Where the Canadian physician assistants are in 2012

Abstract

Canada's physician assistant (PA) profession remains relatively unknown to the majority of Canadians, and the distribution of the approximately 300 Canadian PAs is uncertain. This report presents March 2012 findings from the 2011 Canadian PA survey, including the number of PAs employed and where they work.

Although Canada's PA profession is growing, it remains unknown to the majority of Canadians, and its distribution across Canada is uncertain. Not every member of the profession is a member of the national professional organization. Furthermore, lack of regulation in some jurisdictions means that not all physician assistants are formally identified as such. The 217 respondents to the electronic survey of 2011¹ represented an estimated 70% of 310 known physician assistants in Canada at that time. We investigated whether the Canadian National PA survey tool used was representative of the number of physician assistants employed in Canada; where those physician assistants were; and what those physician assistants were doing.

METHODS

The methods used to determine actual PA numbers in March 2012 involved using phone calls and e-mails to survey employers and, where available, the regulatory agencies across Canada. In Canada, physician assistants are newly regulated health professionals in the two provinces of Manitoba (since 1999) and New Brunswick (2009), with demonstration projects in Ontario (ongoing since 2007).² Manitoba continues to use clinical assistants in physician extender roles to address the shortage of physician assistants. Alberta currently uses a voluntary registry through their College of Physicians and Surgeons. Physician assistants are found in industries such as the Northern Territories diamond mines, Northern Ontario mines, Alberta oil fields, or working as unregulated PAs for private physicians across Canada.

RESULTS

Between July 2004 and January 2012, there were 248 graduates of Canadian Physician Assistant education programs that used a 2-year curriculum (24-26 months in duration).³ From 1984 to 2004, the Canadian Forces used a series of courses over 15 years that culminated in an intensive 6-month capstone program for PA education. How many total physician assistants have entered from the older Canadian Forces pathway or from United States PA programs into Canadian medical practice is unknown. At present, there is no separate stream for international medical graduates (IMGs) who are directed to university PA education programs to become eligible for certification.

LIMITATIONS

Determining the exact number of PAs in Canada is difficult because the profession is unregulated in several jurisdictions, with no mandatory government licensing record kept or required. Although we can determine the number of graduates of Canadian programs since 2004, the influx of American-educated physician assistants and those Canadian graduates who chose not to belong to professional associations have resulted in an incomplete tracking and lost souls.

CONCLUSIONS

Our findings suggest that as of March 2012, there are 143 Canadian Forces physician assistants and 163 civilian employed physician assistants, for a minimum of 306 working PAs in Canada (with 322 Canadian certified physician assistants). These findings suggest that some 16 to 20 PAs are unemployed, retired, or employed outside the main government agencies. The disparity between certified and employed is related to the Canadian certification and maintenance of certification process, which is a voluntary professional standard and as yet not required for practice outside Alberta and New Brunswick.

The profession is still young in Canada and is establishing solid roots. The number of physician assistants graduating from training programs, combined with the demand for PAs from industry and civilian practice, suggests that the profession will continue to thrive.