Education for physician and anaesthesia associates

Once regulation begins, we’ll set the standards for course providers and regularly check that those standards are met. We’ll also approve updated curricula for physician associate (PA) and anaesthesia associate (AA) courses.

Quality assuring PA and AA courses

We have been carrying out our quality assurance (QA) checks of PA and AA courses since early 2021. These checks will continue up to the start of regulation.

After regulation begins, the process will be similar, but we’ll be able to approve courses, set conditions for course providers to meet and publish reports of our checks. Our published reports will include an annual QA summary for each course provider.


All course providers complete a quality assurance self-assessment questionnaire. We ask them how they could show that they meet the standards for managing and delivering education as set out in Promoting Excellence: standards for medical education and training where these are relevant to PA and AA courses.

Every provider has completed at least one self-assessment questionnaire (SAQ) and feedback meeting, and the majority of course providers have also submitted a second self-assessment. The providers have chosen the start date of their annual cycle to fit with their other activities, and after the start of regulation, they will continue with the same quality assurance cycle.


We provide written feedback on the course providers’ self-assessments and offer a follow up meeting to discuss our feedback with them in more detail. We also provide written feedback following the completion of other quality activities, such as visits or targeted meetings with educators and/or students.

Quality activities

We are in the process of undertaking quality activities with all existing course providers. This might include reviewing documents or a visit with a provider to meet staff, educators, students and other important stakeholders. Quality activities allow us to triangulate information we have received in the SAQs and to judge whether we are assured that the course meets our standards.


When regulation of PAs and AAs begins, we’ll have the power to formally approve the PA and AA courses offered by UK higher education institutions. 

The following six criteria must be met for an existing course to be approved:

  1. Satisfactory engagement with the SAQ process
  2. Information triangulating quality activities have been satisfactorily supported by the provider
  3. At least one cohort of students has graduated from the course
  4. The course has students at the point of approval
  5. No major ongoing concerns have been identified or reported to us
  6. The provider has demonstrated that the course has been successfully mapped against the new curriculum

The first SAQ must be submitted by a provider no later than 31 July 2024 for the course to be considered in this first phase of approvals.

Of the 37 PA courses and 3 AA courses currently running in the UK, those who have met our requirements will receive GMC approval after regulation starts. Where our criteria aren’t met, there is the potential to refuse approval, attach conditions to approval or to defer a decision about approval. An example reason for deferral might be until at least one cohort of students has graduated.

Implementing a new education framework

The pre-qualification education framework for PAs and AAs was published in September 2022. It consists of overarching learning outcomes and an outcomes-based curriculum for each profession.

The outcomes ensure consistency, where it's appropriate, between the curricula. This is especially relevant across professional capabilities such as teaching and leadership. Each curriculum sets out the profession-specific capabilities we'll expect students to learn.

We asked course providers to update their courses, including their syllabus and assessments, by Summer 2023 using the relevant curriculum as a guide. We’ll check that they’ve done it appropriately through the quality assurance activities described above.

Following this timeline, PAs and AAs will start to graduate from the new education framework in summer 2025.

Professionalism and fitness to practise guidance

Also in September 2022, we published guidance for PA and AA students to outline the standards expected of them, both inside and outside of their course. PA and AA students will be joining a trusted profession, providing care to patients. This means there is a higher standard of behaviour expected while studying.

We have also published guidance for PA course providers and AA course providers on managing professionalism and fitness to practise concerns. The guidance outlines the processes that course providers should follow if they're worried about a student's professionalism or fitness to practise in their profession.