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Physician Associate - a new role in NHS?

Hi everyone, I am thinking of applying for a PG Dip Physician Associate (former Physician Assistant) course. This is a new role in the UK and has been established in America for more than 40 years. Having done a little research on what they do, I find this profession quite interesting and like the idea of working as a PA. However there is a lot of uncertainty regarding the future - mostly about employment, developing/integration as a profession and currently there is no regulatory body apart from a voluntary register. The course fees are around 18K.

Has anyone thought to apply for this programme too?

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Original post by AZ_713
Hi everyone, I am thinking of applying for a PG Dip Physician Associate (former Physician Assistant) course. This is a new role in the UK and has been established in America for more than 40 years. Having done a little research on what they do, I find this profession quite interesting and like the idea of working as a PA. However there is a lot of uncertainty regarding the future - mostly about employment, developing/integration as a profession and currently there is no regulatory body apart from a voluntary register. The course fees are around 18K.

Has anyone thought to apply for this programme too?


I have not thought of applying, but my local general hospital has just advertised for their first physician associate post, so the role is certainly taking off round here....


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I would point out that, from what I've seen in the last 12 months, the number of jobs available in the field is negligible. We're talking less than 5 nationally per year, which are obviously horrendously oversubscribed in terms of applicants.

There also appears to be a little bit of hostility from hospital doctors, who you'd be supervised by. A lot of them seem to think that, by being supervised by consultants, you are taking away training from them. Perhaps a silly point, but nonetheless one to consider.
Reply 3
Thank you for your replies. This is what UoB says:

Why study this course


•

Make a real difference to patient care and the NHS while typically earning a salary of £30,764 rising to £40,558 (with possible progression in exceptional cases to £47,088)… All UoB's graduates are currently being paid at least £30,000 p.a. Many Trusts offer a formal internship training year which would typically start on approximately £25,500

•

Be part of this new and rapidly growing UK profession and follow a career path which has already had proven success in the US (there are over 86,000 Physician Associates practising there)

•

Pursue a profession that is supported by the NHS and the Department of Health: over 30 hospitals employ PAs across the UK and the numbers are growing fast

•

95% of our past graduates are now working as Physician Associates in almost every clinical area from specialist mental health to paediatric surgery to oncology to general practice.

Original post by AZ_713
Thank you for your replies. This is what UoB says:

Why study this course


•

Make a real difference to patient care and the NHS while typically earning a salary of £30,764 rising to £40,558 (with possible progression in exceptional cases to £47,088)… All UoB's graduates are currently being paid at least £30,000 p.a. Many Trusts offer a formal internship training year which would typically start on approximately £25,500

•

Be part of this new and rapidly growing UK profession and follow a career path which has already had proven success in the US (there are over 86,000 Physician Associates practising there)

•

Pursue a profession that is supported by the NHS and the Department of Health: over 30 hospitals employ PAs across the UK and the numbers are growing fast

•

95% of our past graduates are now working as Physician Associates in almost every clinical area from specialist mental health to paediatric surgery to oncology to general practice.



I think it is an emerging field and one that is really going to take off in the future. It makes sense really, as the initial training period is so much shorter it will be easier to "plug the gap" during workforce shortages.

The example I use is theatre technicians. A few years ago you could just be an auxiliary nurse who happened to land a job in theatre, now it's a profession in it's own right. I see PAs going the same way


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I genuinely don't see it taking off over here, its been kind of on the.radar for a number of years now, and the fact that the name has been changed and that it hasn't spread very far suggests a lack of job security. Plus, being the equivalent of a foundation trainee all your life would be properly miserable. If you want to work as a doctor, why not go the whole hog?

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Original post by Mushi_master
I genuinely don't see it taking off over here, its been kind of on the.radar for a number of years now, and the fact that the name has been changed and that it hasn't spread very far suggests a lack of job security. Plus, being the equivalent of a foundation trainee all your life would be properly miserable. If you want to work as a doctor, why not go the whole hog?

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This. Where's the career progression? Yeah you're qualifying quicker and earning more initially than a doctor, but you've not really got anywhere to go with it.
I can't really see how they would fit in to the current structure.

The optimist in me says that they would do all the dogsbody stuff of an FY1, freeing up more time for training. Can't say that sounds like a good job.
Reply 8
A poster above expressed concern about job availability for Physician Associates. This has not been a problem at all for the profession. The UK Association of Physician Associates has tracked all job postings for the last several years. From Sept 2012- Sept 2013, there were 125 jobs for Physician Associates posted, with only 36 graduates nationally to fill them.

