Maryam is a newly qualified Physician Associate working in Emergency Medicine at a Major Trauma Centre. She has a background in Biochemistry. Before starting her PA training, she received 3 medical school offers which she declined to pursue her career as a PA. She started an Instagram page to share her journey and increase awareness about what being a PA entails. You can follow her @biochemist.to.pa. Today, Maryam is sharing her journey to becoming a PA.
Hi everyone! My name is Maryam, and I am a Physician Associate (PA) working in Emergency Medicine. PAs are healthcare professionals with a generalist medical education who work alongside junior doctors, physicians, GPs, and surgeons to provide medical care as an integral part of the multidisciplinary team. I qualified in March 2022 and started working in May 2022. I work at a Major Trauma Centre (the largest in Europe), so as you can imagine, work has been busy! I really love my job – I thrive on the challenges and opportunities that working in the emergency department (ED) gives. It keeps my clinical mind sharp because I meet patients who don’t have a diagnosis yet. My role therefore involves clerking them (taking a history to find out what the problem is), examining them, ordering appropriate investigations, using my findings to come up with possible diagnoses, and starting a management plan.
I turned down three medical school offers to pursue the PA course (unheard of, I know) and so having been through the application and interview process for both Medicine and MSc Physician Associate Studies, I have been asked to share my journey with you all today.
My journey starts back in 2016 when I began my undergraduate degree in Biochemistry. I had never applied for medical school before this, simply because I never thought it’s what I wanted to do. During my first year, I met a third year Biomedical Science student at a university society event, and she told me about the Physician Associate role. This was the first time I had ever heard of it, but like many students, I wasn’t quite sure what I wanted to do post graduating, so I made a note of the course name in my planner and didn’t think of it again.
Fast forward to the summer before my third and final year of Biochemistry, I really started thinking about what I wanted to do once I graduated. I had just completed eight months of working in a laboratory as part of my undergraduate dissertation project. It was an educational and impactful project, as I was working to find the cure for osteoarthritis, but by the end of it I couldn’t picture myself working in a lab as a researcher/scientist long term. I would spend hours working on cells in the fume hoods and found I really missed interacting with people. Life in the labs can be quite isolating, and at times I would be the only person there, working in a room with no windows. Eventually, I realised I would much rather be working with people and directly helping them in the acute setting.
I knew I wanted a career that offered life-long learning, problem solving, human interaction, and the ability to make a difference, and this was something I could achieve in Medicine. So, after a bit of research, I decided to apply. I sat my UCAT in the summer of 2018, and by October 2018 I had sent my medical school application off. I applied to Queen Mary University of London and King’s College London for both their Graduate Medicine and Undergraduate Medicine programmes. Within a few weeks of applying, I had fortunately secured 4/4 interviews.
As 2019 rolled around, I was preparing for my interviews whilst simultaneously revising for my third-year exams and completing the write up of my dissertation, which was nothing short of stressful! By April 2019, I had received both Queen Mary offers and a Kings Graduate entry medicine offer. Alhamdulillah (All praise belongs to God).
Throughout my entire application and interview process, I used to get doubts if medicine was the right choice for me. It wasn’t the extra 4-5 years of studying the degree that made me feel unsure. It was the years of training after qualifying as a doctor. It would take so much time, commitment, sacrifices and compromises. Now I had those three offers, I still didn’t feel completely convinced - in fact the doubts were getting stronger. The conversation I had two years earlier kept playing on my mind. Maybe the PA course was the right path for me. It was a very difficult and isolating time for me because everyone I spoke about it with tried to discourage me from changing paths. They would tell me how lucky I am to have those three offers (especially since two of them were graduate entry offers), but as grateful as I was to be given this opportunity, I couldn’t shake the feeling that this may not be right for me.
I thought long and hard about why I want to make the switch. I loved the idea of studying medicine, but I wanted something with more flexibility and something that gave me a healthier work/life balance. I wanted to succeed in hobbies outside of medicine too, and I felt that it would be more challenging to do that as a doctor. Travelling, being there for special family moments, spending time exploring other things I like - I would be sacrificing a lot of this. So, I messaged a PA that I came across on LinkedIn, and asked them question after question, trying to learn everything I could about the course and life post-graduating. At the end of April, I decided that becoming a PA was so much more attractive to me.
