Welcome to the blog and resources for learning
about the Physician Assistant Profession in Canada
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Recently on the Blog
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
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
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
Here I list the best resources for where to look for PA jobs in Canada.
Job Postings Across Canada
1. CAPA PA Job Listings
Membership required. The Canadian Association of Physician Assistant website is often the first resource employers access when they are interested in hiring a PA. These employers will often contact CAPA, who will post the job listing for free on the website. What’s great about this job board is that the majority of CAPA members who have access to this job board are Canadian PA students and Certified Canadian and American Physician Assistants. These area is frequently checked by PAs looking for employment.
Screenshots of the CAPA PA Job Listing:
2. HealthForceOntario PA Initiative Website
These are publicly listed, Ontario specific jobs. From time to time, employers will request to have these jobs posted at Health Force Ontario website. These are accessible publicly and some of these job postings are also found on the CAPA website as well.
Health Force Ontario is also the body that releases new grad funded jobs, however, these are not publicly available for viewing.
3. Hospital Specific HR Websites
Hospital Human Resources websites often have their own job listing and posting system. This would either require entering “[Name os hospital] physician assistant job” in a google search to find it, or browsing through different hospital websites in their “Careers” section. Sometimes these job postings are publicly available, other times they are accessible only via “internal” means (e.g. only on the hospital intranet server).
4. Manitoba Regional Health Authority Career Websites
The Windsor Regional Health Authority (WRHA) has an external (public) and internal job listings for PAs. It takes a bit of navigating through their website before you find Physician Assistant specific jobs. These jobs are for Winnipeg and surrounding areas. Visit the WRHA Job Listings Website >>
Northern Regional Health Authority may provide relocation assistance and/or other incentives as per their Current Opportunities webpage.
Prairie Mountain health is in a rural area that borders a national park. You can visit their Find a Career webpage to find career opportunities.
South Health covers 20 rural municipalities. To see career opportunities, visit their Careers Page.
5. Job Search Engines (e.g. Indeed.ca, Monster.com, etc.)
These public sites are a free-for-all for job postings. Employers submit their job postings which are automatically approved and posted for public viewing. They pay a nominal fee to have the jobs appear first or for longer durations.
Our Orthopaedic Clinic posted a job on Indeed for a part time position to cover a maternity leave. I was overseeing the resumes coming in, and had specifically included in the qualifications, “Canadian Certified Physician Assistant (CCPA) or American Certified Physician Assistant (PA-C)”. Although we did receive resumes for candidates who did qualify, we received an overwhelming response from International Medical Graduates, administrative assistants, Physiotherapy Assistants, and Occupational Therapy Assistants.
Nonetheless, the PA jobs you find here posted on Indeed can often be found on the CAPA Job Listing page.
6. PA Networking Facebook Groups
There are quite a few Canadian PA Facebook Groups that are used for networking and job postings. Several are closed / secret and members that are approved are often Canadian Certified or current PA students. What’s great about these groups is that jobs that are shared are often by fellow PAs, and from an employer perspective the jobs advertised in these groups are to specifically qualified PAs (CCPAs, or PA-Cs).
The CAPA Facebook group is a closed community (contact email@example.com to request joining) and you must be a member of CAPA in order to join. For any Ontario specific groups, you must contact the Ontario Chapter president to request to be added and find out requirements for joining.
Have any other resources for job listings in Canada? Let me know in the comments below!
Both are very similar positions, but have important differences. As a PA, its important to know the difference since many patients and other health care practitioners often ask what the difference is between the two.
Educated by the Medical Model
Bachelor or Master’s in PA studies
Regulation dependent on jurisdiction
Practices in all areas of Medicine
Educated in Nursing Model
Bachelor’s in Nursing, then Master’s in NP Studies
Regulated Health Care Professional
Independent or dependent practitioner within a scope of practice (e.g. NP Clinics)
In Ontario: Primary Care, Medicine, Emergency, Paediatrics and OB/GYN
PA vs NP – History in Ontario
Physician Assistants have been in Ontario since 2007 (5 years) at the start of the Ministry of Health and Long Term Care for Ontario (MOHLTC) as part of a PA demonstration project to evaluate impact of PA’s in Ontario recruiting IMG’s and PAs trained in the US. They have been supported by the Ontario Medical Association since their introduction to Ontario. In 2008, two PA education programs were launched by McMaster University and PA Consortium (University of Toronto Medicine, Northern Ontario School of Medicine and Michener Institute of Applied Health Sciences). Military-trained PA’s have been working in the Canadian Forces for over 50 years graduating from the Canadian Forces Medical Services School at Borden, Ontario. Learn more about the history of PAs in Canada at the CAPA website.
