THE CANADIAN PA GUIDE

What is a Physician Assistant in Canada?

An introduction to the profession, clinical practice, education and the pathway to becoming a PA.

by Anne Feser, CCPA • Last updated October 30, 2026

Welcome to the Canadian PA Guide on Physician Assistants in Canada!

Physician Assistants are becoming a more familiar part of healthcare in Canada, but there are still plenty of questions about what PAs actually do, how they are trained, and how their role fits within a medical team.

This guide provides an introduction to the Canadian PA profession, starting with the fundamentals of the PA role and education, and how PAs fit into Canada's healthcare system.

SECTION 01

What is a PA?

Physician Assistants (PAs) are healthcare professionals who practice medicine in collaboration with physicians to provide patient care. [1-3, 5]

PAs are trained to assess patients, diagnose and manage medical conditions, order and interpret diagnostic tests, prescribe medications, perform procedures, and assist in surgery. [2, 3]

The PA role can look different from one setting to the next. In family medicine, a PA may see a mix of acute and chronic problems. On a surgical service, their responsibilities may include inpatient rounds, assisting in the operating room, and postoperative follow-up.

What remains consistent is the PA’s medical training and their role in providing care as part of a healthcare team.

SECTION 02

PA Scope of Practice

PAs are trained as medical generalists, giving them a broad foundation to practice across different medical specialties and clinical settings. They work in collaboration with physicians, within a formalized PA/MD supervisory relationship. [2-5]

The specific responsibilities of a PA depend on their clinical training, the setting in which they practice, and the arrangements established with their supervising physician(s) and healthcare team. [4, 5]

SECTION 03

How PAs Work Within Healthcare Teams

PAs work collaboratively with physicians and other healthcare professionals to provide coordinated patient care.

The PA-Physician Relationship

The PA/MD supervisory relationship is a formal, ongoing arrangement in which one or more named physicians delegate defined medical tasks to a PA and oversee how the PA performs them. [4, 5]

A successful PA/MD relationship includes several components:

Working With Other Healthcare Professionals

PAs work as part of an interprofessional healthcare team, communicating regularly with colleagues to assess patient needs, develop care plans, monitor treatment, and respond to changes in a patient’s condition. [2, 3]

How collaboration works depends on the clinical setting:

When happens when a PA is added to a healthcare team or service?

The benefits of adding a PA extend beyond seeing more patients. Adding a PA to a healthcare team provides additional clinical capacity, but their contribution extends beyond seeing more patients. By taking on ongoing clinical responsibilities, PAs can help teams manage workloads, maintain consistent patient care, and help reduce delays in treatment. [6-9, 42]

1) More Clinical Capacity. A PA can assess and manage patients, review investigations, address concerns, and provide treatment and follow up, which spreads workload across the team. [6, 7]

2) Improved Continuity of Care. PAs provide a familiar, consistent presence on healthcare teams, helping patients receive ongoing care even as physicians and medical trainees rotate through a service. PAs follow patients from admission to discharge, keep track of history and plans, and reduce gaps in care during team changes and handover. [6-9]

3) Better Care Coordination. Care slows when investigations, consultations, or treatment plans are not followed up. PAs help keep care moving by arranging consultations, following up on recommendations, tracking outstanding investigations and treatment plans, and coordinating discharge planning to avoid unnecessary delays. [2-3, 8-9]

SECTION 04

Where PAs Work

Medical Specialties

PAs can be found working in a wide range of medical and surgical specialties, including:

  • Primary care and community: family medicine, geriatrics, paediatrics, sports medicine, occupational medicine, addiction medicine, palliative care

  • Acute and hospital based: emergency, internal medicine, hospital medicine, critical care, trauma

  • Mental health, pain and rehabilitation: psychiatry, pain medicine, physiatry

  • Medical subspecialties: cardiology, dermatology, endocrinology, gastroenterology, hematology, infectious diseases, nephrology, neurology, oncology, respirology, rheumatology

  • Surgical specialties: general, orthopaedic, cardiothoracic, vascular, neurosurgery, plastic, urology, otolaryngology, obstetrics and gynaecology

Practice Settings

PAs work in different environments depending on the role and the patients they serve.

