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When and how did you start preparing for job process?

I started preparing for the job process near the end of my last rotation. I worked on my resume and cover letter while studying for the Canadian Entry to Practice Certification Exam, which unfortunately was scheduled in the middle of Health Force Ontario’s (HFO) hiring cycle. Once the list of HFO funded jobs are released, I sent out my application. I adapted the idea from Anne and created a GoogleDoc listing all the employers I sent my application out to. This was to keep track of which employer I should be following up on if I did not hear back in a week, dates of interview, etc.

BG's Experience with the Career Start Program

  1. How many jobs did you apply to?
    I applied to 10 positions
    – two were immediately filled (they had a candidate in mind already), one withdrew from the program. So, technically I only applied to 7.
  2. How many job interviews did you receive? 
    I attended 3 job interviews, and was invited to second round for two of them.
  3. How many job offers did you receive? 
    I received one offer and unfortunately had to forfeit one interview. The employer requested that I accept or decline the offer within 48 hours. I had another interview at a later date so I had to forfeit my interview with the second potential employer.

How did you prepare for these job interviews?

To prepare, I tried to anticipate what questions would be asked at the interview. I spent a lot of time doing mock interviews with my partner.

How did you make your decision about where to work? 

I completed an elective at the position that I accepted. I felt comfortable with the staff and nurses whom I worked with during my elective. To me, the Physician/Nursing-PA relationship is important. I was familiar with the tasks and the position described allowed me to participate in the clinic, as well as in the OR. The down side is that I have to relocate to a different city, away from my family. However, it is truly a unique opportunity that I felt was hard to pass up.

What do you think made you a successful candidate at the job of your choice?

I believe that having completed a rotation there gave me an advantage. Two out of the four staff knew me and gave me positive feedback for my performance as a clerk. I was interviewed by a different staff whom I have not worked with. However, I felt that my rich experience from my electives in a variety of surgical specialties also gave me an edge at the interview.

What tips do you have for new graduates when approaching the Career Start Program? 

  • It definitely helps to do electives in areas of interest (to strengthen resume), in areas with no PAs before or in areas where the employer is hoping to hire.
  • It is important to have a good understand of what a Physician Assistant can do in that area and advocate to the staff/residents/nurses. There will be curiosity as to what a PA can or cannot do for them. I know a classmate of mine who completed a rotation in a subspecialty who did not have a PA before. They were interested in hiring after learning about the Career Start funding and my classmate offered to help write the funding application.
  • When it comes to applying, I think the applicant should reflect on what they value. The majority of funded jobs are outside GTA – rough estimate of 65% were outside of GTA so it is competitive for the positions in bigger cities.
  • Some new grads are very fortunate to work in the location and area of medicine that they are passionate about. If not lucky, they should be very open minded – location vs area of medicine. There may be a time where they need to decide what is more important – Is it worth waiting for new positions/applying outside of HFO or relocating.

Did the majority of your classmates obtain work after graduation?

All my classmates who were seeking employment after graduation did obtain work, though the timeline of when employment was secured varied (some started before HFO funded positions rolled out; some started months later). Also, a few of my classmates had to make compromises; relocating to another city being the most common.

Any overall thoughts about the Ontario Career Start Program/process?

I felt that the Ontario Career Start Program process was very time sensitive.

Employers had one month to review applications, interview, and select a successful candidate. This is especially difficult for hospital positions that they have to go through HR (PAs are hospital employees, not hired by physician). After understanding this, it is not a surprise to see hospital positions being interviewed very late in the cycle. Which brings us back to the dilemma I brought up before: forfeit future interviews and accept the first offer or decline offer and hope for more interviews.

Some of the potential employers withdrew from the HFO program, which is unfortunate for us applicants.

The one thing I did appreciate what that HFO would email us when a position was filled or withdrew from the program.

Illustrations in this post created by Sapann-Design – Freepik.com

Celina Wu

I met Celina a few times while she was a first year PA student when I helped to facilitate the Casting Workshop at University of Toronto, and again seeing her at the CAPA Conference in Winnipeg in 2016. Celina’s experience with finding employment after graduation was unique, as she was employed before Health Force Ontario jobs were released in the fall of 2016. I thought it would be valuable to get her perspective on the job hunt

Some of her favourite elective rotations as a second year PA student:

  • Sunnybrook Health Sciences in Toronto Centre (Emergency Medicine, OB/GYN, and Cardiac Surgery)
  • a rotation in Pediatrics through Shigami Kwe in Sudbury, Ontario
  • an international elective in India for the Himalayan Health Exchange in rural medicine with Sandy, another fellow PA student (now grad) who documented the experience in her blog.

