1. PostGraduate Diploma Physician Associate Studies Karen Roberts, MSc, PA-C/R
OCTOBER 2014 1

2. Outline of Session Definition of the Physician Associate
Development of the Profession
PA Responsibilities and Attributes
Employment
Professional Issues
Training Programmes

3. What is a Physician Associate?
“…a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and /or general practice team under defined levels of supervision.”
(The Competence and Curriculum Framework for the Physician Assistant, Dept. of Health, Sept 2006)
Note: CCF updated in 2012.
PAMVR.pdf 3

4. Development of the Profession
Developed by doctors
Need for primary care services
Medical Education Model
Increased capacity and access

5. Physician Associate Responsibilities
The PA is trained to:
Take Patient History
Perform Physical Exam
Formulate Differential Diagnosis
Create Treatment and Management Plans
Perform Procedures
Select/Recommend Medications
Request and Interpret Diagnostic studies
… All with doctor supervision (the PA works to the scope of practice of the supervising doctor)

6. Physician Associate Attributes
PAs are trained to be:
Aware of the limits of their competence
Team players
Lifelong learners
Autonomous decision makers within their scope of practice and level of experience

7. From within the Doctor-PA relationship, to the doctor’s patients
How does a Physician Associate work?
To the medical model
With doctor supervision
Within the scope of practice of the supervisor
As a dependent clinician
In a relationship between doctor and PA which is based on mutual trust and respect
From within the Doctor-PA relationship,
the PA exercises autonomous medical decision-making, to extend healthcare
to the doctor’s patients

8. Physician Assistants globally
USA – 47 year history with > 100,000 qualified
UK – 220 PAs, growing demand (outpacing supply)
The Netherlands – ~1000 PAs from 5 programmes
Canada – >300 PAs
Sub-Saharan Africa – similar models; various titles; unknown numbers
Australia – now training PAs
Germany – training in progress

9. Rationale: UK Role
The PA profession helps to meet UK health care needs by:
Building capacity
Expanding skills mix
Redistributing doctor workload
Developing a defined health profession to expand midlevel staff without depleting current roles
Help meet demand for increased quality of care

10. Physician Associate Employment in the UK
~220 trained PAs working in:
A&E
Trauma & Orthopaedic Surgery
ENT
Paediatric Intensive Care
Paediatric Surgery GI
Acute Medicine
Haematology
Derm/Lymphoedema
Infectious Disease
General Practice
Cardiology
Respiratory
Oncology
Urology
Psychiatry
Vascular Surgery
Plastic Surgery
GUM (Sexual Health)
Geriatrics

11. DH specification for PA education
Competence and Curriculum Framework
Updated 2012
Competencies Procedural Skills Matrix of Conditions
Programme Specification
~ 3200 hours over 2 years ~ 50% clinical (incl. 200 simulation hours) ~ 50% theory
2006

12. PgDip PA Studies - Clinical Placements
General Practice
Acute Medicine
A & E
Obs/Gynae
Paediatrics
Mental Health
Surgery
Electives: Cardiology, Gastroenterology, Dermatology, Neurology etc.

13. National exam Taken after completing university course
Required to practise as PA
SBA + OSCE
Ensures minimum standards across UK PA programmes
Re-certification exam EVERY 6 YEARS

14. PA MVR Current Issues Registration & prescribing Salary
Voluntary list √ → voluntary register √ → statutory register
Prescribing as integral to role rather than extension
UKAPA - Leading Organisation (
Registering Body
Salary
Band 7 (£30-39k) to 8a (£38-45k)
Occasional Band 6 internship job post
PA MVR

15. PA Training programmes
Current programmes
Aberdeen
Birmingham
St George’s, University of London
Worcester
Wolverhampton (Oct 2014
Coming soon
Plymouth (Jan 2015)
In development or interested
~20 other universities

16. General requirements Excellent interpersonal skills Motivated
Self-directed learner
Professionalism
Maturity
Strong communication skills (verbal & written)

17. Final thoughts Newly qualified PAs will still function as beginners
Can make a substantial contribution in continuity for
Patients
Health care teams
Pioneering as a Physician Associate
Still relatively new role to the UK
Opportunity to participate in change/creation
Not THE solution, but PART of the solution!

18. SUMMARY Intense Training Student Enthusiasm & Dedication
Demand for PA role
Opportunity to be part of a profession in the making

19. Questions?
Thank you!