Table 2.

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

Physician associate17,18Registered medical practitioner14Registered paramedic19Registered pharmacist11
Domain: inflexible boundaries: education, regulation and certification
RegulationManaged Voluntary RegisterGeneral Medical CouncilHealth and Care Professions CouncilGeneral Pharmaceutical Council
Educational requirementPGDip or MScMBChB/MBBSDipHE/FdSc or BScMPharm
QAA level of registration qualificationLevel 7Level 7Level 5 (pre-2018) or 6Level 7
Certification examinationYes: must be completed before entry to Managed Voluntary RegisterNoNoYes: at end of pre-registration year
Pre-registration yearNoYesNoYes
Engagement with CPD and/or CE100 h over 2 years.Annual engagement; must be tailored to scope of practice and needs of individual; annual personal development planCPD requirement is outcomes based and, as such, does not have set number of hoursAnnual CPD requirement for continued registration, tailored to scope of practice and needs of individual
Recertification examination/assessmentNational Recertification Examination every 6 yearsAnnual Review of Competence Progression for physicians in trainingNoNo
Prescription-only medication statusNoneIndependent prescriberExemptionsPGD, emergency supplies of medication
Domain: inflexible boundaries: core competencies
Patient assessment: history takingYesYesYesYes
Patient assessment: physical examinationYesYesYesYes
Patient assessment: requests diagnostic investigationsYesYesYesYes
Patient assessment: interpreting diagnostic investigationsYesYesYesYes
Patient assessment: makes a diagnosisYesYesYesYes
Patient management: develops a management planYesYesYesYes
Patient management: undertakes therapeutic interventionsYesYesYesYes
Domain: flexible boundaries
Professional experience of clinicianYes, and agreed with supervising physician; might change with roles in new clinical specialitiesDeveloped through formal exams with Medical Royal Colleges and Foundation, Core and Speciality training schemesCan develop, recognising that paramedic might become more specialised/focused in their practice over time or with change in rolesFormally developed, with Foundation year leading to full registration; develop through post-registration education and research; some roles are very specialised
Patient populationAllAllAllAll
Supervision/collaborationNamed supervisor(s) who must be contactable during working hoursConsultant or GP named as an educational supervisor; none at consultant/GP levelAutonomous practice, knowing when to refer on appropriatelyAutonomous practice, knowing when to seek help or refer on appropriately; to provide leadership in pharmacy practice
Practice guidelinesAware of, and work with, guidelines, but not restricted by protocolsAware of, and work with, guidelines, but not restricted by protocolsAware of, and work with, guidelines, but not restricted by protocolsBe 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.