The History of the Physician Assistant

The Physician Assistant (PA) profession evolved in the United States during the mid-1960s, in response to a shortage and uneven geographical distribution of doctors working in primary care. The first trainees were highly skilled military medics who, following Vietnam War service, had no equivalent medical role in civilian life. These days, PAs continue to be a safe and effective part of the U.S. health system with almost 84,000 practicing PAs and 156 accredited programs.

Mid-level clinicians have been employed by the Canadian Forces (CF) for over 50 years and in 1984 the first class of “Physician Assistants” graduated from the Canadian Forces Medical Services School at Borden, Ontario. They are generally acknowledged as the first formally trained PAs in Canada.

In 1997 Warrant Officer Thomas Ashman, stationed at Canadian Forces Station Alert as a PA, conceived the idea of a National Academy of Canadian PAs. In October 1999 the Canadian Academy of Physician Assistants (now the Canadian Association of Physician Assistants- CAPA) was formed; Thomas Ashman was elected founding president. CAPA’s goal was to be a national professional organization that advocated for Physician Assistants and represented its membership across Canada (By PAs for PAs).

In 1999, the Canadian Forces funded the development of CAPA with the intent that it would become self-sufficient and expand to include a civilian component. In September 2001 CAPA, with assistance from the Canadian Forces Medical Services School, developed the Occupational Competency Profile for the Civilian PA in Canada; this OCP was adopted by the Canadian Forces. The first Physician Assistant Entry to Practice Certification Examination (PA Cert Exam) was conducted in 2005, confirming a national standard of quality and professionalism for PAs trained and certified in Canada. September 2009 sees the release of an updated National Competency Profile and Scope of Practice for Canadian physician assistants.

In September 2002, the Canadian Forces inaugurated a redesigned PA program to align with requirements for accreditation by the Canadian Medical Association (CMA). In 2008 the first two civilian PA education programs are launched at the University of Manitoba and McMaster University. The PA Consortium (University of Toronto, Northern Ontario School of Medicine, and the Michener Institute of Applied Sciences) launched a third civilian program in January 2010.

In June 2003, the CMA recognized the PA as a health professional. This paved the way for an accreditation process to begin; in June 2004 the CMA Conjoint Accreditation Services surveyed and accredited the Canadian Forces Health Services School PA education program. Since then, three other programs have been accredited: the University of Manitoba Physician Assistant Education Program, the McMaster University Physician Assistant Education Program and the Consortium of PA Education (University of Toronto, Northern Ontario School of Medicine and The Michener Institute for Applied Health Sciences) Physician Assistant Education Program.

In 1999, Manitoba enacted legislation allowing PAs to function as Clinical Assistants (Canadian Certified). It should be noted however that in 2009 there was an amendment made to allow practice under the title of Physician Assistant. The province currently has numerous PAs practicing in medical and surgical specialties. In May 2006, the Ministry of Health and Long-Term Care for Ontario (MOHLTC) announced the inclusion of PAs in Ontario’s provincial health care system. The first PAs began work the following January as part of the first phase of a demonstration project evaluating the impact of PAs in the Ontario health care system. The province of New Brunswick followed suit in 2009 when the College of Physicians and Surgeons of New Brunswick announced that licensing for PAs would now be provided under the Medical Act. In January 2010, Regulation 14 was created in order to dictate the terms of practice for PAs in the province. Most recently, on December 3, 2010, the Council of the College of Physicians and Surgeons of Alberta passed a bylaw allowing PAs to register as non-members. However, PAs are not regulated by the College.

For information about the history of the PA profession, visit the PA History Center Web page. For a list of historical events related to the Canadian PA profession, read this document.