Why Physician Associates Are Paid More Than Doctors | Doctor Reacts
ฝัง
- เผยแพร่เมื่อ 2 เม.ย. 2022
- I want to make it clear that I have nothing but respect for PAs and have had exclusively very good working relationships with them - the two I worked with previously were nothing short of excellent and I'd happily work with PAs in the future.
This article, however, is questionable.
ghoopi.com/why-physician-asso...
Want to find out more about the medical school process?
Head over to www.ollieburton.com!
If you like my content and want to help me make more, you can buy me a coffee at ko-fi.com/ollieburton
10% off Complete Anatomy 2020: 3d4medical.tapptrk.com/DMNGMW...
Social Links:
Facebook ► / ollieburton
Twitter ► @ollieburtonmed
Instagram ► / ollieburtonmed
VIDEOS:
Getting SHOCKED in the labs! (for SCIENCE) ► • Getting Shocked in the...
My First Week At Med School! • Year 1, Week 1 Graduat...
UKCAT / INTERVIEWS:
5 Top QR Tips: • UKCAT Quantitative Rea...
4 Great VR Tips: • UKCAT Verbal Reasoning...
Abstract Reasoning For Beginners: • UKCAT/UCAT Abstract Re...
I think the irony of point three, "Physician Associates make less mistakes" couldn't be more ridiculous. Fewer. Fewer mistakes!
This cracked me up too
Lol this is a bloody joke 😂. They are ward clerks following doctors advice
@yaz6565 hideously incorrect statement. In the UK PAs needs to have completed a undergraduate degree in a life or health sciences degree to have the basic science background. They then do a 2 year medical masters degree to independently assess, examine, order tests, diagnose, refer, interpret results and manage their own patients. They are at a point they can independently run minor operations, scope and ultrasound lists, do lumbar punctures, bone marrow and US guided biopsies etc after gaining experience and completing in-house, consultant guided CPD. PAs have studied and worked hard for 5 years at university and then career long CPD to be a medical component of the MDT, not replacements for senior Dr's and certainly not ward clerks.
@@AML89found the PA- go the patients bloods for me
@@AML89 Also, PAs are not a replacement for ANY doctor, including "juniors". An FY1 DOCTOR is more clinically competent than a PA
Thanks for continuing to open dialogue on touchy subjects.
Great video as always Ollie, I think you have made a very fair video on a (sometimes) touchy topic. I think whoever has written this article has a huge PA bias and like you mentioned, likely does not have a direct understanding of a medical curriculum which leads to a misleading article. The biggest point of contention from the medical community seems to be the starting salary, this is due to doctors being underpaid rather than PAs being overpaid. To get a starting salary of £42,000 for 37.5 hours a week from a 2-year degree is unjustifiable when the salary of a CT2/ST2 Doctor (who has got into the most competitive course at university, typically done a minimum of 5 years) and then has worked as a fully qualified doctor for 3 full years is £40,257 for 40 hours a week. This doesn't mean that PAs should be paid less, more that doctors should be paid more when they are starting out (and good for the PAs for securing that starting salary).
I think another issue that I have noticed here in the UK is, often due to PAs not having prescribing licences or being in departments for longer periods of time, there is a tendency for them to get greater access to training opportunities which would greatly benefit doctors. For example, going to fracture clinic whilst juniors are doing TTOs on the ward or getting theatre time whilst a junior cannot because they are on call. The UK in itself is a few years behind the US which is suffering significant scope creep from 'mid-level practitioners', is for a different reason over the pond, the US seem to be using the cheaper costs of PAs/ANPs/Anaesthetic associates to drive down the cost of a staff wage bill whilst continuing to charge the patient the same. The UK is suffering for a different reason. In a well functioning medical system, you would have a doctor where they are needed, not someone with less experience/different training, the difficulty falls with the complexities of medical training. The UK needs more doctors, doctors take a minimum of 4 years (graduate) or 5 years to produce, we are suffering a huge workforce shortage so more funding is going towards new roles with shorter training to help fill the gaps. Take this article for example, "anaesthetists.org/Home/Resources-publications/Anaesthesia-News-magazine/Anaesthesia-News-Digital-April-2022/Desflurane-workforce-and-morality", this is a consultant Anaesthetist and medical director openly acknowledging there are not enough anaesthetic training posts, you have a known workforce (anaesthetic specialist registrars) that add a huge value whilst in training, however, the system lacks the capacity to train more of them, so instead, the decision is made to increase training for an unknown workforce that'll likely require huge amounts of training themselves (assumption) and come in less skilled at entry, will train shorter and do less when fully qualified. You can see the argument being made for itself, they need the workforce ASAP, but in the long term, it will be damaging to the profession.
I think PAs are an excellent resource and being in a single department for a longer period than rotating doctors provide a great experience. Additionally, it's more on the members of the medical profession to argue for greater pay uplift rather than complain about a PAs starting salary. I think when the lines between roles are blurred and you take away training opportunities from doctors it begins to cause a bit of friction. When roles are clearly defined, issues don't arise, a current problem seems to be junior doctors losing out on training opportunities as they are seen as more of a service provision role.
PAs actually study at university for 5 years, not 2. They need a life or health sciences undergraduate and then an approved 2 year, longer than full time postgraduate degree. In their careers, Dr's will earn substantially more than PAs as they have constant pay progression leading to 6 figures. PAs top out at around £60k for chief roles and cannot go higher.
@@AML89 Agreed it is 5 years in total but the PA degree is 2 years, even if you have a biology degree it would be extremely loosely linked to clinical practice. I would be interested to see a graph on when the pay for medicine levels out because when you include all the mandatory (but not covered ) fees for medicine - eg GMC, medical insurance, exams (I have spent £1600 just on exam fees the past two years, all mandatory for me to progress) then throw in the life costs of having to rotate around a deanery (I'm planning on orthopaedics so that's 8 years of rotation) then it can become quite an expensive job. Doctors don't reach 60K for base hours until ST6-8, so 5 years med school, 2 years foundation and 6 years specialty training, this is assuming of course the doctor has moved immediately on from F2 to core (competition ratios are around 4:1 depending on specialty, but I'll just continue to use surgery as an example) and then 5:1 for ST2 -> ST3.
