Is there a role for physician associates in sexual and reproductive health?

Posted 04 Jun 2020

Date: 04 Jun 2020

Author: Aimee Ehrenzeller

Who are Physician Associates? And what can they add to the multidisciplinary team? In her blog post, Aimee shares her thoughts on the introduction of PAs to the sexual health workforce.

Physician Associates are a relatively new addition to the medical workforce in the UK. At the time of writing this blog, there are approximately 1700 PAs working in the UK, in a variety of medical specialties. In order to qualify as a PA, students undertake a 2-year MSc or PGDip following an undergraduate degree, which is usually in a biomedical or health science. Due to the short, intense period of training, PA students must complete a set number of placement hours in core clinical areas including paediatrics, mental health, obs and gynae, emergency medicine and general practice. Sexual health is not a mandatory part of a PA’s training, and therefore, awareness of PAs and what they can bring to the specialty once qualified is limited.

Having completed my training, I chose a career in primary care. I enjoy the variety of conditions, getting to know my patients and the ability to see patients of all ages. I have a particular interest in women’s health and, fairly early in my career, I decided to pursue further training in intrauterine techniques. I was introduced to a fabulous SRH consultant who was keen to teach me, despite never having worked with PAs before. Together, we ironed out the bumps in the road that can occur when trying something that has not been done before. With the support of Dr Massey, the FSRH kindly agreed to let me sit the online exam and complete the coil-fitting training. I was later awarded a Letter of Competence in Intrauterine Techniques, which I believe is a first for PAs!

Having worked closely together during my supervised training, Dr Massey and I came to better understand how PAs can complement the SRH MDT.

PAs have a general medical background and skillset

A PA’s training focuses on the core skills required to practice in all areas of medicine: history taking, examination, clinical reasoning and managing conditions. PAs are taught how to handle issues like consent, capacity and safeguarding issues. They are trained to explain complex medical concepts to patients and support shared decision making. This generalist training means that PAs can easily slot into any area of medicine.

PAs can undertake training in advanced procedures

PAs perform procedures in all areas of medicine, including lumbar punctures, chest drains, joint injections and minor operations. In the same way, PAs can be trained to fit coils and implants, perform hysteroscopies and biopsies and much more. The PA role is very flexible and upskilling works best when there is a good balance between meeting service demands and the interests of the PA.

PAs are a stable member of the workforce

As PAs enter into permanent posts upon completion of their MSc or PGDip, they are not usually required to undertake any rotations or further formal training. This means that they can become a stable member of a workforce, providing continuity of care for patients and also supporting junior doctors who rotate through the specialty. Experienced PAs are actively involved in teaching junior doctors, and can also provide cover to safeguard protected teaching time.

PAs come from diverse backgrounds with transferable skills

PAs often have a background in science or healthcare, which can be beneficial for practice. They can carry out audit work and participate in service redesign.

Physician associates are a flexible addition to the MDT and their role can be moulded to fit the service needs. If you are interested in finding out more about the role, please read the blog I wrote for the RCGP about my day-to-day role.