SPACES course

Learning objective 2: Year 2 PA students

LO2 (1/2): Who Are PAs and PA Students?

Registered Physician Associates (PAs) are healthcare professionals who have undergone two years of postgraduate training. They work collaboratively within interprofessional healthcare teams, practicing under the supervision of doctors.

Year 1 PA students

Year 1 PA students follow a full timetable consisting of clinical science lectures, PBL, pharmacology lectures, anatomy workshops, clinical examination skills sessions, and communication skills training. In addition to their academic schedule, they participate in weekly supervised clinics within a GP surgery to begin applying their knowledge in a clinical setting.

Year 2 PA students

After successfully passing their Year 1 exams, PA students’ progress to Year 2, which focuses primarily on secondary care clinical placements. These placements cover the core GMC requirements; acute and emergency, and general medicine, surgery, mental health and primary and community care together with Obstetrics & Gynaecology, Elderly Medicine, and Paediatrics, providing students with diverse and comprehensive hands-on experience. They are also required to attend 3 1-week blocks back at BSMS with a focus on more advanced communication skills and allowing BSMS faculty to check in on their progress and help consolidate their learning.

National exam requirements

To work as a PA, PA students must pass the Physician Associate Registration Assessment (PARA) before applying for General Medical Council (GMC) registration. The PARA, delivered by the Royal College of Physicians (RCP) assessment unit, consists of a 200-question online knowledge-based assessment (KBA) and a 14-station OSCE. Students are permitted up to four attempts at each component and must complete both within 18 months of passing either section.

The GMC’s Physician Associate Registration Assessment (PARA) content map, published in September 2022, defines the core knowledge, skills and behaviours that newly qualified PAs must demonstrate, structured across four domains—Professional Values and Behaviours; Clinical Capabilities; Areas of Clinical Practice; and Professional Knowledge. Supervisors can review this map to tailor placement experiences and feedback, aligning student learning with the expected competencies required for GMC registration.

LO2 (2/2): What PA Students Are Expected to Do & GMC Requirements

PA students in Year 2 should:

• Take histories and perform examinations
• Formulate differentials & management plans
• Participate in monitoring & follow-up
• Communicate with patients and the MDT
• Engage in health promotion

Boundaries & Supervision - PA students must only:

• Perform BSMS-trained procedures with appropriate supervision
• Work within their healthcare capacity and, as they are not yet qualified, they must always be supervised

General Medical Council Requirements

It is important that supervisors of PA students are aware that, even as trainees, PA students must uphold the same high standards of conduct and professionalism expected of registered clinicians. General Medical Council (GMC) Good Medical Practice guidance for PA and Anaesthesia Associate students sets out how core principles—such as patient safety, honesty, respect, and accountability—apply both on and off placement. By reinforcing these standards early, you can help students internalise the behaviours that will make them trustworthy practitioners and model values that they will carry into their careers.

As supervisors, it’s also important to be aware that the GMC now formally regulates Physician Associates and Anaesthesia Associates as distinct professions alongside doctors. The GMC sets and enforces the standards of clinical practice and professional behaviour these students must meet, approves their course curricula, and maintains a register to ensure ongoing fitness to practise. It also provides guidance and investigates any concerns to uphold patient safety and public trust in all regulated healthcare roles.

Learning objective 5: Medical education in clinical practice

LO5 (1/2): How Students Learn in Clinical Practice

Students learn best not by watching, but by doing — with guidance, reflection, and feedback.

Common elements of workplace learning include:

• Legitimate peripheral participation: Students start on the edge of a clinical activity and move inward as they gain confidence
• Role modelling: Students observe how professionals communicate, think, and make decisions — and then emulate these behaviours
• Feedback loops: Short, timely feedback helps correct errors and reinforce good habits
• Active involvement: Learning is not passive — it depends on being given purposeful roles, even small ones

Letting a student present in handover or summarise a case to the consultant builds real competence.

LO5 (2/2): Your Role in the Learning Process

As a supervisor, you are a facilitator of learning. You don’t need to give lectures — just help students link theory to practice.

Tips:

• Think out loud — e.g. “This patient’s chest pain could be cardiac or reflux… I’m leaning cardiac because…”
• Ask reasoning questions, not just recall — “What else could it be?” or “What would you do next?”
• Encourage reflection — “How did that consultation go for you?”

Every interaction is a learning opportunity — even a corridor chat.