I wouldn't class it as substantially more.
@jamesarkley the PA national exam is about £850 I think and PAs have to pay for at least 50% of their MSc/pgdip as there's limited funding available. Most courses are approx £11k/year for tuition. Then there's equipment, living costs etc. I think both PA and medicine end up being very costly and the vast majority of PAs will never see more than about £50k, which is why so many have left the profession. Ultimately I don't think the issues is PAs getting paid too much, I think it's Dr's not getting paid enough. Dr's have unenviable training routes and quite frankly should get a lot more cash. I'm 100% behind that. Re appropriate Subjects for PA, courses prefer undergrads with more of a clinical focus:anatomical sciences, biochemistry, biomedical science, biomedicine, human biology, medicinal chemistry, microbiology, neuroscience, nursing (adult, child, mental health), operating department practice, optometry, paramedic science, pharmaceutical science, or physiology. That list was taken from a PA courses list of acceptable undergrads.
You are an incredibly important TH-camr, I wish you all the luck for your career in your future, you have my Vote.
Great video, i think you was spot on about this, although still has not made my decision easier
I am from the US, we have a similar though not identical situation here. Interns and residents are both woefully underpaid and horrendously overworked. I think this occurs because they are treated more like pledges to an exclusive club or fraternity than professional employees. Who's to blame? The whole system. Hospitals obviously want to maximize profits which means controlling costs. Senior drs continue to support gruelling work hours as necessary to train and provide optimal patient care, but really I think there's an underlying attitude of I suffered through it, so can you (the pledger/,pledgee mentality) Patients in the US at least are just overwhelmed by the rising costs. However, I for one don't want to be treated by anyone on the 23rd hour of a 24 hour shift or by some one who is so stressed financially they are chronically distracted. Possible solutions involve reaching out and education patients to the benefits of system change and young doctors (together with some seniors) organizing collectively for change. If you're going to move a mountain, you're going to need a lot of hands.
Yeah but the thing is when you become an attending your salary multiplies by multiple orders. Something which does not happen when you become a consultant in the uk.
dude, I think every doctor in EU would take that trade knowing their salary would boost to 300K+ USD and well beyond after residency so I don't get why US are trying to justify the salary is the same in both continents, even with ur increase tuition fees and loans, its no where close:P probably why most of my class and in general around EU want and are stil trying to get a residency job in US. And the salary for US residency is basicly the same as starting money for junior doctors everywhere so its not like that's a valid argument aswell
That was such a great comment!
I hope that you started with a joke. Because you told us you lived and worked in the NHS - which is absolutely superb
Hi, from the U.S. I just subscribed. I've been a PA for more than 20 years. Thanks for sharing this with us! The person who wrote this article doesn't seem to know some basic things about PA training; kind of embarrassing, actually.😓 I don't comparisons between MD/DO vs PA will ever end. Well, we'll just keep working together to bring the best care to our patients. I wish you the VERY BEST in your positive endeavors! Peace.🙂👋🏽👨🏾⚕️
As a PA student myself it is incredibly frustrating to read an article like this. In a time where us as PA’s need to prove ourselves and the role, it’s things like this that ruin it a bit for us all. I hope things change within the system and junior dr’s get paid what they rightfully deserve!!
Junior doctors are overpaid.
@@taffyterrierlmao, sure they are. With the hours worked, they are underpaid.
@@Lumpycheeses Blair cut junior doctors working hours from 100 to less than 50, doubled their basic pay and awarded them overtime, night shift allowance and weekend enhancements.
Hi Ollie, I'm a rural generalist trainee doc in Australia, and I've always had concerns with the PA system - they tried to enter Australia, but were roundly scoffed at - since it seems all they do what we should be training/incentivising our juniors to do. Ward jobs, admin and discharge summaries are important! I believe generally trained juniors are the reason Commonwealth health services do so well, especially compared to the lack thereof in North American systems, and hence their scramble for 'mid-level practitioners' to do jobs they were simply unwilling to provide sufficient remuneration for
That being said, I have nothing against anyone who trained as a PA in a system that has already accepted it. They're simply doing a very employable job they were trained for!
Also curious about your comment about there being no benefits to juniors rotating - do you have evidence for this? My role is to admit patients to hospital, see them in primary care and also work as an anaesthetist (I'm a GP Anaesthetist trainee) - and I have to say every rotation I did in hospital contributed something to my practice and understanding 👍
As a PA this article is really baseless and such an obtuse view on what the biggest issue is at hand. Junior doctors are insanely under payed!!! In my experience as a PA student and a qualified clinician now, the job role and responsibility difference between the junior docs and I definitely do not reflect the pay grade difference. A much bigger fight is to come to correct this disparity! Hears to a good fight Ollie ✊🏾
not only the job role and responsibility but the years of education and the nature of those. Thank you for ackowledging
Junior doctors are overpaid.
Having watched and looked at the article, I think it is quite self evident the person writing hasn't got a foggiest clue about anything, with all due respect to the author. So I think using this article for a video is inevitably perpetuating harmful narratives despite your preface.
Despite completing both medicine and pa studies I would still be hesitant to commenting on the comparison between the two programmes as I only have the reference points of just two universities and even if you compared the teo universities medical programmes, they would also be drastically different.
The courses are fundamentally different and what the purpose of the training is hugely different. PA’s are trained to be competent members of the ward team and could put drains in or other unique speciality specific skills that are lost within a rotating medical system. Doctors are ultimately trained to become consultants and managers of the team. That managerial role is definitely becoming more prominent for earlier with the enhanced roles of everyone else in the mdt. That’s ultimately why I choose to do medicine as that is the role I want, as well as the better pay in the future.
My experience of both courses was that both courses were gruelling with their pace. PA was the equivalent of sprinting up a steep slope but a shorter overall ascent in comparison to medicine which was not as steep with opportunities to pause/revisit sections but overall much greater. I do think medical programmes are also not very time efficient and while longer I don’t think the knowledge gap is as large as I thought it would be. I think this is for a few reasons.
