Ria Agarwal

My family and I are from New Delhi and moved to England when I was young for career progression, and to receive better healthcare for my sister who was born with a heart condition. There is a strong emphasis in some Asian families to enter into professions with income stability, or that welcome people from a diverse range of backgrounds, such as medicine or dentistry, and consequently this was expected of me also. While I achieved the A-levels to enter into professions such as these and I liked the idea of helping others in a healthcare career, I was very conscious of the work–life balance issues that I had observed. For example, my dad was a surgeon, and if his clinics ran late it would often be a few hours before I was picked up from primary school, through no fault of his own. Observing doctors in my family having to deal with legal issues also impacted my views on a future career path.

I decided to study biomedical science in order to give myself time to think about a future healthcare career. Despite doing some voluntary work at a hospital and hospice over this time, I completed the degree still not really knowing what to do, although my family remained very firm in their opinions that I should consider medicine. I worked as a healthcare assistant for a couple of years and continued to contemplate other options such as occupational therapy and nursing – but ultimately came back to the concept of wanting to work with patients in a medical capacity.

After doing some googling, I found the physician associate (PA) profession which ticked all the boxes for me. However, I still had to persuade my family who had always wanted me to enter a more traditional profession with a clearer career trajectory and salary scale. When I embarked on my PA training, I had to move 3 hours away from home as the only university training PAs at the time was in London. When people asked my family what I was doing, they didn’t feel comfortable explaining the career path I had decided to take. They felt embarrassed and anxious about my decision.

Unfortunately, shortly after I started my PA studies, my dad was diagnosed with metastatic prostate cancer. This made being so far away from home incredibly tough. Placements were also quite hard as the role was very new in 2011. My classmates and I were frequently scrutinised on placement about whether there was any point in our role existing, leaving me feeling uncertain about whether I had made the right decision. Despite this, and a lack of support from my family (who still frequently told me they still disagreed with my choice of being a PA), I passed the course and my national exams, and secured one of the only primary care jobs in the north of England at the time. My dad passed away during my first year of work, but I was pleased to at least be closer to home when this happened.

After everything that has happened, I am delighted to have found a home for myself as a primary care PA. I have been fortunate to have had the opportunity to give talks about the PA role to several doctors over the years and to educate them about what we can do. It is amazing to see so many PA courses and jobs throughout the country now compared with 2011, and I can see definite advantages of students with difficult personal circumstances not having to relocate so far away from their support networks.

Being in such an innovative profession has given me the opportunity to get involved with activities that I may not have been able to do in any other profession, such as lecturing and examining PA students, and mentoring newly qualified PAs. I hope that through adding dimensions such as this to the PA career trajectory, others who face similar challenges to me can see what this role has to offer, and change the stigma around how the PA profession is perceived in some cultures.