'No jobs' for new physician associates

Martina Otero says she and her classmates are "in debt" and "wanting to work"

A couple who spent two years studying to become physician associates at Ulster University and are now in debt have said they feel "let down" and confused about not getting jobs in the health service.

Both told the BBC they gave "blood, sweat and tears" and are now out of pocket after spending two years training and travelling to placements in hospitals across Northern Ireland.

The Department of Health pays fees for students undertaking the two-year physician associates (PA) degree based at Magee College in Londonderry.

Students graduate as healthcare professionals who work under the supervision of a doctor in a range of medical specialities in primary and secondary care.

While there is no written guarantee of a job at the end of the course, students said there was an assurance along the way that they would be needed to fill posts in the workforce.

BBC News NI understands tension has developed between health unions and the regulation bodies about the management of PAs across health and social care.

While student fees are paid and the health trusts receive payment to cover placements, it is felt that there is no funding to cover salaries for the latest recruits.

The Department of Health said it is currently undertaking an evaluation of the physician associate role and funding the UU course, and assessing their contribution to the health service in Northern Ireland.

"Clearly, our objective should be to retain these valuable healthcare professionals in Northern Ireland. Unfortunately, the inadequate funding made available to the department presents a very significant challenge in being able to create the necessary new positions," it said.

There are around 80 physician associates working in Northern Ireland health trusts and in primary care.

Conor Finnerty, 25, said he and his girlfriend Martina Otero, 26, are "waiting in the wings to work" and are keen to fill the gaps in the health service that everyone has been "crying out about".

The pair met on the course, and since graduating Conor has been working in a supermarket and Martina has returned to a job as a health support worker.

Martina said throughout the course the class of 18 students were assured they would get a job after graduation but only two managed to secure posts.

"The course is intense, 9-5 from Monday to Friday, and then at the weekends I travelled back to Belfast for my part-time job," she said.

"The second year we had placements in hospitals but did not receive travel or living allowance. It was expensive and most of us are now in debt."

Conor Finnerty has been working in a supermarket since finishing his physician associate course

The role of physician associates has come under the spotlight after the British Medical Association said "dangerous situations" were being allowed to develop in which medical associate professionals could be seeing patients without clear supervision.

In June, it launched legal action against doctors' regulator the General Medical Council over how it plans to regulate physician and anaesthesia associates in what the BMA has said is a dangerous blurring of lines for patients between highly skilled and experienced doctor and assistant roles.

The GMC will become the regulator of physician associates (PAs) and anaesthesia associates (AAs) in December 2024.

The BMA has said that physician and anaesthesia associates – who complete a two-year course rather than a five-year medical degree – need regulating, but that the GMC is not the right organisation to do this.

By choosing the GMC as the regulator for PAs and AAs, the BMA says the government is undermining and devaluing the medical profession and confusing patients.

The BMA has objected to the GMC using the term "medical professionals" to describe PAs, which it said should only used for fully trained doctors.

During their placements, Conor and Martina said they felt needed on the wards and were supported by nurses and doctors.

"We felt an indispensable part of the team wherever we worked - I wanted to make a difference, but unfortunately haven’t been given the chance to do that," Conor said.

The couple appreciate that most students are in debt but they question why the Department of Health is paying to educate students on specific courses when there is no guarantee of jobs at the end of it.

All 18 students had to sit their national PA exam in Liverpool in February to graduate. The exam fee was £900 and students also had to pay travel and accommodation expenses.

Next year's application for the course is currently open on the University of Ulster website.

According to Conor and Martina, without funding and forward planning by the Department of Health there will be even more PAs looking for jobs in the future.

Martina said she always wanted to work in the health service but not with the pressure of being a doctor or consultant.

What she liked about the course was that it was fresh, novel and she would be part of a “pioneer” idea which would make a difference in the health service.

“I feel very let down by the system, at the start I was angry but now I feel so let down.

"I feel that PAs could contribute so much to health care. We are all just waiting here for jobs -  we want to work," she said.