1. School leaving students need time to mature, learn to function as an adult, go party, play sports and figure out how to study. Grad entry programmes like gem/pa don’t have to do as this has already happened. I also do think this impact attendance to placement that is seen by the generalisations between grad med and undergrad med in University that run both programmes.
2. Because of the goal of producing consultants and the historical traditions of medicine there is lots of time arguably wasted on intricacies that don’t really effect modern clinical practice/you can’t remember by the time you sit finals. Eg despite 2.5 months of neuroanatomy my knowledge of neuroanatomy is only slightly better than the 0% I understood after PA.
3. With a Spiral learning curriculum topics revisited multiple times which is really useful for consolidation and giving really good exposure to specialities to help with deciding future career decisions.
4. The holidays are longer. So I had like 7 weeks holiday across both years of my pa programmes and generally had to use them to revise for an upcoming progress test unlike medical which outside of one year was vastly more.
When it comes to pay and why they are paid more that is a tough question and I did think what everyone has said is absolutely right about doctors being underpaid and not the pay of PA’s itself. But I do think there is more to it than just that both from the government trying to produce a service that “meet the needs of the population” and what is still believed (ultimately should be) attached to being a doctor in training. While I don’t agree with ideology behind many of these argument I think these are the logical
1. It’s in the governments interest to pay as little as possible that they can get away with. Graduates at 23/24 who this is their first job are less likely to have kids, buying homes etc are more likely to be accepting of 30k with the understanding you’re pay will increase significantly in the future. Especially if you’re not living in the south east or bristol etc. If you compare this to a mature students who are likely have these additional factors in mind then the need for better pay at the start is only way to make it attractive, as unlike medicine pay and career progression is not that clear cut as they are tied to the agenda for change pay. For many of the people I trained with this was their career progression from having been a band 6 nurse prior to do the course and without the band 7 pay they may not have done it.
2. Ultimately the government is trying to increase the number of sas doctors and senior clinical fellows type roles as part of service provision, as that is more cost effective than consultants. Hence the lack of increase in consultant post and training at different levels despite the increasing number of medical students. PA’S fit into that service model of producing competent members of staff 20 years down the line that cost less than the consultant would. Hence you can pay them better now and save money later, vs doctors where you underpay them initially and cost the government maximally towards the end.
3. There is an expectation that they are there for purely service delivery after the initial few years and therefore won’t cost the nhs the impact our training will. Although I would argue in the modern nhs this isn’t true as most of our training we now have to pay doctors will be on external courses etc.
I don’t think I’m the fountain of all knowledge on this topic but this is my two cents on it. Ultimately PA’s are here to stay and will be part of our teams and doctors pay and job is being eroded but that is by the electorate and how the people they trust to make the decision about how the nhs provides its service and how much it should cost. I think that is the fundamental problem and as doctors we need to educate and challenge on.
One of the problems with medical training is re is too much inefficiency, this results in a very long training path. As training is controlled by the Royal College they are very reluctant to make changes. Consequently other ways need to be found to gain health practitioners more quickly. Specialisation requires a lot of generalised training first, this is very inefficient.
Under agenda for change, anybody above band 7 doesn't get paid for overtime, so there is little motivation for career progression so a PA may well spend their career on the same pay band.
Lol this article is ridiculous, Im a senior registrar in anaesthetic training, I cover Obstetrics, ICU, theatres all independently, I've done all my postgraduate exams and fully qualified now, but technically still in 'training', does that mean I should get paid less than a PA because I'm in training ?! What a load of nonsense, Salaries across all levels of Non-Consultant Doctors need a pay restoration/rise , I refuse to use the terminology Junior doctor or trainee doctor. I started Medicine 14 years ago and am 2 years from becoming a Consultant, does that me a Junior ?!
Tbh the whole system is f*cked up. This is absolute joke.
Really enjoyed this video Ollie. But have to fact-check you on one small detail. 'Graduate entry medicine, 4 year programme...is the shortest you can do a medical degree' This is in fact incorrect. There are at least 6 medical schools which offer a 3-year accelerated graduate entry medicine programme for dentally qualified applicants wishing to pursue a career in Oral and Maxillofacial Surgery or Oral Medicine. I'm currently in 4th year (my second year) of the A30x programme at Bart's and The London, which is one of these courses, there are 9 of us at Barts. Most places only offer between 2-4 places on these programmes and they're generally unbelievably (and understandably) competitive. Would happily talk about this pathway with you in depth if you were interested in making a video on it at somepoint. Please keep producing great content :D
Thanks Ryan, much obliged - I have been trying to do a bit of reading on this this afternoon and how convoluted! I've had to dig so deep into university websites to find out specifically what they do for the OMFS pathway as a lot of the course codes are the same! You're more than welcome to come on and chat about it, would be enlightening I'm sure! I must admit that I have no idea how it works with EU regulations but something must carry over from dentistry!
@@OllieBurtonMed very convoluted indeed, it was a real nightmare when it came time to research the degrees for my own applications, the available information is often very limited and out of date. So much of the information is hearsay and handed down orally from one year to another. At Barts for example I had to email someone to get a special application form, just so I could apply! Some of the courses recruit through UCAS whereas others are autonomous and run their own recruitment processes and timelines - Bart's and Glasgow for example.
Also are these pays before tax or after tax ? Because I never got paid that much through my entire FY1 OR FY2 ???
All of these are before tax
Are PAs the same as ACPs because my experience has been very much of certain of these members being very cliqui and often treating the junior doctor as an outsider
Similar but not the same. ACPs are drawn from other training professions, whereas PAs are their own profession. I'm sure cliques exist among all of these groups including doctors
Our training and foundation experiences are different. A variety of HCPs can undertake this training. For example I was a senior nurse with many years experience before undertaking my MSc. In my location I feel we intergrate well with all members of the team and I feel sad your experience has been different. I learn so much from the medical team and like to think I return this in same way thefore enhancing each other’s knowledge
Great video on a difficult topic. I've voted for you because you're spot on that as doctors we are being egregiously underpaid. Hope you get the role
Doctors are overpaid.
