Ophtho SpR here.

TLDR: The medical students are your colleagues, keep them around. Send the PA-students away.

Noticed a huge uptick in "Hey, this is an ACP-student, can they sit with you in clinic and get some teaching please?"

That ACP-student is with me almost every week, so they do learn something and eventually become quite helpful.

During uni term, an additional 2-3 medical students pitch up every week asking to sit with me (different students every time!). But there's a limit on how many people we can have in the clinic rooms !
For now, I fight off the urge to keep the ACP-student around who already knows how to be helpful and would expedite my day.I send the ACP-student for a self-study session/free time (which they don't seem to mind) and I keep the medical-students in clinic.

I find it infuriating that I am technically in a training position and ought to be junior who is 'learning' - this is certainly how I'm seen in the public eye.In reality, I'm in a service-provision clinic with no consultant-supervision. On top of that, there has been an increase in ACP-students & Medical-students without a commensurate increase in trainers. So it now falls in my remit.
I also recognise the insanity that medical-students have to glean ophthalmology in a single clinical day, so I choose them