Medical associates: the introduction of PAs, ANPs, and ACPs is creating new challenges for doctors on rotational training

The addition of new clinical staff on hospital wards is welcome. The steady introduction of physician associates (PAs), advanced nurse practitioners (ANPs), and advanced clinical practitioners (ACPs) has undoubtedly helped to manage the ever increasing demand in UK hospitals. However, this new blend of different clinical ward roles is disrupting the training, skill development, and professional autonomy of rotating doctors. Given that these non-traditional clinical roles are likely to stay and expand,1 attention needs to turn to navigating the new dynamics these roles bring and to ensuring that clinical work remains collaborative and safe.Rotational training brings several challenges.2 Doctors arriving on hospital wards need to navigate new systems and adapt to new processes of working every three to six months. It takes time to develop professional relationships with colleagues, nursing staff, and ward consultants. The presence of permanent ward clinicians can be valuable in easing this transition, helping disoriented doctors…
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