I got onto the programme in east London with a degree in sports medicine. The exam wasn’t too difficult either.
Can you pls make a video on the difference between biomed and a medical degree?
Are Physician Assistants embedded in structured Training programmes that actually cost a huge amount to provide?
No
I honestly think theres a lot to understand in medicine and 5 years plus of groundwork is crucial to being a medical physician. Doctors have that academic groundwork to understand the human body, then we further hone down on our clinical skills post graduation. Its impossible for that plus clinical skills to be done in 2 years .
PAs need to have a 3 year life/health sciences undergraduate degree to provide the fundamental science background before they're eligible to do the 2 year, more than full time medical masters degree. So in the UK PAs are also at uni for 5 years.
@@AML89not the same thing as a 5 year medical degree and you know it
@saraha4660 I didn't say it was. My point was to highlight PAs have a solid basis of education
@@saraha4660 Medical degrees have been dumbed down.
If a nurse, physician associate, or other healthcare worker who isn't a medical doctor has a doctorate, can they be addressed professionally as Dr? Or is it considered to be misleading/confusing?
Around patients would be broadly considered unwise, at least without a lot of clarification. Between professionals, would be fine.
I feel one day you will be health minister olie
Hi, I am an aspiring PA student. Do you know if UK PAs are able to practice in the US post qualification? If yes, what is the pathway like?
I don't believe so no. At present I don't believe the UK PA qualification is recognised outside of the UK, although that may change post regulation
'I AM AN ASPIRING Clown' more like.
I respect the sentiment but can we not react to gutter pieces like this because they clearly have zero authority and we end up just giving them more attention
That's very fair comment Ali, point taken
People will read this article though and could get the wrong idea. I think with videos like this it just reminds people who don’t think to fact check themselves to not believe everything they read.
@@SonyTene1 Mate, the point of my comment is that literally NOBODY is visiting such an irrelevant site, author is a nobody, forget evidence - even the points aren't well written.
Ollies vid + a reddit post is the most publicity this article has ever seen.
It looks like it was written by someone with English as a fourth language and minimal exposure to healthcare.
We don't need reaction videos for such rubbish because the immediate reaction for 99% of people is 1) 'Idgaf' 2) 'this article makes no sense'
I think that neither is congruent with the current cost of living in the UK. How long into your career are you supposed to live in single room in a houseshare ?
10:50 Not quite - you can complete a graduate entry medical course in 3 years if you have a dental degree. Not all such courses are listed on UCAS (e.g. Glasgow), but some are (e.g. KCL).
Is this still true today? I know this used to be the case but I'm fairly sure that the EU set the minimum standard to 4 years
@@OllieBurtonMed It is true but this is an exception just for dentists with a dental degree only not a common thing for everyone
@@anupamchandran723 I've just had a look to check, King's is 4 years on their website? A104 Maxfax entry. I can't find anything on the Glasgow course
@@OllieBurtonMed I think the Newcastle upon Tyne programme for Maxfax entry does 3 years for medical school if studied directly after a dental degree at the same university because I knew someone who did it and Newcastle teaches both with the same tutors
@@OllieBurtonMed sorry I was mistaken about KCL, it’s 4 years. 3 year courses include universities:
Glasgow
Leeds
Bham
Manchester
Liverpool
Bart’s
I’m happy to provide URLs, but you can easily find this information on each university’s website.
I’m not even a doctor but can tell that this article was written by someone really salty who didn’t get into medical school!
PA is N0T physician "associate"but is physician assistant in the USA.
It's an interesting discussion. In the UK I believe it's always been associate, in the USA the relevant faculty has voted to change the name to associate, but this has been blocked in many states as misleading to patients.
Associate TO the physician
Do we need a degree to be Physician Assistant?
You need a masters or post htad diploma after a science degree
In an ideal world the role of a PA would be to do ward scut work e.g. scribing for ward rounds, TTOs, calling micro, requesting routine bloods and following up on the results. Seeing as junior doctors, as the author of article repeatedly alludes to, are 'in training' this would allow us to better access training opportunities like going to clinic, theatre etc. Unfortunately due to the fact that a) they don't rotate allowing them to build rapport within in their department and b) they can't do basic things like prescribe and order ionising scans, the opposite tends to be true.
@@purpleblush7106 The job I described above is literally the day shift job of thousands of doctors, even up to and including core surgical trainees who have gone through a rigorous selection process involving numerous post graduate exams, expensive courses and many additional hours doing audits, writing publications etc so that they can begin training for their surgical career. If you would be unhappy doing that job, because you feel like your training makes you overqualified to do so, then just think how they would feel. This role is clearly unrewarding and uneducational but someone has to do it. My argument is that this role should be given preferentially to PAs to allow doctors in training which (includes FYs) to actual obtain the training they are entitled to. I would argue that doctors out of training (trust grade/ locums) should also be given this role with preferentially as well. This doesn't mean that once the routine ward work has been completed that PAs could not then pursue other more educational opportunities, but this should never be at the expense of a doctor - PAs going to theatre whilst the actual surgical trainees are manning the wards doing the scutwork is a complete joke but often happens due to the reasons I outlied above.
I didn't suggest that PAs beimg unable to prescribe was due to incompetence.
