Taken from the Faculty of Physician Associates website: http://www.fparcp.co.uk/faqs/

 

What is a Physician Associate (PA)?

 

A physician associate is a dependent health care professional who has been trained in the medical model and works with supervision of a doctor or surgeon. PAs obtain medical histories, conduct comprehensive physical exams, request and interpret tests, diagnose and treat illnesses and injuries, and counsel on preventive health care.

 

As in the early days in the United States, PAs in the UK are not able to prescribe medication at this time. PAs are involved in acute medicine as well as chronic disease management.

 

The PA concept started in the United States more than 45 years ago, and the model has since spread to Canada, Australia, the Netherlands and the United Kingdom. A number of other countries around the world have similar but not identical non-physician providers.

 

How are Physician Associates Trained? (Written by PASOC President)

 

All Physician Associate training places are graduate entry. That means that all PA Students have already studied and achieved an undergraduate honours degree (usually a BSc(Hons) in a science or health related subject).

 

Current ARU PA Student backgrounds:

 

- Biomedical Scientist

- Medical Engineer

- Operating Department Practitoner

- Diagnostic Radiographer
- Registered Nurse

- Public Health

- Sports Scientist

 

Following their 3 year (or 4 year in Scotland) undergraduate science/health degree potential PA student needs to apply for one of a handful of approved PA programmes. These are currently only being offered in England and Scotland within the UK. Gaining a place on a PA programme is highly competitive so a strong personal statement detailing why you are interested in the PA profession and strong acaedmic grades (2:1 or 1st class honours degree) can sometimes not be enough to get an interview. Extra skills, experiences and extra-curricular activities are highly reccomended.

 

Once accepted on to an approved PA programme, PA student will either study to PGDip or MSc level (all ARU students study to MSc level). This consists of 1 year of didactic teaching through problem/scenario based learning, seminars and lectures. During this time, students must undertake a minimum of 200 hours of clinical skills (which is usually a mixture of GP placements and simulation suites).

 

After passing first year, students progress to full time clinical placement within the community, primary and secondary settings. They must undertake a set number of hours within different clinical specialities concentrating mainly on adult inpatient medicine. This will be supervised practice with a named consultant in charge of directing the PA students learning.

 

To graduate and be able to pratice as a Physician Associate in the UK, students must sit and pass the national exam. All students from across the UK will sit the same exam which tests their clinical skills, clinical knowledge and pharmacology/prescribing knowledge (although UK PA's are currently not able to prescribe due to UK legislation). Upon graduation, Physician Associate students must apply to the PA Managed Voluntary Register (PAMVR) which is held and managed by the Faculty of Physician Associates at the Royal College of Physicians of London.

 

How did the Physician Associate profession begin?

 

The Physician Associate profession was founded in the mid-1960s during a time of primary care physician shortage in rural areas in the USA. Dr. Eugene Stead of the Duke University Medical Centre in North Carolina put together the first class of physician associates in 1965. For more information, see the Physician Associate History Centre website.

 

How do PAs fit into the NHS?

 

Physician associates can be found working in GP surgeries, Accident and Emergency departments, and inpatient medical and surgical wards throughout England and Scotland. See below for examples as to how PAs can be used;

 

In a GP surgery, PAs see patients of all ages for acute and chronic medical care. PAs can refer patients to consultants, the EAU or to A & E when clinically appropriate. Other duties include home visits, prescription reauthorisation, review of incoming post and laboratory results. Physician associates are an additional health care team member to help the practice reach Quality Outcome Framework targets.

 

In Accident & Emergency departments, PAs are able see whatever comes in the door. They see patients in minors and majors as well as resuscitation and post resuscitation. They are also able to see medical, trauma, mental health, paediatric, obstetrics and gynaecology cases. PAs obtain the history, conduct the physical exam, request investigations. They are able to make referrals both to in-house specialities as well as arrange for outpatient appointments or GP reviews. PAs are able to discharge or admit patients and can arrange for intermediate care or community services as well. Some experienced PAs help with teaching for the PA and medical students as well as FYI and FYIIs.

 

In which clinical settings do PAs practice?

 

PAs work in a wide variety of practice settings, including:

• GP Surgery

• Inpatient Ward of Hospital

• Geriatrics Ward

• Acute Medical Unit

• Medical Assessment Unit

• Accident and Emergency

• Intensive Care Unit

• Outpatient Department of Hospital

• Walk in Centre / Out of Hours care

• Specialty Outpatient Surgery

• Psychiatry Clinic

• Community Mental Health Services

• Operating Theatre

 

Ritsema TS, Paterson KE. "Results of the Third Annual UKAPA Census" London, England, United Kingdom, August 2013.