Anyone who has received an invitation from the CSMLS to attend an ad hoc meeting concerning registration of PAs should think twice before accepting. The CSMLS certifies (‘registers,’ if you prefer) technologists. The loosely-formed committee (of which I am a part) which has been formed within the last few months and has been looking at improving the lot of Canada's PAs, has agreed that eventually, all fully-qualified Canadian PAs will hold an MSc. We do not see the CMSLS being involved in the standardization of credentials or training or certification or regulation of Canadian PAs. If you are invited, my advice to you is that you not attend. Your absence will make the statement for you (and will greatly simplify matters).
Sunday, January 29, 2006
Sunday, January 15, 2006
ASSOCIATE (v.)
I must apologise for the long time between posts. The pace of the work in Kelowna was certainly hectic in November and December. I barely had a chance to come up for air. The volume of work in January seems to be somewhat more manageable…so far. I thought you might like to know just how busy it is here. The 3 sites produce about 45,000 cases annually. Three PAs do all of the gross descriptions for those cases. 7 pathologists sign-out those cases. The Ottawa Hospital produces only slightly more cases per year. Twelve PAs and 28 pathologists work at TOH.
To bring you up to date on life in the Interior of BC from my perspective...we will be interviewing candidates for the PA position in Kelowna within the next 1 ½ weeks. This person will assume the position that I have held since May, 2005. I’ll become the PA Quality Coordinator for the three sites within the Interior (Vernon, Kelowna and Penticton). In that role, I will enjoy interacting with the PAs, the Clinical Director (when we get one), the pathologists and the regional manager to introduce a common manual for surgical pathology and gross description templates.
Other news – there will be a 21-week PA locum in Vernon beginning in July (a maternity leave). Also, we will be looking at hiring a casual PA to fill in during vacations and other leaves of the three PAs. It was very nice that Alan Wolff decided to do a 2-week locum in Vernon during Danielle Lee's vacation in January.
Now to the subject of this post: several PAs across Canada and myself have been corresponding recently; trying to firm-up arrangements with the Canadian Association of Pathologists (CAP) so that Canada’s PAs can form an association (The Canadian Association of Pathologist’s Assistants (CAPA)) as a branch of the CAP. It was very nice of the CAP to offer this to us. It means that we will not have to expend huge amounts of time (and money) in drawing-up our own constitution. Cytotechnologists have already associated with the CAP. I envisage the PA arrangement to be similar. The problem (well, one of the problems) is that Canadian PAs are not yet certified. How does one define a PA? Our credentials and our responsibilities are all over the map. We are lucky that our American colleagues have shown the way, partly. The difference is that they already have an accredited training course in place so the definition is significantly less cloudy than in Canada. They have gotten around this problem as well though in that they have allowed for differing levels of membership. You can still belong to the association, but in an ‘associate’ capacity (presumably without voting privileges…but you still get invited to the AGM!) if you, for instance, do not hold a degree. With the CAP’s assistance and direction, we hope to define the criteria for membership in the CAPA.
I think that until the CMA accredits a PA training program, we cannot expect to associate to the same degree as the Cytotechnologists however. The inaugural executive committee can hopefully come up with some criteria for that which defines a Canadian PA and that will go a long way to firming up the definition when drawing up a list of key responsibilities for PAs.
There are a number of contentious issues that we’ll need to grapple with. Among these, perhaps the most difficult will be deciding whether or not to admit non-degree holding PAs into the association. If we agree that we will do this (and I think we should), we then need to decide how many years of bench experience will be required before they are admitted. Certainly those who already hold AAPA memberships or fellowships will be admitted. Foreign-trained medical doctors practising as PAs will likely be admitted but, like all other PAs, will require an assessment from an impartial pathologist (hopefully using a format provided by the CAP); this is in keeping with the wishes of the CAP (see the Position Statement on the CAP website http://www.cap.medical.org/position_statement_assistants.htm). There are already many MLTs who have evolved into PAs. In fact, most Canadian PAs are MLTs. The contribution that they provide to the provision of excellent healthcare should not go unrecognized. They deserve to be allowed to associate along with the [minority] of degree-holders. We can set the bar high for the future (ie. when there are PAs being trained in Canada using an accredited curriculum) but should grandmother/father those who are currently practising.
We should also stipulate that the degree holders hold an appropriate degree (eg. BSc in Biology; MSc; MD).
What do we do about those who never perform autopsies? What about those who perform only autopsies?
I would be interested to hear any input that you might have to this subject. I am sure that many of you have lots of things to add and have many questions; I’d be glad to hear from you. We had hoped to have a 2006 meeting of Canadian PAs but it’s looking like this might have been a little optimistic.
An update re PA workload units: the CIHI will be looking at this in the fall and the following spring (2007). The wheels of bureaucracy certainly do turn slowly. The good news is that they are turning.
