New Physician Associate Grade

The Royal College of Surgeons in Ireland is running a two year MSc course for Physician Associates, a new grade of staff to be introduced to the Irish Health Service, writes Maureen Browne.

Physician Associates are highly skilled healthcare professionals who provide a broad range of medical services. PAs support doctors in the diagnosis and management of patients and are trained to perform a number of roles including taking medical histories, performing examinations, making diagnoses and analysing test results.

Physician Associates are intended to complement the healthcare team. They do not replace doctors or nurses, but are an example of innovation in the area of skill mix.

The Department of Health, the HSE and the Royal College of Surgeons in Ireland are currently evaluating the Physician Associate project which began in Ireland in July 2015,

The General Surgery Directorate at Beaumont Hospital, in Dublin, in collaboration with the RCSI, is piloting the two-year project.

The recruitment of four international Physician Associates is part of this project, “to demonstrate the unique support that PAs can provide in the diagnosis and management of patients.”

As regulation is not yet in place, PAs in Ireland and the UK do not currently have prescribing rights

While working across a number of clinics at Beaumont Hospital, these Physician Associates also act as mentors and tutors for students on the PA master’s programme at RCSI

The Physician Associate (PA) role has grown rapidly internationally. A PA works as a member of a medical team under the supervision of a doctor or surgeon in a wide variety of workplaces (including all types of hospital and surgical care, GP practices and community health services).

The College says that working as a qualified Physician Associate can offer great variety and job satisfaction. “PAs practise medicine as part of a consultant-led multidisciplinary healthcare team. PAs provide focused care to patients by supporting doctors in the diagnosis and management of patients in a wide range of healthcare settings. The role of the PA includes taking medical histories, performing examinations, making diagnoses and analysing test results. As PAs mature in their role, their level of autonomy in medical decision making will increase.”

As regulation is not yet in place, PAs in Ireland and the UK do not currently have prescribing rights. However, pharmacology is a key component of the PA curriculum as well as in the delivery of medical care.

Discussions are taking place within the Department of Health to plan for regulation of the PA profession in Ireland.

The teaching/learning approach in the RCSI course includes problem-based case studies, lectures, workshops, simulation, online learning and projects. Quality clinical placements are completed in Community Medicine, General Hospital Medicine, Front Door Medicine, Mental Health, General Surgery, Obstetrics and Gynaecology and Paediatrics. There are a range of assessments including OSCEs, MCQs, Short Answer questions, essays and presentations. Year 2 includes a dissertation.

Applications are invited from Level 8 Health Science or Science related degree candidates with a minimum classification of 2.2 award or equivalent qualification. Candidates who present a Level 7 degree plus relevant work experience may be considered on a case-by-case basis.

The College recommends that potential applicants who do not have an honours degree or whose degree isn’t science or health-related should contact the College to assess their suitability and for advice and guidance.   Potential applicants should send as much information as possible including module titles and content.

As this is an intense programme of study at post-graduate level, the RCSI highly recommends that those doing the course do not work outside. “In order to succeed you will need to commit fully to acquire the knowledge and skills necessary to be a competent PA. The course is time intensive, with an equal amount of time spent outside of the classroom for every hour in the classroom.”

This is a rapidly developing professional group with over 110,000 PAs now qualified and employed in the US. In the UK, 200 PAs have qualified since programmes began just eight years ago.

As the USA has strict rules for all PAs educated outside of the country, it is not possible to practise as a PA with a qualification awarded outside the USA.