The Health Service Executive (HSE) has “paused” recruitment for physician associates, despite paying tuition fees for 36 students in exchange for service commitment post-graduation.
Physician associates (PAs) assist doctors and surgeons by taking medical histories, performing examinations, making diagnoses and analysing test results, under the supervision of a consultant.
A spokeswoman for the HSE said the executive contributed to tuition fees for students undertaking the PA master’s degree in the Royal College of Surgeons in Ireland (RCSI) in order to “enhance the workforce”.
A total of 36 students have received funding from the HSE, seven of whom received funding for the second year of their programme and who graduated in January. The remaining 29 students had their full tuition paid for, and are due to graduate in January 2026.
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The spokeswoman declined to say how much had been paid, saying it was “commercially sensitive”, but, according to the RCSI’s website, course fees are about €12,000 per year.
As part of the agreement, the 29 students were expected to provide a three-year service commitment to the HSE, while the seven students who received one year’s worth of fees were due to provide a two-year service commitment.
However, the spokeswoman confirmed recruitment for the role has since been paused pending a review as the PA role is “currently not a sanctioned grade within the HSE”. There are an estimated 40 PAs working in the health service.
The spokeswoman said the review will be conducted by an “independent expert”, and the recommendations will be “incorporated into the role of the PA in the future”.
“In light of the ongoing work in relation to the PA role within the HSE, the regions were advised to pause recruitment of the physician associate,” she said.
Orla Brett, president of the Irish Society for Physician Associates (ISPA), said the society was “really frustrated and very disappointed” by the recruitment embargo.
“It’s mainly disappointment for our new graduates and students coming through. They dedicated two years of their lives to study this course and they’re a ready-made workforce to work in the HSE and they’re being stopped by the HSE,” she said.
Some of these students are now on jobseekers’ allowance or working in retail or hospitality jobs “despite being highly skilled to work in the healthcare system”, she added.
In November 2024, the UK government announced a review into what PAs do in the National Health Service (NHS), with health secretary Wes Streeting saying there were “legitimate concerns over transparency for patients, scope of practice and the substituting of doctors”.
Ms Brett said there is “fear and opinion” around patient safety issues as a consequence of negative incidents that happened in the UK.
“There haven’t been any documented patient safety concerns from any Irish PAs that we’re aware of,” she added.