Nurse Practitioners have a 40-year-history of working in Ontario (since the 1970s). They were originally pioneered to expand the RN role in remote communities in Ontario. Today there are over 400 NPs working in various settings. In August 2008, the title “Nurse Practitioner” became protected. Learn more about their history at the NPAO website.
PA vs NP – How much autonomy?
Physician Assistants will always work under the supervision of a Physician and do not have the ability to open up clinics independent of a supervising physician.
Nurse Practitioners have the option of opening up their own clinics. You can learn more about Nurse Practitioner led clinics on the NPAO site.
PA vs NP – Education
Physician Assistants: To become a PA, you are required to complete a minimum of 2 years of a university undergraduate degree (with some “recommended” courses), a minimum GPA, and if you are interested in PA Consortium (University of Toronto, NOSM, and Michener) then you are required to have 1680 hours of paid health care experience; this is not a requirement of the McMaster program. GPA of 3.0 or higher. You do not need a science undergraduate degree to apply to the program. Nurses may also apply to become PA’s.
- In Ontario, there are two schools that offer PA programs, both are Bachelor’s degree in PA studies.
- Education is based on the medical model
- Program length is 24 months. The first 12 months includes basic medical foundations, and the second year consists of clinical rotations through different areas of medicine. You cannot bypass any aspect of this training, and this applies irrespective of your experience or background.
- PA education is not tiered (unlike PA education, which allow you to graduate with specialty certificates). Once a PA graduates, they are open to practice in any area of medicine (whether surgical, generalist or non-surgical specialties).
Nurse Practitioners must complete a Bachelor in Nursing first, THEN apply to a Master’s in Nurse Practitioner studies. The NP programs are competitive to get into, they require minimum 2 years of direct RN nursing experience in the last five years (3640 hours) with a GPA of B or higher in an undergraduate nursing program.
- There are 9 schools in Ontario that offer the primary health care NP program, admission requirements differ between each school. At time of writing they include: Lakehead University, Laurentian University, McMaster University, Queen’s University (satellite site: Trent University), Ryerson University, University of Ottawa, University of Western Ontario, Windsor University and York University.
- Education is based on the nursing model
- Study is full time or part time. The full time option is one year with seven required NP courses. The part time option allows you to take up to three years to complete the courses.
- There are three different specialty certificates (Primary Health Care, Adult and Paediatrics) with different universities offering the different programs.
PA vs NP – Scope of Practice
Physician Assistants Scope of Practice:
- According to this OMA document, PAs should be “permitted to prescribe” medications and write orders as delegated by the supervising physician. These are usually done through medical directives (which is a way for the supervising physician “to incorporate frequently delegated acts that performed competency by the PA, and serve to increase efficiency of patient care and improve patient flow“) or as it falls under the Delegation of Controlled Acts (College of Physicians and Surgeons of Ontario).
Nurse Practitioners Scope of Practice:
- Nurse Practitioners have the ability to prescribe most medications according to the 1991 Nursing Act, but cannot prescribe controlled substances (See Controlled Drugs and Substances Act).
- Nurse Practitioners are able to order x-rays (chest, ribs, arm, wrist, hand, leg, ankle foot, hip, knee, and mammography), ultrasound (abdomen, pelvis, breast, specific organ, transvaginal technique and pregnancy), non-urgent ECGs, and spirometry (reference).
- Nurse Practitioners may also order labs as necessary.
PA vs NP – Where can they work?
Physician Assistants graduate as generalists, with supplementary experience depending on where they choose to complete clinical rotations during their 2nd year of clerkship. PAs may choose to work in any field of medicine ranging from family practice to Orthopaedic Surgery. A table provided during the McMaster PA Information Session outined some of the areas the graduates from the program were working. This includes family medicine, Hospital Medicine, Emergency Medicine, Orthopaedic Surgery, Colorectal Surgery, ICU, Specialty Clinic, Rehabilitation medicine, Paediatrics and Gynecology. In the US, there are some PAs working in highly specialized areas such as Interventional Radiology and Oncology.
