A physician associate (PA) — also known as a physician assistant in the USA – is a new kind of medically trained, generalist clinician, working in both GP practices and hospitals. PAs study a two year long condensed medicine post-graduate diploma, or master’s degree after achieving a 2:1 or above in an undergraduate biomedical science, or health science degree (meaning that nurses, pharmacists, physiotherapist and radiographers can also become PAs).
The role of a PA is to assess, diagnose, treat and provide health education to patients. We are currently awaiting regulation, which will give us prescribing rights and the right to order ionising radiation tests such as X-rays and CT scans.
PAs help to maintain the continuity of patient care. Unlike how junior doctors routinely rotate across wards and specialities before settling in one for the rest of their career, PAs work straight away in the speciality of their choosing, and will remain there indefinitely. This also gives experienced PAs the opportunity to train new foundation trainee doctors starting on the wards to ease their transition. Physician associates also provide shift cover, allowing doctors time to attend training, theatre and clinic. With the help of PAs, physician burnout is significantly reduced, with approximately 320 junior doctor hours saved per week according to recent research.
There is a misconception that PAs “steal” the roles of junior doctors, but that could not be further from the truth. Every doctor I have spent time with whilst on placement was extremely grateful that I could take bloods, urine, patient histories, chart physical observations and ECGs, giving them time to write their many discharge notes or see more complex patients requiring specialist medical expertise.
PAs will never replace doctors, we are only there in an enabling role to increase the efficiency of wards and GP practices, by taking pressure off the doctors we work with. Becoming a physician associate is an alternative career in medicine, without the long years of university and postgraduate speciality training. What drew me to the role was the fact that I will have the rare opportunity to practice medicine in multiple specialities (emergency/acute medicine, surgery, cardiology, gastrointestinal and psychiatry, to name a few), without having to settle in just one for the rest of my career like doctors do, or return to university to retrain. This is due to the physician associate’s six-yearly revalidation exam covering all areas of medicine PAs are required to maintain a high degree of knowledge in, regardless of the speciality they’re currently working in.
This suits me personally, as my interests tend to change, and I would like a career that enables that to happen. The flexibility of the PA role is likely one of the reasons why over 87% of physician associates in the UK report being ‘very’ satisfied with their job. Considering that physician associates are one of the only growing healthcare professions in the UK, this is a very good sign!
How It All Started
So, long before I graduated from my undergraduate degree in biomedical science, I knew I wanted to work in a patient-facing clinical setting. I love studying how the body works and how disease processes affected everything, from the person’s biochemistry, to the individual as a whole. I also knew I wanted to apply that knowledge directly to helping people instead of in research.
Like many other PA students, before I knew what a PA was, I first considered, and attempted to apply (halfheartedly) to study medicine. I knew I would enjoy the patient care aspect and the deep scientific knowledge of organ systems required, but the dire lack of work-life balance made me constantly doubt whether becoming a doctor was right for me. But, to avoid being stuck working in a lab for the rest of my life, I applied three times over the past 5 years with no success.
At first I was extremely hurt, my self-esteem took a massive hit and I fell into a period of low mood, feelings of worthlessness and failure. I was 24 and nowhere near where I wanted to be in life. My career was non-existent and I felt like I wasted my entire life based on just 3 medical school cycle rejections and the fact it was all out of my control was a lot to process.
As I began to accept my circumstances and give up on my dream of being a clinician, I came across an article about physician associates. I found that I fulfilled, if not exceeded the entry requirements for the course, and that it allowed a perfect balance of medicine and an actual life that can be had outside of the hospital. I felt excitement about my future again and rushed to send in my application hours before the deadline. At the time I only had a faint idea about the course. I saw that it was two years long, required a previous biomedical science or healthcare degree and relevant clinical experience was desired. As I fulfilled those criteria, I arrogantly thought I bagged a place.
When I got my first interview, it was a shock. I grew used to feeling rejection over the years, so I never had any high expectations, regardless of how well I fulfilled the entry criteria. After the initial surprise subsided, I realised I had no idea how to prepare for an interview I never thought I’d get. I ultimately underprepared and didn’t receive a place at the university I first applied to.
