Physician associate

Physician associates are trained health professionals who provide crucial support to doctors and have regular direct contact with patients

As a physician associate, you'll consistently work under the direct supervision of a named senior doctor, who is either a consultant or general practitioner (GP). You will carry out tasks such as the examination, diagnosis, management and care of patients.

You'll be part of a medical team and will typically work in GP surgeries or hospitals as part of a medical team.

While you can work autonomously with appropriate support, you will need to stay within the limits of your scope of practice and know when to refer to doctors and other healthcare professionals.

This a relatively new role in the UK, which is growing and developing over time. It should not be confused with the role of physician assistant.

This is not a route to becoming a doctor. For information on how to train to be a doctor, see hospital doctor or general practice doctor.

Responsibilities

As a physician associate, you'll need to work within a defined scope of practice. In general, you will:

• take patient medical histories during face-to-face and/or telephone consultations
• carry out physical examinations
• order diagnostic tests and analyse results
• make diagnoses and clinical assessments
• carry out a range of diagnostic and therapeutic procedures within the scope of your role
• develop and deliver appropriate treatment and care management plans in consultation with patients, their relatives and carers
• organise further investigations, treatment and referral to a doctor/other healthcare professional where appropriate
• evaluate the effectiveness of care management plans
• make home visits to patients who are unable to visit the surgery/hospital due to their condition
• provide patients with advice and counselling on health promotion and disease prevention
• maintain accurate clinical records
• complete paperwork and other administration duties, including writing reports, letters and other correspondence.

Physician associates must not provide care or treatment without supervision. In addition, they are not currently allowed to prescribe or request ionising radiation, such as CT scans or x-rays.

Salary

• Jobs in the NHS are usually covered by the Agenda for Change (AfC) Pay Rates consisting of nine pay bands. Preceptorship posts that support newly qualified physician associates with the transition to the workplace typically start at around £35,392 (Band 6).
• Following your preceptorship year, you will usually be employed on Band 7, starting at £43,742 and rising to £50,056 based on your skills and experience.
• Experienced (higher-level) physician associates may earn between £50,952 and £57,349 (Band 8a). You will usually need at least five years' experience and a relevant Masters degrees for these roles.

Income figures are intended as a guide only.

Working hours

You can expect to work 37.5 hours per week. Working hours can vary and you'll be expected to be flexible across a seven-day period as you may be required to work shifts, which can include out of hours, nights and weekends.

Part-time work and job shares are sometimes available.

What to expect

• You'll work as part of a multidisciplinary healthcare team alongside consultants, GPs, physicians and surgeons. Most of your time will be spent working in hospitals or GP surgeries. Home visits may also be required.
• Jobs are available in hospitals and GP surgeries throughout the UK. Job security is relatively high.
• ;Physician associate' is not currently a protected title but the Faculty of Physician Associates (FPA) is campaigning to achieve statutory registration of the profession. In the meantime, you're advised to join the Physician Associate Managed Voluntary Register (PAMVR), with the FPA, on becoming qualified.
• Being a physician associate is a rewarding career as you're able to make a significant contribution to patients' health. Patient caseloads and a lack of public knowledge about the role can be challenging.
• You'll be expected to adhere to a professional, ethical code of conduct at work.

Qualifications

To become a physician associate you'll need to complete the relevant programme of study. There are two options for this:

• Integrated undergraduate Masters in Physician Associate Studies (MPAS) which is a full-time course, lasting four years. This is currently available at the University of Central Lancashire and the University of Reading. You'll typically need three A-levels (or equivalent), usually at AAB or above, including chemistry and a further science to get a place on a course.
• Physician Associate Postgraduate Masters or Diploma (PGDip) you will need to have completed an undergraduate degree, usually in a bioscience-related subject to get on the course. This is the most common route to becoming a physician associate.

Degree subjects that may be considered for entry to the postgraduate courses include:

• allied health degree (e.g. occupational therapy, diagnostic/therapeutic radiography, physiotherapy or paramedic science)
• anatomy
• biochemistry/medical biochemistry
• biology/human biology
• biomedical science
• chemistry
• genetics
• medical science
• microbiology
• nursing
• pharmacology
• pharmacy
• physiology.