Nurse Practitioners are considered Registered Nurses who are in the extended class with additional education and experience. They must use the title RN(EC) to represent RN in the extended class or Nurse Practitioner (NP).
- Categories of NP Roles:
- Primary Health Care Nurse Practitioner (NP-PHC): includes community health centres, long term care, palliative care, aboriginal centres, public health, occupational health, correctional services, ambulator care centres (urgent/emergency deparmtents) and family health teams.
- Adult Nurse Practitioner (NP-Adult): Working in internal medicine roles at a hospital. This program is offered by University of Toronto.
- Paediatric Nurse Practitioners (NP-Paediatrics): Work exclusively with paediatric patients (infants, children and adolescents). Specific work settings include neonatal care (McMaster has specific training program for this) and general paediatrics (University of Toronto has a specific child progam).
- NP-Anesthesia (NP-A): is the newest regulated NP specialty. Involves care of patients and families through perioperative process. Ther emay be intra-operative component to role, but are not administering anesthesia alone in the OR. Apart from OR, they may work in sedation/anesthesia with airway management diagnostic areas.
PA vs NP – Are they Regulated in Ontario?
Physician Assistants are not regulated in Ontario. An application was sent to the Health Professions Regulatory Advisory Council (HPRAC) who performed a jurisdictional review, HPRAC found that the evidence submitted did not meets its risk of harm threshold (Canadian Medical Association document). PAs are regulated in Manitoba under the College of Physicians and Surgeons of Manitoba.
Ontario Nurse Practitioner Resources
- College of Nurses of Ontario – Nurse Practitioners
- Nurse Practitioners’ Association of Ontario
- Ontario Primary Health Care Nurse Practitioner Program
Here we’ll cover some strategies to prepare for the MMI, discuss how the MMI works, and some suggested resources (scroll to the bottom).
What is the MMI?
The Multiple Mini Interview is many short, structured interview stations allowing interviewers to evaluate soft skills. The MMI was developed by McMaster’s School of Medicine in 2001 to address the concern that traditional interviews did not predict performance in medical school or ability with patient interaction.
Why do PA schools choose to use the MMI instead of the traditional interview?
Problems with the Traditional Interview – Imagine sitting in front a panel of three judges who are overseeing your interview. They each take turns asking your questions. They have a list of questions on their sheet from which to pick, “What made you decide PA school? How do you handle pressure or criticism? What are your greatest strengths? What are your greatest weaknesses? How are you a good fit for the program?” Or many of these other questions you may come across in this extensive list in a “traditional” medical program interview.
There can be a few issues with the “traditional” interview approach
- An intimidating setting – A traditional one-interviewer, one-interviewee evaluation setting is a lot of pressure (or in the example above, a 3-interviewer on 1-interviewee).
- You have one opportunity to make a good impression – If you “fumble” in one of your answers, this may paint the way the interviewers may view you for subsequent questions you answer. There is no opportunity for a real “fresh start” on a new question in a traditional interview.
- If using “traditional” interview questions – some interviewees can anticipate and prepare for the questions ahead of time. Interviewers may get “canned” answers that have been doctored, memorized and rehearsed. PA Programs want individuals who will excel in their program and to be good representatives of the profession. However, some candidates that are not good fits may actually EXCEL at an interview, but turn out to be poor fits for the PA Program.
The MMI addresses several of these issues:
- There is more than one chance to make a first impression, in fact, there are 12: McMaster has 12 station circuit, each station with its own interviewer who is listening to answers from different candidates from the SAME question. It is difficult to escape bias, or to make a fresh impression if you happen to not do so well early on in the interview. The MMI eliminates this, since each question you answer will be with a different interviewer. So if you felt you did badly early on in the MMI with a particular question, that interviewer’s impression won’t carry on to later questions (because you have different evaluators!).
- Less predictability of Interview Questions: For interviewers, the structure of the MMI allows for less ability to express “rehearsed questions”. Imagine walking into an interview not knowing what questions to expect, you read the scenario on the door which has a question that they wish you to discuss at length with the interviewer inside. Content of the questions may deal with (not limited to) “communication, collaboration, ethics, health policy, critical thinking, awareness of society health issues in Canada and personal qualities. Applicants are not assessed on their scientific knowledge.” – McMaster Prospective Student Site. Most traditional interviews ask “Why do you want to be a physician assistant? Tell us about yourself, etc.”.