This includes:

  • Hospitals: Emergency departments, inpatient units, intensive care units, operating rooms, and hospital-based clinics.

  • Primary care: Family medicine practices, community health centres, and other primary care clinics.

  • Outpatient and specialty clinics: Ambulatory care, specialist consultations, procedures, and follow-up appointments.

  • Long-term care and rehabilitation: Long-term care homes, rehabilitation facilities, and other settings supporting patients with ongoing care needs.

  • Rural and remote healthcare: Community health facilities and remote clinical services, including communities with limited access to healthcare.

  • Occupational and industrial healthcare: Workplace health clinics and remote industrial worksites, including mining operations.

  • Military healthcare: Canadian Armed Forces clinics, military bases, and operational environments.

Can PAs Change Specialties?

Yes. This is called lateral mobility, the ability to move between medical specialties during a career. Physicians train in one specialty during residency, while PAs receive broad medical training that applies across specialties.

However, a lateral move to another specialty does not mean PAs can practice in a new seting without preparation. The PA builds on existing knowledge and develops the skills of the new setting through orientation, mentorship, clinical experience and supervision. For example, a PA moving from emergency medicine to orthopaedics brings assessment and procedural foundations and learns the surgical workflow and postoperative care. [2,3]

SECTION 05

PA Education

PAs in Canada complete an intensive, full-time education program that combines medical sciences, clinical skills, and supervised clinical experience. Most programs follow a two-year structure, beginning with classroom-based learning and progressing to clinical rotations.

PA education follows the medical model, an approach also used in physician education. Students learn to apply medical knowledge to clinical problems: assessing patients, developing differential diagnoses, interpreting investigations, and formulating treatment plans. Some programs draw on their university’s medical school curriculum and provide opportunities for shared teaching or clinical placements alongside medical students. [29–35]

PA Programs in Canada

Canada has seven university-based PA education programs across five provinces. Programs differ in the degrees awarded, admission requirements, curriculum delivery, and clinical placement arrangements.

Typical PA Program Structure

Year 1: Medical Foundations (PA-S1)

The first year focuses on building a foundation in clinical medicine. Students study subjects such as anatomy, physiology, pathophysiology, pharmacology, and clinical medicine while developing practical skills in patient assessment and communication.

Learning typically includes lectures, case-based discussions, simulation, clinical skills laboratories, and early clinical exposure. [29-35]

Year 2: Clinical Rotations (PA-S2)

The second year focuses on applying medical knowledge in clinical settings under the supervision of experienced healthcare professionals. Students complete rotations across several areas of medicine, which may include family medicine, emergency medicine, internal medicine, surgery, paediatrics, psychiatry and obstetrics and gynaecology.

During these placements, students participate in patient assessments, develop clinical reasoning skills, and gradually take on greater responsibilities appropriate to their level of training. [29-35]

SECTION 06

After Graduation

Graduating from a PA program is only one step toward entering practice. Additional certification and registration requirements apply.

National Certification

Graduates of recognized Canadian programs may be eligible to write the PA Certification Exam (PACE) from the Physician Assistant Certification Council of Canada (PACCC). Passing earns the Canadian Certified Physician Assistant (CCPA) designation. Certification is required to practice in Canada. [17, 18]

Maintenance of Certification (MOC)

PACE is a one time exam, and certification is kept through continuing professional development (CPD). PAs log CPD in the My MOC platform and must complete at least 250 CPD credits over five years, with a minimum of 25 per year and 25 credits in feedback and improvement activities in each five year cycle. They also renew CAPA membership every year. [19, 20]

Provincial Registration

In provinces that regulate PAs, you must also register with the provincial regulator before practising. In several provinces this is the same College of Physicians and Surgeons that regulates physicians. Requirements vary and may include proof of education, certification, liability protection and provincial practice requirements. [4, 21-28]

Registration makes PAs accountable to a body that sets standards, oversees registration and investigates concerns. Patients and employers can check whether a PA is registered and in good standing.

