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Question for any healthcare professional

Hi, I’m a 3rd year biomedical science student and I don’t know whether to go into physician associate studies or adult nursing. I want to work in healthcare, ideally in a hospital. I was leaning towards becoming a PA but due to the controversy and negativity surrounding physician associates, I’m rethinking my decision. I don’t want to go into PA school and have regrets. Please give me some advice. Which would you recommend?

Reply 1

Hi there. I think you are right to be cautious about the PA training. There has been a lot of controversy around the scope and safety of their practice for a long time. Hopefully, that will lessen in December with the long-awaited regulation by the GMC. There is a lot of worry about PA's replacing doctors in the skill mix, having a detrimental effect on patient safety. These concerns are not to be taken lightly. There is a real worry that the rush to fill the huge HCP staffing gaps in the NHS by getting people into the workforce fast and furious is compromising care quality and patient safety. Plus, this 'skill-mix' tinkering is an excuse to spend less on the workforce. Why have 1 fully trained Dr when you can have 2 PA's? Or 2 fully trained RGNs when you can have 3 NA's (the nursing version of PA's)?

There is also concern in the nursing community re PA's, not just from a patient safety POV. PA caseloads often overlap with the types of patients seen by Advanced Nurse Practitioners (ANP). So that's PA's with 2yrs of training (often with zero prior healthcare experience) vs (ANP's) with a minimum of 5 years training (BSc & MSc). It is rare, if not unheard of to go straight from newly qualified to advanced practice, so most ANP's have multiple years of clinical practice experience under their belt by the time they reach ANP. So we have an issue of a knowledge and experience gap, but also there is a concern re the loss of progression roles for nursing.

I also wonder about the career progression of PA. It seems quite a closed pathway. Again, maybe this will change with regulation under the GMC but nursing does have more options to move through NHS banding, work in research, work privately, or work in other scenarios like local authorities (school nursing for instance). Nurses are autonomous practitioners, unlike PA's, so that's another bonus. You'd be working as part of a multi-disciplinary team but that's a different thing and comes with the territory in healthcare.

At the end of the day, no one can tell you what to do, or what is best for you. Only you know that. A lot could change with the PA role in the next 5 years, now it is being regulated but you'd be basing your decision on a gamble unless you wait and see a little longer. See if the landscape changes. Whilst I've probably made nursing sound like the better option, it's not perfect and I'm not sure I'd recommend it wholeheartedly either! When it's good, it's great, but the politics, the emotional labour, the shifts (hospital) are a killer and hard on family life and relationships, you can be like ships in the night if you have a partner who works 9-5.

Have you looked at Physio, Occupational Therapy or Radiography? Still patient-facing but better work-life balance. Those are what I would look at. You can usually do them as MSc pre-registration courses too (2yr not 3yr) because you have a healthcare science background), limited university choice though.

Sorry for mega message! Best of luck

Reply 2

Original post
by Anonymous
Hi there. I think you are right to be cautious about the PA training. There has been a lot of controversy around the scope and safety of their practice for a long time. Hopefully, that will lessen in December with the long-awaited regulation by the GMC. There is a lot of worry about PA's replacing doctors in the skill mix, having a detrimental effect on patient safety. These concerns are not to be taken lightly. There is a real worry that the rush to fill the huge HCP staffing gaps in the NHS by getting people into the workforce fast and furious is compromising care quality and patient safety. Plus, this 'skill-mix' tinkering is an excuse to spend less on the workforce. Why have 1 fully trained Dr when you can have 2 PA's? Or 2 fully trained RGNs when you can have 3 NA's (the nursing version of PA's)?
There is also concern in the nursing community re PA's, not just from a patient safety POV. PA caseloads often overlap with the types of patients seen by Advanced Nurse Practitioners (ANP). So that's PA's with 2yrs of training (often with zero prior healthcare experience) vs (ANP's) with a minimum of 5 years training (BSc & MSc). It is rare, if not unheard of to go straight from newly qualified to advanced practice, so most ANP's have multiple years of clinical practice experience under their belt by the time they reach ANP. So we have an issue of a knowledge and experience gap, but also there is a concern re the loss of progression roles for nursing.
I also wonder about the career progression of PA. It seems quite a closed pathway. Again, maybe this will change with regulation under the GMC but nursing does have more options to move through NHS banding, work in research, work privately, or work in other scenarios like local authorities (school nursing for instance). Nurses are autonomous practitioners, unlike PA's, so that's another bonus. You'd be working as part of a multi-disciplinary team but that's a different thing and comes with the territory in healthcare.
At the end of the day, no one can tell you what to do, or what is best for you. Only you know that. A lot could change with the PA role in the next 5 years, now it is being regulated but you'd be basing your decision on a gamble unless you wait and see a little longer. See if the landscape changes. Whilst I've probably made nursing sound like the better option, it's not perfect and I'm not sure I'd recommend it wholeheartedly either! When it's good, it's great, but the politics, the emotional labour, the shifts (hospital) are a killer and hard on family life and relationships, you can be like ships in the night if you have a partner who works 9-5.
Have you looked at Physio, Occupational Therapy or Radiography? Still patient-facing but better work-life balance. Those are what I would look at. You can usually do them as MSc pre-registration courses too (2yr not 3yr) because you have a healthcare science background), limited university choice though.
Sorry for mega message! Best of luck
No, don’t apologise. Honestly, thank you so much for your mega message. I needed it. It was so informative and helpful. I have so much respect for the NHS and all of its staff and I completely understand the frustration that doctors and nurses feel towards the PA role. Your post summed it up perfectly. I will definitely check out some of the allied healthcare professions and see careers support at university. Even if I did continue to go down the PA route, I’d have to apply for 2026 entry because I don’t have any work experience so I guess that gives me more time to see how things change and what happens. Right now, I’m going to learn more about nursing and focus on getting work experience. I just wanted to ask about the nursing work experience and interviews. How are interviews like? How do I get work experience (I’m really struggling with this one)? What else should I know about getting into nursing? Sorry for bombarding you with so many questions and I genuinely thank you for your time.