@@justadude8369 if there is an opportunity for learning why should junior doctors get to monopolise it or get first dibs on it (genuine Q)? is it cos you guys went through 6 yrs of med school and did all that "numerous post graduate exams, expensive courses and many additional hours doing audits, writing publications etc"? ok admittedly that is a long and hard way to get the foot in the door but once you get your foot in the door and ready to look after a patient how you got there should not matter so much i think in my humble opinion. what matters is you are there and ready to look after patients. people shouldn't be favoured more just cos they took the supposedly more prestigious and traditional route in (or should they? if yes, why?). any learning opportunities that arises should be distributed fairly and equally amongst colleagues (at least in an ideal world). if you know scutwork is part and parcel of junior doctor role why not take it gracefully and not moan about having to do it whilst your pa colleague goes to theatre? cos chances are that it was just a one-off thing and mostly junior doc in training are the ones who will be given priority above all else (correct me if im wrong). also remember that medicine is a team effort and yes that team now also includes PA and isnt a team only as strong as its weakest link? your opinion regarding trust grade docs (outside their training) and scrutwork is understandable and reasonable to an extent but it is ridiculous when you extend that same statemetn/opinion towards PAs. every PA (unless locuming) you see on ward are on training as well and need to be nurtured and require those learning opportunities just as much junior docs on training require in order to develop, grow and thrive in their roles. if having highly skilled PAs improves patient care and the standard of care delivered why not take steps towards that direction? What’s wrong with junior docs occasionally covering for PAs while they go to theatres? Why get so butthurt? Cos Im pretty sure these things wouldn’t be happening on a regular basis anyway.
@@purpleblush7106 A core trainee NEEDS a certain amount of cases performed/assisted in theatre for them to be able to apply for registrar training, just as an FY doctor needs a certain number of cases to apply for core training, if they wish to do so. For a PA, going to theatre is an interesting and educational experience but it is not a requirement for them to progress their career, because it is not their job - they are not surgeons and can never be surgeons unless they go to medical school. Doctors only do 4-6 month rotations in each specialty before moving on so they only have this brief period to get their case numbers in which ever specialty they are training in. Their time is further limited by service provision commitments like nights and on-calls in which they are unable to go to theatre. Its not uncommon for trainees to have to come in on their off days, unpaid, just to get their numbers up. Theatre time is essentially a precious and finite resource for trainee doctors - why should they be denied priority in something that is essential for the progression of the career they are supposed to be trained SPECIFICALLY for just so a PA can cosplay as a surgeon for an afternoon? Like I said, no problem with PAs going to theatre, as you say, its a valuable and educational experience. And due to the non-rotational nature of PAs there will be plenty of opportunity to over time, and many FY doctors are not interested in surgery. But it should never be at the expense of a trainee, whether that is registrar, core trainee or foundation.
Unfortunately these things do happen, although it obviously varies from trust to trust. And isn't necessarily the fault of the PAs. Some consultants would rather upskill one non rotating member of staff (e.g. an SCP or PA) than train a new doctor every 4-6 months. This is an extremely short sighted approach - how do we expect to have a competent generation of surgeons when we are treating those future consultants so poorly?
And whats more the situation has only gotten worse since COVID - with redeployments and cancellation of elective lists surgical training has been extremely poor for this generation of trainees. Its now more important than ever to prioritise those who have a need to be in theatre versus those who do not
@@purpleblush7106 I think some of the confusion here comes purple because that's how the introduction of PAs was sold to many doctors at the beginning as the logic for introducing them - to the tune of 'junior doctors are so pressured by administrative tasks such as ward round typing, TTOs, discharge letters etc etc that they're too busy for proper training' - there is some degree of understanding that this is the problem that PAs were introduced to fix, by handling that more routine work in order to free up junior doctors to be trained in clinics/theatres etc. In practicality the PA role is extremely poorly defined (not that this is necessarily a problem of course, it makes them flexible) - but it makes it unclear on the whole what the purpose is supposed to be. The research literature has shown a big identity crisis among PAs for exactly this reason, because there's no agreement or universality on the nature of the role.
FACTS.
Doctors are not paid less than PAs. I graduated in 2003 and I will be a band 7 for the rest of my life. The doctor colleagues I work with will eventually become consultants and be on £100, 000 plus. Why is this about money? I thought it was about patient safety? We have demanded regulation since we started here. When will this happen?
Make it clearer and specific that doctor's training have different levels. In your video you meant "doctors who are underpaid" are doctors who are newly grad and in-training (not a full consultant/ full scope doctors). It makes more sense that doctors who are still in-training have lower salaries than full pledged consultants (of course!) This is simialr to PA's. because PA's have different scope and levels of training. They are allied health professions not under medics.
and in wales , the course is funded. so no debt from it and way better money. god us medics are mugs
This article is absolute nonsense. I think people (understandably) get fixated on comparing the two roles and the reasons for the pay difference but it is really just a business tactic akin to any other corporate environment when you want to attract future employees to a new role. The dedicated 2 year course and generous starting salary makes the role appealing in contrast with medicine, but it is very important to remind ourselves this is only more appealing for SOME people and for a variety of reasons. An example would be, if someone truly has no interest in working towards becoming a consultant and will be satisfied remaining at ‘CT level’ both in responsibility and pay for years to come, why should that stop them from entering a medical role altogether? a preference which is favoured by the PA programme. Equally, If someone is already in a corporate role from their undergraduate degree earning in the 30k salary range, there is less appeal going back into education for a minimum of 4 years to be earning the same as before for another 2, compared with 2 years training for a guaranteed pay rise alongside doing something you would really enjoy. Again this would only appeal to those satisfied with the prospect of not progressing to consultancy etc. I also believe this salary difference is a retention strategy, whereby if qualified PAs ever feel as though they would like to follow the medical route, it is UNappealing to return to higher education again and be on a starting salary lower than their current income. The body that set this PA starting salary may have preempted that if there was minimal impact on salary between roles, some PAs would be lost to the medical route in years to come, which is clearly not the intention with introducing the role. Additionally, it seems as though the only area where pay increase is not as restricted for PAs is in primary care. We don’t all need reminding primary care needs more clinicians entering it in as short a period of time as possible, which can be achieved with PAs as this again, appeals to them and any prospective PA applicants/students. It is indisputable Doctors alongside many other HCPs deserve more pay, but on the topic of comparing and contrasting why PAs have the starting salary they do, I think it is simply just a case of making the role appealing in the here and now. It has been decided on a stand alone basis, probably determined by comparing the average salaries of other masters graduates after X amount of years. It is nothing to do with comparing deservability to other healthcare roles which seems to be the notion behind most of these discussions.
