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 slowly 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) What formal education do Physician Assistants have? Accessed July 4, 2016.
(2) NCCPA. How and When to Maintain Certification. Accessed July 4, 2016.
3) ARC-PA. Entering the Process. Accessed July 4, 2016.
4) NPAEP. About the Project. Accessed July 4, 2016.


  1. jackson October 20, 2021 at 12:05 pm - Reply

    Is there any word on this possibly changing in the future?

    • Anne Dang October 20, 2021 at 6:16 pm

      Not at this time. I think CAPA and the PA programs are focusing on expanding the PA profession in Canada first.

  2. Amrit May 8, 2022 at 9:14 am - Reply

    Can I do my undergrad in Canada and then apply to a PA school in the US?

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