Celina is now employed in family medicine practice in Toronto. Here she discusses how she obtained employment shortly after graduating.

Celina Wu

Celina during her international elective in rural medicine for the Himalayan Health Exchange

When and how did you start preparing for the job process?

Theoretically, I prepared for the job process during my training as a student. I approached clinical rotations as if though I were “interviewing” for the positions and received a job offer after completing my rotation at my current clinic.

How was your job process different than your peers?

I had secured a job which is funded outside of Health Force Ontario (HFO) thus I felt less pressure during the HFO interviewing process. I thought I would see what my options were and applied to numerous HFO-funded positions – none of which mounted into anything significant.

How did you make your decision about where to work? 

I started working a month after graduating, before HFO funding was announced. I had already spent time in the clinic as a student, so there was a sense of comfort going back to familiar territory. Furthermore, the location of my clinic is my ideal location for work, namely downtown Toronto. I was apprehensive accepting any offers that was limited to a 1-year term, so I was more than happy to take on a permanent position at my clinic. While I did not immediately recognize the benefits of family medicine, I have come to quickly learn the perks of stability (10 am -6 pm, no weekends!) and the fulfillment of patient care continuity.

What do you think made you a successful candidate at the job of your choice?

I attribute the success of my job with working hard, being proactive and a bit of luck. I would spend longer hours at the clinic than required, help with any tasks that needed to be done, and developed great relationships with amazing staff (I could not be luckier!).

What tips do you have for new PA graduates when approaching employment?

I would encourage PA students to be proactive during their clinical rotations and express their interest(s) to their supervisors/employers. It is much easier, in my opinion, to land a job where you spend a month demonstrating your skills and knowledge than it is to compete with 60+ peers who on paper have the same experiences as you. Be proactive early!

How are you involved in PA advocacy? 

  • Answering pre-PA questions via in-person meeting, phone calls, emails
  • Sharing experience, notes, tips with current PA students
  • CAPA secretary, Board of Directors
  • UofT PA MMI file reviewer, MMI interviewer

Do you think its important to get involved?

I think it is EXTREMELY important to be involved. Given the novelty of the PA profession, I believe educating practitioners and the community of our roles and services is our duty as a PA. As a student, I received valuable advices and mentoring from countless PAs; now as a PA, I hope to be as supportive and inspiring to PA students/pre-PAs as my seniors have been to me (thanks Anne!).

About the Author

Celina Wu

Celina Wu is a physician assistant (PA) in family medicine and received her training at the University of Toronto. For her undergraduate degree, Celina was in a concurrent program in Kinesiology and Athletic Therapy at York University. Celina subsequently went to McGill University where she received her Master’s of Science in Neurosciences and published a first-author paper in the Journal of Neuroinflammation. In her spare time, Celina enjoys globetrotting, painting and learning about auto-mechanics.

Connect with Celina:
LinkedIn | CAPA Board of Directors

I had the pleasure of meeting Andrew who completed an Orthopaedic Surgery elective rotation with us during his second year of PA school. My PA colleague and I were delighted to hear he secured a position in Orthopaedic Surgery (it’s a not-so-secret bias that we hope all of the students who rotate with us end up in Ortho/MSK).

He has kindly agreed to write about his experience as part of the 2016 Career Start Grant program. He successfully obtained a funded position through the Ontario Career Start Grant after graduation.

When and how did you start preparing for job process?

Early on into the program, I already had a good idea which areas of medicine would best fit my personality, skills and interests (i.e. a fast-paced working environment with opportunities for practical skills and with a lot of variety). Once it was time for the first years to choose our clinical rotation streams, I selected the one that front loaded the fields I would be interested in (in my case, emergency medicine and general surgery). This enabled me to get a feel for that field and gave me ample time to plan the rest of my elective blocks to have more time in said fields. Much like how senior medical students use their clinical rotations as an opportunity to secure residency, I used my clinical rotations as an opportunity to have an extended job interview.