- Candidates have to think on their feet. With the MMI, its nearly impossible to predict what questions will happen, thus the answers given by the interviewee are more spontaneous, more natural, and perhaps more “reflective” of the interviewee’s actual merit and character.
The MMI format
On each door, there is a scenario posted with a question at the bottom. You have TWO MINUTES to read the scenario and question, before the buzzer goes off and you enter the room:
After you’ve had two minutes to read the scenario, the buzzer will go off, and you will enter the room. You will be met by an interviewer who will listen to you speak about the scenario you just read for 8 minutes.
After speaking with the interviewer with 8 minutes, you will switch to station 2 where you can read the next scenario.
A Few MMI Tips
Anticipate Anything: MMI questions aren’t restricted to any subject. This varies from school to school, so expect questions outside the area that you are pursuing. Remember, the point of the MMI isn’t to assess your knowledge, rather your soft skills, and ability to critically think.
Research: Do as much research as you can specifically on the:
- The format of the MMI, make sure you have an understanding of how this works. It will alleviate some anxiety about the uncertain nature of the MMI.
- The Philosophy of the school: What specific features are they looking for in ideal candidates to the program?
Practice Questions MMI style: How to practise: Print some sample questions (some sources for MMI questions are listed below). Paste the first sample question on a door (don’t read it yet!)
- Get a timer, give it to a friend who will act as a timer and interviewer.
- With the friend sitting inside a room, and you positioned outside the room, have your friend start timing 2 minutes while you read the question on the door.
- Have the friend knock, when the two minutes are up, walk in.
- Begin speaking about the subject while your friend times for 8 minutes.
Why Practise? It gives you confidence about the interview format, there aren’t as many promises, and that added confidence and calm will also reflect on the interviewer’s impression of you.
Format your answers: Organization to how you answer the questions will help you organize your thoughts, much like an essay. This is applicable regardless of whether you are doing an MMI or more traditional interview. Are you trying to persuasive? explanatory? Reading up on essay formats may help give you an idea about how to answer different types of questions. (e.g. Pros vs. Cons, Chronological, Your opinion vs devil’s advocate).
Suggested resources for preparation of the MMI
Online Guides to the MMI:
- Practice questions and guides are available online which you can find with a simple Google Search. Often using the search term “MMI” or “Multi Mini Interview” or “Medical School MMI”
- The McMaster MD Program, of which the McMaster PA Education Program is based off of, has a website with information of the MMI as well as a PDF Training Manual for interviewers of the MMI.
- A quick Youtube Search of “Multi Mini Interview” reveals helpful videos and sample scenarios that you may view.
PA Blogs that discuss MMI strategies:
- Eden, now Manitoba PA Graduate from University of Manitoba discusses MMI strategies: http://eden-pa.blogspot.ca/p/pa-interview-mmi.html
- McMaster PA Student Resources has a whole page dedcated to Application Tips, including a section on the MMI.
- Sandy Vuong, now McMaster PA Graduate recounts her day at the MMI for her interviews.
- Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians by Philip C. Hebert
- Multiple Mini Interview (MMI) for the Mind by Kevyn To M.D.
Mock MMI’s Practice Groups: I have had many Pre-PA students ask me about that one. Although good in theory, it may be difficult to find “local” mock MMI groups (again, you’d likely have to do a google search or skim through Canadian premed forums). I found practicing on my own, with a friend or family member serving as the interviewer very helpful. They could watch my body language as I got to practice building comfort around interviewing. You may also practice in a mirror so you can get used to hearing the sound of your own voice.
American certified Physician Assistants may work in Canada. American PAs who have successfully completed an accredited American Physician Assistant Program, and challenged and passed the NCCPA’s Certification Exam are able to practice in Canada. They do not need to complete PA school in Canada to practice.
Many PA employers now require or prefer certified American PAs to write the Canadian Entry to Practice Examination and to be a registered CCPA.
How do I work in Canada?
Now this is a much more challenging question. There are several ways to apply to work in Canada. I outline a few points her for temporary work and work as a permanent resident. The most up to date, reliable information about working and living in Canada may be found on the Canadian Immigration Commission website.
- International Experience Canada (IEC) Program – If you are under the age of 35, you can gain experience working in Canada through the International Experience Canada Program, which encourages young people to obtain international working experience in Canada before settling in their home countries. The official website outlines criteria and participating countries.
