Physician's associate career (or nursing?)

[ladybirdsaredotty]

I had a thread a while ago about possibly training to be a children's nurse and you lot were so helpful. I've mainly been put off doing that although a bit of me really wants to do it (I do a related job and love aspects of it). Anyway, my local uni now runs a Physician Associate Studies masters which I could potentially apply for (although my 1st degree is old so I would need to check). Happy to stand corrected but it seems like Physician Associates do specific tasks usually done by doctors and it's a way to save the NHS some cash on doctors and senior nurses (they start at band 6 or 7 but it's quite a flat career structure). As I have 3 DC under 7 I am keen to try to do a qualification that will result in a good job but I am a bit worried that, as the role is fairly new, the whole idea may get shelved, or there will be an excess of graduates chasing very few (my local trust has only just advertised for its very first Physician Associate roles). I am wondering if nursing may be the way forward after all. Anyone have any thoughts? Thanks for reading

I have a genuine interest in both of these careers, just trying to work out what's the best way forward for my family

Blimey. A two year course (on the back of what 3 year degrees btw?) and you are straight in at a band 6. What clinical experience are you getting in those two years and who will be supervising you when you qualify? In my role you generally need a really good grounding as a band 5 to build up your clinical experience before going for a band 6 position.

I have a friend who has just finished her PA course - 2 years and a lot of placement in different clinical areas as well as tons of study.

She is now started in a job in her local trust and is loving it.

It suits around her home business and is something she is really interested in. She has her home business partly as a sideline but partly as a hobby.

This is a niche role which demands a degree to be considered for a place.

It was only created by NHS in the last 2/3 years so this is the first real rollout of the new PAs after their 2-year masters.

www.prospects.ac.uk/job-profiles/physician-associate

If you look under responsibilities you will see - have direct contact with patients, taking medical histories, carrying out physical examinations and making home visits among others.

Now think about when Drs are training (ie university students) for example, they will learn how to take a medical history and learn how to ask relevant questions and then they go back to their team or consultant and present the case in an accurate concise manner with the findings of what examinations they have completed on the patient,

What symptoms does the patient have?
What was pulse, resps, BP, temp like?
Any chest problems - wheezing, was it clear on listening or any crackling on any areas?
What medical problems does patient have?
Are they on any meds? Are they taking them? Any problems with them?
What does the patient feel is wrong with them? What does the PA feel is wrong.

Think about eg when you go to a hospital (A&E), the Dr usually asks you a ton of questions and writes all the answers down. They will check your vitals, why you came and all sorts of questions. It is to put a full picture together and work out what is going on. They are not asking for fun or being nosey. They need to know so can help you.

So I think the PA job would be like taking a full history and general examinations and tests, Im not sure on prescribing responsibilities but instead of the GP having to go thru all each time, the patients case would be presented by the PA to the GP and a discussion takes place to work out the best line of treatment which the GP can prescribe,

If any queries on examination by the PA they can raise with the GP who can double check and that would free up time so the GP can have longer to spend with those who need it and not sure but maybe PA could have limited prescribing ability and I know my friend deffo does injections, bloods, smears, wounds, does forms for samples and all that sort of stuff, notes who needs reviewed which frees up some time for the nurses in the practice (treatment room and practice nurse) so they have longer with patients as needed,

What about graduate entry nursing? You do a 2 year fast track MSc and finish as a registered nurse. Most universities offer an MSc in adult nursing, some mental health, a few learning disabilities and child. You will probably find you have to do something to show you have studied at level 6 or equivalent recently though if your degree is older than 5 years ago, at least you would in my university.

I teach graduate entry nurses and love it. They are super motivated and bring such diverse experience on to the course with them from previous education and careers. Check out the GEN international network website, I think there is more info on there.

Thanks for recent replies!

redeye I would definitely be interested in that, but unfortunately the only university I can realistically get to only does the BSc. Which is a shame, as I really want to do a postgraduate qualification, although getting a professional qualification would trump that!

Scribbly I know...my local trust is actually advertising their first PA roles at band 7! At the uni I'd be attending, it seems to be 2 years of a medical degree, essentially. You obviously don't go into as much depth as the med students, though. You're always working under supervision/direction of a doctor once qualified, so never truly autonomous I don't think, although how that works in practice I couldn't tell you.