The shock of that was far worse than the rejections I received from the MBBS courses. I felt anxious and angry at myself for having to waste another year of my twenties waiting for the next application cycle to begin. Looking back, that rejection was the best thing that ever happened to me. Of course, I struggled a lot with my mental health, but it taught me to not tie my self-esteem to whether I overachieved academically. I also learned that you can never have too much work experience. During the time I had before the next application cycle, I worked as many shifts as possible on a psychiatric inpatient unit, both to save up money and to get a good idea of what the job might entail.
It turned out the next application cycle was only two months after my rejection letter came. I found a number of universities offering the PA course in September instead of January and decided to apply to them as a practice run, before I reapplied to my first choice. I applied to any and all universities, with the mindset that even if I didn’t go to them, I’d have interview and application experience I could use to help me in future applications. The university I currently attend had closed their applications a week before I applied. I was in a “what the hell” mood and sent off an application anyway. My invitation for an interview came the following fortnight and this time, I over-prepared, if that is even possible. I made notes on what the prospectus said about the course, its ideal student, the perks and advantages of choosing that university and wrote answers to potential questions they could ask. I also tracked down some current students at the university to get some tips on how to get through the interview.
I didn’t get any feedback that was useful from my first application cycle, but I spent a lot of time obsessing over what I could have done differently, which may have been unhealthy, but it helped in this cycle. I also changed everything I did last time, from clothing to body language. But, I think my success at this interview wasn’t only due to my preparedness, it was also the university itself. I remember walking into the interview station, meeting my future clinical skills tutor and being so shocked at how kind, encouraging and supportive he was, even to me as an applicant. This behaviour was the opposite to what I received when I interviewed at my first choice. The energy there was really off – I felt like they didn’t even want me at that interview. For this one however, I received nothing but wholesome encouragement. I currently feel very supported on this course, and I have had the opportunity to grow as a person and a student and have gone for things I would never have done as an undergraduate. For example, I am involved with the faculty as a course representative, and I have begun my training to volunteer as an emergency first responder.
Looking back, those rejections I had over the years were honestly, truly the best thing that ever happened to me. As a Muslim, I’ve heard all my life that Allah (swt) has a plan and every dua is answered, maybe just not in a way we expect. It was only this year that I understood fully what is meant by that. I constantly made dua to get into medical school and I did eventually, just not studying the exact degree I initially prayed to study, and I am so grateful for that!
Why I Started My Channel
When I was scouring the internet to find resources on how to prepare for the interview and what to include on my application, I found absolutely nothing. No resources whatsoever. For our American counterparts however, there were plenty of interview tips and application tutorials available, but nothing for British physician associates. I decided that if I were successful in gaining a place at PA school, I would start my own channel in order to help others avoid the stress I went through when I tried to find information. When trying to come up with a name for my channel, I went through many choices, none of which reflected what my goal for this channel was. I wanted to make easily accessible resources to help everyone, but mainly Muslim women as I believe we need more representation in medicine. So eventually I came up with The Hijabi Physician Associate, and it’s already helped to raise awareness of the role as well as encourage muslim women to go for these roles. I receive daily instagram messages of support and questions from a whole range of people, but mainly muslim women. The running theme is that they’ve never seen a brown hijabi woman blog about healthcare and that it’s inspired them.
At first when I got these messages, I was shocked that someone like me could have any kind of influence, and I’m still shocked now when I get multiple direct messages on my instagram and comments on my videos. I’m not saying I have an empire or huge influence, but considering it all started from one video filmed on my iPhone, with a tilted over desk lamp for lighting, this whole experience has shown me that what I do is having some form of impact on people. Recently, I’ve received messages from people who have had their interview offers come in, because they saw my videos and decided to apply. It’s humbling and I don’t say thank you enough. Their successes motivate me more to be the best in my new field, and eventually make changes at a higher level in my career.