PAs support physicians in a range of health care settings and provide care under the supervision of a registered physician. A PA’s practicemirrors that of the supervising physician (e.g., work is assigned and controlled acts performed are delegated to the PA by the physician). The physician and PA work together to define the PA’s role and practice parameters which may evolve and change over time.
The specific duties of the PA vary depending on the individual competencies of the PA, the supervising physician’s area of practice, and the types of duties that the supervising physician chooses to assign. Examples include:
PAs have been integrated into the health care systems of several other jurisdictions and have helped to increase access to health services and overall quality of care. In Canada, PAs have been employed by the Canadian Forces for many years to deliver health care services to members of the military and their families. PAs have been working in Manitoba since 2002, where they are known as clinical assistants. PAs have also practiced in the United States since the 1960s.
In Ontario, PAs were introduced to the civilian health care system in 2007 through a series of demonstration projects in a variety of settings. There are now over 200 PAs working as part of interdisciplinary care teams in over 100 sites across the province. These PAs are helping to decrease wait times, and improve patient access in high need areas including emergency medicine and primary care.
In order to become a recognized PA in Ontario, individuals must complete an accredited PA Education Program, either in Canada or in the United States. There are two PA education programs in Ontario, one is offered at McMaster University and the other at the University of Toronto (in collaboration with the Northern Ontario School of Medicine and The Michener Institute for Applied Health Sciences). The universities are responsible for setting the acceptance criteria and selecting students. Interested individuals should contact the programs directly to inquire about the application process.
Both programs are two years (24 months) long and are accredited by the Canadian Medical Association. Graduates have the skills and competencies necessary to meet Canadian standards and to practice as PAs in Ontario. Up to 54 PAs are expected to graduate annually.
The province has accepted the Health Professions Regulatory Advisory Council’s (HPRAC’s) recommendation not to regulate the profession under the RHPA.
HPRAC provides the Minister with independent, objective advice on, among other things, whether unregulated health professions should be regulated.
HPRAC’s report was supportive of the PA profession with respect to the safety and quality of care that PAs provide as well as the positive impact of PAs on access and wait times. However, HPRAC found that there is insufficient evidence to meet the risk of harm threshold for regulation under the RHPA. After extensive review, HPRAC concluded that the model of physician delegation under which PAs practice, coupled with the current size of the profession, significantly mitigates the risk of harm to patients and the public – which was the key criteria for regulation.
In addition to its recommendation, HPRAC also proposed that the PA profession in Ontario build upon the existing certification process to increase certainty regarding the assurance of practitioners’ qualifications.
The full report and recommendations can be found at: http://www.health.gov.on.ca/en/common/ministry/publications/reports/hprac/docs/hprac_201208_1.pdf
In making its recommendation, HPRAC proposed that the PA profession in Ontario build upon the existing certification process to increase certainty regarding the assurance of practitioners’ qualifications through the establishment of a compulsory registry for PAs implemented under the governance and oversight of the College of Physicians and Surgeons of Ontario.
The ministry is working with key stakeholders to explore what requirements would be necessary to establish a PA Directory.
In order to work as a PA in Ontario, you need to be certified by the Canadian Association of Physician Assistants (CAPA) or be eligible to write the certification exam. In order to be eligible for certification, you would have had to complete an accredited PA Education program either in the U.S or Canada. If you have earned a medical degree from outside Canada, you must still graduate from a Canadian Medical Association (CMA) accredited PA program or Accredited Review Commission (ARC-PA) accredited program to take the PA Certification Council of Canada (PACCC) PA Entry to Practice Certification Examination (PA CERT EXAM).