Expanding the reach and care of physicians: celebrating Physician Assistants

Every year, November 27 is National Physician Assistant (PA) Day in Canada. At the University of Toronto Department of Family & Community Medicine (DFCM), we’re celebrating the immense value PAs bring to the healthcare system.

The role of a PA has become increasingly more important in the primary care space. Coined as ‘physician extenders,’ PAs are being recognized across the country with three new PA programs being offered in Saskatchewan, Nova Scotia and Alberta. With the provinces of Ontario and Manitoba having delivered PA programs since 2010 and 2008 respectively, it is encouraging to see this new growth in the profession throughout Canada. More and more students are now graduating each year. U of T’s PA Program alone has nearly doubled its enrolment over the past year, going from 30 Year 1 students in 2023 to 59 Year 1 students in 2024.

Britton Sprules is a graduate of 2011, the very first PA Program cohort at U of T. “When I learned [about] the PA Program and that I could spend a large portion of my education at home, in Thunder Bay, I knew this was the right fit for me,” says Sprules.

An integral part of U of T’s PA Program is to bring in students from northern and rural areas so that they can find future work in these regions as physician assistants. With the majority of the program being online, students can participate from anywhere in the province. After graduating, Sprules quickly found work in her hometown of Thunder Bay as a PA in primary care and continues to work in the area to this day. She is a shining example of the program’s mandate and a strong advocate for PAs in northern Ontario.

Sprules later joined the Consortium of PA education program (PA Program) as the Clinical Course Director in 2017. This program, which results in a BScPA degree from U of T, is delivered in collaboration with NOSM University (NOSM U) and The Michener Institute of Education at UHN, and offers students a balance in academic and clinical orientation, extensive access to health care relevant resources, and a curriculum delivery model that maximizes rural training and geographic accessibility throughout Ontario.

As seen in her work with the PA Program, Sprules continues to educate and inspire the new generation of PAs while celebrating how much the profession has grown since she started.

“We need more PAs everywhere, especially in northern and remote communities. While we've made huge strides in the past 10 years, I hope the profession continues to grow its success like our American neighbours,” says Sprules.

While PAs have gained significant traction and regulation in states across the US, Canada is catching up. Regulation of the PA profession in Ontario is expected to occur in spring 2025 with the profession already regulated in Manitoba, New Brunswick, Nova Scotia, Alberta, Saskatchewan and British Columbia.

“As doctors have learned more about PAs and what they can bring to medicine, interest in hiring a PA has increased,” says Jeff Straw, Clinical Skills Course Director for the PA Program. Straw moved to Canada from the US in hopes to shift his role in specialty neurosurgery practice.

“I was excited to be one of the trailblazers for the PA profession, but when I arrived [in Ontario], I discovered just how new the concept was. It wasn’t always easy being the ‘new kid in town,’ but I had a group of supportive physicians at my emergency department,” says Straw, who works at Mt. Sinai as a PA in emergency medicine.

Straw, who was the recipient of the CAPA Educator of the Year Award in 2023, works closely with the PA students as they grow and learn during the intensive two-year program.

"As a Course Director, I see them in the early weeks of their training, when everything is new and the road ahead seems daunting. Then I see them at the end of the first-year, and I witness how much they've learned in such a short period of time."

As more people see the impact that PAs can have in primary care, demand continues to grow.

With the support of the Canadian Association of Physician Assistants and Team Primary Care, PAs who have experience in specialty areas such as geriatrics, addiction medicine, refugee health and Northern and rural health took a lead role in educating and training other PAs as Course Directors at U of T. “This level of PA leadership is definitely a sign of growth of our profession,” says Straw.

Join us in celebrating PAs across Ontario and Canada this PA Day! Find more information about PAs on the Canadian PA site. To learn how to apply for U of T’s program, visit the PA Consortium site.