- Obtain a temporary work permit. This requires several pieces of documentation including a police check, as well as proof that you plan on leaving Canada at the end of your employment.
- Obtain a study permit and enroll in a Canadian school for a vocational or language degree. However keep in mind you’ll pay international student fees and health insurance is not covered. You can then apply for a post-graduate work permit, but there is strict criteria for work after graduation.
- Sponsorship by a Canadian Family Member, which may include a spouse, partner or children
- Married to a Canadian? A spouse, common-law partner or conjugal partner can sponsor you.
- Immigrate to Canada as a skilled worker through Express Entry. You may qualify for Express Entry to become a permanent resident if you have recently graduated in Canada.
This information was last updated February 15, 2017.
Take this “Come to Canada” Questionnaire to check which ways and options you can use to come to Canada.
A large proponent on deciding a career and then going through the process of applying to a PA program, like any professional school, is determining what the job market is for that profession. If you want to know the specifics of how a newly minted PA finds a job after graduation, be sure to read through (especially the last section!) for a walk through of how this is done.
Factors Affecting Employment
- Political Party in Power – some political parties recognize the value of the PA profession versus others who may not. In some provinces, for example, having an NDP vs. Liberal government does make a difference in terms of how far the PA profession can progress in terms of introducing legislation to allow PAs to practice to the top of their scope of practice.
- Stake Holders & Interest Groups – Stakeholders in health care and other interest groups may support or oppose profession, can have an impact on decision makers who influence the PA profession. Examples of these groups include the provincial medical associations, patient interest groups, and hospital associations.
- Provincial Health Care Budget – Provincial health care budgets are challenging as many groups are vying for funding for their programs. Even physicians have to advocate for their portion of the budget and fair compensation. Yes, PAs are a way to save the system money, but other factors (i.e. see two bullets above) must be balanced as well. One factor that may improve the job market is the publication of research studies to demonstrate the economic value of Physician Assistants within our health care system.
- PA Advocacy – PA Advocacy is the promotion of the profession through media, speaking with our MPPs influences our ability to have conversations with important decision makers, stake holders and interest group to advance the PA profession. The PA Profession is a relatively new profession in the Canadian public sector. PA Advocacy is done through CAPA, practicing PAs as well as PA students.
- PAs are not regulated in Ontario, however they are regulated in three other provinces. CAPA last applied for regulation in 2012, and this was declined as PAs did not reach “threshold for harm” (which is in place to protect the public). As one colleague of mine, ES had mentioned, “…this does not mean that PAs will never be regulated, simply that HPRAC did not see it necessary at this time.”
- Also keep in mind other professions in Ontario, including Paramedics, have repeatedly applied for regulation unsuccessfully or other currently regulated professionals have had to apply more than once to obtain regulation.
- PAs would like to have regulation in Ontario. We will likely apply again for regulation again within the next few years once more research on PA value in the health care system is published.
- Lack of regulation, however, does not stop PAs from obtaining employment. However if PAs were regulated, it may create more job opportunities since this would expand our scope of practice and reduce barriers to integrating them more seamlessly into the Ontario Health Care System.
PAs can see patients under supervision of a physician, and the physician does not need to be physically present in the room for this to occur. They operate under delegation of controlled acts, and also under medical directives. How PAs are supervised and How physicians bill for PA work are two different things.
Having a clear funding model for PA jobs in place could certainly open up more job opportunities for PAs in the province, especially in areas of high need such asFamily Practice, long term care, Emergency Rooms, and rural medicine. It would also provide a means of allowing employers to create a permanent/long-term PA position.
Our primary employers are physicians, physician groups, hospitals, family health teams, specialty departments, ER departments, etc. If these important stakeholders are not aware of who PAs are, what they do, and how they can positively impact their practice and patients, they won’t hire. A huge push at the most recent CAPA conference was to increase awareness of the PA profession through advocacy.
This may be one of the most important factors to finding employment. Your ability to network, your references, how you present yourself through cover letters, resumes and your initiative during the job hunt after graduation are all invaluable to any successful job search.