SECTION 07

PA Practice in Canada

Final Notes

The PA profession has come a long way in Canada, and it’s still growing. More healthcare teams are becoming familiar with what PAs bring to clinical practice, and opportunities continue to develop across different specialties and provinces.

For current and future PAs, understanding the profession includes knowing where your role sits in the health system, what accountability comes with it, and how your practice will change over time.

One of the things I appreciate most about being a PA is the flexibility of our medical training. We can build expertise in a specialty, take on new clinical challenges, and continue learning throughout our careers. That flexibility comes with a responsibility to recognize our limits, maintain our competencies, and contribute meaningfully to the teams we work with.

-Anne

References

[1] Canadian Institute for Health Information. Physician assistants. https://www.cihi.ca/en/physician-assistants

[2] CAPA (2021). Canadian physician assistant competency framework 2021: Canadian EPA-PA. https://capa-acam.ca/_uploads/65010339c28b8.pdf

[3] CAPA (2015). CanMEDS-PA: 2015 edition. https://capa-acam.ca/_uploads/65010706a11c6.pdf

[4] College of Physicians and Surgeons of Ontario. Regulation of PAs. https://www.cpso.on.ca/physician-assistants/regulation-of-pas

[5] Canadian Medical Protective Association. (2024, May). Working with physician assistants: Regulation, delegation, and liability protection. https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2024/working-with-physician-assistants-regulation-delegation-and-liability-protection

[6] de la Roche, M. R. P., et al. (2021). Effect of a physician assistant on quality and efficiency metrics in an emergency department: Population cohort study. Canadian Family Physician, 67(2), e61 to e67. https://doi.org/10.46747/cfp.6702e61

[7] Ducharme, J., et al. (2009). The impact on patient flow after the integration of nurse practitioners and physician assistants in 6 Ontario emergency departments. CJEM, 11(5), 455 to 461. https://doi.org/10.1017/S1481803500011659

[8] Decloe, M., McCready, J., Downey, J., & Powis, J. (2015). Improving health care efficiency through the integration of a physician assistant into an infectious diseases consult service at a large urban community hospital. Canadian Journal of Infectious Diseases and Medical Microbiology, 26(3), 130 to 132. https://doi.org/10.1155/2015/857890

[9] Burrows, K., et al. (2020). Understanding health professional role integration in complex adaptive systems: a multiple-case study of physician assistants in Ontario, Canada. BMC Health Services Research. https://doi.org/10.1186/s12913-020-05087-8

[10] Burrows, K., Nickell, L., & Krueger, P. (2025). Physician assistants working in primary care in Canada: Findings from a national survey. Healthcare Management Forum, 38(5), 456 to 463. https://doi.org/10.1177/08404704251347908

[11] Grimes, K., & Prada, G. (2016). Value of physician assistants. The Conference Board of Canada. https://capa-acam.ca/_uploads/6517394f5750f.pdf

[12] Desormeaux, M., et al. (2016). Gaining efficiency: Increasing the use of physician assistants in Canada. The Conference Board of Canada. https://capa-acam.ca/_uploads/65173974e12c4.pdf

[13] Grimes, K., et al. (2017). Funding models for physician assistants: Canadian and international experiences. The Conference Board of Canada. https://capa-acam.ca/_uploads/651739607bf9d.pdf

[14] CAPA. Medical directive example: Family medicine. https://capa-acam.ca/_uploads/6553d0c042196.pdf

[15] CAPA. Medical directive example: Emergency medicine. https://capa-acam.ca/_uploads/6553d11050707.pdf

[16] CAPA. (2023, May). Information brief: Physician assistants. https://capa-acam.ca/_uploads/6557ac9564b06.pdf

[17] Physician Assistant Certification Council of Canada. Certification overview. https://capa-acam.ca/paccc/

[18] Physician Assistant Certification Council of Canada. Certification examination eligibility criteria. https://capa-acam.ca/paccc/pa-cert-exam/eligibility-criteria

[19] Physician Assistant Certification Council of Canada. Maintenance of certification and continuing professional development. https://capa-acam.ca/paccc/continuing-professional-development

