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A professional hybrid of medicine and nursing conceived in the United States, physicians' assistants are now being trained in the UK. But how will they fit into the healthcare team?
IN THE mid-196Os, the United States suffered a shortage of primary care doctors. To address the problem, doctor Eugene Stead helped naval officers become the first cohort of 'physicians' assistants' (PAs), basing his curriculum on the fast-track training of doctors during the second world war.
These healthcare practitioners are now commonplace in the US and nurses often take courses to join their profession. Like medical students, PAs are taught to diagnose and treat medical problems. They conduct physical examinations, order and interpret tests, counsel on preventative health care, assist in surgery, and in the vast majority of states they can write prescriptions.
Most programmes run for just over two years and the typical student already has a degree and four years' healthcare experience. Applicants are often nurses and paramedics.
Interest in similar roles is taking off here, raising questions about how PAs will work with nurses, who will regulate them, and whether nurses will be encouraged to ditch their own profession and become PAs.
Two-year course
The University of Wolverhampton became the first place in the UK to start a PA-style course last September. The two-year programme will give participants a masters qualification as a 'physicians' associate' and prepare them for working in GPs' surgeries, according to Hilary Paniagua, who devised the course.
She has not examined the curriculum of the US courses and could not give examples of how these differ from her own, although students will have opportunities for placements in the US. 'We are keen that these positions will not be replacements for nurses. There are distinct differences between nurses and physicians' associates. I would hate for nurses to feel threatened and not understand the role, but that is par for the course in some ways.'
Ms Paniagua did not give examples of how the work of physicians' associates would differ from that of nurses, saying that they would simply become part of a healthcare team.
The University of Birmingham is also keen to follow the American lead. It is awaiting government approval for a pilot course to train 24 'medical...