Thanks for the thoughtful and considered reply Phoebe! It's your very last point that I'm actually trying to tease out with some FOI requests at the moment, because someone has decided that PA belongs on AFC Band 7 - which I don't disagree with at all! AFC pays according to role and responsibility, rather than through comparison to other graduates (at least that's my understanding) - it just means that doctors have to make this point when we go to future contract negotiations. I don't think PAs should be paid less at all.
This was quite a post; very thought-provoking!🤔 I hadn't considered keeping PAs salaries high enough to discourage them from wanting to become MD/DOs. That's a very good idea (if not somewhat under-handed)!😅 Thanks for sharing this.🙂👋🏽👨🏾⚕️
Pa is standalone and we shouldn’t be comparing let alone driving down the pay of other professionals, we need to increase the salary for doctors not reduce that of pas
A twitch streamer without an OnlyFans 😂 Perhaps you should fix that? 👀 Honestly my experience with them so far as a medical student (and previously a hospital pharmacist) is they hate junior doctors and have a superiority complex. They’re blasé about their abilities to prescribe as though drugs can’t kill people and it should just be their right after a 2 year course. They are convinced they learnt the same as medical students but just in a third of the time. One particularly rude one who was senior told me I was wrong for saying pancreatic cancer is a differential for painless jaundice.. Calling them associates rather than assistants also massively muddies the water for patients and other HCPs. I know you’re going to disagree with me on here Ollie but you must have noticed..
Not going to disagree Zed! I agree there are communication issues with the name associate that we need to be careful about, and it's a simply incorrect position that they learn as much material as a medical student, or have the same knowledge base. If I was teaching a PA student and they told me that, I would correct them, and this is being helped in some way by the new UKMLA curriculum which serves as an easy point of comparison. The real danger is not knowing what we don't know. But ultimately the two roles are different (and have different curricula) - it's why I encourage anyone who wants to be a PA to go to PA school, and anyone who wants to be a medic to go to medical school.
Can you share your experience in switching career from hospital pharmacy to medicine?
I am a pharmacy student and I am planning on applying to medicine.
Did you apply med via graduate entry or undergrad with mpharm?
How long did you work as a pharmacist before applying med?
How much money did you save from work to fund med school?
My plan is do my preregistration in hospital setting and work as a locum community pharmacist for a few years to make the money needed to fund med school. Then hopefully succeed in my med application.
Is it better to apply to med as a hospital pharmacist due to being more clinical? Even if I only do my prereg in hospital?
Sorry for the wall of questions. But thanks
Hi Zed I’m a PA, and its such a shame for me to hear that you had this negative experience with another PA. In my degree the first and foremost information the uni drills into you is that you are not and ever will be a doctor or any kind of “doctor substitute “. Similarly as Ollie mentioned we are always constantly humbled by what can and cannot do. Additionally pharmacology is a huge and critical subject to which we even have research papers to appraise on…definitely not to be “blasé” about!
I sure hope in your future career you come across a more exemplary PA (who studied enough to know the DDx of painless jaundice 😅) and learn that the majority definitely do not “hate junior doctors “ . Good luck with your studies
@@axelle2483 Thanks for this helpful and thorough reply Axelle! Really encouraging to hear
A close family member started the PA course at Brighton in 2021. he is hard working loves the course has gained respect with doctors and junior doctors on his placements now into his second year and even been offerd a position when he qualifies. "however" the structure of the course has been interesting to say the least and in my mind too much is being asked to the point some students are having to put the course on hold for a year because of lack of help and understanding from the finance depeartment of the uni. The students are expected to do a full time week on placement with junior doctors to which they love, but bear in mind JR Docs get paid PA's dont and there still expected to work weekends to pay fees according to the uni, but the course tells them to rest at weekend Errrrrrrrrrr does brighton have more hours in the day than anyone else? not one student i know doing the course has moaned about having to do everything that is required but please if you are thinking of becoming a PA remember the comitment and hours are long are very rewarding but choose your university carefully because from where i am standing the well being of students is not taken into consideration in the finace department especially with the rise in the cost of living in this particular university.
Generally dislike foundation doc TH-camrs. But I liked this vid very much.
i dont think the purpose of this video is to be an anti-PA but rather discuss why the article mentioned is inaccurate. As a failed med applicant and 2023 PA applicant, as well working as an HCA in AnE, i believe a pay rise for FYs should be fair as well as others like CTs. Current pay for PAs are an attractive and is reasonable enough to use as a basis for pay rise for JDs. also note that PAs are not yet fully regulated and I am certain that over the years it will change such as prescribing rights. I ve always wanted to study med but due to the sheer competitiveness and preparation, as well as time, PA course is a closely alternative (not implying PA and med course identical) for me to choose. I like to think PA as a sort of lite "doctoring" which gives you an experience to what sort of clinical experience a doctor has (after all there is a bunch of similaritied between PA roles and doctors). but i am not saying PA should replace doctor, obviously the latter have better career progression and are trained more intensely. I would wish that a career progression for PA should be develop (such as an entry route to medicine perhaps - u could say y not apply again for med, well for me being 28 yrs old, would really like to have a stable income and a reasonable career but i do still consider med but not for now)
so guys, to PA and doctors, let us not quarell with one another but help each other instead. after all patient safety should be our priority.
That’s such a disrespectful and disgusting for the junior doctors - who are actually running the while NHS broken system
Physician Associates being compensated more than Physicians... just gotta take the L. 😬
Because f1 don't know there arse from there elbow and feck all use. Much like a new lt straight out of officer school
This is quite a bizzare video. Physician associates are 'generalists' that work under the medical model. We are soon to be regulated under the GMC and prescribing rights should follow. And as for competition - the UCAT is now being used for admission onto Physician Associate programs. PA is a fantastic career and progression is what you make it. I know cardiology PA's doing cardioversions.
All of that is completely fair, I don't disagree with anything there.
@@OllieBurtonMed Ollie can I ask why you have requested a FOI from the NHS for our role? It seems like your quite ANTI-PA? You don’t need to justify our pay to your fellow peers. We are PA’s and you should focus on your own salaries.