Another posted expressed concern about how doctors view PAs. A study which will be published in 2014 in the RCP Journal "Clinical Medicine" shows that doctors who work with Physician Associates are very happy with the role and are keen for it to expand. Patients are also happy with the role and often choose explicitly to see the Physician Associates. In one practice, when the Physician Associate left to take another post and was replaced by a locum GP, the complaint rate in the surgery dramatically increased.

I would encourage those interested to search out sources of real data and educated opinion such as the Royal College of Physicians, which strongly supports the Physician Associate role.
(edited 10 years ago)
Reply 9
Original post by tamirits


Patients are also happy with the role and often choose explicitly to see the Physician Associates. In one practice, when the Physician Associate left to take another post and was replaced by a locum GP, the complaint rate in the surgery dramatically increased.


This doesn't really mean anything though, does it?

Nurse practitioners in the practice I work in get twice as long to see patients and only see filtered patients. The patients love it because they have time to explain everything and ask after the family.

With regards to complaints, again you are unable to tell anything from this. If patients get everything they want on demand they won't complain and will be happy. If a patients has their antibiotics, their diazepam and their referral to a specialist refused they complain. This does not mean that bad medicine has been practiced.

To suggest that because patients choose to see them means they are equal to or superior to other colleagues is foolish. Patients often choose to see the F2 working in A&E rather than their GP with 20years experience, does this mean the F2 is the more appropriate choice?

I have utmost respect for my health care professional colleagues and routinely refer to hem for further management of patients. What I object to is comparisons being drawn between two completely different professions. It will have taken me 13 years to become a GP and to suggest a qualification awarded in a fraction of the time means we have the same knowledge base and experience is incredible.
Reply 10
Ps sorry if that sounded ranty - it wasn't mean to be!
Reply 11
Original post by Egypt
This doesn't really mean anything though, does it?

Nurse practitioners in the practice I work in get twice as long to see patients and only see filtered patients. The patients love it because they have time to explain everything and ask after the family.

With regards to complaints, again you are unable to tell anything from this. If patients get everything they want on demand they won't complain and will be happy. If a patients has their antibiotics, their diazepam and their referral to a specialist refused they complain. This does not mean that bad medicine has been practiced.

To suggest that because patients choose to see them means they are equal to or superior to other colleagues is foolish. Patients often choose to see the F2 working in A&E rather than their GP with 20years experience, does this mean the F2 is the more appropriate choice?

I have utmost respect for my health care professional colleagues and routinely refer to hem for further management of patients. What I object to is comparisons being drawn between two completely different professions. It will have taken me 13 years to become a GP and to suggest a qualification awarded in a fraction of the time means we have the same knowledge base and experience is incredible.


To be entirely fair I'm not sure they ever went so far as to insinuate that, rather that patients are often far more interested in having time for a nice chat than a focussed consultation in the light of substantial experience.

As a medical student in GP land you find patients asking to see you because they know they get half an hour with the oversight of a quick discussion with the GP, the best of both worlds as seems to be the case in my limited understanding of the work of physicians assistants or practice nurses.

Where I find it hard to establish how PAs would work without going mad is that they don't seem to have an obvious niche in the same way as other allied health care professionals, the role really does seem to be simply 'Doctor-lite'.
Whilst I'm not exactly raving about them, PAs aren't there to replace GPs or indeed any doctors. They're employed underneath doctors on the hierarchy, and are essentially there to perform routine treatments doctors would ordinarily do. They certainly don't have the same level of knowledge or experience.
If you can't get the grades for medicine and want to work in patient care I'd go for nursing over a physician associate. It has a proper career structure, you get paid as you're climbing up the ladder and can go into the admin side or district nursing or nurse practitioner if you don't want to just do ward stuff. Nurse specialists at the top of band 6 or lower band 7 get the salaries you quote. http://www.nhscareers.nhs.uk/explore-by-career/nursing/pay-for-nurses/ and the link at the bottom of that page has the current salaries.
I'd worry that physician assistant is a new post that can be changed by whichever political party is in control. It may take off, but equally it may not. Alternatively you could be a physio and specialise in sports medicine and have your own business, or stay in the NHS and do something like ITU physio. Physios start at band 5 and go up to band 7.
Reply 14
Original post by 345rty
To be entirely fair I'm not sure they ever went so far as to insinuate that, rather that patients are often far more interested in having time for a nice chat than a focussed consultation in the light of substantial experience.

As a medical student in GP land you find patients asking to see you because they know they get half an hour with the oversight of a quick discussion with the GP, the best of both worlds as seems to be the case in my limited understanding of the work of physicians assistants or practice nurses.