Also, I was pleased to sit with the British Columbia laboratory accreditors (DAP) in November. It amazes me that PAs have flown under the radar of the accreditors in all other provinces. It took the BC pathologists to give the accreditors the heads-up about the existence of PAs and the significant change in practice that had occurred recently. Their written report will be available soon and it will contain recommendations (in keeping with the CAP’s stated wishes concerning CME activities, for example) which apply specifically to PAs. I think that all of Canada’s PAs should make their provincial lab accrediting bodies aware of their existence and should also insist that there be specific wording in the accrediting agreement stipulating that there be proper, safe working conditions for PAs, adequate space, CME activities, safety awareness training, etc. I’ll bring you all up to speed on what I learn from the written statement from the DAP once I get the chance to read it.
Other news – there will be a 21-week PA locum in Vernon beginning in July (a maternity leave). Also, we will be looking at hiring a casual PA to fill in during vacations and other leaves of the three PAs. It was very nice that Alan Wolff decided to do a 2-week locum in Vernon during Danielle Lee's vacation in January.
Now to the subject of this post: several PAs across Canada and myself have been corresponding recently; trying to firm-up arrangements with the Canadian Association of Pathologists (CAP) so that Canada’s PAs can form an association (The Canadian Association of Pathologist’s Assistants (CAPA)) as a branch of the CAP. It was very nice of the CAP to offer this to us. It means that we will not have to expend huge amounts of time (and money) in drawing-up our own constitution. Cytotechnologists have already associated with the CAP. I envisage the PA arrangement to be similar. The problem (well, one of the problems) is that Canadian PAs are not yet certified. How does one define a PA? Our credentials and our responsibilities are all over the map. We are lucky that our American colleagues have shown the way, partly. The difference is that they already have an accredited training course in place so the definition is significantly less cloudy than in Canada. They have gotten around this problem as well though in that they have allowed for differing levels of membership. You can still belong to the association, but in an ‘associate’ capacity (presumably without voting privileges…but you still get invited to the AGM!) if you, for instance, do not hold a degree. With the CAP’s assistance and direction, we hope to define the criteria for membership in the CAPA.
I think that until the CMA accredits a PA training program, we cannot expect to associate to the same degree as the Cytotechnologists however. The inaugural executive committee can hopefully come up with some criteria for that which defines a Canadian PA and that will go a long way to firming up the definition when drawing up a list of key responsibilities for PAs.
There are a number of contentious issues that we’ll need to grapple with. Among these, perhaps the most difficult will be deciding whether or not to admit non-degree holding PAs into the association. If we agree that we will do this (and I think we should), we then need to decide how many years of bench experience will be required before they are admitted. Certainly those who already hold AAPA memberships or fellowships will be admitted. Foreign-trained medical doctors practising as PAs will likely be admitted but, like all other PAs, will require an assessment from an impartial pathologist (hopefully using a format provided by the CAP); this is in keeping with the wishes of the CAP (see the Position Statement on the CAP website http://www.cap.medical.org/position_statement_assistants.htm). There are already many MLTs who have evolved into PAs. In fact, most Canadian PAs are MLTs. The contribution that they provide to the provision of excellent healthcare should not go unrecognized. They deserve to be allowed to associate along with the [minority] of degree-holders. We can set the bar high for the future (ie. when there are PAs being trained in Canada using an accredited curriculum) but should grandmother/father those who are currently practising.
We should also stipulate that the degree holders hold an appropriate degree (eg. BSc in Biology; MSc; MD).
What do we do about those who never perform autopsies? What about those who perform only autopsies?
I would be interested to hear any input that you might have to this subject. I am sure that many of you have lots of things to add and have many questions; I’d be glad to hear from you. We had hoped to have a 2006 meeting of Canadian PAs but it’s looking like this might have been a little optimistic.
An update re PA workload units: the CIHI will be looking at this in the fall and the following spring (2007). The wheels of bureaucracy certainly do turn slowly. The good news is that they are turning.
Also, I was pleased to sit with the British Columbia laboratory accreditors (DAP) in November. It amazes me that PAs have flown under the radar of the accreditors in all other provinces. It took the BC pathologists to give the accreditors the heads-up about the existence of PAs and the significant change in practice that had occurred recently. Their written report will be available soon and it will contain recommendations (in keeping with the CAP’s stated wishes concerning CME activities, for example) which apply specifically to PAs. I think that all of Canada’s PAs should make their provincial lab accrediting bodies aware of their existence and should also insist that there be specific wording in the accrediting agreement stipulating that there be proper, safe working conditions for PAs, adequate space, CME activities, safety awareness training, etc. I’ll bring you all up to speed on what I learn from the written statement from the DAP once I get the chance to read it.
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