The ‘physician associate’ will see you now…

There is a war being waged in NHS hospitals. On one side are overstretched junior doctors in understaffed wards. On the other: physician associates (PAs) or, to use the more disparaging term, ‘noctors’.  

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Since 2003, non-medical graduates have been able to gain entry to hospital wards and GP practices if they complete a two-year clinical course that leaves them a ‘physician associate’ or ‘anaesthesia associate’. At first, PAs were rare – ten years ago there were fewer than 150 in England. Since the pandemic, however, the numbers have exploded. There are now approximately 4,000 PAs working in England and Wales. 

PAs are supposed to help doctors with the time-consuming administrative work. Instead, many medics argue that they are stealing training opportunities from medical practitioners. Junior doctors complain about low pay, with foundation-year medics until recently beginning on a base salary of around £28,000 – while physician associates now start on £46,000. Graduates who have completed at least five years of medical school are expected, in some hospitals, to answer to non-doctors who have completed something akin to a clinical crash course. And medics keen to pick up training opportunities for speciality training applications have been pushed out of procedures while PAs benefit. 

The already troubled relationship between doctors and PAs reached a nadir this month when pro-euthanasia politicians rejected an amendment to the assisted suicide bill that would have insisted only fully qualified doctors sign off applications. MPs fear that non-medics could be the ones deciding who lives and who dies. 

It’s not just doctors who should worry about the influx of PAs in hospitals.