)

The description of PAs online seem to be to underestimate a bit of PAs really do. In my course we get to talk to professional PAs often and are even taught by some of them and the extension of their abilities on the working place don't seem to differ a whole lot from those of Junior doctors. As far as surgery goes, we know that PAs cannot operate but they can assist in operation. I have met a PA whose "specialty" was paediatric surgery. She is not the main surgeon, but her main job is to assist operations in children. If I am not mistaken, she also does some smaller procedures by herself with the surgeon's supervision.

PAs also cannot prescribe yet, but we are told in our course that the Faculty of PAs is working in getting us the right to prescribe, and we are taught the basics of prescription.

Lastly I would like to say that please don't have the PA course as your "back up plan". The profession is evolving exponentially and the prospects are amazing! Is a worth career and is just as difficult and demanding as medicine. We are trained in exactly the same medical models, we do mostly the same examinations and OSCEs as a 5th year and we are expected to know no less than a Junior Doctor upon graduation.

Hope that helped a little bit

Hi

I'm a Physician Associate student in my first year. I know that the info we get online about PAs is very limited so I'm open to answer any questions you might have about the course or the career (as far as my knowledge goes since I have not graduated yet)

The description of PAs online seem to be to underestimate a bit of PAs really do. In my course we get to talk to professional PAs often and are even taught by some of them and the extension of their abilities on the working place don't seem to differ a whole lot from those of Junior doctors. As far as surgery goes, we know that PAs cannot operate but they can assist in operation. I have met a PA whose "specialty" was paediatric surgery. She is not the main surgeon, but her main job is to assist operations in children. If I am not mistaken, she also does some smaller procedures by herself with the surgeon's supervision.

PAs also cannot prescribe yet, but we are told in our course that the Faculty of PAs is working in getting us the right to prescribe, and we are taught the basics of prescription.

Lastly I would like to say that please don't have the PA course as your "back up plan". The profession is evolving exponentially and the prospects are amazing! Is a worth career and is just as difficult and demanding as medicine. We are trained in exactly the same medical models, we do mostly the same examinations and OSCEs as a 5th year and we are expected to know no less than a Junior Doctor upon graduation.

Hope that helped a little bit

Hi!!
Oh this is perfect, exactly what I was looking for Thank you so much for replying. May I ask, what degree have u studied before? And how did she get into that job? Like did she have to do any additional training etc. What are you aiming to do once you have your degree? Also, is she a first assistant surgeon? Sorry for all the questions, ir's quite exciting to have an actual physician associate talking to me so I know exactly what happens

Hi
As far as surgery goes, we know that PAs cannot operate but they can assist in operation. I have met a PA whose "specialty" was paediatric surgery. She is not the main surgeon, but her main job is to assist operations in children. If I am not mistaken, she also does some smaller procedures by herself with the surgeon's supervision.

If you are trained in the same "model" and "know no less" than a junior doctor, why aren't they calling you doctors? And how is PA school magically able to do this for you in two years when even a fast track grad-entry medicine course takes 4?


I'm interested in what exactly you think being a "first assistant surgeon" involves? I suspect it might not be quite what you think.

If you are trained in the same "model" and "know no less" than a junior doctor, why aren't they calling you doctors? And how is PA school magically able to do this for you in two years when even a fast track grad-entry medicine course takes 4?


I'm interested in what exactly you think being a "first assistant surgeon" involves? I suspect it might not be quite what you think.

Hi
Sure, this is what I think a first assistant surgeon does: cutting sutures, tissue retraction, assistance with wound closure, cutting deep sutures and ligatures, nerve and deep tissue retraction, handling of tissur and manipulatiom of organs for exposure and access, assisting with homeostasis (most of this under supervision).

Or am I wrong?

So is your dream to do the above, or to be a surgeon?

My dream is to be a surgeon, but if I don't achieve that, then I'd really like to do as above.

Is that information about first assistant surgeons correct?

Is this due to a shortage of surgical trainees or are they integrated into theatre lists in place of a trainee? Or are the SHO's simply shafted by having to stay on the ward because they can prescribe and the PA cannot?

Kind of, but I feel like you're missing the point. You've listed a bunch of technical things which an assistant would do, but the whole deal is that you are assisting. It is not your operation, it is not your patient, you do what you are told by the boss. I've been "first assistant" occasionally since I was a medical student (admittedly a fairly useless one at that stage!) and it's not that special.

Yes, some SCPs/ANPs/maybe PAs in a few years time will be able to do a couple of procedures independently, like carpal tunnels, vein stripping for CABG etc, but they do not have the same amount of surgical training as, you know, a surgeon.


I think it's likely to be a little of both - plus PAs won't do inconvenient things like having to work nights or be on call, so will be around for theatres more often.