Doctors’ leaders criticise GMC advice allowing resident doctors to supervise PAs

The Royal College of Physicians has said it is “disappointing” that new General Medical Council guidance does not state that physician associates (PAs) must be supervised by a senior doctor.

The BMA has also criticised the GMC’s new good practice advice for doctors who supervise and work with PAs and anaesthesia associates (AAs), calling it an “unhelpful contribution.”

Both the RCP and BMA argue that PAs should be supervised only by senior doctors such as consultants, GPs, and autonomously practising specialist or associate specialist doctors and never by doctors in training. But the GMC’s new guidance suggests that other healthcare professionals or resident doctors could take on this responsibility.

Dr Hilary Williams, RCP clinical vice president elect and chair of the RCP PA oversight group (PAOG) said: 

"The RCP published interim guidance for the supervision of physician associates (PAs) in December 2024. In our guidance, we were clear that PAs working in the medical specialties must be supervised by a senior doctor (a consultant, specialist or associate specialist doctor) and never by a resident. 

'It is therefore disappointing that this new resource from the GMC allows for the supervision of PAs by other healthcare professionals and doctors in training – we drew a firm boundary in our guidance to protect the training opportunities and role of resident doctors.

'Patient safety is our priority. This is why we've repeatedly called for a national scope of practice for PAs. They should not work autonomously, prescribe medications, or request ionising radiation. The RCP interim guidance is overall more detailed, structured and explicit about scope of practice, supervision and how PAs should explain their role and responsibilities. We would expect and encourage trusts and health boards to follow this guidance where PAs are being employed to work in medical specialities."

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Source: BMJ, 28 April 2025