Finding Work after Graduation
There are several ways that new PA graduates can secure work:
1) Jobs obtained during 2nd year PA Clinical Rotations
Many of my peers secured work while they were students in PA school completing their clinical rotations. Often what happens is that they impress their supervising physicians with work ethic, attitude, willingness to learn and the supervising physician takes the initiative to secure funding and/or create a PA position within their practice. There are also many students who excel in their clinical rotation, but the supervising physician is not in a position or is not interested in hiring PA. There are a handful of students each year who graduate with a job without going through the career start program or looking for publicly posted job postings. Some PA students even help their supervising physicians help complete the application form for the Career Start Program.
2) Ontario Career Start Program
- What is the Career Start Program? Each year (so far) the Ministry of Health and Long Term Care has provided a “Career Start Grant” for newly graduating Physician Assistants. This grant provides a PA employer a percentage (e.g. 50% for example) of the PA’s salary for 1 year. After which the employer may continue to keep the PA, and pay 100% of the PA’s salary when the funding ends.
- Who can apply for these jobs – These grants are open to Ontario civilian PA graduates who graduated from an accredited Ontario PA program – which include McMaster University and University of Toronto.
- # of jobs – Prospective employers must apply to the Ministry of Health and Long Term Care for these PA grants. The Ministry determines which employers have met the requirements for the career start grant. The jobs are released at the end of a graduating year. With a cohort of approximately 24 students in the McMaster Program and ~30 students in the UofT Program, the jobs are released. From previous years, the number of jobs released usually exceeds the number of grads available to take the jobs. There may be occasions where an employer withdraws after the jobs are posted.
- Where are the geographic location of these jobs? These jobs are located everywhere around the province, from Thunderbay, Brockville, North Bay, Sarnia, Windsor, Sarnia, Chatham-Kent, Niagara, Ottawa, Kingston, Hamilton, Oakville, Toronto and New Market to recall a few cities and townships.
- Where are these jobs in terms of area of medicine? These jobs span many areas of medicine – Family Medicine, Emergency Medicine, Internal Medicine, Geriatrics, Psychiatry, Orthopaedic Surgery, Nephrology, Endocrinology, etc.
- Who does funding go to? There is a priority for funded positions for employers that demonstrate high need. Up until this time of writing (December 2016), the Career Start Program has been in place offering 1 year funded positions. Want to see what the grant application looks like? I found these two PDFs doing a quick google search: 2013 PA Career Start Employer Application, and 2015 PA Career Start Employer Info Package, and 2016 PA FAQ.
- A screenshot of the Application Process & Deadlines from the 2016 info package:
3) PA jobs outside of the “Career Start” Program, Publicly Posted PA jobs
- Unlike Career Start program jobs, these positions are not funded by the government through Career Start and are open to all PAs – including all CCPAs in Canada (not just PAs trained in Ontario), and American trained PAs (PA-C’s).
- Duration of employment depends on the practice needs
- Temporary / maternity – These positions may cover maternity leaves (1 year or less contracts)
- Part time – I have seen jobs postings for physicians looking for PAs to work with them 1-2 days per week, etc. Sometimes the PA is hired as an “employee”, other times the PA is hired as a “consultant”. There are some PAs that juggle 1, 2 or even 3 part time positions, where different days of the week are spent at different clinics.
- Full Time – Some full time positions include benefits (medical, dental, vision), insurance coverage (liability insurance), vacation (2-3 weeks+), and CME funding (e.g. ($1000 per year). PAs in Manitoba are part of a union, in Ontario this is not the case.
Employment rate for new Ontario PA Grads
Longevity of the Ontario Career Start Program
When my class graduated in 2011, there were two graduating classes in Ontario, one from McMaster and one from University of Toronto. All 24 students at McMaster and my year secured jobs within a few months of graduating, however I am not certain of what the UofT rates were. When I graduated, the job I ended up taking was also through the career start program. Right now, there is no indication that the Career Start program will go on indefinitely for future PA graduates.
The job rate is not 100% immediately after graduation
The PA programs have been extremely fortunate to have the Career Start Program offered to their new graduates. In the 2016 class, the majority of graduates were able to obtain employment. In fact, few if any professional degrees have a high employment rate out of graduation. Few if any health care professions have permanently funded positions. Health care cuts are taking place across the province. No one is exempt – from registered nurses, registered practical nurses, physiotherapists, Social Workers, to registered massage therapists, etc. PAs are no exception to this. All other providers are paid through hospital, billing or through a budget. PAs are unique since we may provide a service, but have difficulty with reimbursement.
