At no point have I said PAs are better qualified or better than doctors.
DO I think there is a place for PAs, - yes I do. Healthcare evolves, it is not a stagnant beast and challenging the stereotypical perception of roles in a health care system is what drives progress and excellence. One of the biggest healthcare industries i the world successfully uses PAs and if you look at their models then you can see where the role can compliment both nursing and medical work. Do I think PAS, ANPS, CNS etc replace doctors - no I do not. If health care did not evolve we would not have advanced nurse practitoners, doctors would still be giving the first dose of antibiotics and all iv antibiotics, inserting every venflon and taking every blood.
Tick boxes are what training has become and you observe some trainees seeing it as a game to tick the boxes, because that says I can move on but not guaranteeing they have learned the true value of what that box was supposed to represent.
Yes I do feedback regularly and am vocal on the subject. Hence my example about my current trainee who has ticked all the boxes and is so not ready to progress due to the lack of other "soft" skills which are poorly assessed. By your criteria he should automatically get a training post -disaster for him and patients. Failing to get a number has made him have to re evaluate his lot in life and take a step back. In the pub last Friday he said - I am so not cut out for F2F health care but I can make the grade because playing the game is easy. He has gained insight and is off for a career in a lab /research/ industry which he will be brilliant at. We discussed how the treadmill of medical education does not give you time to think from 18 to spitting you out at the end - unless you ae prepared to jump off, take a leap off faith and accept getting back is going to be hard.
Who knows at 18 what they want to be at 45 - very few people. WE ahve made medical education so regimented that changing your mid, questioining your decision is now vey difficult.