Physician Assistant vs. Nurse Practitioner (PA vs NP)
(Canada Edition)
If you’re looking to become a PA or NP in the United States, check out this post.
If you’re looking to become a PA or NP in Canada - then read on!
This post isn’t about whether being an NP or a PA is better - both roles significantly compliment our health care system in different ways. In fact, many NPs and PAs work together within interdisciplinary teams. What we will uncover are the differences in scope of practice, what the journey looks like for each, and job prospects. Let’s get into it!
There’s a lot to consider when we are choosing a career path in medicine. If you’re deciding on whether to be a nurse practitioner or physician assistant, it’s important to understand each role and scope of practice. There will be nuance between provinces, but we will talk high level here. Let’s start with a quick comparison table:
PA vs NP
| Category | Nurse Practitioner (NP) | Physician Assistant (PA) |
|---|---|---|
| How to Become One |
• Bachelor of Nursing (BScN) • Registered Nurse (RN) license • ~2+ years RN experience (2,000 hrs) • Master’s-level NP program (MN-NP or post-master’s certificate) • NP certification exam + provincial registration |
• Bachelor’s degree (Health/Science preferred) for PA masters programs • Apply to PA program (6 programs in Canada: McMaster, U of T Consortium, Manitoba, Dalhousie, Calgary, Saskatchewan) • 2 years full-time (coursework + clinical placements) • Pass National PA Certification Exam (PACCC) • Register with provincial regulator (e.g. CPSO in Ontario, 2025+) |
| Program Facts |
• 2 years full-time (MN-NP) • 3–4 years part-time (MN-NP) • Post-master’s NP certificate: 1 year full-time • Clinical placement hours: ~700-800 hours |
• 2 years full-time (Bachelor or Master of PA Studies) • Includes ~44–48 weeks of supervised clinical rotations |
| Tuition Costs |
• NP graduate programs: $5,500 – $9,000 (2 years) • Post-master’s NP certificate: lower cost • Must also factor in 4-year BScN (~$25,000+ depending on school) |
• PA programs: $12,000 – $20,000 (2 years) • No additional undergraduate nursing degree required |
| Scope of Practice |
• Independent practice (no physician needed) • Diagnose & treat, order tests, prescribe meds • Perform procedures (suturing, biopsies, casting) • Provide psychotherapy • Scope varies by province, but similar nationwide |
• Work under supervision agreement with physician • Diagnose & treat, order tests, prescribe meds • Surgical assist + inpatient/ER care • Tasks delegated by supervising physician • Scope varies by province & physician agreement |
| Job Prospects |
• Strong growth across provinces • NPs being integrated into healthcare workforce planning • 10% growth from 2021–2022 (largest increase in nursing professions) • Many new funded training spots |
• Government of Canada: strong labour shortage forecast (2024–2033) • Stable prospects in Ontario, BC, Alberta, Quebec, Saskatchewan, PEI • Growing demand in both primary and acute care |
| Annual Salary (Canada) |
• $97,000 – $103,000 average • Lowest median: PEI ($49/hr) • Highest median: Ontario ($57/hr+) • Factors: province, union vs non-union, leadership roles |
• Average: $125,057 • Range: $103,000 (NL) – $148,675 (ON) • Median wage: $42/hr • Factors: funding, environment, region |
What is the difference between a PA and an NP?
Nurse Practitioner Scope of Practice
Nurse practitioners are registered nurses who have additional education, nursing experience, and expanded scope to autonomously diagnose and treat, order and interpret tests, prescribe medications, refer to specialists, and perform medical procedures (1). NPs do not have to work with a collaborating physician, nor do they need medical directives to practice. Scope of practice varies between provinces but is fairly similar.
In Ontario (where I work) for example, NPs can:
Autonomously assess and diagnose
Order a range of diagnostic tests with seldom limitations
Formulate treatment plans
Perform several procedures (e.g. casting, performing procedures below the mucous membrane like skin biopsies and suturing)
Can prescribe, dispense, and compound, and sell medications
Provide psychotherapy to patients (2)
Physician Assistant Scope of Practice
Physician assistants work under the supervision of licensed physicians, but they possess the autonomy to perform a wide range of clinical tasks and procedures (3). In Canada, the scope of practice for a Physician Assistant (PA) is determined by a formal agreement with a supervising physician and outlines the clinical tasks they are authorized to perform, though specific duties can vary provincially.
Conducting patient interviews and taking medical histories
Conducting physical exams
Order and interpret tests
Prescribe medications to patients in collaboration with a supervising physician
Formulating treatment plans
Providing patient counselling and preventative health care
Surgical assist - working directly with surgeons during procedures
Performing other tasks within the supervising physician’s scope of practice that the physician deems the PA qualified to complete (3,4).
Bottom line: NPs and PAs have very similar scope of practice. The main difference is the scope of practice for a PA is determined by a formal agreement with a supervising physician.