“Much like how senior medical students use their clinical rotations as an opportunity to secure residency, I used my clinical rotations as an opportunity to have an extended job interview.”

After the end of my clinical rotations, I went through the motions of updating my CV and drafting cover letters for each and every position I applied to.

Andrew's Experience with the Career Start Program

  1. How many jobs did you apply to?
    I applied to about ten positions
    , of which three withdrew their positions due to funding/ departmental issues. I applied to:

    • three emergency medicine positions
    • one pediatric emergency medicine position
    • three orthopaedic surgery positions
    • one general surgery position
    • two family medicine positions
  2. How many job interviews did you receive? 
    I received six interview invites and attended three.
  3. How many job offers did you receive? 
    I received two job offers of the three interviews I attended.

Sara and Andrew graduated the same year. Here is a direct contrast between their two different journeys to obtain full time employment.

How did you make your decision about where to work?

Truthfully, I had to make a tough decision about where I wanted to work. I had completed a three week rotation at my current workplace during the tail end of my clinical rotation which I found to be very enjoyable. I knew that they were hiring and my end of rotation review was very positive and really made me feel like I would be a welcome addition to their team. I also felt quite good about my interview and was very pleasantly surprised to have received an offer shortly after.

That being said, I had also received an interview invite for another major hospital working in Pediatric emergency medicine that was also very appealing. It was a tough choice as I didn’t have the luxury of time to attend the other interview and hated the idea of that big “what if?” looming over my head. This is not uncommon as it is something that some of my peers have also struggled with. With all that’s said and done, I confidently feel I made the right decision.

What do you think made you a successful candidate at the job of your choice?

As cliché as it may sound, I have to say that having a resume, cover letter, strong interview, having completed a rotation at the job location, and strong references played their role in making me a successful candidate. My CV and cover letter was fairly solid and I owe a lot of it to some friends who helped me review and edit them. It also helped that I have worked with some excellent PAs during my clinical rotations that made excellent references. I later spoke with the administrative director of my division and she flat out told me that my references were very strong and supportive.

Andrew's tips for New Graduates applying through the Career Start Program

Clerkship: Always be on the lookout for new, potential employment opportunities as the year goes on. Ask your preceptors and allied health staff what they know about PAs. Show them how much you know and how much you are capable of. Create opportunities.

Applying: I highly recommend having others involved with reviewing and editing your applications as it can be all too easy to have tunnel vision after reading over your work a dozen times.

Interview: Research the company, read (and re-read) their job posting and be confident (or fake it ‘til you make it).

“The vast majority of my classmates did secure employment after graduation.”

The vast majority of my classmates did secure employment after graduation. For many, they are quite happy with their decision but, like any profession, there are those who are not. Regardless, PAs are a very fortunate group of health care providers who have opportunities available to us early on in our careers. The challenge, as many can attest, is to demonstrate the ability to help our attending physicians either with finance, schedule or by extending the current level of care provided.

Any overall thoughts about the Ontario Career Start Program/process?

I wouldn’t be able to comment as the process itself can vary from person to person. Some of my peers worked with their preceptors to fill out the Ontario Career Start Program application while others (like myself) only had to apply for positions once they were made available.

Andrew now works in Orthopaedic Surgery through a job he secured through the Career Start Program

Andrea Lombardi, CCPA and Todd Bryden did an early morning Breakfast session on the 2nd day of the CAPA conference canvassing questions from the audience of PA students about what life is like as a PA after graduation.

Physician Assistants tips

How to Secure Clinical Observerships as a 1st year PA student

“I’m having difficulty finding Physician Assistants/clinical preceptors in my area to take me on for observerships. As often Physicians and clinics I’ve dealt with often don’t know what we are and are not sure what to do with me.”

