Dalhousie announced a new program in August 2023 to support the Nova Scotia healthcare system. A Master of Physician Assistant Studies (MPAS) program will be available through Dal’s Faculty of Medicine beginning January 2024. Applications close Sept. 14.
Michael Clory is the Assistant Dean for the MPAS program. He explains the new program will be under the umbrella of the Dalhousie Faculty of Medicine.
“To give a bit of context, physician assistants have been working in the United States since the 60s. They’ve been with the armed forces in Canada since the late 60s,” said Clory. “Until now, there have been three university programs in Canada. Two in Ontario and one and Manitoba. The United States has over 300 master’s level programs to train physician assistants.”
Dal’s MPAS is the first of its kind in Atlantic Canada and fourth in the country. In 2019 three physician assistants were hired by the N.S. Health Authority to support the orthopedic surgery program. This sparked the desire for a local program.
“Historically surgical programs have been heavily supported by residents. These are physicians who graduated med school, but they’re doing further training. Now there are restrictions on how many hours they can work,” said Clory. “That work still needs to be done.”
The work of a physician assistant
“The reason we’re looking for physician assistants is to support the healthcare system, which is struggling to provide access to patients,” said Clory.
To better understand the way a physician assistant works, Clory describes a potential scenario.
“In primary care with a family practice, a physician assistant works almost like in partnership with a family physician. They work under a physician but independently within their scope, with supervision,” said Clory. “If you had an appointment, a physician assistant would probably do sixty to seventy per cent of what the family physician can do.”
To show this process in full form, Clory provides another example.
“If somebody comes in with a cough,” said Clory. “Differential diagnosis might suggest pneumonia or a cold or maybe bronchitis. You listen to the lungs. You may or may not require a chest X-ray. You may or may not prescribe antibiotics.”
Other skills learned by a physician assistant include suturing, casting breaks, inserting catheters and drawing blood.
“The physician assistant can also support the physician by taking a lot of the paperwork strain off of them, like following up on lab work,” said Clory. “The physician is more available to see patients which also provides a better quality practice.”
A closer look at the program
Due process and requirements set out by the Maritime Provinces Higher Education Commission slowed the initial start of the MPAS program.
“The earliest, it could be approved in October,” said Clory. “We’re on pretty tight timelines putting together the program, developing the curriculum and onboarding faculty. Applications are closed next Thursday. Then we’ll have to resort to a selection process to get to 24 candidates.”
The training is similar to the education of Dal medical students. Where traditional medical school is a four year program, MPAS is two.
“The first year is very intensive,” said Clory. “48 weeks with of break for summer or anything. We’re kind of cramming in the key essentials, from the first two years of med school into the one year.”
Clory describes the medical model used in Dal med school as involving a strong clinical science foundation.
MPAS students learn to gather information and patient medical histories. They perform physical exams and use a process called differential diagnosis to decide what further tests or treatment might be needed for a patient.
“The second year is really clinical”, said Clory. “They do clinical rotation across different disciplines in medicine. Family medicine, internal medicine, surgery, obstetrics pediatrics and psychiatry.”
Through the MPAS program, physician assistants receive 2,000 hours of clinical exposure. This is impactful for a province struggling to provide health services to its patients. It decreases the wait for a full medical degree but increases medical proficiency past a nursing or emergency medical services level.
“They’re getting exactly the same exposure as medical students get in their clerkship, but they’re immediately employable with on the job of training,” said Clory.