Is it worth it? A comparison study of medical students' aspirations for gaining the Health Care Certificate following employment as Healthcare Assistants.

Background: Medical students seek early patient contact but their curriculum starts with scientific knowledge. We integrated the Healthcare Assistant (HCA) course into semester one for early patient-facing clinical contact. This study compares students' aspirations for this learning with the realities of employed work as HCAs.

Methods: This sequential mixed-methods study used pre-post-scored questionnaire data, followed by post-course focus groups, and interviews a year later. The quantitative data were analysed using SPSS and the qualitative data using thematic analysis.

Results: The learning was highly valued with early perceptions challenged. The learning both accelerated and advanced their medical skills. Their of nurses' work within team-based practice quickly eroded; they ; they while in preparation for clinical learning. Early for starting employment were overcome, building resilience.

Conclusions: HCA training offers a practical patient-facing set of competencies on which to build medical capability. Student text-book scientific knowledge was validated through their experiences with recognition of the importance of empathetic patient-centred care. They quickly learnt and absorbed ward function; experienced good and poor teamworking; highly valued the nursing role; and experienced the every-day stresses of being a front-line practitioner.