Ian Jones had some great advice for this in response, he suggested working on a elevator pitch that concisely describes what a Physician Assistant is, and what your role as a PA student would be in a first year observership/longitudinal placement/horizontal elective would be:

  • To a physician interested in hiring a PA, a good line would be, and as Eden has well articulated in her blog, “The PAs truly function as physician extenders. Here they were like residents that never leave.”
  • To a potential clinical preceptor physician who may be unfamiliar with how PAs function, you can approach them with: “I’m a first year Physician Assistant student from ___ University. I’m looking for a observership opportunity, I live within the community, I know your clinic, and I’m very interested in learning from you in a placement setting where I may follow you while you do your clinic duties for half day/full day once per week for X amount of weeks.”
  • “If you aren’t on LinkedIn, get on it.” Reach out to currently practicing Physician Assistants. Don’t know any? Andrea strongly urges students to join LinkedIn. There’s a growing community of us on LinkedIn and some students have secured placements with me by reaching out on LinkedIn (sometimes Facebook is not always as professional). We also have a LinkedIn group for Canadian Physician Assistants: Networking, Mentoring and Employment you can join too for updates in the community.

We all learn very early on that we quickly become ambassadors for our profession, even as students. Because the profession is still new in Canada (and even in the US where they’ve been practicing for over 40+ years), there are many Physicians that are still unfamiliar with PAs and how we function. We’ve made strides in advocating for the profession and informing physicians, allied health care staff and patients on what we are. So, work on your elevator pitch.

Switching Jobs as a PA & How to Network

Andrea Lombardi, CCPA answered this question emphasizing the importance of networking. Often many job opportunities are not always formally listed in the Job Listings section at the Canadian Association of Physician Assistants website. Some positions are secured through word of mouth and connections.

There are many PAs that are able to switch jobs: Andrea spoke about this, and anecdotally from my PA colleagues and what I’ve learned from the alumni that have graduated from PA schools is that many have found employment. In Ontario, some new grads have 2 years of funding – and we know of some PAs that left their positions before the end of their contract and were abel to secure employment afterwards.

Join a Board of Directors for a charitable and/or health organization: A great resource is boardmatch.org which helps individuals find positions on different boards/committees. Joining a board of directors (BoD) allows members outside the PA community be exposed to your profession.

  • You learn aspects of administration, leadership, management that come in handy as skills later.
  • You are also exposed to many different professionals (MDs, RNs, PT, RMTs, politicians, patient representatives) who can connect you with opportunities that may potentially lead to employment.
  • Even if its joining a “social” committee at a hospital/clinic to organize social functions, helping out and volunteering your time builds valuable communication and leadership skills and helps broaden your network.
  • As Ian Jones put it, “If you’re not at the table, you’re on the menu. In education, we call that service.” As one military Physician Assistant put it,  joining such committees is called “secondary duties”.

Make contributions, develop and invest in yourself, and be open to opportunities where you can grow.

Good things to do as a new PA Hire

Sit down with your employer, and discuss expectations – Andrea Lombardi works in a family medicine setting, and said that she sat down with her employer and had a frank discussion about expectations.

Build relationships with office staff, community pharmacists – 

  • .. with office & nursing staff: Tread lightly, and be extra nice to all the staff you are working with. Building good relationships will be pivotal in helping you advocate on behalf of your patient and ensure the clinic runs smoothly.
  • … with community pharmacists: If you are writing prescriptions on a medical directive, its good for pharmacists in the community to know who you are. You can send a letter introducing yourself, your role, a copy of the medical directives that allow you to prescribe (in Ontario). Andrea took  it a step further and actually had phone/face to face conversations, which often builds stronger rapport.
  • … with allied health (social work, registered massage therapists, physiotherapists, dietitians): you will often be referring your patient onto allied health and establishing these relationships early on is important.

Don’t be afraid to ask questions: Its often better to ask all the clarifying questions at the beginning of your employment, rather than towards the end. Learn how your supervising physician thinks, e.g. how they approach clinical conditions, their patient interactions and management plans. Take initiative, and “know what you don’t know”.

Don’t isolate yourself: The PA community is small (but growing) in Canada.  Often its easy to get caught up focusing just on your practice and not reaching out to the community and staying in touch with other PAs. This doesn’t always have to be a social capacity (although that often more than not helps). The PA community is made of members from many different backgrounds and experiences, many in teaching/mentoring capacities. How can you stay in touch:

  • Don’t lose touch with your graduating class – plan to meet up every couple of months to touch base and see how everyone is doing
  • Don’t lose touch with your program – Once you have a few months under your belt and feel competent to take on PA students for observerships, its a great way to mentor and keep you on your feet about your own clinical knowledge.
  • Attend PA conferences – Although advertised for CPD credits, I find the most I get out of these PA conferences is the networking and advocacy opportunities. Being able to connect with other PAs is POWERFUL, whether online through social media (Facebook, Twitter, LinkedIn).

