Spotlight series: physician associates (PAs) in surgical specialties – paediatric plastic surgery

The physician associate (PA) profession has grown by over 300 in just 1 year and PAs currently practice in over 50 specialties – one being surgery.  

In this spotlight series, we will hear from qualified PAs working in various areas of surgery. They’ll share their journey, from what made them want to be a PA and the skills they have gained from working in their surgical area, through to what they find challenging and most rewarding about the PA profession.

Stephanie Kerr qualified as a PA from St George's University of London in 2016. Stephanie then went on to work as a PA in general practice before becoming the first PA to work at Great Ormond Street Hospital for Children (GOSH). Currently a PA in paediatric plastic surgery, Stephanie is also PA education lead at the hospital. Here is her story.

What made you decide to become a PA?

Initially, when I left school I wasn’t sure what path I was heading in. I always had an interest in science and studied anatomy at the University of Dundee. Towards the end of the course, I had to start focusing on what was next. It was my mum who mentioned becoming a PA, as a friend had joined the profession.

Luckily there was a PA course open day at my university. After speaking with PAs and PA students, it resonated with me that I did not want to commit to medical school. I wanted to begin working quickly, and the 2-year PA course suited my ambitions perfectly.

Can you tell us more about your experience of working as a PA in paediatric plastic surgery? 

When I qualified as a PA, I worked in general practice for a year and treated a lot of children; my love for paediatrics grew. At that point, I hadn’t thought about surgery as a pathway. I then saw the advert for GOSH and began thinking about how surgery is immediate problem solving and that aspect interested me.

As PAs we are taught limited paediatric training, so I threw myself in at the deep end. I was the first PA at GOSH and was, therefore, able to set the foundation, which was rewarding. My supervisors were very supportive and keen to have me involved in the surgical elements early on. I was shadowing in complex surgeries and assisting where possible. I’ve now been in my role for 3 years and having that exposure from the beginning has helped my confidence greatly.

What diagnostic/investigation and procedural skills have you gained?

Stephanie Kerr

GOSH is a tertiary centre and paediatric plastics is a large field so there are complex surgeries performed regularly. As a result, there is always something new to learn (which I love). As a PA, we follow a patient's journey from the beginning, and a specific case has remained with me.

A patient suffered from severe sepsis and I was involved in the case upon admission. Sadly, the sepsis had attacked the patient’s legs and they both required amputation. The surgery was complex and intense at times but being trusted and supported to perform the suturing was so rewarding.  

I am supporting the patient’s rehabilitation and post-operative appointments too. Getting to see how well they are adapting and thriving is the most rewarding part – there is no other feeling quite like it.

How would you describe the impact your role as a PA has had?

As I mentioned, I was the first PA to join GOSH and it’s rewarding to know I have helped pioneer the profession at the hospital. It has since been proven how impactful our roles are and we are looking to recruit two more PAs into surgical specialties. I’ve also grown into the role of PA education lead which involves developing education plans for my PA colleagues and PA trust policy and competency frameworks. 

We are also a support system for junior doctors during the induction period. We’re available to help guide and show them systems, leaving consultants free for patients. This means there is less requirement for locums on our wards as we can help to cover when consultants are required in surgery. There is a large portion of trust placed in PAs in surgery at GOSH – due to how keen we are to learn.

As a PA working in paediatric plastic surgery, what challenges do you face?

The main challenge we face is patients and families not understanding what PAs do / how we fit into the care plan. I have not come across any negative feedback, which is comforting but I do need to explain the scope of my role.

On occasion, it can be difficult to secure consistent time in theatre as consultants want to be present due to the nature of the surgery [GOSH performs a high proportion of complex procedures]. I’m lucky that my consultants are always keen to ask me to assist in theatre when staffing levels allow.

What do you find most enjoyable and rewarding being a PA?

Working in paediatrics is special because children are so adaptable to their conditions. It’s amazing how positive they remain and how grateful their families are for the support. Particular cases I remember well are children being born with symbrachydactyly [a condition characterised by short, stiff, webbed or missing fingers]. Surgery is performed to create fingers, and children go on to lead a fulfilling life. Knowing I have played a part in that is extremely humbling.

I also thrive on learning and growing my knowledge – something I get to do every day. I run a plagiocephaly clinic each month as I am trained in this area.  My role as education lead also allows me to help teach other PAs and sharing knowledge to help them grow excites me and adds even more variety to my work.

What does the future look like for you as a PA?

The luxury for PAs is that our profession doesn’t take on a clear path and we can create our own future, which is exciting. I enjoy teaching and educating other PAs and building my educational portfolio is a key focus area.

Becoming more confident and building my surgical skills is a priority too. I’m confident in excising, incising and vacuum pumps. Additional skills I am keen to learn are local anaesthetic operating lists and extravasation management.

What advice would you give to a PA looking to practice in paediatric plastic surgery?

Focus on gaining patient-facing experience. During my undergraduate study I volunteered with the British Red Cross first aid team, but any form of patient interaction will be beneficial. For example, it could be working as a receptionist in a GP surgery or as a healthcare assistant. Gaining experience helps with understanding the healthcare profession and provides a knowledge base to build on.

Overall, being proactive and enthusiastic is key. You must also have a love of working with children and this helps in the journey to fulfilment as a PA.

We’re always looking for qualified PA FPA members to share their story. If you’re interested in sharing yours, get in touch using the contact details below. If you’re thinking of a career as a PA, you can learn more about how to begin your journey here.

Get in touch to share your PA story:

Jenna Donaldson – FPA communications officer
[email protected]