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A Novel Primary Healthcare Physician Associate Internship: Results from a Service Evaluation

Silverwood; Lawton

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Abstract Background: Physician associates (PA) are dependent healthcare professionals with two-years post-graduate generalist medical education. PAs can work in primary care immediately after graduation. However, PAs are novel to, and still relatively uncommon within, UK primary care. Recognising the challenges presented by UK primary care, including the undifferentiated, complex sociomedical and non-protocolised presentations, a novel one-year internship scheme was established to support PAs to work in primary care and to support PA retention in primary care and within the geographical region. This evaluation sought to gain feedback to guide further roll-out and development of the internship and to establish its success in supporting PAs into primary care. Methods: The Staffordshire PA Internship (SPAI) scheme was introduced in Staffordshire in 2017. PAs worked concurrently in primary and secondary care posts for one year, with protected weekly primary care focussed education sessions. Posts were subsidised and PAs were centrally employed. Evaluation data pertaining to the first two cohorts were sought from the PA interns, supervising GPs and practice managers. Results: By evaluation end, eight of the ten PAs had completed the internship. Practices valued the subsidised, central employment model of the internship as it provided a risk-limited opportunity to explore the PA role, which iteratively developed to establish weekly timetables that best suited PAs and practices. While the one-year PA programme had seen PA interns develop significantly from the start, many practices and PAs felt that a two year programme may have been preferable. There were mixed views about whether a split post or sequential posts may be preferable, however, PAs did not have experience of the latter. Conclusions: This test-of-concept SPAI was successful in retaining PAs in primary care in the geographical area of the internship. However, it highlighted the need for PA interns to have intensive supervision, particularly in the early weeks, and a dedicated educational programme, which was only possible due to the internship arrangements. The optimal internship design remains unknown, however, sole primary care internship posts may accelerate upskilling of PA interns for the challenges of primary care and may better support their integration within practices.


Silverwood, & Lawton. (2020). A Novel Primary Healthcare Physician Associate Internship: Results from a Service Evaluation. BMC Family Practice,

Acceptance Date Sep 15, 2020
Publication Date Sep 15, 2020
Journal BMC Family Practice
Print ISSN 1471-2296
Publisher BioMed Central
Keywords Physician associate, internship, primary care, evaluation, integration, implementation


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