Keynote Speaker Charts History of PA Profession in UK, Presents Global Challenges

Phil Begg's Power Point Presentation

Keynote speaker Phillip Begg provided an intriguing glimpse into the rapidly developing PA profession in the United Kingdom — as he termed it, the “New Kids on the Block” — and addressed the challenges he saw for PA education and educators in the next 10 years as the PA profession spreads around the world.

Begg described the remarkably rapid progress of the PA profession in the UK over the past few years, since the first American PAs began work there in 2001 and the first PA program began development in 2004. Begg is associate dean for primary care at the University of Wolverhampton, England’s fifth largest university, which has more than 26,000 students, 8,000 in its School of Health.

PA education in the UK, Begg said, has been “led by the universities,” though in many ways the profession and programs are centralized to a degree that would not be possible in the United States. The UK has nationally agreed upon competencies, a national curriculum, and a national certifying exam. The Competence and Curriculum Framework even provides a working definition of the PA: “A physician assistant is not a doctor, but a new healthcare professional working to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and/or general practice team under defined levels of supervision.” Begg drew murmurs from the audience when he noted that clinical placements (rotations) are funded by the government-funded National Health Service (NHS), and the bulk of students’ tuition is also paid by the government. With three programs now operational, and a fourth expected to come on board soon, Begg said that by 2011 the UK will have 150 graduates.

The PA profession is emerging as part of a total overhaul of the NHS. Begg pointed out that NHS CEO David Nicholson has said that “new roles are emerging and becoming embedded in the traditional health care systems.” As in the United States, the UK is facing an aging population, a projected shortage of health care providers, and increasing demand for care, especially in rural communities. The PA profession can help fill this gap, Begg said.
 
Begg described the acceptance of PAs in the UK in terms of a model he attributed to Ruth Ballweg — any idea passes through three stages of reaction: ridiculous, controversial, and obvious. The PA profession in the UK is now well on its way to being “obvious,” he said. 

Turning his attention to the development of the profession in the rest of the world, Begg reviewed the now more than 20 countries where PA-like professions are in place or under development. “I firmly believe that we have reached the tipping point for PAs globally,” he said.

And this new global reality offers challenges and opportunities for PA educators everywhere. Begg suggested that the globalization of the profession might mean a renewed focus on public health and ill health prevention; the exchange of faculty and knowledge in an effort to create nation-specific solutions; greater cross border development, which would involve a more transient profession; and recognition and reciprocation agreements to allow stronger developmental initiatives.

Begg’s presentation is posted on the PAEA Web site.