Regulation - LGIC

College of Physicians and Surgeons of Ontario is proposing amendments to regulations made under the Medicine Act, 1991, to regulate Physician Assistants.

Regulation Number(s):
• O. Reg. 865/93 (Registration)
• O. Reg. 114/94 (General)
• O. Reg. 856/93 (Professional Misconduct)
Instrument Type:
Regulation - LGIC
Bill or Act:
Medicine Act, 1991
Summary of Proposal:
In Ontario, the regulation of health professions is based on a self-governance model. There are 26 health regulatory colleges governing 28 health professions under the Regulated Health Professions Act, 1991, (RHPA) and their respective health profession Acts. Under this framework, colleges have the authority to make regulations on a variety of subject matters, including standards and qualifications for certificates of registration.

In June 2021, the provincial government passed Bill 283, Advancing Oversight and Planning in Ontario's Health System Act, 2021. Schedule 3 amended the Medicine Act, 1991 to regulate PAs with the College of Physicians and Surgeons of Ontario (CPSO). In order to bring PAs under CPSO's oversight, amendments to three regulations are being proposed to create the necessary framework to enable PAs to register with CPSO.

O. Reg. 865/93 (Registration)
The proposed changes to O. Reg 865/93 would set the following requirements for registration for PAs:

1. The applicant must have a minimum of a baccalaureate degree evidencing the successful completion of a program designed to educate and train persons to be practising physician assistants which was:
a. accredited by the Canadian Medical Association or Accreditation Canada at the time the applicant graduated;
b. accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) at the time the applicant graduated;
c. another accrediting body as approved by Council; or
d. another program as approved by Council; and

2. The applicant must hold certification as a physician assistant as follows:
a. Canadian Certified Physician Assistant (CCPA) certification by the Physician Assistant Certification Council of Canada (PACCC);
b. Physician Assistant-Certified (PA-C) by the National Commission on Certification of Physician Assistants (US); or
c. another certification as approved by Council.

In addition, the CPSO is proposing a 24-month transition period for two educational programs authorizing practice as a physician assistant where:

1. the applicant successfully completed the Canadian Armed Forces Health Training Centre Physician Assistant Program or the Ontario Physician Assistant Integration Program by the Centre for the Evaluation of Health Professionals Educated Abroad; and
2. the applicant is able to satisfy the Registrar or a panel of the Registration Committee that the applicant engaged in practice in Canada within the scope of a physician assistant during the two-year period that immediately preceded the date that the applicant submitted their application.

All applicants, including those during the 24-month transitional period, will also be required to complete the College's Jurisprudence and Ethics Module and provide evidence of the following: French or English fluency, standing in any other jurisdiction or profession in which they were/are regulated, and good character, including a criminal record check.

O. Reg 114/94 (General)
There are two proposed changes to O. Reg 114/94. The first change enables PA members to perform controlled acts under delegation from physician members of the CPSO. The second amendment implements a Quality Assurance program for PAs that is based on the model currently in place for physicians.

O. Reg. 856/93 (Professional Misconduct)
There will also be minor housekeeping amendments to O. Reg. 856/93 to reflect the inclusion of PAs as members of the CPSO.
Analysis of Regulatory Impact:
The regulation of PAs may result in some costs for individuals seeking to register with the CPSO, including application and membership fees and professional liability insurance premiums.
Further Information:
Proposal Number:
Posting Date:
June 26, 2023
Comments Due Date:
August 11, 2023
Contact Address:
Health Workforce Regulatory Oversight Branch
438 University Ave, 10th floor
Toronto, ON M7A 1N3