RCSI University of Medicine and Health Sciences welcomes the position statement from the Medical Council (Ireland) on the statutory regulation of physician associates.

The School of Medicine at RCSI offers the only MSc in Physician Associate Studies programme in the Republic of Ireland and RCSI has been advocating for a regulator since the role was first introduced in 2016, to regulate and set a scope of practice. A regulator that ensures a streamlined process for monitoring physicians associates and their supervising consultants, while protecting the public, is the overarching goal that RCSI has been advocating for.

Physician associates are not replacements for doctors, but they increase the productivity of the medical or surgical team by enhancing access to care for patients and complement the roles of medical or surgical trainees, as directed by their consultant supervisor.

The proportion of the Irish population aged over 65 is expected to grow from 15% currently, to 18% by 2030 and towards 30% by the 2050s. As we age and our population grows, the demand for healthcare will increase. By 2030, demand for inpatient bed days could increase by up to 37%. Demand for emergency department care could increase to somewhere between 16% and 26%. Demand for GP visits is expected to increase by between 20% and 27%.

Without significant change in our health service, the future demand for healthcare is unsustainable and we will face a public healthcare crisis that will see many more of us unable to access the care we need. Worldwide there is broad agreement that the most promising model for a sustainable healthcare system is one that increases productivity by extending the scope of practice of existing healthcare professionals and creates new professional groups, in line with calls from the World Health Organisation (WHO) to innovate medical workforces.

To that end, RCSI introduced prescribing for nurses in 2007, is a strong advocate for advanced nurse practitioners, is supportive of prescribing rights for pharmacists and has successfully completed a pilot that allowed integration of physician associates into the Irish health workforce.

RCSI’s introduction of the Physician Associate Studies programme underpins our commitment to supporting an increased capacity in the Irish healthcare system to provide safe and quality patient care.

Ireland’s experience to date has been very positive and this differentiates us from other countries who have faced challenges with the introduction of the physician associate role.

Since the launch of the programme in 2015, physician associates have made a positive contribution to healthcare teams across Ireland. To date, 76 physician associates have graduated from the two-year programme with 60% working in public hospitals, while 40% are employed by the private sector. Services are provided across most medical and surgical subspecialities.

Over the last two years, RCSI and the Irish Society of Physician Associates have contributed to the work of the relevant parties in the health sector to ensure that physician associate job descriptions and scope of practice represent the role of Irish physician associates working across all medical and surgical specialities with clear definitions to assure the highest level of safety and quality care for all patients.

Physician associate graduates have completed a level 8 science degree, followed by a rigorous 24-month full-time postgraduate didactic and clinical curriculum. The programme focuses on the acquisition of medical and surgical principles derived from evidence-based education and practice guidelines. Many physician associates have previous healthcare roles, including nurses, and other health professionals. Prior to commencing a professional clinical role, graduates are required to pass a national exam (Irish National Physician Associate Exam). Upon successful completion, the fully qualified physician associate is required to complete continuing professional development annually, and demonstrate continued competency every six years, by re-sitting a certification exam. These requirements demonstrate the profession’s commitment to patient safety and professional responsibility with the aim to safeguard the public.