Where I find it hard to establish how PAs would work without going mad is that they don't seem to have an obvious niche in the same way as other allied health care professionals, the role really does seem to be simply 'Doctor-lite'.


I agree, i probably overacted a little!

I suppose I get frustrate when these new schemes are heralded as being the answer to the problems the NHS faces. All I can see is it adds another level of confusion for patients (how are they suppose to keep track of who they are actually seeing) and these people will still need supervising by doctors and so it simply adds another (I'd argue unnecessary) step in the patient management pathway.
Reply 15
Original post by Egypt
I agree, i probably overacted a little!

I suppose I get frustrate when these new schemes are heralded as being the answer to the problems the NHS faces. All I can see is it adds another level of confusion for patients (how are they suppose to keep track of who they are actually seeing) and these people will still need supervising by doctors and so it simply adds another (I'd argue unnecessary) step in the patient management pathway.


I quite agree, the challenge of balancing the need for a fast efficient system where 5 minute slots with suitably broadly trained and experienced GPs with patients desire for a half hour chat about their dog is a nightmare. Unless people are prepared to pay much more for their healthcare the latter is not going to be tenable.

Patient satisfaction is clearly over weighted at present...


EDIT, is patient satisfaction over rated would make an epic interview question if any applicants are lurking.
Reply 16
I too am also thinking about applying for the Physician Associate PG Diploma, but like has been mentioned above, i'm worried that the lack of opportunities for career progression (from what I gather, it seems as if you would be working around the level of a junior doctor throughout your career) would be very frustrating, and am also concerned by the uncertainty surrounding whether the position will really take off.....or will end up being scraped! If it really takes off then great..but if not it would be very frustrating to go through a very intense 2 year program and to fork out £18000 in tuition fees only to not be able to get a job at the end of it. Having already received student loans for my first degree, if I was to apply for medicine and secure a place, I would not be eligible for the government student loans, so would have to fund myself, which currently is definitely not an option! (I would also be almost 30 by the time I graduated!) Again- frustrating! This is one of the reasons the PA role appealed to me over medicine. I'm really in two minds as to whether to apply.
Reply 17
To ch8334,

Two ways I would look at the choice between PA & Medical School

1. Money - PA is short term gain in comparison to Medical School. It's cheaper and quicker, require less grades and less competition. You will get a well paid job out of it. However long term career progression is not as good and the salary is capped far below a consultants.

2. Work-life balance - medicine takes up your entire life, the training is long and the competition is harsh every step of the way. You will be grey before you make it, and will still be working nights at 60 if the government gets its way with consultant on site 24/7. (I'm not saying PA's do not work hard, but the junior doctor training is more geared towards service provision and the managers know we will take the crap, most consultants are unsupportive and we won't get a good reference for the next job up the training ladder. A PA can leave, there are other jobs and they are in small supply, a doctor cannot quit, there will be another junior monkey to take the training post. (Plus it's the same working conditions in every hospital) Or you could be a locum doctor/staff grade and leave the consultant rat race.

I'm ranting. I hate my job and am jealous of the PA's 9-5. It depends on what you want. If you want a good work life balance, PA is a great stable job. You get the same satisfaction, as the basic jobs are similar. Plus you will be a hell of a lot better than the junior doctor when they rotate to your speciality, and when the junior doctor get to grips with it, the training programme moves the poor sod onto another speciality for training. However you are not independent, which can be a good thing as the doctor will always take the fall.

If you want to be the boss and don't mind breaking your neck to get there, be a doctor. You could always go through medical school after PA once you are financially secure.

Interesting with regards to the RCP view on PAs. I wonder if it is from junior doctors because the PAs fuzzy role does not help distinguish boundaries - one PA went so far as to state he can do everything I can (SHO), but he just can't sign for things. Now how does a doctor supervise that particular PA? (It also doesn't help when they are older too)
Original post by Dd3817
one PA went so far as to state he can do everything I can (SHO), but he just can't sign for things.


Sounds like a dreadful career choice to me. Lifelong chip on the shoulder.
Original post by Caponester
Sounds like a dreadful career choice to me. Lifelong chip on the shoulder.


I don't agree with it being a dreadful career choice, I think it's quite a good option for those who are slightly older and want a less intense route into healthcare.

I do think it is a bad career choice for those who want/wanted to get into medicine, however. We have lectures with the PAs and some of them have a massive chip on their shoulder, and are very bitter towards medics (constantly in disbelief about people that get in etc). They also bang on about how intensive their course is, compared to ours. This is not to say all of them are like that though.

I do wonder what the future will hold for PA's, it will be interesting to see if the profession takes off.