Benefits of Attending the CAPA Conference

  • Connecting PA students with clinical observership opportunities
  • Finding mentors to help guide you along your PA career, whether you have issues about employment, want guidance on where to practice, the job hunt, or if you have an interest in research.
  • Bouncing issues around employment and advocacy off prominent/well experienced PAs in the military and civilian populations
  • Seeing where our profession stands in terms of funding and regulation for our jurisdiction
  • Learning strategies for how to advocate within your own community – how to approach your local MP, ministers of health, etc.

UK Physician Assistants

Physician Assistants are more commonly known as Physician Associates in the United Kingdom (UK) and work with physicians. Like Canadian and American PAs, Physician Associates have direct patient contact, taking histories, performing physical examinations, ordering and interpreting investigations (such as blood work or imaging), diagnosing medical conditions and initiating treatment plans.

They are autonomous, but dependent practitioners, which means they work under the supervising of the supervising physician. They are also trained under the medical model like doctors. These Physician Associates work in general practice, easing the pressure on the general practitioner workload, and in specialty and subspecialty practices. PAs work in specialties like GP surgery, A&E, hospital inaptient ward, Hospital ICU, Hospital Operating theatre, hospital outpatient department, Medical assessment unit or acute medical unit, rehabilitation, specialist surgery, walk in centres, and psychiatry services (RCP, FPAs).

The Faculty of Physician Associates reviews whether a Physician Associate is qualified and fit practice in the UK, and thereby join the Physician Associate Managed Voluntary Registrar (PAMVAR).

Can Physician Associates from the UK work in Canada?

I actually had to consult Canadian Association of Physician Assistants (CAPA) for this one. As of January 15, 2014, the answer in short is no, they cannot. 

If you graduated from a PA Program, in order to practice in Canada the PA program has to:

a) Graduate from an NCCPA certified (American) institution
b) Graduated from a Canadian Medical Accredited Program.

If you wanted to practice in Canada as a Physician Assistant, you can do so by:

Can Canadian PAs work in the UK?

There are several Canadian trained Physician Assistants that are currently practicing in the UK. Read the Royal College of Physician’s Faculty of Physician Associates leaflet on “Who are Physician Associates?

From email correspondence with the FCP, they have recommended that PAs who practice in the UK must pass the American PANCE* or the UK PA national certification exam which is composed of a written and OSCE component.

I contacted the Royal College of Physicians Faculty of Physician Associates and received this response:

“Unfortunately there is no international reciprocity for PAs. UK trained PAs are not allowed to work in Canada or anywhere else outside the UK. Similarly PAs trained outside the UK are not eligible to work as PAs in the UK without repeating the two year training programme and passing the national PA exam.

The only exception to this rule is for US PAs as is true in Canada. This is due to the profession being in existence for decades in the US and US PAs frequently being used to demonstrate the effectiveness of the role in countries not yet utilising PAs.

If you are relocating to the UK you would certainly be eligible to apply for one of the 27 PA programmes we currently have in the UK. Please find a list of them here.”

*Please note in order for Canadian PAs to challenge the American PANCE, they must have graduated from an American accredited PA school. At time of writing, Canadian PAs must go back to 1st year American PA school, complete PA school and then they may challenge the PANCE. 

Learn a little bit more about Physician Associates in the UK

Physician Associates UK Infographic

American PAs

The short answer is the Canadian trained and certified Physician Assistants cannot practice in the United States. However, American trained and certified Physician Assistants can practice in Canada.

Canadian PAs cannot practice in the US

At present the American NCCPA has not accredited any PA programs in Canada therefore Canadian PAs cannot write the PA-C certification (PANCE or PANRE) exam for the US.

If Canadian PAs were interested in practicing in the US, you would have to go through an American PA school (both years, didactic year and clinical rotation year – nothing skipped), and write the PANCE test thereafter. There is a possibility that some of your PA school courses may transfer over.

