Starting Tuesday, April 1, 2025, Physician Assistants (PAs) will become regulated health professionals.

PAs must register with the College of Physicians and Surgeons of Ontario (CPSO) to practice as a PA and use the title “Physician Assistant.” As of Monday, Jan. 6, 2025, PAs can begin registering with CPSO. 

To learn more, read our FAQs below. 

Frequently Asked Questions – Physician Assistants (PAs)

A PA’s scope of practice depends on the authority provided by their supervising physician through delegation, medical directives or direct orders. It will reflect their supervising physician's scope of practice and is determined by the PA’s knowledge, skill and judgment. This means that each PA’s scope of practice will vary according to a number of factors, including the individual’s education, training and experience.

No. PAs may only prescribe medication through delegation and where a medical directive is in place, or if they have received a direct order from a physician.

No. The regulation will not change to how PAs currently practice. Their scope of practice and professional relationship to physicians and other health care professionals will remain the same. The difference is that PAs will be designated as a regulated health profession, which adds value in public protection through standardized education, quality assurance and professional conduct expectations.

There is no direct impact on nurses as a result of this change. PAs will be regulated health care providers accountable to CPSO. The PA’s scope of practice remains unchanged.

No. However, if there is a medical directive, PAs can communicate orders from physicians to nurses. In this case, the medical directive must also authorize nurses to perform procedures or treatments. Nurses are not directly accepting the order from the PA but are carrying out the physician’s order under the medical directive.

As always, nurses must ensure orders are clear, complete and appropriate as outlined in CNO standards and organizational policies relevant to the practice setting.

No. A PA cannot delegate a controlled act that has been delegated to them. This is called sub-delegation, which is prohibited under the Regulated Health Professions Act, 1991.

As per the Medicine Act, 1991, PAs can only perform controlled acts if they are delegated by a physician. Therefore, they cannot accept orders for controlled acts from an NP. However, PAs can accept orders from NPs for other activities outside of controlled acts provided they have the knowledge, skill and judgment to do so as determined by the employer. For example, a PA may administer an oral medication ordered by an NP.

No. Under the Medicine Act, 1991, PAs can only perform controlled acts if they are delegated to them by a physician through a direct order or medical directive.

The CPSO will begin regulating PAs on Tuesday, April 1, 2025. 

After April 1, 2025, any concerns about the professional behaviour or conduct of a PA is reportable to CPSO.

 

Nurses who may have practice-related questions can complete a Practice Support form. One of our Advanced Practice Consultants will respond.