PA PRACTICE • INTERNATIONAL RECIPROCITY

Physician Assistants are more commonly known as Physician Associates in the United Kingdom (UK) and work with physicians. Like Canadian and American PAs, Physician Associates have direct patient contact, taking histories, performing physical examinations, ordering and interpreting investigations (such as blood work or imaging), diagnosing medical conditions and initiating treatment plans.

They are autonomous, but dependent practitioners, which means they work under the supervising of the supervising physician. They are also trained under the medical model like doctors. These Physician Associates work in general practice, easing the pressure on the general practitioner workload, and in specialty and subspecialty practices. PAs work in specialties like GP surgery, A&E, hospital inaptient ward, Hospital ICU, Hospital Operating theatre, hospital outpatient department, Medical assessment unit or acute medical unit, rehabilitation, specialist surgery, walk in centres, and psychiatry services (RCP, FPAs).

The Faculty of Physician Associates reviews whether a Physician Associate is qualified and fit practice in the UK, and thereby join the Physician Associate Managed Voluntary Registrar (PAMVAR).

I actually had to consult Canadian Association of Physician Assistants (CAPA) for this one. As of January 15, 2014, the answer in short is no, they cannot. 

If you graduated from a PA Program, in order to practice in Canada the PA program has to:

a) Graduate from an NCCPA certified (American) institution
b) Graduated from a Canadian Medical Accredited Program.

If you wanted to practice in Canada as a Physician Assistant, you can do so by:

• Completing a PA Education Program, which includes four schools: University of Manitoba, University of Toronto (PA Consortium), McMaster University and the Canadian Forces.
• You may be required to complete a PA Entry to Practice Certification Exam, which is required by certain jurisdictions and employers.

There are several Canadian trained Physician Assistants that are currently practicing in the UK. Read the Royal College of Physician’s Faculty of Physician Associates leaflet on “Who are Physician Associates?”

From email correspondence with the FCP, they have recommended that PAs who practice in the UK must pass the American PANCE* or the UK PA national certification exam which is composed of a written and OSCE component.

I contacted the Royal College of Physicians Faculty of Physician Associates and received this response:

“Unfortunately there is no international reciprocity for PAs. UK trained PAs are not allowed to work in Canada or anywhere else outside the UK. Similarly PAs trained outside the UK are not eligible to work as PAs in the UK without repeating the two year training programme and passing the national PA exam.

The only exception to this rule is for US PAs as is true in Canada. This is due to the profession being in existence for decades in the US and US PAs frequently being used to demonstrate the effectiveness of the role in countries not yet utilising PAs.

If you are relocating to the UK you would certainly be eligible to apply for one of the 27 PA programmes we currently have in the UK. Please find a list of them here.”

*Please note in order for Canadian PAs to challenge the American PANCE, they must have graduated from an American accredited PA school. At time of writing, Canadian PAs must go back to 1st year American PA school, complete PA school and then they may challenge the PANCE.