Physician Assistants (PAs) are highly skilled health care professionals educated in the medical model who practice medicine. PAs can work in any clinic setting to extend physician services, complement existing services and aid in improving patient access to health care. (CMA Toolkit) Learn more →
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.
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.
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.
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.
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.
Have more questions that you didn’t find the answer to here?
We’ve started a Canadian Pre-PA Networking Group where you can ask questions directly to PA students and PA program and currently practicing Canadian PAs. Just request to join and start posting!
Opinions and views expressed in this article are that of the authors and does not represent any association, program or organization.
Thank you to Ohood, Deniece O’Leary and Erika N. for reviewing the article before posting!
Hi! I’m Anne, a Canadian Certified Physician Assistant working in Orthopaedic Surgery.
I’ve been writing about my PA experience since starting my PA journey and I’m excited to share CanadianPA.ca as a resource to help you learn about the role and impact of Physician Assistants in Canada.
This blog is my way of helping you, the way others have helped me, discover the PA profession and pursue a career that I love.