How to become a locum physician associate in the UK

A locum physician associate covers clinical work on a session-by-session basis for the organisations that need them, as a self-employed professional rather than a salaried employee. This guide walks through everything you need to do to start, in order, and the common pitfalls that catch people in their first year.

1. 01

   GMC statutory registration

   GMC registration for Physician Associates and Anaesthesia Associates opened on 16 December 2024 with a two-year transition window. From 13 December 2026 it becomes a criminal offence to use the title or practise without GMC registration. Apply now: voluntary registration is open, the previous Faculty of Physician Associates (FPA, RCP) PAMVR closed in December 2024, and waiting risks a backlog as the deadline approaches. Your reference number is a seven-digit identifier prefixed with the letter A (e.g. A1234567).

2. 02

   Pass the PARA exam

   GMC registration evidence requires a pass in the Physician Associate Registration Assessment (PARA), or its predecessor the Physician Associate National Examination (PANE), within the last 24 months, with both parts passed within 18 months of each other. The RCP runs PARA on the GMC's behalf. Older qualifying routes are handled case-by-case under GMC transitional guidance. Revalidation rules for PAs are still being designed by the GMC and have not started; expect annual appraisals and at least 12 months' notice of your first revalidation submission.

3. 03

   Secure a Responsible Officer / designated body

   Under the new GMC regime, every PA needs a designated body for appraisal and revalidation. NHSP or a CQC-registered agency can act as your prescribed connection. Without one, you cannot revalidate.

4. 04

   Understand the scope and prescribing limits

   As of 2026 PAs cannot independently prescribe in the UK. Post-Leng Review, trust-level scope of practice documents are being enforced more strictly. Before any booking, check the host’s scope-of-practice document and supervising clinician arrangement.

5. 05

   Register with medical locum agencies + PCNs

   Holt Doctors, Medacs, and ID Medical all run PA desks. For primary care, approach PCNs and GP practices directly – primary care PA locum rates (£30–£45/hr) are typically better than acute trust bank.

6. 06

   Sort indemnity separately from employer cover

   CNST covers employed NHS work. Hold personal indemnity with MDU, MPS, or MDDUS – they all now have PA-specific products. Scope and indemnity terms have tightened post-2024 in response to high-profile cases; confirm terms explicitly.

7. 07

   Document supervision carefully

   PA locum work exists inside a supervisory relationship. Keep written records of your supervising clinician arrangement at each booking. This is both a regulatory expectation and your main medico-legal protection.