Course providers often require a minimum 2:1 first degree, although some universities will accept a 2:2 in a relevant subject. Alternative qualifications and relevant healthcare experience may be accepted at some institutions. Entry requirements and course content varies between courses, so contact providers directly for information. For a list of courses, see the Faculty of Physician Associates (FPA).

Training is full time, intensive and takes two years. You'll typically spend 46 to 48 weeks a year studying, with the main focus being on general adult medicine rather than a speciality. The course also includes 1,600 hours of clinical training, with 350 hours of that being in general hospital medicine and at least 90 hours in another setting such as surgery or mental health.

A level 7 physician associate degree apprenticeship is also available. This allows you to work and earn a salary while completing the relevant qualification. You’ll need to apply for an apprentice position with a healthcare provider.

All courses will have requirements in terms of criminal checks, health checks and language requirements. Contact providers directly for further information.

Once you've successfully completed your training course, you must pass the Physician Associate National Examination (PANE), which is run by the FPA. You can then become a member of the FPA and join the Physician Associate Managed Voluntary Register (PAMVR).

Skills

You'll need to have:

• interpersonal and verbal communication skills for dealing with both patients and colleagues
• written communication skills for writing letters and reports
• a caring attitude towards patients and the ability to show empathy and tact
• effective time management, planning and organisation skills
• the ability to work as part of a multidisciplinary healthcare team as well as on your own
• problem solving and analytical skills with the ability to process and interpret information accurately
• a flexible approach to work to handle a varied and busy caseload
• the ability to work well under pressure and to understand the pressures that face doctors
• general IT skills
• self-motivation, resilience and patience
• a commitment to ongoing professional development.

Work experience

You'll usually need some prior health experience in a clinical setting to get a place on a course. You can contact NHS Trusts directly to find out about work experience and voluntary opportunities - see the list of NHS Authorities and Trusts for contact details. It may be possible to work shadow a physician associate to provide an insight into the responsibilities of the role.

Experience of working with the public and anything that shows you have strong communication skills will also be helpful.

You could consider getting student membership with the Faculty of Physician Associates (FPA). This provides you with discounts on conferences, workshops and events, which can be good for networking and finding out about work experience opportunities. It will also show your commitment to the profession.

Physician associates come from a range of backgrounds and experience in pharmacy, nursing, psychology, the allied health professions and cardiac physiology can all be helpful.

Find out more about the different kinds of work experience and internships that are available.

Employers

The majority of physician associates work in general practice, acute (internal) medicine or emergency medicine.

You could be employed in:

• GP surgeries
• hospitals (both NHS and private) - in, for example, A&E departments, inpatient wards, outpatient departments, surgery and paediatrics.
• health centres
• psychiatry services
• rehabilitation facilities.

Physician associates who have trained in the UK are not currently able to practise outside the UK, although this may change in the future.

Look for job vacancies at:

• BMJ Careers
• HealthJobs UK
• NHS Jobs
• NHSScotland Jobs

Professional development

During your first year post-qualification, you will complete a preceptorship, consisting of structured support and on-the-job training to help you transition from being a student. You'll have a dedicated supervisor and will be able to work autonomously with their support. You will also have a mentor who will help you further develop your clinical and professional skills and encourage you to undertake a specialism.

It is strongly advised that you join the Physician Associate Managed Voluntary Register (PAMVR) with the FPA once you're fully qualified. To remain on this register, you'll need to undertake 50 hours of continuing professional development (CPD) per year. As an FPA member, you'll get access to a CPD diary and e-portfolio to help you keep track of your CPD activities, which may include:

• participating in seminars and workshops
• attending courses
• undertaking research projects
• undertaking relevant study at Masters level
• making presentations at conferences
• reading journals
• participating in committees and working parties.

To remain on the register, you will have to recertify every five years.

Career prospects

Your progression and development as a physician associate will depend on your increasing knowledge of specialties and general medical knowledge.

With experience and further training, you may become established in one particular health field but must retain a broad medical knowledge. This ensures that you are up to date and can contribute generalist knowledge to highly-specialised teams. Your broad medical knowledge also gives better career flexibility through the ability to switch between specialties. Areas of specialty may include mental health or paediatric care.

This is a relatively new role but there are some opportunities for progression to management, teaching or research as you gain more experience.