Government still required to approve and enact regulations

The Board has approved regulatory changes that bring CPSO one step closer to regulating physician assistants (PAs).

While legislation has been passed to initiate the regulation of PAs, much of the necessary work to complete this process relied on the development of regulations by CPSO under the Medicine Act, 1991.

CPSO worked closely with various stakeholders, including the Canadian Association of Physician Assistants, to develop the draft regulations. In so doing, CPSO aimed to set high-level expectations aligned with the principles of right-touch regulation, while being mindful of the need to adequately prepare for future changes.

In June 2023, the Board approved the release of draft amendments for a 60-day public consultation period, which ended in August. Following the consultation, minor revisions were made to the regulations. The draft regulations can be found online in CPSO's Board materials.

Revisions to Regulations following Consultation

• Enabling Mechanism

One of the regulatory amendments articulates when and how PAs can perform controlled acts, in keeping with the current practice of delegation. The draft regulation required physicians to be satisfied, “after taking reasonable steps”, that the PA has the knowledge, skill, and judgment to perform the authorized act safely and competently.

The words “after taking reasonable steps” were removed after consultation feedback suggested that physicians are not always responsible for decisions about hiring.

• Registration (O. Reg. 865/93)

Minor revisions were made to the draft Registration regulation to align the Emergency Circumstances Practice Class for PAs with that of physicians, and to enhance consistency and clarity.

• Quality Assurance (O. Reg. 114/94, General, Part VII) and Professional Misconduct (O. Reg. 856/93) Regulations

No revisions were made to these draft regulations.

These regulatory amendments are CPSO’s to recommend, but the government must ultimately approve and enact the changes before they can take effect, which is anticipated to be in 2024. Once in effect, Ontario will join a number of other provinces in bringing PAs under the regulation of the provincial medical regulator.

In a separate decision, the Board approved an application fee of $300 and a renewal fee of $425 for PA registration.