‘A pause in recruitment means a pause in our lives’

A NAVAN woman who is due to qualify as a physician associate later this year is among dozens of students left in limbo after the HSE paused recruitment of these roles.

Emma Smyth is currently undertaking a two-year masters' degree at the Royal College of Surgeons to become a physician associate, which she explained is an emerging healthcare profession in Ireland but is well established in the US.

“It involves working within the medical team under the supervision of a consultant or GP to diagnose patients, order tests, perform procedures, assist in surgery, and provide continuity of care among many other responsibilities. The role originated in the US and is very well established there now with physician associates providing care across all medical specialities,” said Emma.

She explained that the intention is not that physician associates would replace doctors but rather would complement the medical teams and there are currently around 75 physician associates within the Irish healthcare system with about half of these working in the public sector. With non-consultant hospital doctors changing every few months, she said the role also allows continuity of care for patients.

Emma did her primary degree in sports science and exercise physiology and while working as an occupational therapy assistant in Navan Hospital, she came across the role and decided to pursue a career as a physician associate.

“There are currently four physician associates working within Our Lady’s Hospital Navan. I previously worked in Navan Hospital, and I have been on placement there and I have seen myself the impact they are having on our local hospital. They facilitate extra clinics, they have added extra surgical lists, and they are a constant member of the team for patients to see every time they revisit the hospital,” said Emma.

She is due to qualify in December but as things stand there are limited employment prospects after the HSE paused the recruitment of new physician associates to the public health system. While the avenue of private hospitals and GPs is still open, there are currently no open posts being advertised and generally over half of graduates are employed in public hospitals.

“It is a very worrisome time for myself, and my fellow students and physician associate graduates. A pause in recruitment means a pause in our lives with some graduate students currently on Jobseekers Benefit and others working in retail while awaiting this embargo to be lifted. We are an Irish trained workforce that are motivated to work in the Irish Healthcare System to improve patient care, decrease waiting lists and support other medical staff,” said Emma.

She also pointed out that he HSE has funded this master’s course for all 26 of its current second year students with an undertaking that they would be employed by the HSE for three years after graduating. She explained that the course fees are approximately €24,000 which works out at approximately €600,000 that has been financed by the HSE, yet until the embargo is lifted, they will not be able to be employed in the public system.

An independent review of the physician associate role was included in the HSE Service Plan for 2025 and Emma said they haven't been told when it will commence, how long it would take or if recruitment is dependent on the outcome of the review. She said no patient safety concerns have been reported and they don't know the reason for the review.

Orla Brett is the President of the Irish Society of Physician Associates and has worked in the role for the past six years at Beaumont Hospital. “The intention of our role isn't to replace doctors. It is an additional member of the healthcare team. We don't introduce ourselves as doctors, we don't see ourselves as doctors, our role is a profession in its own right.”

Physician associates are not yet regulated by a regulatory body and Orla said that this is a complex process that takes time. They also are waiting for a scope of practice and independent payscale to be agreed. The ISPA was established in 2019 to support students members and qualified physician associates in Ireland and is responsible for the managed voluntary register until statutory regulation is in place and members are required to be certified and undertake continuous professional development.