91¶ÌÊÓƵ

Adopted by the 229th Council session, Montevideo, Uruguay, April 2025
and by the 76th 91¶ÌÊÓƵ General Assembly, Porto, Portugal, October 2025

PREAMBLE

The 91¶ÌÊÓƵ and its constituent members share the British Medical Association’s concerns about the way in which non-physician practitioners including PAs (physician associates or physician assistants) and AAs (anaesthesia associates) have been introduced in the United Kingdom and other countries and makes the following recommendations in light of the independent ‘Leng Review’ into PAs and AAs commissioned by the UK government and other similar reviews.

RECOMMENDATIONS

In the interest of patient and clinician safety and to ensure broad clarity of understanding, the 91¶ÌÊÓƵ affirms that:

1. The terminology used for physician associates and anaesthesia associates is confusing. These roles must be titled ‘assistants’ rather than ‘associates’ to make it clear that they assist physicians.
2. Terms previously used for physicians such as ‘medical professionals’ and ‘medical practitioners’ should not be expanded to include PAs and AAs, nor should they be described as being ‘medically trained’ or ‘trained to the medical model’. This is because it is proving to be confusing for the public and misleading for physician supervisors and other members of the multi-disciplinary team who may wrongly presume that assistants have the same knowledge, skills and expertise of a physician, with adverse consequences for patients.
3. PAs and AAs should work under the supervision of physicians and within clearly defined scopes of practice with clear limits, and should undergo regular quality assurance and appraisal. Physicians and their representative bodies should be properly consulted on any proposed changes to these scopes given such roles utilise a limited subset of skills and knowledge of physicians.
4. PAs and AAs should be deployed to assist rather than replace physicians.
5. The training of PAs and AAs should not be prioritised at the expense of training for physicians and medical students, including the funding for such training.