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Nurse practitioner vs Physician Assistant Education
How does the educational path differ between an NP and a PA in Canada?
Nurse Practitioner Education
If you want in-depth information on this, read this post. If you want a snap shot, here it is:
First you attain a bachelor of nursing degree (BScN) from any Canadian university - there are many programs to choose from. I went to Queen’s University.
After you complete the BScN, you are eligible to write a certification exam to become a registered nurse (RN) - and you register with a provincial governing body (e.g. College of nurse of Ontario, if practicing in Ontario).
Then you gain experience as an RN. Most nurse practitioner programs in Canada require you to have at least 2000 hours (~2 years full time) as an RN before you apply. In my opinion - the more experience you have, the better. I worked in both hospital and community-based settings for varied experience.
Then you apply to a nurse practitioner program (which is a masters’s-level program) - here is a full document of programs within Canada. There are programs in most provinces, with several universities to choose from. Ontario has the most NP programs - 10 in total. Most NP programs in Canada are “primary health care” or “all ages.” Meaning, they train you to provide care to patients of all ages (new born to old age). It is primary care/family focused, however there are some acute care programs in Canada, but they are limited. That being said, many NPs who have a primary health care NP designation work in acute care settings (inpatient units, ICU, emergency departments).
You have 2 options: either you can apply for a masters of nursing-nurse practitioner (MN-NP) program (2-year full time or 3-4 year part-time); OR attain a masters of science in nursing degree THEN apply for a post-masters nurse practitioner certificate program (1 year full time, 2 years part time). Curriculum is a combination of clinical courses, theory courses, and clinical placements or “practicums.”
MN-NP program: has both non-clinical (e.g. statistics, research based) course, and clinical courses (e.g. pathophysiology, advanced health assessment, pharmacology). This includes several supervised clinical placements.
Post-masters certificate program: only clinical courses (because you already have a masters degree). This includes several supervised clinical placements.
Average clinical placement hours: 728 to 800 clinical hours
Once you complete the program, you will be eligible to write an NP certification exam, and attain a license, similar to the RN registration process (5).
Tuition for NP programs: 2 year NP graduate programs can range from approximately $5,500 to $9,000 for a one to two-year program. 1 year certificate programs are cheaper. You have to factor in costs for the 4 year undergraduate RN degree as well.
Physician Assistant Education
There are 6 PA programs in Canada. Two are bachelor degrees, and 4 are masters degrees. I will go into each program, as there are different admission requirements.
1. McMaster University Physician Assistant Education Program (Hamilton, Ontario):
Bachelor of Health Sciences, Physician assistant (BScPA) degree
Minimum 2 years of undergraduate university
Minimum GPA 3.0 from cumulative undergrad study
No specific course or background requirements
Work and/or volunteer experience is not mandatory
McMaster supports the training of Canadian Armed Forces (CAF) members interested in career progression as a Physician Assistant (will the same admission criteria)
Curriculum: 2 years, full-time. Year 1 focuses on course work, year 2 focuses on 48 weeks of supervised clinical placements.
Distance education is not available.
2. PA Consortium (University of Toronto, Northern Ontario School of Medicine, The Michener Institute for Education at UHN) (Toronto, Ontario):
Bachelor of Health Sciences, Physician assistant (BScPA) degree
Canadian Citizenship or permanent resident
Minimum 10 full-year courses (20 half-year courses) or the equivalent of 4 semesters of undergraduate university education from a recognized university.
GPA: 3.0
Short periods of time are spent in Toronto, but otherwise the student can be in their home location during the first year.
Curriculum: 2 years, full-time. Year 1 focuses on pre-clerkship courses; year 2 focuses on 44 weeks of supervised clinical placements - half assigned in northern Ontario, half assigned in southern Ontario.
3. University of Manitoba (Winnipeg):
Master of Physician Assistant Studies (MPAS)
A 4-year Bachelor’s degree, preferably in a health sciences field (can apply in your final year)
GPA: 3.0 (3.5 is competitive)
Undergraduate courses required: Human Anatomy, Physiology, and Biochemistry (Microbiology and Psychology are considered asset courses)
Curriculum: 25 months, full-time. Year 1 is 56 credit hours of coursework; year 2 focuses on 48 weeks of clinical rotations.
4. Dalhousie University (Nova Scotia):
Master of Physician Assistant Studies (MPAS)
A 4-year Bachelor’s degree from a recognized, accredited university
GPA: 3.0
Undergraduate courses required: Human Anatomy, Physiology, and Biochemistry
Curriculum: 2 years, full-time. Year 1 focuses on pre-clerkship clinical courses, year 2 focuses on full-time clinical rotations. No distance learning available.
5. University Of Calgary (Alberta):
Master of Physician Assistant Studies (MPAS)
A 4-year Bachelor’s degree
GPA: 3.2
Prior client-facing healthcare experience
Pre-requisite courses required before starting the program: Human Anatomy and Human Physiology (minimum grade of B)
Curriculum: 2 years, full time. Year 1 focuses on pre-clerkship clinical courses, year 2 focuses on full-time clinical rotations.