- Take for instance medical school/residency graduates as covered by the National Post: medical schools are churning out physician graduates who graduate to unemployment. In fact, there is quite a high unemployment rate of Orthopaedic Surgeons in Ontario despite the high demand and long wait lists for Orthopaedic Surgeries. Other health care professions in addition to physicians – pharmacists, registered nurses, lab technicians, pharmacy assistants, physiotherapists all face similar issues of obtaining employment after graduating from school.
- Every PA you ask in Ontario will have a differing opinion, some believe the employment rate is abysmal, others believe that the employment is reasonable. As per a recent thread in PreMed 101 forum, the recent matriculation demonstrated an unemployment rate of 4 out of 56 PA grads obtaining a job.
What happens if you do not secure a job through the Career Start Program?
- There are some new PA graduates who do not secure a job through the Career Start Program, and this does happen to some students from each graduating class.
- These PA graduates may obtain work through publicly posted PA positions. Sometimes this is done creatively and not through conventional means. The following examples demonstrate a few creative ways to find work after graduation:
- Examples of ways to obtain jobs outside of career start funding: (These examples are to demonstrate different ways Ontario PA grads have obtained work)
- Student A did not obtain Career Start Program funding, instead they applied to publicly posted jobs and obtained a full time position with benefits in a private office in the GTA.
- Student B did not obtain Career Start Program funding after graduation; unfortunately Student B was not able to obtain a full time position, however they obtained two part time positions at two different practices based on job postings they found on Indeed.ca and the CAPA Job listing page. They will be two times per week at Clinic A in St. Catherine’s Nephrology, and three times per week in Clinic B in Niagara for Family medicine.
- Student C DID obtain a job through the Career Start Program, however it was not a good Employer-Employee Fit, thus Student C did leave their 1 year contract before it ended. They applied to another job posting, and was able to obtain a part time position two days at a week a Pain Clinic Practice. It was until 6 months later they were able to secure a full time position through a job posting found on the CAPA Job Listing page.
- Student D did not obtain a Career Start Program funding after graduating, however did apply to a Manitoba position and was accepted. Student D moved to Manitoba to start their career.
- Student E did not obtain a Career Start Program funding job, however did apply and accepted a maternity leave at another clinic. They worked closely with other doctors as well that one of the other doctors asked Student E to start full time at another clinic that the a separate group of doctors were starting in a different jurisdiction. Once the maternity leave was up, student E started as a full time PA with a new group of doctors.
- Student F started off in a Career Start Program funded position in a family health team, however once the 1 year contract was almost up HR mentioned they did not have resources to extend the position. However, there was a special Psychiatry outpatient clinic that the family health team wished to start with a Psychiatrist. Once the 1 year contract was up Student F started full time with the psychiatry outpatient assessment.
- Student G did not obtain Career Start Program funded position, however did apply to a position that was advertised through an email they received from their PA program. The physician was only interested in an Ontario PA grad who had passed their CCPA. After a few emails exchanged and an interview, Student G secured a position within 6 months of graduation.
- Examples of ways to obtain jobs outside of career start funding: (These examples are to demonstrate different ways Ontario PA grads have obtained work)
- Finding work in other provinces – Some PAs do chose to migrate to Manitoba or Alberta for other job opportunities as it is a better fit given their situation. New Brunswick has introduced legislation for PA regulation and plans to introduce more PAs as well. BC is another potential province that may be taking on PAs as the work for PA advocacy in that province continues.
- Finding work in other countries – I know of 2 PAs that have gone to Ireland to help pioneer the PA profession in a pilot project. One PA from McMaster Class of 2010 has gone to the UK to work and teach.
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At the end of the McMaster PA Program info night on Wednesday, November 23, 2016, the Assistant Dean Kristen Burrows and Academic Coordinator Nancy Aza fielded questions from the prospective students in the audience. Questions ranged from specific questions about admissions to employment outlook upon graduation.
Question and Answer Period
Q. What is average GPA of students that get into the program?
A. Average GPA of students who were accepted in the McMaster PA Education Program was 3.7 in the last round of applications.
