Training as a Physician Associate

[GoneOffOnATangent]

Hi, are there any physician associates out there? I'm considering retraining and have recently discovered that there is a 2 year PG qualification for this role. I've never come across the role before, so am interested in experiences of the training and job. Ideally I think I'd like to work in A&E.

A cursory glance at NHS jobs shows a number of vacancies but I'm wondering more generally whether there will be plenty of opportunities upon graduation. I'm also curious about working conditions/ work-life balance etc. Is the role well respected?

The pay would be a good step up from my current role but there doesn't appear to be enormous earning potential. I've worked in healthcare before lower down the scale (primary and secondary care settings) so I understand the pressures and stresses in that type of environment. I suppose I'm wondering if it would be worth it in the long run. TIA

Hi.

I’ve never actually met one (!) but you would be highly sought after if you went down this route. With lots of shortages in JD and medical posts, lots and lots of trusts are looking to employs physicians assistants because they can do some of the role, allowing them to focus on other tasks. Even if there was no advertised role, I’m sure you could email in and a trust would employ you

My brother in law is currently doing the postgrad, seems to be fantastic opportunities- good pay, arguably better working conditions than JDs, highly sought after. He says a bit of awkwardness and snobbery from some HCPs on placement but probably more as the role is new and some aren't completely sure what it entails.

I was offered a place to train about 5 years ago and turned it down due to worries about getting a job. Not sure if things have improved or not but make sure your local trusts employ them. Round here they don’t….I worked for the nhs for over 15 years and never met one or seen a post advertised locally.

I thought at the time it could go one of two ways….either the role take off…..or trusts train up nurses to be advanced practitioners as they can prescribe so can be argued they’re more useful. Locally they are going down the advanced practitioner route.

Thanks both, that's really encouraging.

Part of my concern is that the role seems to have a lot of responsibility (it seems comparable to a junior Dr in some respects, from what I've read), but the long term career prospects and earning potential is limited. I've previously considered an accelerated medical degree but many still consider a-levels (mine aren't good enough!) and obviously the cost is huge.

I feel that the pharmacy professions isn't very well respected by other HCPs or patients. It's quite disheartening, and I wonder whether this type of role would be viewed in a similarly.

@CovidCorvid Thanks, that's interesting, and sums up some of my worries really. It seems a bit of a superfluous role, and there seems to be a lot of overlap with other roles. A quick search showed several vacancies locally (mainly in general practice) but I feel like it's quite a niche qualification, and if the roles aren't there, you're stumped!

Here newly qualified PAs can get £40k, I'd say although there are more limits to where you can go with it, you actually start off in a better position. I'm a midwife and it'll take me ages to reach that kinda pay, if ever!

Even if there was no advertised role, I’m sure you could email in and a trust would employ you

NHS recruitment definitely does not work like that! If you emailed them speculatively, you'd be told any vacancies will be advertised on the NHS website.

It's not a role that has been as widely embraced as in the US, as above I'd say more trusts have gone down the nurse practitioner route. I can imagine the GP practices recruiting are doing so because they can't fill GP vacancies. That would concern me, the role is not sufficiently clearly defined to make it a role in itself, more a filling in the gaps that others cannot cover.

The concerns that sprung to mind have been echoed by a few of these replies. The role seems to entail a lot of Dr responsibilities but without the career advancement, pay prospects or 'kudos'.

The money looks attractive initially but I wonder if there'll be an unreasonable amount of responsibility and stress for it! Feels almost too good to be true...

There also seems to be a lot of courses, so I wonder if the number of graduates will start to outstrip the number of jobs over the next 2-3 years

You absolutely could not pay me enough money to do a junior Dr's job forever. It looks awful. I say this as an experienced hospital nurse.

We have PAs at out trust and they are fantastic but do seem to take on the role of an FY1 and can be treated as a bit of a dogsbody. Inability to prescribe is a major limitation though.
I'm not sure re progression - feel like there would be a ceiling at 7/8a. 8a prob less likely as ACPs are 8as usually.

PA here

Been a PA for about 3 years and worked on both primary and secondary care

I have seen departments with them and would suggest either going for a full fat medical degree or doing something else.

The departments with them have generally reported they are slower and more risk averse than the medically qualified and whilst cheaper to employ are significantly more expensive in overall cost per patient seen as slower and request more investigations. Acceptable if you cannot get someone medically qualified, but what does that tell you about the job if they can’t fill it?

@GoneOffOnATangent I wouldn't say that the pharmacy professions aren't well respected, there's so many opportunities now in pharmacy from working in industry, GP practice, medical writing, as well as the better known hospital and community roles. And many pharmacists are now prescribers, running specialist clinics and it's a really interesting role.

