First cohort of PA students in clinical rotations

Eight students from the first cohort of the University of Toronto’s physician assistant program began a 20-week series of clinical rotations in Sudbury and Thunder Bay in January.

Launched in partnership with the Northern Ontario School of Medicine (NOSM) and the Michener Institute, the two-year program is open to candidates with a minimum of two years of university with courses in anatomy, chemistry and physiology, and at least one year of professional health-care experience. The program is approved for 20 students, but enrollment has fallen short of the target for the first two intakes, said John Shea, clinical co-ordinator with NOSM and a physician assistant himself.

There are 18 students in the first cohort currently doing clinical rotations and 14 who were accepted into the first year of the program in January.

Students come from a variety of health-care backgrounds, including kinesiology, nursing and massage therapy. There are also diagnostic imaging technicians, one chiropractor and one paramedic, said Shea.
The Northern Ontario School of Medicine would like to see more Northern Ontario candidates apply for the physician assistant program and ultimately serve as PAs in the North.

The first year of the program follows a distant learning model with four month-long sessions in Toronto spread throughout the year. In the second year, students do 40 weeks of clinical rotations in family medicine, emergency medicine, mental health, pediatrics, surgery and women’s health.

Krista Slavinski, a second-year PA student, recently completed a six-week rotation in family medicine at the Shkagamik-Kwe Health Centre in Sudbury and is doing rotations in general surgery, emergency medicine and mental health at Sudbury Regional Hospital before heading south to Toronto for 20 more weeks of clinical rotations.

Slavinski, who has a Bachelor of Science degree and a diploma from the West Coast College of Massage Therapy, worked as a registered massage therapist for eight years.

Most massage therapists burn out after seven years because the profession is so physically demanding, said Slavinski.

“Even though I enjoyed my career and got a lot of satisfaction out of it, I knew it wasn’t something I was going to do forever, so I had my eyes open for other opportunities, and when I heard about the PA program, it seemed like a really good fit for me.”

Slavinski enjoyed the six weeks she spent working with preceptor Dr. Tim Zmijowskyj at the Shkagamik-Kwe Health Centre.

“I learned a tremendous amount working at Shkagamik-Kwe and everyone there was fantastic. One of the many good things about it is that it’s multi-disciplinary. There are elders, pediatricians, family doctors, chiropractors and even a massage therapist, so I was able to get a lot of experience.”

Opportunity

The introduction of physician assistants to Ontario “is a valuable opportunity for us to expand the number of practitioners in the province,” particularly in underserviced regions like Northern Ontario, said Zmijowskyj.

“If all of the PA students are like Krista, it will be very positive, not only for primary care, but for the entire health-care system,” he said. “Her enthusiasm and motivation were unparalleled.”

Physician assistants, he explained, are not regulated health-care professionals and don’t have a defined scope of practice. Instead, they work under the auspices of a physician, taking patient histories, performing physical examinations, ordering diagnostic tests, interpreting results and formulating treatment plans. They can also give injections, suture, perform casting and administer pap tests.

Their prior health-care training and experience comes in handy, said Zmijowskyj.

“A lot of the PA students have a prior health-care background and that goes a long way. In Krista’s case, she was a massage therapist and the massage therapy training she did in B.C. was quite in-depth and extensive, so she was able to transfer some of those skills into the primary care environment.”

Zmijowskyj looks forward to working with another PA student in the fall and says the experience will help define a role for physician assistants joining the Shkagamik-Kwe Health Centre team.

Preceptors wanted

Shea, who served as a physician assistant with the Canadian Armed Forces in Cyprus, Afghanistan, and around the world on submarines, and now recruits preceptors and co-ordinates clinical rotations in Northern Ontario for NOSM, invites other primary care physicians and family health-care teams interested in serving as preceptors to contact him.

Physician assistants are currently being paid through a demonstration project of the Ministry of Health and Long-Term Care and start out with a salary of $75,000 plus benefits.

The deadline for candidates applying to join the program in January 2012 is April 1.

www.facmed.utoronto.ca/programs/healthscience