ABSTRACT
Of 165 PAs and PA students in the United Kingdom in December 2010, 127 (77%) responded to a census survey. PAs work in 19 medical and surgical specialties; experienced PAs are more likely to practice in primary care. Prior to PA training, respondents worked in a wide variety of health professions.
Physician assistants (PAs) are health professionals who are licensed to practice medicine with physician supervision. PAs are trained in the medical model to perform diagnostic and therapeutic services previously performed only by physicians. Studies suggest that
quality of care provided by PAs is comparable with physician care and that doctors and patients in the United States, where PAs have practiced for more than 40 years, are highly satisfied with the PA role.1,2 More recently, other countries have begun to train and license PAs as well.3
In 2003-2004, a small cohort of experienced American PAs was brought to England to investigate whether the PA role would fit within the National Health Service (NHS). Because the pilot project was deemed successful, several UK universities developed PA training programs.4 As of mid-2011, there are three active UK PA programs. Each offers a postgraduate diploma upon completion of a 2-year full-time program. Currently, PAs who practice in the UK include both UK and US graduates. This study characterizes the PA profession in the United Kingdom for the first time.
Methods The authors developed a survey that asked participants about professional and educational background, demographics, specialty, and scope of practice. The survey was sent via e-mail to all UK PAs and PA students. Notices about the census were also posted on the UKAPA Web site. De-identified data were collected via a Web-based survey tool in January 2011. The study design and survey instruments were granted exempt status by the research ethics boards of George Washington University and the UK NHS.
The UKAPA, the PA programs, and the UK board responsible for administering the certification examination were able to identify 71 people who are qualified to practice as PAs in the UK and 94 PA students. All survey respondents were classified as "students" or "graduate PAs" based on their student status as of December 31, 2010.
Results The majority of PAs are female (75%). Their mean age is 37 years, and they are drawn from at least 10 different ethnicities (Table 1). PAs are practicing across England, with concentrations of PAs near training programs (Figure 1). Three-quarters of respondents (76%) had health care or scientific research experience prior to training as a PA (Figure 2).
PAs are employed in 19 different medical and surgical specialties. Those who graduated before 2009 are more likely to work in general practice (Table 2). Practicing PAs were asked about their daily clinical activities. All reported "taking a medical history" and "performing physical examinations." Most reported performing patient education (97%), interpreting ECGs (81%), and conducting psychiatric assessments (76%). Surgical and emergency medicine PAs reported performing invasive procedures such as central line insertion, lumbar puncture, and intubation.
