By Naju Ibrahim, Physician Associate Vascular Surgery at University Hospitals Birmingham
The Physician Associate role is reaching its second decade since its introduction in the United Kingdom. The role allows graduates, and recently, undergraduates, to pursue a career in the medical and/or surgical fields. It is best suited to individuals who are naturally inclined pioneers in paving their career progression. If you would like to improve the standards of healthcare, be challenged in an intellectually demanding field and gain career satisfaction, then you have the potential to succeed as a Physician Associate.
1. Application to Physician Associate School
a. Personal Statement
Below are potential discussion points in an application to PA school:
- Your understanding of the PA role, duties, responsibilities and limitations
- Your understanding of the current legal standing of PA regulation
- Evidence of your willingness to grow clinically and become an ambassador for the role
- Expression of individualism and something profound – what makes you stand out
- Why you think you would be a good candidate
b. Interview
The interview is a platform to confirm what you’ve written in your application to PA school. It also allows the panel of interviewers to test your knowledge and ability to learn. The interview differs between PA schools, from a single interview to a full day of interviews. There may be a clinical and/or ethical scenario.
I have experienced both types of interviews and the important take home messages are as follows:
- Remain calm and don't allow nerves to make you feel like you have under-performed.
- Express yourself in a clear way as this is an essential requirement when working as a qualified Physician Associate; effective communication is fundamental in healthcare and within the multidisciplinary team.
2. Course
Most PA schools use problem based learning in year one, progressing on to case-based learning in year two.
Skills gained over the two year course:
- History taking
- Clinical Examination
- Procedural skills
- Basic Life Support
- Intermediate Life Support
- Presenting
- Audit-related work
- Exposure/Placements in Primary and Secondary care
3. National exams
All Physician Associate students who successfully complete either an MSc or PGDip in Physician Associate Studies are eligible to undergo the National Exams which consists of two parts; two written exams and one practical exam. The practical exam consists of fourteen objective structured clinical examination (OSCE) stations. All Physician Associate students are required to pass the National Exams in order to qualify as a Physician Associate and register on to the Physician Associate Managed Voluntary Register (PAMVR).
A PAMVR number is provided to all who have successfully qualified, consequently allowing them to undertake work as a Physician Associate in the United Kingdom.
4. Day to day Working Life of a Physician Associate in Surgery
Surgical Ward
08:00 – surgical ward round begins
11:00-14:00 – ward round jobs are completed – venepuncture/cannula/catheterising/reviewing a deteriorating patient/performing clinical exams/referring to other specialities/perioperative care/writing discharge letters
14:00- 16:00 – chasing bloods and acting on any abnormal bloods/prepping for the following day
During clinics
09:00 – you see patients in the outpatient clinic setting – slower pace to ward work and allows for the PA to develop specialist knowledge. If any queries arise, the consultant is always there for advice and confirming management plans
During theatre
08:00 – introduction to all staff in theatre for the day/discuss patient cases/scrub in to theatre/may scrub in as 1st assist
On-call Surgical Assessment Unit
08:00 – Handover + post-take ward round
Remainder of the shift – clerking patients, performing the appropriate clinical examination, reviewing bloodwork, initiating management, reviewing patients with the surgical registrar +/- on-call surgeon, adding patients to the acute take list.
5. Things I wish I had known
You may need to explain your role as a Physician Associate (fairly often!) to future work colleagues and the general public.
Service requirement changes with time and you may need to be flexible with these changes, for example extended working hours, weekend and evening cover.
Progression and development is dependent on how much you put into your training; the more you put in, the more you get out. Involve yourself in audits and quality improvement projects; undertake research with a medical/surgical team with the aim to publish.