Career Options
Improvements in health careOne of the central pieces of the McGuinty government's plan to improve health care in the province is the introduction of four new medical specialties. DAVID CHILTON |
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 [ 2006-05-31 ] |
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The four -- nurse endoscopist, surgical first assistant, clinical specialist radiation therapist and physician assistant -- would work collaboratively or under the direction of a physician.
When Minister of Health and Long Term Care George Smitherman made the announcement in mid-May about the four new positions as part of a much broader health-care strategy, no timelines were given for the rollout of these latest professional jobs.
However, Dr. Joshua Tepper, Ontario's assistant deputy minister, health human resources strategy, says there are already two surgical first assistants working in Sault Ste. Marie. These SFAs had already been trained in a pilot project, Tepper says, and were thus ready to start. According to the Ministry of Health, an SFA works in collaboration with surgeons and operating room teams.
NURSE ENDOSCOPISTS
As for the other specialties, Tepper says they will come on stream at different times since colleges and universities will need to expand or create programs to train individuals who want a career in one of the new positions. Some nurse endoscopists will graduate this summer, Tepper says. Trained nurse endoscopists will be allowed to perform flexible sigmoidoscopies for colorectal cancer screening.
Physician assistant pilots begin next fall. There is no word on clinical specialist radiation therapists. They work with specialist nurses and physicians on cancer treatment programs.
Dr. David Bach, president of the Ontario Medical Association, says doctors weren't consulted about the four medical specialties, and the OMA has heard very few details about the program, although he expects to have a meeting with Smitherman in the next few weeks.
Despite being kept in the dark about the initiative, Bach says, "these (professionals) can play a very important role." The OMA supports innovation, he continues, but is naturally concerned about patient care, qualifications and training.
Some might expect applicants for the new positions to come from the registered nursing ranks, although Tepper says that's not entirely the case.
"We hope to tap into the pool of international medical graduates," Tepper says. "I've talked to some of them and there's a lot of excitement about the programs."
Other potential practitioners would be nurses, paramedics and science graduates who head straight for training in one of the specialties, Tepper explains.
Another place to look for physician assistants -- trained and experienced physician assistants -- would be the Canadian Armed Forces. There are well over 100 of them working alongside doctors in military operations and on peacekeeping missions around the world. All PAs are trained to take medical histories, perform physical exams, order lab tests or x-rays and make basic diagnoses. These skills resemble those of nurse practitioners, a growing part of the health-care systems in Ontario and elsewhere.
PHYSICIAN ASSISTANT
Physician assistants have been in the Canadian army for "decades," says Tepper, adding that a PA's skills are used extensively in many jurisdictions, including the U.S. When Ontario's physician assistant program is working it will be at least the third province to have one. Manitoba's is sufficiently advanced that government in Winnipeg requires them to be provincially regulated, and last year a group of physician assistants were trained at Montreal General Hospital.
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