Recently graduated physician associate Bradley Sewell explains how his experiences as part of the LGBTQ+ community are helping to inform his clinical practice.
I qualified as a physician associate (PA) from Swansea University in 2020 and have since been working in a joint post of primary care and sexual health and reproductive medicine. As someone who identifies as a gay man, LGBTQ+ issues are something I champion to be addressed for both patients and staff.
My role in primary care involves working as part of a rural general practice surgery in Wales. I work alongside GPs, pharmacists, nurses, healthcare assistants, and other amazing clinical and non-clinical professionals. I am undertaking an intern year as a PA in Wales, meaning I have access to increased educational opportunities and support as I develop my PA practice. In primary care, I see patients face to face with undifferentiated presentations. This is a big learning curve, but my GP supervisors are supporting my development, and I am building on my existing knowledge.
Sexual health is a newer area for PA practice, but one I am enjoying hugely. As well as helping to pioneer the PA role in this area of practice, I am learning vast amounts from a clinical perspective. I am the first PA in the UK to be enrolled onto the diploma ran by the Faculty of Sexual and Reproductive Health (DFSRH), and I am also undertaking my training to obtain my letter of competence for insertion and removal of contraceptive implants. My daily work involves a mix of telephone and face-to-face appointments, dealing with both contraceptive and genitourinary medicine issues. My consultant supervisors are also working to develop my skills and knowledge further in specialist clinics with them.
Working in sexual health allows me to use my experiences as a member of the LGBT+ community to empathise with others and allow patients to talk openly with me about their sexuality or any sexual health needs. My team are great advocates for such equity in care, and I find this has transferred to my primary care practice. I have had consultations around psychosexual issues and try to promote sexual health in both of my roles, including HIV testing, STI testing, contraception and general sexual wellbeing.
I have built up some core therapeutic relationships with my patients, particularly those in the LGBT+ community, and it is very rewarding that people feel they can discuss their sexual health issues with me in both primary care and sexual health practices. I am aiming to develop my skills in the health needs of men who have sex with men (MSM) and HIV in the future. As someone who has historically experienced homophobia both in the workplace and as an adolescent in my personal life, I hope to continue to advocate LGBT+ issues throughout my professional life as a PA.