Master of Physician Assistant Studies (MPAS)
A 4-year Bachelor’s degree
GPA: 75%
Completion of credit units in the following areas, with a minimum grade of 75%: Indigenous studies, human anatomy, human physiology
Curriculum: 2 years, full time. Year 1 focuses on pre-clerkship clinical courses, year 2 focuses on full-time clinical rotations.
All graduates of a PA program will qualify to challenge the National Certification Exam through the PA Certification Council of Canada (PACCC).
Next, you register with the regulatory body for the province where you’ll be practicing, as Canada does not have a single national authority for physician assistants.
For example, in Ontario, Since April 1, 2025, PAs have been regulated by the College of Physicians and Surgeons of Ontario (CPSO).
Tuition for PA programs: tuition ragnes from $12,000 to $20,000 for the 2 year full-time programs.
Bottom line: If you’re already a registered nurse and are looking for autonomy and extended scope of practice, then an NP degree may be right for you. If you have health sciences undergraduate years under your belt and want to pursue a career in medicine, a PA degree might be a good fit.
Where do NPs vs PAs work?
Nurse practitioner job landscape in Canada: The NP job landscape in the Canadian healthcare system is evolving at a rapid pace. Canda is incorporating NPs in healthcare workforce planning. Provincial governments are funding and subsidizing NP programs and jobs which is encouraging growth of the profession (7). In 2023, 121 training positions were added to the primary health care NP program in Ontario (7). In 2022, 7,113 NPs were employed in direct patient care, with a growth rate of 10% between 2021 and 2022, representing the largest percentile increase compared with other regulated nursing professions (8)
Physician Assistant job landscape in Canada: according to the Government of Canada, the PA occupation is expected to face a strong risk of labour shortage over the period of 2024-2033 at the national level - meaning, there will be jobs available. Job prospects in Ontario, BC, Alberta, PEI, Quebec, and Saskatchewan remain stable.
Both PAs and NPs work in a variety of similar settings - providing flexibility in work.
Primary care: family medicine practices, community health clinics, public health, pediatric clinics, long-term care and nursing homes, etc.
Acute care: inpatient units, ICU, emergency departments, trauma centers, etc.
NP vs PA Salary (Canada)
Nurse practitioner salaries in Canada: they vary between provinces and work environment (e.g. primary care vs. acute care). According to the Government of Canada Job Bank website, in 2024 the lowest median hourly rates for NPs were reported in PEI at approximately $49/hour, and the highest median rates in Ontario at approximately $57/hour (9). The annual NP salary is approximately between $97,000 and $103,000 annually - with Ontario reporting the highest median salaries. There are many factors contributing to variability of wages - including union vs. non-union positions, stipends or bonuses added to annual salaries, whether an NP is in a leadership position (higher wages), among other factors.
Physician Assistant salaries in Canada: according to the Canadian Association of Physician Assistants compensation report (2024), the mean national salary for a PA was $125,057 (10). Newfoundland and Labrador reported the lowest salary at $103,000, and Ontario the highest salary at $148,675. The median hourly wage in Canada is $42/hour. Similar to NPs, there is variability with compensation due to multiple factors - funding, work environment, etc.
If you’re looking to advance your career in healthcare, both the NP and PA paths are excellent options—it really comes down to your background and long-term goals. In Canada, NPs and PAs are making a huge impact on patient care and strengthening our health system. As an NP, I have deep respect for my PA colleagues—their knowledge and professionalism are invaluable. At the end of the day, we’re at our best when we learn from one another and work as a team, not in isolation.
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Other reads that might be of interest:
Nurse Practitioner vs. Medical Doctor (NP vs MD)
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Maier CB, Batenburg R, Birch S, Zander B, Elliott R, Busse R. Health workforce planning: which countries include nurse practitioners and physician assistants and to what effect? Health Policy. 2018 Oct;122(10):1085-1092. doi: 10.1016/j.healthpol.2018.07.016. Epub 2018 Aug 11. PMID: 30241796.
Ontario Helping More Students Become Nurse Practitioners. Government of Ontario [Internet]. [2023; 2025 Oct 1]. Available from https://news.ontario.ca/en/release/1003850/ontario-helping-more-students-become-nurse-practitionersCanadian Institute for Health Information. CIHI [Internet]. [2023; 2025 Oct 1]. Available from https://www.cihi.ca/en/nurse-practitioners#:~:text=In%202022%2C,growth%20rate%20of%2010%25Government of Canada Job Bank. [Internet]. [cited 2025 Oct 1]. Nurse practitioner in Canada. Available from https://www.jobbank.gc.ca/marketreport/wages-occupation/26454/ca
Canadian Association of Physician Assistants. [Internet]. [cited 2025 oct 1]. Compensation report. Available from https://capa-acam.ca/_uploads/6762225987c29.pdf