Notification of bylaw amendments: physician assistants

On October 25, 2023, the College Bylaws were approved, introducing a framework for licensing and regulating physician assistants to respond to the urgent need to resource emergency departments in the province. The approved Bylaws set out the regulatory requirements for physician assistants (including registration, renewal of licensure, currency of practice, continuing competency, and application and licensing fees) and define how supervising physicians will assign, delegate, and authorize under supervision aspects of practice for physician assistants.

Since the approved Bylaws came into force, concerns have been raised that the current Bylaws do not allow physician assistants to provide the level of support required in a team-based emergency department setting. To address the concerns raised and enable physician assistants to support emergency departments in hospitals as intended, the College Board approved amendments to sections 10-1 and 10-3 of the Bylaws. The proposed amendments continue to require a supervising physician to be personally satisfied regarding the physician assistant’s competency to perform the restricted activity, while enabling the physician assistant to perform restricted and delegated acts with more autonomy in situations where the supervising physician deems appropriate.  

On March 12, 2024, the College posted the above proposed bylaw amendments on its website for a six-week period giving registrants and other interested parties the opportunity to review and comment. The feedback received during the consultation period was reviewed and considered, leading to further proposed changes and clarification summarized below.

  1. Section 10-1 — Definitions

    The proposed amendments clarify the circumstances where physician assistants would be able to initiate assessment and treatment of patients.

    The proposed amendments remove the requirement that physician assistants must perform the restricted activity as competently and safely as the delegating physician given that physician assistants will not have the same training and experience as a trained emergency physician.

    The proposed amendments clarify the process around obtaining patient consent and require physician assistants to identify themselves and their role when providing care.

  2. Section 10-3 — Delegation to physician assistants

    The proposed amendments provide clarity in two restricted activities that may be delegated to physician assistants. Physician assistants who are authorized (by delegation) to prescribe and administer a drug may do this by way of subcutaneous and intramuscular injection. Physician assistants who are authorized (by delegation) to perform insertion and maintenance of airways not requiring visualization of the larynx, may perform this activity when the use of advanced airway devices is not required.

    The proposed amendments include the addition of a restricted activity that may be delegated to physician assistants, specifically, wound preparation, wound cleansing, and suturing of simple wounds.

  3. Section 10-4 — Authorization to physician assistants to perform activities under direct supervision

    The proposed amendments include the addition of two restricted activities that a delegating or supervising physician may authorize physician assistants to perform under direct supervision, specifically, performing insertion of intraosseous device and performing needle decompression of suspected tension pneumothorax.

The revised proposed bylaw amendments will be posted for a two-week period, providing College registrants and other interested parties the opportunity to review and comment.

For more information, please see the bylaw amendments page.