Without the PA-C designation we cannot write the American PANCE exam, or apply to jobs or practice as Physician Assistants in US.  Canada has many American-trained Physician Assistants

How to become a CCPA in Canada

  1. Graduate from one of the four Canadian PA schools that is accredited by the Canadian Medical Association Conjoint Accreditation.
  2. Write the Exam – Once a PA graduate has completed an accredit PA program (In Canada or the United States), they may challenge the PA Entry to Certification Exam (which is overseen by PACCC). If they successfully pass they are designated “CCPA”, Canadian Certified Physician Assistant. 
  3. Maintain certification by completion “40 credits annually and must also complete at least 25 credits in each section of the Maintenance of Certification Program before their cycle ends.”

Therefore, both Canadian and American PA grads can obtain a CCPA designation. 

How to Obtain a PA-C in the United States

A Canadian’s “CCPA” designation is recognized in the United States. Therefore to obtain a “PA-C” you must:

  1. Graduate from an accredited American PA school, PAEA provides a list of accredited schools
  2. Write the ExamWrite and pass the Physician Assistant National Certification Exam (PANCE) exam.
  3. Maintain certification by completing 100 CME credits every 2 years minimum, and write the Physician Assistant National Recertification Exam (PANRE) at the end of your 6 or 10 year cycle.

Why CCPAs cannot write the PANCE Exam

For Canadian PAs with a CCPA designation, we would have to start at “Step 1” of the American PA-C process.

In order to take the PANCE, (regardless of PA education) you must graduate from a PA Program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), which only accredits PA schools which are physically located in the United States, and where their students are geographically located in the United States for their education (3)

Therefore, Canadian PA programs cannot be accredited by the ARC-PA, nor can Canadian PA graduates challenge the PANCE exam.

Q. I’m a Canadian student/citizen, should I go to the US to obtain my PA education?

This entirely depends on your preferences, flexibility and financial situation. I’ve outlined a few things to consider if you wish to go study abroad in the US:

  • Financing your Education: As a Canadian student studying in the US, you would be paying international student fees ON TOP of the fees for PA school. Tuition for PA school differs from school to school, and state to state.  Living expenses away from home would also be factored as well. There may be scholarships and bursaries which may aid with tuition, however Canadian provincial student loans have different rules if you plan to study outside the country. So find out what you qualify for if this is a route you are seeking.
  • Obtaining a work visa: If you wish to work in the US following completing your education in the US, as a Canadian citizen/student you would have to work on obtaining a work visa with comes with its own set of applications, deadlines, and visa renewals if you plan to extend your stay in the US.
  • Flexibility: You have the ability to practice in the US as well as Canada with PA-C status. So your options are not as limited.

This was not an option I considered while applying to PA school since I wished to stay close to my family and did not wish to leave the province. Of course, I could see the benefits of going to study abroad and being exposed to the American Health Care System where PAs are used much more frequently in many more areas of medicine than they are in Canada (e.g. Ophthalmology, Interventional Radiology, etc.).

A physician who I had worked with as a 2nd year PA student had completed his fellowship down in the United States, where he worked with Physician Assistants frequently. There were entire teams compromising of Physician Assistants at hospitals running clinics and assisting in the OR in an Orthopaedic Surgery setting. At this time in Canada, there are less than a handful of PAs in each hospital (some of my colleagues are often the only Physician Assistant working in the entire hospital, especially in community/rural settings). This is slow changing as we continue to have more PAs graduate and practice in Canada.

If you are a Pre-PA Student…

If you are a Pre-PA student considering where you would like to practice in the future, the American PA degree would provide flexibility in terms of where you can practice whether that be in Canada, the United States, or even the United Kingdom. In fact, the UK has been working on a National Physician Assistant Expansion Project (NPAEP) who is specifically recruiting US PAs (4).

However keep in mind that if you are Canadian, and go the United States for PA school  you may have to pay international student fees, the tuition may even be higher if you were to factor in how poorly the Canadian dollar has been doing recently.


(1) CAPA-ACAM.ca What formal education do Physician Assistants have? Accessed July 4, 2016.  https://capa-acam.ca/features/faq/
(2) NCCPA. How and When to Maintain Certification. Accessed July 4, 2016. http://www.nccpa.net/CertificationProcess
3) ARC-PA. Entering the Process. Accessed July 4, 2016. http://www.arc-pa.org/
4) NPAEP. About the Project. Accessed July 4, 2016. http://npaep.com/about-the-project/

Hello, I'm Anne!
I'm a Canadian Physician Assistant who writes about the PA profession in Canada. Learn more »


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