Career Insights with Anne Dang: Become a Physician Assistant (PA) in Canada

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So, if you are already subscribed, you must have gotten the insider scope about the new Career Insights series. Well, in this series, you will be getting loads of career and professional insights from industry experts, it is definitely going to be very informative.

You will get first hand advice on how to pursue your dream career, the steps to follow, academic requirements, advice for both foreigners and locals and much more.

This first feature is for two sets of people:

  1. If you're interested in pursuing a fulfilling career in an alternative medical field path other than the common routes and
  2. If  you are or planning to become a resident/citizen of Canada.

If this is applies to you, lets get started with Anne Dang of Canadianpa.ca

Get to know Anne Dang

Hi! I’m Anne, a Canadian Certified Physician Assistant currently working in the Orthopaedic Surgery Practice. I’ve been practicing for 6 years, and I write about the Physician Assistant (PA) profession on my blog, the Canadian PA .

I enjoy advising PA students through the McMaster PA Student Advisor Program, working as a clinical preceptor for Canadian PA students who are completing 2nd year rotations in Orthopaedic Surgery. I volunteer a lot of my time working on PA Advocacy for the Canadian Association of Physician Assistants (CAPA), coaching PA students.

I’ve been involved in graphic and web design since the age of 12, through self-teaching. Although my parents really encouraged me to pursue a career in health care, I have always found a way to stay involved in the world of web and graphic design. I’ve found a way to combine my love for tech, social media and medicine into a way that helps others interested in pursuing the PA profession.

Outside of work I enjoy crafting, graphic and web design, volunteering and outdoor activities.

"I am personally very impressed with what she has done in the Physician Assistant field, her selfless contributions, advocacy and mentorships. You can find out more about Anne here .

Just like me, there are a lot of people who are not very aware about the Physician Assistant medical route in Canada."

 

Anne shares why most people are not aware of Physician Assistants in Canada

Physician Assistants in the civilian setting was only recently introduced into Canada and Ontario. They have a longer history in the Canadian military, and have been around a few decades in Canada. I think the fact that the profession is still being pioneered is a factor.

Another factor is that, there are currently 600 PAs across Canada, with 300+ being concentrated in Ontario, whereas, there are 82,000+ physicians in Canada in family medicine and medical specialties. Source . Also, there are are 298,743 nurses in Canada in 2016 according to the Canadian Nurses Association.  Source

Groups like physicians and nurses are more well known because of how long they have been around, the large numbers that are working and practicing in Canada. Newer less common roles such as Nurse Practitioner and Physician Assistants are not as common and therefore not as well known.

Anne teaching hand anatomy during an injection workshop Ottawa, ON for the Canadian PA conference.

"As the name suggests, a lot of people may be tempted to think all PAs do is assist Physicians and most likely do the same thing as Nurses. Well, that is not the case."

The similarities and difference between  related medical careers

Physician Assistants (PA) are more similar to physicians (MDs) and Nurse Practitioners (NPs) than they are to nurses. Patients may see a PA or NP instead of the physician for their primary care or specialty care needs.

PAs, NPs and MDs take histories and perform physical exams, order and interpret investigations (like x-rays labs, etc.), they diagnose, and perform an assessment plan. They also prescribe and set the treatment plan.

PAs do a lot of the same tasks as physicians do (as mentioned before - history taking, physical exam, diagnosis and treatment  - but may autonomously in collaboration with physicians. PAs and MDs are also both educated in the medical model.

Registered Nurse also do some assessment and planning, and helping carry out treat plans set by the physician. They work to monitor symptoms, collect vital signs, do general assessments and exams, and prepare patients for exams and treatments. Nurses also do their own assessments and nursing treatment plans based on the nursing model.

It is important to note that Physician Assistants are NOT medical assistants, medical secretaries / administrative assistants, personal support care workers, or a “doctor” in training.

Excerpt from my post on What a PA is not :

PAs are trained under the medical model, nurses are trained in the nursing model. Nurses may choose to pursue PA school or Nurse Practitioner (NP) school. There are some of my PA colleagues who were registered nurses before becoming Physician Assistants.

Read The Differences between Nurse Practitioners and Physician Assistants .