@@TheDilpesh For the purposes of junior doctor contract negotiations! We're ramping up campaign for pay increases at the moment, and what I'm looking for is the rationale as to why the PA role is placed at Band 7, or specifically to find the wording that specifies X,Y,Z roles and responsibilities are worth X amount of money. That obviously is information that it would be good for us to have, because it provides a good case for a junior doctor pay increase. As we've highlighted the problem is not that PAs are overpaid, but that junior docs are underpaid - and it's a good point of comparison. I'm not anti PA at all by the way, my research at the moment is trying to improve PA training experiences and get the voices of trainee PAs into the literature - will be presented at one of the largest MedEd conferences this summer. I very regularly help PAs apply for PA school, checking personal statements, free interview practice etc. 100% happy to help get people where they want to be and I think the role is a good thing. Junior doctor pay is a separate issue correct, but how well the PA role is valued is a good point of information for a JD pay boost campaign.
That’s the issue; PA’s somehow have create this role for themselves whereby they’re often doing things such as cardioverson, to the detriment of doctors who should be prioritised for such training opportunities whilst the PA takes over more of the routine running of the department in which they’re working.
@@charliegoblin9680 Charlie how inconsiderate of you. Just because your a junior doctor does not automatically entail you to do all the clinical jobs in the ward. You need to appreciate and understand we as PAs are capable of doing much more than our job description to alleviate the workload on the ward. PAs training to do cardio versions isn’t the problem here, individuals like yourself need to rethink and allow other clinicians to learn, develop and lead in some clinical duties. This is not me saying PAs should take over the ward however if competent. Take over cardioversions for example to alleviate doctors ward jobs. I don’t just see PAs as an extra pair of hands but more so as generalist clinicians ready to tackle what is infront of them.
PAs are projecting and coping so hard in these comments 🤣
please don't call them physician associates. they are god damn physician assistants ffs
Exact same thing,tje US are changing to Associate now.I prefer assistant and I am a PA.The problem is the NHS giving the PAs roles beyond their scope
Hi Ollie, I really enjoy your videos and I appreciate how you have disseminated this article in a way that is respectful towards the PA profession.
I however would like to share another perspective. Dare I say it, I actually do not agree with the sentiment that junior doctors are radically underpaid. In fact, PAs aside, when compared to other newly qualified healthcare professions held to similar standards of regulation and professional conduct (see the HCPC and NMC guidelines) the starter wage for junior doctors is, I believe, actually rather generous - at your own admission the stated figure also does not include additional worked hours and enhancements.
I do feel that this comment thread lacks perspective. I am not sure if most people are aware, but upon qualification Nurses, Paramedics, Radiographers, and other allied HCPs have a starting salary of band 5 (£25,655) after 2 years they may progress to £27,780 and after another 2 years to £31,534. Although clinical progression to band 6 or even band 7 is possible, many of the above will remain in band 5 posts for much of their career due to competition and lack of training opportunities. With this in mind, I think that is fair to say that the earning potential of a Junior Doctor is comparatively impressive and over the course of a career far exceeds that of any other profession several times over (including the PA role).
I myself have entered my PA course from a background in radiography. I qualified at band 5, advanced into a band 6 role as a specialist CT Radiographer, practiced for 5 years at this level and am now undergoing the 2-year post graduate program. As far as I am concerned, I have progressed through the agenda for change banding and my band 7 salary will be certainly justified.
Although I understand that not everyone holds my clinical background, the Physician Associate role is an advanced practice role and other than the current lack of prescribing rights it matches similarly banded roles (i.e. Nurse Practitioners) in terms of clinical scope and entry qualifications. This is why PA’s receive the pay that they do under the AfC pay scale.
Ultimately, public sector pay is not reflective of inflation and with the rising cost of living we could all do with a little more money, but I think that when compared to the rest of the NHS workforce medicine is by no means a financially squeezed profession.
I don't think it's appropriate to compare doctors' salaries to those of allied HCP's who have done less lengthy degrees and whose roles are simply not on the level of clinical responsibility junior doctors have to take. We should compare the pay of doctors to PAs and ANPs, not allied HCPs. Fy1/Fy2s should be paid equally to PA's, if not more considering they have even more clinical responsibility and longer hours. Don't get me wrong, i definately think all HCPs deserve some form of payrise and the NHS is a woeful system
@@Witsandblades I really hope that doesn't happen to PAs when they get regulated - someone would have to shoot themselves in the foot several times to get a pay cut on becoming a regulated profession.
So you took a faster course than a regular medical student but you earn like them and this is fine to you but when somebody else do the same becoming a PA this is not acceptable. In years you will get much more money than them.
I mean there's a key difference here - the accelerated medical programmes meet the exact same curriculum requirements and we take the same exams as the normal programme. Whereas a PA programme isn't a medical degree, and it's a different qualification.
I'm a PA and the grad medicine is way harder amd more in depth than the PA courses and the training much better.Ollies training is the exact same number of hours as undergrad med while the PA only covers core disorders and very superficial pathophysiolgy because it is not intended to be an accelerated med degree .Ive learned all the things we didnt learn while working with doctors.
I am a doctor working with PAs and frankly they are of no use and I have seen their incompetence lead to patient death.
I take it this means we can’t be friends? 😅I’ve actually been a long time fan of yours, even before posting such articles online! There are many hyperbolic articles and my intentions aren’t to trigger or spread misinformation but to open dialogues on *difficult-to-approach* topics using mostly satire and exaggeration. apologies if it was in poor taste!
I do stand by anything that makes people think through their choices carefully before making decisions though (individuals still deciding on what to study).
The reality of the matter is people study medicine sometimes for bad/wrong reasons, potentially increasing the chances of a patient having a negative interaction with a bad doctor, or them hating the course they study. I genuinely believe that if people know more about their options, they can make better decisions and we will have a stronger healthcare system, and happier healthcare professionals.
There are even options further to the PA role that students should explore if they’re interested in medicine, but don’t want to be doctors or PAs!