[20] Physician Assistant Certification Council of Canada. (2024). Refreshed maintenance of certification framework. https://capa-acam.ca/_uploads/65f081495a90b.pdf

[21] College of Physicians and Surgeons of Alberta. Physician assistant registration. https://cpsa.ca/physician-assistants/registration/

[22] College of Physicians and Surgeons of Manitoba. Clinical assistants and physician assistants. https://www.cpsm.mb.ca/registration/applying-for-registration/clinical-assistants-and-physician-assistants

[23] College of Physicians and Surgeons of Nova Scotia. Physician assistant resources. https://cpsns.ns.ca/registrants/physician-assistants/physician-assistant-resources/

[24] College of Physicians and Surgeons of New Brunswick. Regulation 6: Physician assistants. https://cpsnb.org/assets/33dfaf4e-9f65-46e1-be64-24f05a20ba45/Regulation%206-Reglement%206%20BIL.pdf

[25] Government of Prince Edward Island. (2023). Physician assistants regulations (EC2023-428). https://www.princeedwardisland.ca/en/legislation/regulated-health-professions-act/physician-assistants-regulations

[26] College of Physicians and Surgeons of British Columbia. Physician assistant. https://www.cpsbc.ca/registrants/current-registrants/registration-and-licensing/physician-assistant

[27] College of Physicians and Surgeons of Newfoundland and Labrador. Physician assistants. https://cpsnl.ca/licensing-and-registration/physician-assistants/

[28] College of Physicians and Surgeons of Saskatchewan. Regulatory bylaws: Physician assistant licensure provisions. https://www.cps.sk.ca/imis/ContentBuddyDownload.aspx?DocumentVersionKey=1f40f38c-6513-40f5-86ef-f628c867d8ea

[29] McMaster University. Physician Assistant Education Program. https://healthsci.mcmaster.ca/physician-assistant/

[30] University of Toronto PA Consortium. Prospective students. https://paconsortium.ca/prospective-students-0

[31] University of Manitoba. Master of Physician Assistant Studies. https://umanitoba.ca/medicine/physician-assistant-studies

[32] University of Calgary. Master of Physician Assistant Studies. https://cumming.ucalgary.ca/physician-assistant

[33] University of Saskatchewan. Master of Physician Assistant Studies. https://medicine.usask.ca/mpas/curriculum.php

[34] Dalhousie University. Physician Assistant Studies. https://medicine.dal.ca/departments/PAStudies.html

[35] Western University. Master of Physician Assistant Studies. https://www.schulich.uwo.ca/find-your-program/graduate-studies/master-of-physician-assistant-studies.html

[36] Government of Saskatchewan. (2025, September 9). Saskatchewan builds future physician assistant workforce. https://www.saskatchewan.ca/government/news-and-media/2025/september/09/saskatchewan-builds-future-physician-assistant-workforce

[37] Western News. (2026, June 8). Western launches Ontario's first graduate-level physician assistant program. https://news.westernu.ca/2026/06/western-physician-assistant-grad-program/

[38] Government of Prince Edward Island. (2024, November 13). Health PEI welcomes new associate physicians and physician assistant. https://www.princeedwardisland.ca/en/node/70243

[39] Canadian Association of Physician Assistants. (2024, October 1). Physician Assistants start working in Northern Quebec to help increase access to care. https://capa-acam.ca/advocacy/press-releases/physician-assistants-start-working-in-northern-quebec-to-help-increase-access-to-care-a-significant-milestone-for-pas-who-are-now-able-to-practice-medicine-coast-to-coast-2024-10-01

[40] College of Physicians and Surgeons of British Columbia. (2025). College Connector, Vol. 13 No. 4. https://www.cpsbc.ca/news/publications/college-connector/2025-V13-04/01

[41] CBC News. (2023, November 6). Pilot project aims to relieve overworked doctors with physician assistants. https://www.cbc.ca/lite/story/1.7017415

[42] Canadian Interprofessional Health Collaborative. (2024). CIHC competency framework for advancing collaboration 2024. https://health.ubc.ca/sites/default/files/documents/CIHC_EN_061124.pdf