PAs do not compete for nursing jobs, as PAs do not do the same clinical duties as nurses. PA scope of practice is very similar to Nurse Practitioners more than it is to Registered Nurses. In the United States, there are some practices that advertise for a PA or NP for the same position.

Nursing duties can be divided into four major categories:

  1. Assess patients’ physical, mental and emotional health status. This includes taking history & performing basic physical exams and ensuring appropriate medical documentation throughout the patient’s stay.
  2. Carrying out physician orders for ordering investigations and initiating a treatment plan. This can mean administering medications, wound care, starting an IV, and injections.
  3. Monitoring results of treatment and alerting the physician of any untoward outcomes.
  4. Patient and family education, counselling on treatment plan and preventative health. (Source)

Physician Assistants (PAs) and Nurse Practitioners (NPs) would perform detailed patient assessments (histories and physicals) and initiate orders as an extension of the physician.

Nursing staff may often consult with PAs and NPs for the supervising physician’s patient (as they would consult with residents, fellows or clinical clerks).

These advanced practice providers (APPs – the PAs and NPs) have medical directives and/or a document signed off by authorizing officials (e.g. hospital or department staff, supervising physician, department lead) which outline the APP’s scope of practice.

PAs are trained as generalists, which means they can enter any specialty of medicine - whether it is Family Medicine, Emergency, Hospital (internal medicine, etc.), or in specialties like Orthopaedic Surgery, Plastic Surgery, Rheumatology, Urology, Dermatology, Physical Medicine & Rehabilitation, Psychiatry, Neurosurgery, Neurology, Oncology, etc.

"She has a whole lot to share on this, make sure to check her website for more details, I am personally impressed with the amount of useful information she provides and the amount of work she has done to promote the PA profession. Canadianpa.ca is a wealth of knowledge."

Physician Assistant infographic

 

"If you are interested in a typical practical path to becoming a PA, Anne shares her educational experience below".

How I became a Canadian Physician Assistant

At the time I was in the Bachelor of Health Sciences Program at McMaster University, almost all of my peers were applying for medicine, with a smaller minority aiming for other health care professions such as Pharmacy, Dentistry, Physiotherapy, etc.

I knew I wanted to practice medicine, but I wasn’t sure if “being a doctor” was the right fit for me. Especially looking at the work-life balance and stress I had seen in physicians that I was working with in my summers as a research assistant on a clinical trial.

I attended career info sessions (e.g. Naturopath), career fairs (visited booths on Chiropractic Colleges), went to the Pre-Med club to listen in on the different medical programs in Canada.

The first time I heard about the PA program was while I was sitting in the BHSc office speaking with my guidance counsellor. She had mentioned a graduate from the program was a 1st year student in the PA program - the more I looked into the Physician Assistant profession, the more the career resonated with me. Once I sat down and spoke with the 1st year PA student, and attended the info session I knew this was my first choice after completing my 4 year degree.

I applied to McMaster’s PA Program during my 4th year of university. I completed the supplemental application, attended the Multi-Mini interview and started the program in September 2009. At this time Manitoba already had its PA program starting, and University of Toronto would accept their first class in January 2010 (back when PA Consortium had a January start, now it is a September start).

I wrote a post about the Canadian PA school admission requirements . However to summarize it here, the PA route depends on which school you are applying to. McMaster, for instance requires minimum 2 years of university completed, GPA of 3.0 and supplementary application to be completed before an invitation of the MMI.

PA Consortium, which is a combination of University of Toronto, Northern Ontario School of Medicine and Michener Institute requires a minimum GPA of 2.7 (at time of writing, November 2017), full  hours of health care experience (which can be paid, clinical placement, or volunteer - refer to their website paconsortium.ca for the most accurate up-to-date information) with some recommended course work to be completed, in addition to letters of reference.

University of Manitoba offers a Master’s PA program, requiring candidates to finish 4 year Bachelor’s degree or higher (no later than May 30th) of the year you hope to enter the MPAS program, police check, letters of reference,  achieve a 3.0/4.5 GPA scale in most recent 60-credit hours, and complete University of Manitoba Faculty of Graduate Studies application. They also have criteria for “competitive” applicants, achieving a GPA of 3.5 or above, completed courses in Biochemistry, Human Anatomy and Physiology with minimum grade B.

