Canada

Overviewedit

As of October 2018update, there are approximately 800 physician assistants working in healthcare settings in Canada. The first formally trained physician assistants graduated in 1984 from the Canadian Forces Medical Services School at Borden, Ontario. The Canadian Medical Association (CMA) recognized physician assistants as a health professional in 2003. Physician assistants are able to perform medical functions such as ordering tests, diagnosing diseases, prescribing medications, treating patients, educating patients and performing various medical and surgical procedures. Physician assistants are labeled under the federal government national occupational classification code 3124: allied primary health practitioners.

Education and Certificationedit

The first civilian physician assistant education programs were launched in 2008 at the University of Manitoba and McMaster University. In 2010, a third civilian program was launched by the consortium of physician assistant education (University of Toronto, Northern Ontario School of Medicine, and The Michener Institute). Admission to the physician assistant program in all three of the university programs across Canada are highly competitive with grades, education, interviews, professional experience, credentials, personal statements and testing considered in the candidate selection process. Approximately 15 seats at the University of Manitoba are available yearly while the two other programs in Ontario respectively have approximately 30 seats at the University of Toronto and approximately 24 seats at McMaster University. In Canada, the education of a physician assistant generally consists of three years of professional post-graduate university education. The education is delivered over a two calendar year time-frame by completing fall, winter and summer semesters for both years of the program in either a master level university physician assistant program or post-graduate professional university bachelor level physician assistant program. Physician assistant graduates become eligible for the certification exam by being a graduate of a Canadian physician assistant program that is recognized by the Physician Assistant Certification Council of Canada (Canadian Armed Forces physician assistant program, University of Manitoba, McMaster University and the consortium of physician assistant education all of which are accredited by the Canadian Medical Association).

Scope of Practiceedit

Physician assistants resemble and provide many of the functions of physicians in Canada and act as advanced-level medical provider. Physician assistants may be compared to the role of nurse practitioner by the general public and may be confused as the same profession. Nurse practitioners in Canada practice under an advanced nursing model. Physician assistants practice under a medical model, similarly modeled after medical school (physician) education. Nurse practitioners practice within their defined specific scope of practice autonomously and sometimes collaboratively. The defined scopes of a nurse practitioner include the areas of (family care, adults and paediatrics). Physician assistants are permitted to practice in all medical specialties by mirroring the practice of a physician with a full range of skills and scope by practicing both autonomously as a clinician and collaboratively with physicians when required. Some examples of practice areas for physician assistants include (emergency medicine, critical care medicine, cardiology, psychiatry, community and family medicine, neurology, surgery, orthopaedics, internal medicine, oncology, gastroenterology, military medicine, respirology, dermatology, women's health and many more specialities). Physician assistants may perform certain roles which have been traditionally only provided by physicians in clinical practice, making the PA's medical training over other providers unique in this regard.

Compensationedit

Physician assistant salaries in civilian practice in Canada are relatively new and can range from approximately $80,000 CAD for entry level positions to $142,000 CAD a year for experienced providers which are not on call and up to $178,000 CAD for experienced providers which are on call. As the physician assistant profession is newer to civilian practice in Canada, salaries have been improving to reflect physician assistant positions and their value to the health care system. Salaries in Canada currently remain lower, in comparison to the United States where a range from approximately $110,000 USD to $150,000 USD is common place and in some cases even up to $200,000 or more in specialized medical areas. Physician assistants in the province of Ontario must be paid at minimum $75,000 CAD annually, although organizations may find it challenging to recruit physician assistants at this salary. In provinces where physician assistants are not currently regulated, the title physician assistant may not be a protected title. Employers incorrectly may post job postings that make reference to the title physician assistant, with duties of assisting a physician, such as a clerk or medical assistant. The compensation report published in 2019 by the Canadian Association of Physician Assistants outlines the typical salaries across Canada being an entry median salary of approximately $80,000 CAD and an experienced median salary of approximately $105,000 CAD. Generally, provinces which have regulated physician assistants for longer periods of time, or larger urban areas compensate significantly more that the listed median salaries at both the entry and experienced levels. Competitive hourly compensation rates for physician assistants vary between approximately $50.00 CAD for entry level providers to $70.00 CAD dollars an hour for experienced providers. This salary is in line with other allied primary health practitioners listed under the national occupational classification (NOC:3124).

Regulationedit

Physician assistants are currently practicing across Canada in the Canadian Armed Forces as commissioned officers in domestic and international environments and have been in practice since the 1960s. Physician assistants outside of the Canadian Armed Forces practice usually in the public health care system in the provinces of Manitoba, Ontario, New Brunswick, Nova Scotia and Alberta. Physician assistants have been regulated in Manitoba since 1999 and in New Brunswick since 2009 and are registrants of their respective provincial college of physicians and surgeons. In Ontario, Alberta and Nova Scotia the profession is not regulated at this time. Physician assistants in Ontario were introduced in 2007 to the public health system as a joint venture between the Ontario Ministry of Health and the Ontario Medical Association. In Alberta, a registry has been established for physician assistants under the College of Physicians and Surgeons of Alberta with future regulation underway. In Ontario, future regulation has been discussed by the Ontario Ministry of Health in which physician assistants would be members of the College of Physicians and Surgeons of Ontario. Physician assistants are represented by the Canadian Association of Physician Assistants, which originally was formed in October 1999 as the "Canadian Academy of Physician Assistants".