Reply 3

Morning.

I'm not a nursing admissions tutor, so I can't advise directly re getting onto nursing courses. Your best bet is to email the admissions depts of the courses you are interested in and ask them about the kinds of work experience they are looking for. Obviously direct nursing experience is impossible and though some students
go from HCA and care work to nurse training, many don't. Often it's things like volunteering, so consider a role with local people that demonstrates you have good communication skills and are compassionate. It doesn't have to be 'medical' in nature.

Re nursing interviews - Interviews used to be mapped to the 6C's of nursing,

Care
Compassion
Courage
Communication
Commitment
Competence

I assume they still are. So plan your interview work around demonstrating how you fit those and why they are important in nursing. Discuss things like lifelong learning in nursing, read a couple of evidence based nursing journal articles, especially useful for the competency element. You have to re validate your professional registration (PIN) every 3 years (CPD and demonstration of practice), you have to demonstrate your competency and update your knowledge throughout your career. As you already have a BSc, you can also discuss modern nursing and the importance of science knowledge and understanding, your ability to read and critically analyse scientific papers and data will benefit you hugely in your studies and practice and is worth mentioning in interview. This is true of whichever profession you go for.

(It's me replying btw, I don't why the first reply anonymised. The box must've been ticked).

Reply 4

Thank you so much. I'm literally so grateful for your time and advice. Much love 💓

Reply 5

Go for nursing - hands down a better career option. Trust me I did PA and masisvely regret. Nurses can progress through the banding, and can expand scope to do procedures and independant prescribing in a way much more accepted than PAs can. Also you have a better chance of senior leadership positions. Also lots of nursing vacancies unlike PA!

Reply 6

If you are a 3rd year biomedical student then your logical next option is 4 years of graduate entry medicine in reality.

Physician associate is a fixed role, there is no progression and the qualification is not accepted abroad. The Royal colleges also seem to be taking an increasingly hostile view toward the role.

Reply 7

Original post
by ErasistratusV
If you are a 3rd year biomedical student then your logical next option is 4 years of graduate entry medicine in reality.
Physician associate is a fixed role, there is no progression and the qualification is not accepted abroad. The Royal colleges also seem to be taking an increasingly hostile view toward the role.

Yeah, I did this degree to figure what I wanted to do because I didn’t know at 18. All I knew was that I wanted to work in healthcare. A lot of my peers will be applying for graduate entry medicine and my sister is also applying to med school next year but I’ve personally never intended to do medicine and considering I don’t share the same passion to be a doctor as others, I don’t think I’d be very successful. My plan is to do adult nursing. I’ve spoken to a few nurses and that was an option I previously considered. I think I’d make a better nurse than a doctor. Hopefully with experience, there will be progression and I like that I will be able to work in any department. Anyways, I’m going to take a gap year once I graduate to get some work experience so I can figure it out and make an informed decision. I thank you sincerely for your time and response though and I agree, it’s a very uncertain time to be a PA and I don’t have any intention of pursuing that anymore.

Reply 8

Original post
by PA screwed
Go for nursing - hands down a better career option. Trust me I did PA and masisvely regret. Nurses can progress through the banding, and can expand scope to do procedures and independant prescribing in a way much more accepted than PAs can. Also you have a better chance of senior leadership positions. Also lots of nursing vacancies unlike PA!

Yes, I have decided to become a nurse. Thank you so much for your response and I really hope things get better for you and other physician associates.

Reply 9

Original post
by Sadia Firuj
Yeah, I did this degree to figure what I wanted to do because I didn’t know at 18. All I knew was that I wanted to work in healthcare. A lot of my peers will be applying for graduate entry medicine and my sister is also applying to med school next year but I’ve personally never intended to do medicine and considering I don’t share the same passion to be a doctor as others, I don’t think I’d be very successful. My plan is to do adult nursing. I’ve spoken to a few nurses and that was an option I previously considered. I think I’d make a better nurse than a doctor. Hopefully with experience, there will be progression and I like that I will be able to work in any department. Anyways, I’m going to take a gap year once I graduate to get some work experience so I can figure it out and make an informed decision. I thank you sincerely for your time and response though and I agree, it’s a very uncertain time to be a PA and I don’t have any intention of pursuing that anymore.

If you are a good solid nurse you will be able to work in any department you choose. The harder or more fast paced environments tend to be for people who are sure of their abilities and who volunteer for that particular role. If you are already keen on working in the emergency department or intensive care you are halfway there. These places is where you will see nursing at the absolute peak of the vocation. The only step beyond that is working in a nursing role for the the military or in some kind of humanitarian situation.

Best of luck. We really do need ambitious and increasingly academic nurses because the profession is being asked to do more and more as time goes on.
(edited 11 months ago)

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