Physician’s Associates qualify for courses with degrees including homeopathy and English literature

More than 3,500 physician associates are already deployed in England, with plans to train 1,000 more annually to take the total up to 10,000 within 12 years

Degrees in homoeopathy, computer science, English literature and human resources are being accepted as entry qualifications to train to become a physician associate, the Daily Telegraph can reveal.

The NHS is rolling out a mass expansion in the use of such workers, despite concerns that patients are being put at risk by workers with insufficient training.

More than 3,500 are already deployed in England, with plans to train 1,000 more annually to take the total up to 10,000 within 12 years.

The workers do not go to medical school but are usually expected to have either a science degree or a clinical qualification before they embark on a two–year postgraduate course to train to become a physician associate.

But an investigation by the Telegraph reveals that universities offering the course are accepting a wide range of first degrees, with little scientific content.

Degrees in geography, banking, anthropology and nutrition are among those which have been accepted by universities offering courses for physician’s associates.

‘Significant healthcare experience’

The figures for 2021 to 2023 show Anglia Ruskin University in Cambridge accepted two students with degrees in homoeopathic medicine, while Bournemouth University accepted degrees in anthropology, nutrition and computer systems engineering.

The University of Hertfordshire accepted graduates in English literature and history for its physician associate course in each of the past three years.

It said graduates with a non–science degree would “usually have either significant healthcare experience of some sort or have done some vocational training.”

St George’s, University of London accepted a BSC in banking, along with degrees in nutrition and geography. St George’s said the geography candidate was required to attend a summer school before joining the physician associate course. Meanwhile, Brunel University accepted a course in human nutrition, while Reading University accepted forensic anthropology.

The workers do not go to medical school but are usually expected to have either a science degree or a clinical qualification – JANIE AIREY/CEF

For each of the past three years, the University of East Anglia accepted degrees in international health services and hospital management, management and global health.

The Telegraph sent Freedom of Information requests to universities offering courses to become a physician associate in the UK. Fourteen provided full data.

Between them, they accepted 148 degrees in 2021, 173 degrees in 2022 and 135 degrees in 2023 which were neither biomedical science nor a professional medical qualification such as nursing, midwifery or an allied health profession.

In total more than 30 universities in the UK now offer courses to become a physician associate, with a rapid increase in recent years.

The figures suggest that hundreds of places are being given to graduates without any scientific or medical qualifications annually.

Several universities refused to give details of qualifications held by their students or claimed that they did not know what degrees they had.

Specific undergraduate integrated “Master of Physician Associate Studies” programmes are also available, with courses requiring A–levels or equivalent for entry.

Registered healthcare professionals such as nurses, allied health professionals or midwives can also apply to become a physician associate, the website states.

Physician associate duties

Physician associates are supposed to share some of the duties performed by doctors, including taking medical histories, examining patients, making diagnoses and analysing test results.

However, they are supposed to work under the supervision of a doctor at all times.

In recent years, there has been growing concern that the workers are being used to do tasks which require a fully qualified doctor.

The concerns have deepened since the death of Emily Chesterton, 30, from Salford, who died after two appointments with a physician associate whom she believed was a GP.

Ms Chesterton consulted the Vale Practice surgery in north London on October 31, 2022. Her symptoms included calf pain, a swollen and hot leg, shortness of breath and she was finding it increasingly difficult to walk.

The young actress believed she had been seen by a GP – but instead, a physician associate prescribed her propranolol medication for anxiety. She collapsed later that evening and was rushed to hospital. However, her heart had stopped beating and doctors could not save her life.

Under Government plans, the profession will be regulated from April,

However, the plans have met a backlash from the medical profession.

The British Medical Association has said that allowing the General Medical Council (GMC) to regulate the workers would “blur the lines” between doctors and non–doctors.

Many medics are opposed to the increased use of associates, whom they fear patients will wrongly see as doctors, even though they do not have a medical degree.

They have expressed concern that letting the GMC regulate physician associates, alongside doctors, is “potentially dangerous” because it could confuse the public, diminish the status of doctors, and leave patients at risk of being treated by someone without the appropriate skills.

Registered healthcare professionals such as nurses or midwives can also apply to become a physician associate, according to the NHS Careers website – iStockphoto

Prof Phil Banfield, chair of BMA Council said he was concerned that physician associate students were being recruited from non–science degrees, adding to the need to have national standards to provide clear limits to the scope of their work.

He said: “Questions need to be asked how and why this is being allowed to happen. But of greater concern are the responsibilities of a physician associate in the workplace once they have undertaken their training. They have a role to play in patient care but they are not medically qualified and less experienced in medical training and knowledge than even the most newly qualified doctor.

‘National standards’

Prof Banfield said: “If we have PAs without a science–based first degree alongside those who do have them, it further highlights the need for the national standards and guidance on the role and scope of physician associates and anesthesia associates, such as that recently published by the BMA, which we believe should be adopted across the NHS until quality and safety assurances can be addressed more fully.”

A spokesman for the Faculty of Physician Associates said: “Higher education institutions determine their own entry requirements for enrolment in physician associate courses across the UK. Our Physician Associate Curriculum provides a standardised framework to ensure high–quality physician associate education across the UK.”

An NHS spokesperson said: “While universities set the entry requirements for postgraduate physician associate courses, all students who have completed a PA course must also pass the Royal College of Physicians national exam to fully qualify, and under new regulation, all universities courses will be quality assured by the GMC.”

A Department of Health and Social Care spokesperson said: “Physician Associates (PAs) have worked in the NHS for over two decades, and are an important part of clinical teams, providing support to thousands of patients every day – under the supervision of doctors.

“They typically undertake an undergraduate degree in a health, biomedical science or life–sciences subject, before undertaking two years of rigorous postgraduate training to gain significant clinical experience. Alternatively, some universities offer a four–year undergraduate PA master course.

“Ahead of regulation, the General Medical Council has published learning outcomes for associates, which set out education requirements as well as minimum expectations for knowledge and skills required.”

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