Physician Assistants in Canada


  • Leslie St. Jacques
  • Sahand Ensafi
  • Maitry Patel
  • Richard Tsang


Canada, Physician Assistants


Physician Assistants began working in the Canadian Armed Forces over 50 years ago and were initially called “medical assistants”. The name changed to physician assistants (PAs) in 1991 (1).

PAs work in team settings, with an individualized scope of medical practice similar to their supervising physicians. PAs are flexible and nimble in the work assigned based on clinical need, patient volumes, wait times and gaps in the clinical care process. PAs may work shifts and participate in on-call activities. Specialized roles are adopted by PAs who have had the requisite training andexperience as determined by the supervising physician. This includes performing procedures and assisting in the operating room.

PAs work under the supervision of physicians and can have multiple supervisors. Supervisors in academic hospitals may delegate some aspects of the supervisory role to physicians in post-graduate training programs such as residents and fellows. Experienced PAs can achieve a high level of autonomy but are not independent practitioners. Legislation governing the medical acts civilian PAs perform is determined at the provincial level and may involve the use of a scope of practice document or medical directives.

Author Biographies

Leslie St. Jacques

Leslie St. Jacques is the President of CAPA and is the discipline Co-lead for PAs at UHN. She is the PA Education Stream Lead for the province of Ontario’s COVID Care Learning Education Task Force. Leslie holds a Graduate Diploma in Clinical Epidemiology from McMaster University and her research interests include evidence-based medicine and knowledge translation in acute and critical care, psychosocial oncology and pituitary tumours.  She has been active in policy development enabling PA practice.   Leslie works in peri-operative neurosurgery for the oncology team at the Krembil Brain Institute.  She is also a registered social worker (MSW) and holds a Master’s in Environmental Studies in Planning.

Sahand Ensafi

Sahand Ensafi has been an Emergency Medicine PA at UHN in Toronto, Ontario, Canada since 2013. He has taken part in numerous quality improvement initiatives within the Department of Emergency Medicine at UHN and continues to pursue opportunities in health policy and leadership. Outside of his clinical duties, Sahand is actively involved in PA Education as an Assistant Clinical Professor at the McMaster University PA Program and a Course Facilitator at the University of Toronto PA Program. He is also the Ontario Director of CAPA and the Vice-President of the Ontario Physician Assistant Association. Sahand has focused on PA integration initiatives in Canada over the last 6 years and was recognized as the CAPA “Physician Assistant of the Year” in 2019 for his strong clinical work as well as his efforts in PA leadership and advocacy. 

Maitry Patel

Maitry Patel is a Radiation Oncology Physician Assistant at UHN, working in multiple disease sites within
oncology clinics since her graduation from the McMaster Physician Assistant Education Program in 2014, while being actively involved in the PA community. She is an Instructor within the Department of Family Medicine at McMaster University. Since 2019, she has served as the Alternate Director of the Ontario Chapter on the CAPA Board of Directors. She is active in multiple capacities within the Association of PAs in Oncology. Maitry has been the recipient of CAPA honor roll for her work in progressing the PA profession nationally, Excellence in Patient Experience, and Excellence in teaching support awards. Maitry has a special interest in developing easily accessible patient education material and advocating for equal delivery of care across the board. Maitry is now pursuing an Global Executive MBA at the
Rotman School of Management at the University of Toronto with a focus on Healthcare and the Life Sciences.

Richard Tsang

Richard W. Tsang, MD, is a Staff Radiation Oncologist at the Princess Margaret Cancer Centre, at UHN. He is also Professor at the Department of Radiation Oncology, University of Toronto.  He has been active staff at Princess Margaret Cancer Centre since 1990.  His clinical and research interests are in hematological malignancies, thyroid cancer, and precision radiation therapy. His administrative roles in the Department of Radiation Oncology have included: Clinical Programs Director, and Lymphoma site group leader. He is a Steering Committee member for the International Lymphoma Radiation Oncology Group (ILROG). He is also co-Lead for Physician Assistants at UHN.  His education includes an M.D. from the University of Ottawa, Residency in Internal Medicine and in Radiation Oncology, University of Toronto, FRCP(C) and a Research fellowship at Gray Laboratory, Cancer Research Campaign in London, England.




How to Cite

St. Jacques, L., Ensafi, S., Patel, M., & Tsang, R. (2021). Physician Assistants in Canada. Social Innovations Journal, 8. Retrieved from