No hate towards doctors at all! if anything I would hope this article brings awareness to the fact that doctors ARE underpaid, NOT provide reasons why PAs SHOULD be paid more, completely not the point of the article.
I however enjoyed listening to this assessment of the article and have included an authors note back to this video if that’s ok. Happy to speak about this some more in the future!
We can be friends dude! I came to it fairly antagonistically I freely admit, but if you feel the criticisms are fair and they're taken onboard then that's more than fine by me. I completely agree re people choosing the wrong reasons to apply for one or the other and establishing a dialogue is important - there were just a few big points in there that rankled me (as you can probably tell!). Equally more than happy to discuss it further in the future if you want!
In all fairness you are critiquing a piece of nonsense from an unofficial source that doesnt represent any PA ive ever met.You do not need a biomed science degree to get iinto PA school in the UK,just a science degree of any kind.However,PAs were never intemded to be replacement doctors so the comparoson is redundant.
Doctors underpaid. PA not overpaid. Just because PA are able to negotiate as an occupation a decent pay rate, does not mean doctors should start throwing their toys out of the pram demanding other people are paid less. If they want better pay to be in proportion to their other allied health care professionals, negotiate for it through the proper means.
At no point did I ever say that PAs should be paid less and I don't think that. Doctors need to negotiate better pay. That doesn't mean PAs should be paid any less, which I don't think they should be.
@@OllieBurtonMed absolutely you are right...
Doctors need to negotiate about their pay...
@@OllieBurtonMed i wanna ask that which website are u using to check band salaries?...
And can a physician associate be a physician on experience basis ?
Can PA do doctorate? To be doctor
Waiting for ur response ollie😊
@@yahyakhan7492 if a PA wants to be a medical Dr then they must go to medical school
The answer surely is PA's are at the top of their pay scale whereas Drs continue to progress past PAs.
These are both newly qualified wages that we're comparing here
I have watched your videos for a while and I quite liked them. In saying that, you should have considered the impact that entertaining an article like this, would have on the PA community.
You have stated that it’s not PAs that are overpaid, but juniors that are underpaid. And yet you have indulged in an article that inaccurately represents PAs and you have made incorrect comments on the PA role which consequently allows for a greater divide between the two professions. Just take a look at your comment section.
This is a greatly misleading article, but your points on the PA role are also misleading.
It’s a shame that we can’t put this constant comparison to an end.
Please note that physician associates do, and have always, practiced medicine. And this has also been stated by the GMC in their pre-regulatory curriculum.
With respect Laurah I've tried to engage in as open and free a dialogue as I can on here in the comments and am open to learning - is there anything I've gotten especially wrong in my assessment?
Re the practicing medicine comment, I've clarified in another answer that the nuance for me is somewhat academic but it was too complex an issue to get into the video. To summarise - I don't know at what stage someone practices medicine, even as a physician. I don't know if I self-identify as practicing medicine because of the limits of my experience. That's more what I was getting at. It's trying to tease apart the nuances in what physicians, PAs, nurse practitioners etc do and the different models of training.
Re the comments section, yes it's a mixed slate. I've not engaged with any anti-PA rhetoric and have only voiced my support for them or engaged critically with specific questions. I don't moderate comments on my channel other than removing spam so naturally yes there will be some present who are actively anti-PA, as we know a small subset of doctors are.
Sorry about the delay on your comment becoming visible, it went into my held for review section for some reason which I don't check very often.
@@OllieBurtonMed “PAs don’t practise medicine because they don’t have a medical license” you may need to further dig into this. Unfortunately you won’t be able to speak on this from a PAs point of view. PAs become general clinicians by the end of their degree who practice medicine as stated by the FPA and GMC. I understand that the extent of this may be different for you as a JD, and although I understand your comment now, this is not what was portrayed in your video other than simply “no medical license = no practising medicine”
The article specifically mentions a further “1 year training post”. This training year is optional. This is what I mean by the article is inaccurate and by speaking on inaccuracies (which you are not aware of), you end up spreading misinformation and fuelling arguments of those who already don’t like the role for whatever reason. Back to the comment though: The training post is not band 7, it is band 6. It is an internship post taken up by newly qualified physician associates as a preceptorship year. There are jobs that sometimes do not take on PAs without preceptorship years and there some that do and offer training on the job instead.
Not only 2 years of the PA study are based around clinical studies. Every candidate has to have had an adequate level of clinical studies prior to studying the degree. And of course you cannot do the PA MSc/PGDip without this degree, so it too, plays a part in the PA course. For example, someone with an undergraduate in biomedical science or pharmaceutical science will be required to have done certain modules and have a pass mark for those modules by each university (varies between universities) prior to even being invited to an interview.
An example of this is modules such as advanced pathophysiology which includes diagnosing patients based on set of clinical data presented, case studies, analysis of bloods and other tests performed such as carrying out plethysmography LFTs etc. This, of course, varies between universities but there is a degree of clinical studies that will need to have been completed prior to the MSc. This allows for a good foundation to be set before beginning the degree. Due to this, there are some universities that specifically ask for university interim grade transcripts, or require modules to have been done, or simply don’t allow certain degrees to even apply, and I’m sure you can appreciate that the same can be said for certain GEM courses too.
There are more issues that I can’t keep listing. But my issue is not the comment section in itself or trying to put an end to free speech. It’s the fact that there already is to an extent an unspoken divide between both professions. When someone with a platform like yours, decides to film a video like this on an article that is partially inaccurate, you should know exactly what you’re saying about the other role. Because if you don’t, you run the risk of spreading misinformation which consequently, rather than helping things, makes them worse. Both professions exist for the patients, that should be the focus. Advocating for a higher JD pay can be done without all of the constant comparison. It is not often that the public sees non-PA TH-camrs strongly advocating for the role. Something you did a while back which was great, which is why it’s disappointing for quite a few of us who have seen this.
@@laurahsupyrik7136dude,there are many PA schools in the UK who accept applicants with no clinical science whatsoever, as in zero anatomy or physiology so in most cases they really have only 24 months clinical teaching