Note: Some of admission requirements may change or evolve over time.

"Find out more about a typical day of a PA on canadianpa.ca, a lot of experts share their experiences.

You may want to get information on career development and growth as a PA in Canada, keep reading".

Required certifications and trainings for PAs

Multiple and endless certifications, masters, Phd. are not necessary. Although in some areas of medicine (for example, Emergency Medicine), candidates may benefit from having a recent ACLS certification, CPR certification - health care provider level.

The University of Manitoba offers a Master’s Degree in PA Studies. The two Ontario Programs - University of Toronto and McMaster University offer Bachelor’s Degree. Whether you have a Master’s of PA studies or Bachelor’s does not matter when it comes to PA employment.

The only factor affecting potential employment is obtaining your PA Certification. Canadian PA graduates and American pAs looking to practice in Canada must register through the Canadian Association of Physician Assistants to write the certification exam. Once you pass, you are considered a “Canadian Certified Physician Assistant (CCPA)” . In order to maintain this designation, you need to complete a certain number of continuing medical education (CME) hours per 5 year cycle.

"A number of foreigners or people looking to move to Canada may be considering a career in the medical field or/and specifically as a physician Assistant. Anne has some advice for you".

You may want to get information on career development and growth as a PA in Canada, keep reading".

Foreigners and immigrants who would love to practise as Canadian Physician Assistant

For all Canadian PA programs you need to be a Canadian citizen or obtain permanent resident status. Before you apply ensure you meet the minimum English language requirements (i.e. a certain score on TOEFL exam).

Once this is accomplished, you may now start looking at Canadian PA school admissions. Realize that PA role is NOT a bridging program to practice as a physician in Canada. You can look into other roles such as Clinical Assistant program in Manitoba, other bridging MD programs offered to International Medical Graduates (IMGs) in provinces and areas that are underserved. I’ve written about options for IMGs on Canadianpa.ca

As a PA you are not an independent practitioner. PAs work in collaboration with a supervising physician. Therefore you can only perform delegated duties that fall within the scope of your supervising physician.

For example, if you learned a previous skill where you were performing a paracentesis as an IMG, but you know work as a Canadian PA in a family practice. If your supervising physician does not perform paracentesis, you cannot perform that paracentesis in that setting as a result.

Physician assisant
Being a PA includes History taking, Physical Examinations, Investigations, Diagnosing, Treating, prescribing, and performing procedures. A large part is also patient education, which PAs play a large role in. In my role in the Orthopaedic Surgery Practice I educate patients about their conditions, what to expect before and after surgery, about treatment options (operative vs. non-operative) and about their medications. I counsel patients on positive lifestyle changes, smoking cessation and the impact on healing post-operatively

"Why then should you pursue a career as a Physician Assistant?"

Here are a few reasons Anne loves her profession and why it's totally worth it

  • Less than a decade in school before practicing medicine - I enjoy the PA role because the duration of the program was 24 months and I was “done”. I could start working as staff after 2 years.
  • Lateral Flexibility - I loved the lateral flexibility as well. Should I decide not to work in Orthopaedic Surgery anymore, I can make the switch to Emergency, Family, Dermatology etc. without having to go back to school. At present this is not possible with physicians unless you go back to residency or complete special fellowships as an extension of your family practice degree.
  • Work-Life Balance -  I like the work life balance as well. Although 2nd year PA school was very rigorous with shift work and , once I started working I had regular hours. I have time for activities outside of work.

"There is a lot more information on renumeration, medical field comparisons, typical day in the lives of PAs  and so much more on  canadianpa.ca "

  • Finally, we stop here with Anne Dang of canadianpa.ca , I am sure if this is your career of interest you have learnt a lot and also visited her site already. 

    I hope you enjoyed this and gained a lot of information, do subscribe to get notifications of more posts like this, I will be sharing on a wide range of careers, most especially in Canada but hopefully other parts of the world as well.

    Please leave your comments, thoughts and questions. Feel free to reach out if you have any further enquiries or career paths you need insight on.

    There's a new career insights post coming up next week, you don't want to miss it!  Can you guess which career we will be sharing on next ? 

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