Do bear in mind that you have to have a life sciences degree before doing the PA course. So it's not just 2 years of study. It would out as 5.

Nico good advice, thanks!

Free and my degree happened to have been 4 years, so 6 years in total. But I graduated so long ago (I'm now 37) that I'm worried about counting those 4 years as part of my training!

I don't really see the point of a PA, some nurses can do far more and privet better pay. Are there any career levels as a PA?

Toddlertea I remember you from my nursing thread! 👋

I'm not sure I get it really, either. I know the career structure is fairly flat but obviously starts at a higher band than nurses tend to...

Toddlertea what is it that some nurses can do that PAs can't? Prescribe? Obviously nurses may have more actual experience...

At my information evening yesterday, we were told that legislation had been going through to make it so PAs would be able to prescribe, but that’s been put on the back burner due to Brexit. They’re hopeful that it’ll pass within the next few years.

The course I have a place on is sponsored by the local NHS trust, so I won’t have to pay tuition fees to the university. I’m hopeful this means the trust are keen to continue hiring PAs (they currently have about 20), as otherwise they’d have wasted their money training us.

We use PA’s in my work. They work anaesthetics, they do local and generals. They work under very specific guidelines and with a consultant anaesthetist in the unit. We are a very niche unit but they also provide the service within the main hospital theatre suite.

Fiona Interesting, thanks. My (potential) uni is still unsure of how fees will work for next year, apparently...

At the open day I went to, they described it as the first three years of a medicine degree crammed into a masters!

I'm in London and the NHS website has a few PA jobs.

Fiona it's great you are being funded

Dreaming sounds intense! All my DC are young, one is a baby. If I could leave it a few years for the DC to get a bit older and so I could see what the job situation is like, I would. But at 37 I feel like I need to apply either now, or next year at the very latest really...

(gp) I'd go for nursing. PA roles are not widespread and no scope for properly independent work eg nurse prescribing not open to pa as nor regulated the same way. Much more scope for specialising if you do the nursing qual too.

knotty thank you. Every time I think I'll go for it, someone comes along with a compelling reason why I shouldn't! But thank you all, this is great food for thought

There's more opportunity for career dev as a nurse. Friend of mine is hand 8 working as an advanced neonatal practitioner. She is on the paeds sho Rota and does the same role as the SHOs but with much more experience is better than the SHOs!

Nico in an ideal world, and assuming I'd be good at it, that's the sort of job I'd want (eventually!). But part of me feels it's silly to go for nursing if I could do the postgrad PA course and get paid more at the end, at least in the short term. I literally can't decide...

ladybird that's my thought process. I'm a similar age to you and I think I'd rather earn more immediately than have long term career progression.

I also don't think you can do a nursing degree and get to band 8 without going shift work, whereas at the PA open day I went to they said the clinical placements aren't shift work over 24/7.

Dreaming exactly that (regarding pay).

I'm never sure about whether I'd rather work shifts or not. Me and DP currently work shifts around each other for childcare (57 hours a week between us) and it works well, although we don't see each other much...

Different things suit different people, if I were 25 and pre children then I think nursing would be a better option due to career progression. As it is, I don't think I'll be ready to start working as a PA until I'm 40 and I'd rather be earning more immediately but know I'm unlikely to earn mych more over the next 20 years or so.

My DH works long hours and travels frequently, and no family nearby so shift work is virtually impossible for me.

PAs are not widely used despite having been around for a good while. The job might be more sexy than band 5 nursing but there are far fewer career options and opportunities.
If you want to stay basic grade doing the job then PA might be better but if you are ambitious the harder slog of nursing might stand you in better stead.

Hi there, I'm currently training to be a PA (1 month in) and the course is amazing! Talking to people who have already studied the course it seems most people get job offers from their placements (GP or hospital) before they have even finished, so don't be put off by a lack of advertised jobs. All of the last cohort at my medical school have jobs.

My degree is also very old (Biological Sciences, 17 years ago!) but I'm having no trouble understanding everything and keeping up.

Just a warning - it's VERY full on. You need to learn a lot and very quickly (the Anatomy ). You will be exhausted (especially if you have kids - I have 4). But if you want a career in medicine as a science graduate I would highly recommend it.

As someone has already mentioned regulation has been put on the back burner due to Brexit but it will happen. This will of course make PA's very desirable when we have prescribing rights. My med school predict this will happen within two years (but who knows).