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Report Thread starter 3 months ago
I want to work in healthcare, and I have a particular interest in Emergency Medicine from my experiences working in ED.

However, I have seen that many people are training as Advanced Care Practitioners and gaining ‘Consultant’ ACP positions that involve clinical work without having to go through med school.

I’ve been told that ACPs are earning similar wages to junior doctors and have a better work life balance. A few people have negative things to say but I don’t know how much of this is being exaggerated.

Do doctors consider ACPs to be inferior?
Is an ACP role similar to being a junior doctor? And is it likely in future that will be equivalent to or replace doctors?

Which would be the better career to pursue for someone interested in emergency medicine?
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Report 3 months ago
The reality is, it depends what you want to do. ACP can be a great role and is highly respected (within most areas-medicine being the area where I've seen them be treated as glorified F1's). However in ED, I have only seen them be respected, but it is worth noting that training and support will differ significantly depending on where you do your training.

The reality is, whilst ACPs have been integrated really well within some clinical areas, in others it has proved more challenging. Usually (in my experience) ACP's work incredibly well within ED and the role has been well brought in. They have national accreditation through RCEM and therefore there exists a national standard for them. This is not true for ACP's working in other specialities.

I would say the very good ones end up working at Senior Reg level, but their pay does not necessarily reflect this.

However, to become an ACP you need to be an experienced practitioner prior to applying for the programme. If your interest is EM, then you would probably want to look at either RN or Paramedic. Paramedics though have limitations on their practice and if they do become ACP's, they can not currently complete the prescribing module- although I suspect this might change.
It is also extremely competitive and those who apply will regularly have 10+ years of experience with a multitude of PG quals.

For me, I've been an RN for 9 years, but choosing the medical route because; you are not tied to 1 speciality straight away, internationally recognised qualification, it is a defined role, opportunities in pre-hospital (or better), increased scope of practice. etc....

The choice I suppose is do you want the role of a Doctor or the role of an ACP? Whilst they can overlap, they are different.
Do you have the grades for Medicine, if you don't ACP would be a great path to go down and you would end up working at a similar level.

Hope that's helpful
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Report 3 months ago
The thing about becoming an ACP is that it takes a long time to get there and then you cap out pay wise quite quickly. When I checked this, you need at least seven years post qualification experience to become an ACP from an AHP background. It’s a long time to be doing a role you’re less interested in to pick up a role that you’re more interested in. It’s why I’ve ruled it out. And then for all the skills and expertise you have you can’t really advance and this can feel restrictive.

If I were looking to avoid medical school I’d pick the PA role instead. The pay is more or less the same as an ACP but chances are you’re going to be able to prescribe with that as they will be regulated by the GMC.

I wouldn’t say that doctors in my trust look down on ACPs or PAs because the only ones in any position to do so are the consultants and they've got better things to do than wave their medical school degree certificates in their faces. Most doctors in our trust will be trained by an ACP or PA at some point and the nurses value them because they tend to be attached to wards long term. Certainly if nurses want something done quickly at the moment and it’s within an ACP or PA’s remit they lean towards asking them because the juniors have just rotated in and they can’t do as much right now. Give it time, though and the doctors are going to be up to speed. The ACPs and PAs certainly cushion that chaotic period when doctors rotate through departments. And yes, they tend to clock out at similar hours to the AHPs and they do have a better work life balance. But there’s always a trade off. Doctors put in their time in the trenches for the promise of the highest salary and decision making power you can get in a clinical role in the NHS and it generally does deliver.

If you want to specifically work in the ED, I would recommend the PA route rather than going through the ACP route which is long and unnecessary if that’s your ultimate aim. However, PA is a four year course and there aren’t many places that offer it at undergraduate level. Of course, if you’ve got a degree already, this shortens to two years and loads of places offer it. Another thing to remember, though, is that the grades to get into a PA course aren’t dissimilar to the grades for medical school, whichever route you take. Just something to think about.

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