Q. I did not do well in my first year, are summer courses included in GPA calculation?
A. Yes. All undergrad courses in your entire university career are included in the GPA.
Q. Do you have to have paid clinical experience to apply to the program?
A. No. McMaster does not require previous health care experience.
Q. What are requirements for being on call?
A. This occurs in second year of PA school. Being “on call” means that the PA students are available to make visits at the hospitals at any time they are needed (e.g. Being on call at the weekend means you do not necessarily have to be at the hospital – you can choose to stay at the hospital or go home, however if the hospital pages you, you are required to come in to the hospital). This will vary between settings depending on what your rotation. You may do a whole day, and may be on call for an overnight. Call may occur in Surgery, Psychiatry, and in other specialty practices.
Q. How much do PAs earn in Ontario?
A. This varies depending on what you are able to negotiate and the employer setting (e.g. hospital vs private office). Around $80,000-$110,000+ is a starting salary, however this varies between urban vs rural, hospital vs office/private, and specialty practice. Some hospitals have a pay scale (via google: “a graded scale of wages or salaries paid within a particular organization or profession”) for their PAs, other PAs have to negotiate each year for better benefits and increase in salary.
Q. Is there a guarantee of employment upon graduation?
A. The program does not guarantee that you will get job, very few – if any – post-secondary education programs offer that. They also do not guarantee that you will get a PA Career Start Program grant either. Some PA graduates do find work outside of the PA Career Start Program (i.e. sometimes their supervising physicians they did rotations with in 2nd year choose to hire them with or without funding).
Q. Can PAs be involved with organizations like Doctors without Borders?
A. PAs have done international elective as students (e.g. most recently Sandy Vuong, now PA grad recently completed an internal elective in India). However at this time, Doctors without Borders will not take on PAs in a clinical role, from their website:
Q. Is there a role in PAs in geriatric medicine?
A. The challenge is going into the PA profession with a specific area of medicine in mind. There is no way to predict what jobs will be released by the Health Force Ontario Program by the time you reach graduation. Jobs will vary by area of medicine, city/town (urban or rural Ontario) and by employer type (hospital, solo physician, group of physicians, Family Health Team, etc.). If you find a supervising physician who is working in Geriatrics who is interested, you can encourage them to apply for Health Force Ontario’s PA Career Start Grant funding or propose a funding model that might work in this clinical setting.
Q. Who qualifies for the Career Start Program Grant funding?
A. Each year only the new graduates of the University of Toronto and McMaster PA Program in Ontario. American PAs, IMGs, Military PAs, even PAs who are gradates of UofT and McMaster PA graduates from previous years do not qualify.
Q. What settings/scope do PAs work in?
A. It is difficult to generalize the scope of how PAs work since it varies so much between PAs and practice settings. For example, there are some PAs that may work in internal medicine 4 days per week and dermatology 1 day per week. Some PAs that may be in charge of well baby exams & maternal health only in family medicine setting, whereas other PAs do a wide variety of clinical problems and procedures. Your scope of practice depends on what setting you work in, how much experience you have, the scope of your supervising physician and what they choose to delegate to you.
Q. Can Canadian trained PAs work in the US?
A. We cannot work in the US unless we are a certified American Physician Assistant. In order to write the American National Exam, you have to have graduated from an accredit PA program. We can work in the UK, as one of my classmates has worked there for over a year as well as in Ireland. Read on about PAs practicing in the US and Canada.
Q. Can PAs prescribe in Ontario?
A. This depends on the setting you are in. PAs cannot prescribe independently, however if they are working in a practice setting that has medical directives, the PA may prescribe certain medications. For example, PAs in hospitals with connection to the hospital pharmacist, or PAs in community settings with the community pharmacist. PAs do not have access to restricted medications (narcotics, benzodiazepines).
Q. When will PAs be regulated in Ontario?
A. At this time it is not known. The last application was done in 2012, as PAs applied to be regulated under the Regulated Health Professions Act (1991). This was declined for several reasons, however one being that PAs do not reach threshold for harm which is a criteria required to get regulated. There needs to be another application submitted to the Health Professions Regulation Advisor Council (HPRAC). HPRAC advises the Minister of Health whether unregulated professions (e.g. paramedic, physician assistants) should be regulated, and whether amendments to the Regulated Health Professions Act should be made. This application will be submitted once it reaches the health minister’s agenda. Things that would strength the application This is dependent on PAs numbers, demonstrated risk of harm. PAs involved in advocacy and the Canadian Association fo Physician Assistants are working towards this.
Thanks for reading! Have any questions you’d like to add that you don’t see here? Feel free to comment below or email: firstname.lastname@example.org.
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