Accessibility of Physician Associate Studies: Student Experiences of Financial Support. A Cross-sectional Online Survey

Abstract

Abstract Background The number of Physician Associates (PAs) within the NHS workforce is rapidly rising. In other healthcare professions, researchers have highlighted the prevalence of financial barriers to careers, and the importance of widening access to applicants. However, this has not been explored among PA students. The aims of this study were to: 1) explore PA students’ perceptions of financial support whilst studying; 2) identify whether PA course funding is appropriate for students to study effectively; 3) establish baseline demographic data for those undergoing postgraduate PA studies. Methods 189 PA students completed an online survey during 2021, which examined their perceptions of financial support. Survey measures comprised basic demographic questions, binary responses, Likert scales, and open-text responses. Quantitative data were analysed descriptively, while qualitative data were analysed using reflexive thematic analysis. Results Basic demographics were in keeping with data from the annual census of qualified PAs. Respondents were predominantly White British/European (67.1%), with 87.8% identifying as female. 16.5% students had financial dependents, with 77.4% of those disagreeing that they were well-supported financially in caring for their dependents. Most PA students (94%) worried about finances, and 83.2% agreed that this negatively impacted their studies. Students perceived the costs associated with the course to be excessive, with undisclosed travel costs, an unexpected rise in exam fees, and lack of governmental loan provision featuring prominently as financial stressors. Funding was perceived to be insufficient for PA students to thrive whilst studying, and concerns were heightened for those with dependents and/or disabilities. Concerns about finances also had detrimental impacts on mental health. Conclusion Our findings indicate that the current format of PA courses favours those with financial privilege, geographic mobility, and no caring responsibilities. The PA profession was perceived by students to be at risk of deterring promising talent, and of becoming a ‘closed shop’. Universities and government loan providers should consider how they can best support PA students, such as through: greater transparency of financial information, funding of placements in the same way as they are for other healthcare students, and increasing of grants and scholarship provision.