Intended for healthcare professionals


Medical associate professions: how physician associate and similar roles are developing, and what that means for doctors

BMJ 2018; 362 doi: (Published 18 September 2018) Cite this as: BMJ 2018;362:k3897
  1. Abi Rimmer, deputy editor, BMJ Careers, London, UK
  1. arimmer{at}

Doctors’ concerns about these new members of the medical team are not borne out in practice, finds Abi Rimmer

Discussions about the role of medical associate professions (MAPs) at this year’s BMA annual representative meeting in June served to highlight a longstanding feeling of unease that some doctors have about these emerging roles.

Doctors at the meeting voted in favour of a motion warning that MAPs or “non-doctors” were being put in a position of “taking decisions they are not qualified to make.” The motion will therefore become part of BMA policy.

Speaking at the meeting, retired consultant surgeon Anna Athow said that MAPs were doing “doctors’ work” such as taking patient histories, examining patients, arranging tests, making diagnoses, and starting treatment plans. “MAPs do not have a doctor’s training; nor are they regulated. They are to be supervised by a doctor. MAPs have two years’ training. This is not safe,” Athow said.

Despite such concerns, MAPs are already starting to become an integral part of the medical team. Physician associates (PAs) have been working in the NHS for around 10 years, with at least 297 employed across primary and secondary care in England, according to NHS Digital. The Faculty of Physician Associates, which runs a voluntary register of the profession and oversees training and education, has been part of the Royal College of Physicians since 2015.12 In 2016, the Royal College of Anaesthetists, in collaboration with the Association of Physicians’ Assistants (Anaesthesia), agreed on a scope of practice for these professionals.3 And earlier this year the Royal College of Surgeons launched a new associate membership category for MAPs who work within the surgical care team, such as surgical care practitioners and PAs.

Ian Eardley, vice president of the Royal College of Surgeons and a consultant urologist, …

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