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Who are Physician Associates and what do they do?

This post is for people wondering what the PA role is and the sorts of jobs we do. It is also helpful for current students and qualifieds who are looking for ways to describe themselves to their colleagues and patients.

Who are we?

Physician Associates begin their lives as postgraduate students, usually with a life science or health science degree. Some have clinical experience from previous jobs or volunteering experiences but depending on which University they attended, it is not always necessary. I myself started with a Biology degree. Others from my course had Biomedical, Nursing and even Pharmacy degrees.

From here, they attend PA school for 2 years learning medicine before gaining their Postgraduate Diploma/Masters in Physician Associate studies. Part of this training is University teaching which can involve lectures, workshops, anatomy teaching (with cadavers) and communication sessions with simulated patients. The other part is clinical placements, where students can be placed in a variety of settings including GP, acute medicine, surgery and psychiatry. PA’s can then get jobs in GP, hospital and community settings.

What do PA’s do?

The Faculty of Physician Associates at the Royal College of Physicians is the professional body that supports PA’s in the UK. They describe PA’s as ‘medically trained, generalist healthcare professionals, who work alongside doctors and provide medical care as an integral part of the multidisciplinary team. Physician associates are dependent practitioners working with a dedicated medical supervisor, but are able to work autonomously with appropriate support.’ But what does that mean?

  • Medically trained: refers to being taught at medical school to a medical model for 2 years

  • generalist healthcare professional: we are taught general medicine and have placements across a variety of specialisms rather than training in a certain specialism.

  • integral part of the multidisciplinary team: means we work with doctors, nurses, pharmacists, physiotherapists etc. to combine expertise and provide quality healthcare.

  • dependent practitioners working with a dedicated medical supervisor: this means we work under the supervision of a doctor who we can ask for support and advise

  • work autonomously with appropriate support: in certain situations where experience and support is permitting, we can work independently

Here are some examples of general jobs PA’s do:

  • take medical histories from patients

  • carry out physical examinations

  • form differential diagnoses (list of possible medical causes) and management plans

  • perform diagnostic and therapeutic procedures e.g. taking blood, cannulation, suturing

  • request and interpret diagnostic studies e.g. understanding blood results, ECGs, x-rays

  • health promotion and disease prevention guidance

More specific type of work will depend on the environment they work in and their experience. I know PA’s working in Cardiology, Respiratory, AMU, A&E, General surgery, Vascular surgery, Cardiothoracic surgery, the list goes on and on!

What’s the difference?

PA’s are often confused with doctors by patients and colleagues, hence the name of this blog! This could be because we work directly alongside them and since the role the is quite new in the UK, people aren’t aware that PA’s exist. We often don’t have a uniform like nurses or other healthcare practitioners and this paired with a stethoscope is usually enough to cause confusion. PA’s are also commonly compared to Advanced Nurse Practitioners (ANPs). They too work alongside doctors to diagnose and manage complex diseases. So, what’s the difference?

Well firstly, doctors train at medical school for 5 years. Once they become doctors they undergo foundation training followed by training pathways as they specialise in their chosen specialty. Usually once they’ve decided which training pathway to undertake, it is difficult to change later.

There are no such structured pathways for registered PA’s. They can either take a contract in which they rotate through departments for a while before settling into a permanent position (like myself). Or go straight into a permanent speciality from the get go. We also have the flexibility to move between specialities, even from hospital to GP and vice versa.

Doctors are autonomous professionals who have prescribing rights and can order investigations involving ionising radiation like x-rays and CT scans. As discussed already, Physician Associates are dependent practitioners. In the UK, Physician Associates are currently unable to prescribe and request investigations involving ionisation radiation. This is hopefully due to change in the future as we campaign to achieve statutory registration of the profession.

In terms of ANPs, they are nurses who receive further specialist training to become advanced practitioners. The main difference is that they have a nursing background and train in a specialism e.g. diabetes or heart failure. Whereas PA’s have medical training in generalist medicine.

So hopefully that’s busted some myths and made things clearer!

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