The deadline to accept or reject your UCAS offers was the start of May, and applications for the PA course I wanted opened at the end of May. Time was ticking for me to make a decision. After lots of prayer and thought, I sat with my parents and told them that I was thinking of declining my medical school offers and going for the PA course. My parents, like many South Asian Muslim parents, have always pushed me to have a fulfilling and rewarding career, and they felt studying Medicine would give me that. They raised me to remember God (Allah) and be grateful for the blessings He gives. I knew how blessed my position was and the impact I could have as a doctor and so did my parents. So as soon as I told them I didn't want to be a doctor and instead, wanted to pursue a course they had never heard of to become a type of healthcare professional they had never met, they were immediately appalled.
Almost instinctively, they said no. They were quite adamant that I would be making a mistake. My mums reasoning was that graduate entry programs are so competitive and out of the thousands of applicants, I had received not one, but two graduate offers, so why would I decline that? She told me if I were to decline my offers tomorrow, she would be very disappointed in me. On the other hand, my dad explained I was given this opportunity to become a doctor because God (Allah) knows how capable I am. However, he ended the conversation saying ultimately the decision is mine. As grateful as I was for the position I was in, I knew what I wanted for my future. My parents' views came from a good place, and I understood why they felt that way, but I gently explained to them that I need to do what is right for me, and I will live with the consequences of my decision.
The next day I went to university as normal, except it wasn’t a normal day at all. It would be the day my life changed (for the best!). The UCAS deadline closed at 6pm so I attended my lectures and then went to the study area and logged into my UCAS portal. This wasn’t a decision made on a whim - it was a well thought out decision; after all, I had an extensive list with the pros and cons of Medicine and the pros and cons of Physician Associate studies. With the clock ticking, I whispered “Bismillah” (In the name of God) and declined all three medicine offers.
At this point, applications for the PA course still hadn’t opened. My parents were worried I was going to graduate in one month with no place at university for further study and no job lined up post qualifying. But I had a plan. For the next month, I decided to solely focus on my exams and take it easy after the stressful four months I had experienced. And by the end of June, I had sent off my PA school application. I didn’t know if it was good enough and I found myself constantly battling the fear of being rejected, only worsened by the pressure and comments from those close to me about how I had made a mistake. I had only applied to one university for the PA course because I needed to stay in London and the second London university that offers the course had closed for applications. By the mercy of Allah, I received an invitation to interview in November which went a lot better than I imagined, and a month later I received my offer! I could’ve cried when the email came! My parents still didn’t seem entirely convinced in my decision, but I think deep down they knew I had a vision and reason for doing what I did.
I began my PA studies in January 2020, and fast forward two years, and an entire pandemic, I passed my masters. I then had to sit an external National examination under the Faculty of Physician Associates (FPA) in the Royal College of Physicians (RCP) which allowed me to qualify as a PA in March of 2022! The struggle had paid off Alhamdulillah. My parents are completely on board now too. I even overheard my mum on the phone to her friends telling them about the PA course and how good the role is. Progress!
I have been working in ED for four months now and I absolutely love what I do. I don’t have any regrets about declining those medical school offers. At times I have met individuals who feel differently about the role, but that’s expected, especially for a course that is so new. If you truly love what you do, it doesn’t matter what obstacles come your way - you’ll be able to meet them head on and overcome them. Becoming a Physician Associate has been a crazy and intense journey, but it has made me a more resilient and determined person. Now I share my story to hopefully inspire a generation of students to come. My advice to you all is that if you are struggling to decide between medicine or the PA course, take a step back and think about this well. Take people’s opinions into account but remember you make this decision for you, because at the end of the day you will be the one that lives with the outcome of the decision you make. Write out the positives and negatives for each course and make the list personal to your life. And whichever path you choose to pursue, pursue it with conviction, and your hard work will pay off.
Author: Maryam Syed | @biochemist.to.pa
Editor: Dr Latifa Haque