Table 2.

Comparison of physician associate scope of practice to that of three other healthcare professions

Element	Profession
	Physician associate^17,18	Registered medical practitioner¹⁴	Registered paramedic¹⁹	Registered pharmacist¹¹
Domain: inflexible boundaries: education, regulation and certification
Regulation	Managed Voluntary Register	General Medical Council	Health and Care Professions Council	General Pharmaceutical Council
Educational requirement	PGDip or MSc	MBChB/MBBS	DipHE/FdSc or BSc	MPharm
QAA level of registration qualification	Level 7	Level 7	Level 5 (pre-2018) or 6	Level 7
Certification examination	Yes: must be completed before entry to Managed Voluntary Register	No	No	Yes: at end of pre-registration year
Pre-registration year	No	Yes	No	Yes
Engagement with CPD and/or CE	100 h over 2 years.	Annual engagement; must be tailored to scope of practice and needs of individual; annual personal development plan	CPD requirement is outcomes based and, as such, does not have set number of hours	Annual CPD requirement for continued registration, tailored to scope of practice and needs of individual
Recertification examination/assessment	National Recertification Examination every 6 years	Annual Review of Competence Progression for physicians in training	No	No
Prescription-only medication status	None	Independent prescriber	Exemptions	PGD, emergency supplies of medication
Domain: inflexible boundaries: core competencies
Patient assessment: history taking	Yes	Yes	Yes	Yes
Patient assessment: physical examination	Yes	Yes	Yes	Yes
Patient assessment: requests diagnostic investigations	Yes	Yes	Yes	Yes
Patient assessment: interpreting diagnostic investigations	Yes	Yes	Yes	Yes
Patient assessment: makes a diagnosis	Yes	Yes	Yes	Yes
Patient management: develops a management plan	Yes	Yes	Yes	Yes
Patient management: undertakes therapeutic interventions	Yes	Yes	Yes	Yes
Domain: flexible boundaries
Professional experience of clinician	Yes, and agreed with supervising physician; might change with roles in new clinical specialities	Developed through formal exams with Medical Royal Colleges and Foundation, Core and Speciality training schemes	Can develop, recognising that paramedic might become more specialised/focused in their practice over time or with change in roles	Formally developed, with Foundation year leading to full registration; develop through post-registration education and research; some roles are very specialised
Patient population	All	All	All	All
Supervision/collaboration	Named supervisor(s) who must be contactable during working hours	Consultant or GP named as an educational supervisor; none at consultant/GP level	Autonomous practice, knowing when to refer on appropriately	Autonomous practice, knowing when to seek help or refer on appropriately; to provide leadership in pharmacy practice
Practice guidelines	Aware of, and work with, guidelines, but not restricted by protocols	Aware of, and work with, guidelines, but not restricted by protocols	Aware of, and work with, guidelines, but not restricted by protocols	Be aware of, and take a critical view of, national and local policies and guidelines, without being restricted by them

BSc = Batchelor of science; CE = continuing education; CPD = continuing professional development; DipHE = Diploma of Higher Education; FdSc = Foundation degree in science; MBChB/MBBS = Batchelor of Medicine and Surgery; MPharm = Master of Pharmacy; MSc = Master of science; PGDip = Postgraduate Diploma; PGD = Patient group direction; QAA = Quality Assurance Agency for Higher Education.