I know a PA who works in hospital and seems to really enjoy it. I'm not entirely sure exactly what the role involves but I do think there's a lot of responsibility with it.

@Tomaytoes

PA here

Been a PA for about 3 years and worked on both primary and secondary care

My late Mum was tended to by a PA at A and E, and the care and attention she received was honestly outstanding. I wrote to the hospital board after the crisis and commended her to them.
So thank you, on my family's behalf - PAs are not looked down on by my family.

I met one when I was a patient in my own hospital. I couldn't see the point of the role. Can do less than an advanced/ specialist nurse and can't prescribe anything.

Thankyou

As a new profession there’s lots of uncertainty around the role. It can be tough constantly trying to explain the role especially with lots of preconceived ideas from patients and other staff. Most change their minds when they’ve worked with us though.

It’s a great profession and most PAs would recommend it as a career. I don’t know what will happen re career structure but there will be one!

There's also a move to employing paramedics to cover roles in primary and secondary care where they can't find staff. Cheaper than a PA and I think (?) can maybe prescribe some stuff....I certainly know paramedics who have done a prescribing course so they must be able to as long as they've done the extra training.

It would worry me long term that at some point even the trusts which currently employ PAs realise they can get the same/more for less money and knock the whole idea on the head. But I'm very risk averse...maybe I'd have made a good PA! :)

@confusedlots I've worked in pharmacy for years from counter assistant to tech, in community, hospital and a stint at a dispensing Drs. In general, I really don't think pharmacists or technicians get the pay or respect they deserve for their level of training, responsibility and workload.

I agree there are lots of interesting roles in pharmacy but in my experience, the rewards (monetary and otherwise) aren't worth it for the front line roles at least. I wasn't for a second suggesting that I felt they weren't worthy of respect, so I hope my comment didn't come across that way.

@Tomaytoes I take it you like your job? Do you think the role is pretty futureproof? The lack of prescribing ability does seem slightly odd, given that so many roles have the option to gain prescriber quals. Do you think this might change? Do you think you're fairly paid for the responsibility you have?

I'd be interested to know more about your actual day to day role and responsibilities if you'd be happy to share?

Sorry for all the questions!

In the ambulance trust I work, the local health board nhs trust and local GPs I've never come across a physicians associate. They seem to be going down the advanced practitioner route with lots of funded places for HCPs instead.

I do like my job although I’m changing roles soon but that’s because there’s so many opportunities!

PAs are here to stay, just look at America. Prescribing rights will come but it’s never been an issue, just ask the duty dr to prescribe if needed. Once you’ve built up a good working relationship they’ll trust that you know what you are doing.

The profession should’ve been regulated by now but has been delayed due to brexit and then covid. Once we are regulated, prescribing rights will follow

@CovidCorvid

There's also a move to employing paramedics to cover roles in primary and secondary care where they can't find staff. Cheaper than a PA and I think (?) can maybe prescribe some stuff....I certainly know paramedics who have done a prescribing course so they must be able to as long as they've done the extra training.

It would worry me long term that at some point even the trusts which currently employ PAs realise they can get the same/more for less money and knock the whole idea on the head. But I'm very risk averse...maybe I'd have made a good PA! :)

Advanced paramedic practitioners have been able to do the independent prescribing module as part of there masters degree for a few years now. A standard paramedic can not prescribe but we have an ever expanding number of drugs we can administer plus PGDs, so there are GP surgeries using paramedics as well as AP. I have even heard of GP surgeries use emergency medical technicians to go out on home visits to do observations and assessment and feed that info back to the GP who then does a phone consultation.

Have you considered Clinical Perfusion Science? It's a much more established role, greater potential for career progression and increasing earnings. You'd qualify on a band 7 and could progress to 8a within 2-3 years. Then management roles after this. Depending on the centre you work at there's the possibility of earning a fair bit extra through overtime /on calls. Lots of people do locum too. It's highly specialised and technical, with a lot of responsibility. Lots of demand for trained staff and the qualification is recognised in a number of other countries too.

The downside is that there isn't much patient interaction, can be pretty stressful and the hours can be long sometimes (not always).

You might also want to look into the NHS scientist training program, but I'd say the same caveats as physician associate in terms of career progression apply to this too.

@Letsallscreamatthesistene

You absolutely could not pay me enough money to do a junior Dr's job forever. It looks awful. I say this as an experienced hospital nurse.

Too right. Or do a doctors job at all!!