Winter / Spring 2014 - Health Care

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careeroptionsmagazine.comWinter/spring 2014

career options

5 reWarding alternatives to medical school

6 Where the nursing jobs are

10 physician assistant: an emerging career in canada

a cure for the

common career

There are more opTions in

health care Than you mighT Think!

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Career OptiOns!

Career OptiOns HealtH Care Winter/spring 2014 3

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13 American International Medical University (AIMU)

10 Athabasca University, Faculty of Health Disciplines

13 Atlantic University School of Medicine (AUSOM)

13 Columbia University Medical Center

4 Manitoba Nurses Recruitment and Retention Fund

8 Marskell Group and Health Careers Interaction

3 New England Center for Children (NECC)

3 New York Chiropractic College (NYCC)

13 Opticians Association of Canada

2 St. George’s University (SGU), Schools of Medicine and Veterinary Medicine (Grenada)

8, 13 Xavier University School of Medicine (Aruba)

5 alternatives to med schoolIntroduction by Carleton University Co-op and Career Services

6 navigating the nursing fieldBy Grace Kennedy

10 What is a phYsician assistant?By Jordan Adams

12 medical transcription 101By Tiara Wells

10 Physician

assistants: an emerging career niche that will help with canada’s coming shortage of doctors and nurses

12

career optionswinTer/spring 2014


alternatives to med school

epidemiologist Epidemiologists study disease

outbreaks and patterns, and

develop strategies to control

and prevent them. They act as

medical “detectives” to find

out the cause of an outbreak

by analyzing data and trends,

and examine the factors that

impact outbreaks (environmen-

tal, behavioural, microbial and physiological, for example). Their

findings often have a large impact on public health programs

and policies. Most employers will require at least a master’s

degree in epidemiology, which can be obtained at several univer-

sities throughout Canada.

genetics technologist Genetics technologists study

the genetics of a cell to help

diagnose genetic diseases and

disorders. They examine samples

of blood, bone marrow, tumours

and other biological specimens

using specialized equipment.

These laboratory tests are used

to diagnose and treat patients.

Scientific advancements and discoveries mean that this field is

constantly evolving. Genetics technologists can work in hospi-

tals, private laboratories, forensics and academic research. Two

institutions in Canada offer post-graduate training: the Michener

Institute and the British Columbia Institute of Technology.

medical illustratorMedical illustrators render sci-

ence and medicine visually by

creating both traditional and

digital illustrations. It is an ideal

job for creative people with a

background in both science and

art. The field is evolving as new

design technologies mean new

ways to convey art in multimedia.

There’s just one Association of Medical Illustrators-accredited

graduate program in Canada: the two-year University of Toronto

Biomedical Communications program. According to the program’s

website, graduates work in fields as varied as pharma and biotech

visualization, medical-legal visualization, health communication,

research dissemination and textbook publishing.

optometristOptometrists specialize in the

health of the eyes. They treat

patients’ problems with vision,

and prescribe glasses, contact

lenses and medicines. Optome-

trists can also specialize in differ-

ent areas, such as pediatric care

and low vision. It takes seven to

eight years of post-secondary

education to complete a Doctor of Optometry. Two universities

in Canada offer the program: the University of Waterloo and the

Université de Montréal. The average optometrist earns between

$70,0000 to $80,000 per year excluding benefits, according to

Waterloo, and enjoys a stable working life with routine hours and

few emergencies.

Applying to medical school is a very competitive process, and not everyone who is interested in becoming a doctor will ultimately be successful in gaining admission. However, many of the aspects that draw people to practise medicine, such as the ability to help people, job security and good salaries, are also present in a variety of other professions and occupations.

Introduction by Carleton University

Co-op and Career Services

6 Winter/spring 2014 CareerOptiOnsmagazine.COm


rn Job opportunitiesCommunity:• Health clinics • Schools• College and university health services• Workplace wellness programs • Doctors’ offices • Home care • Family planning clinics • Poison control centres • Prenatal and well-baby clinics • Rehabilitation centres • Sexually transmitted disease units • AIDS hospices• 24-hour telephone advice lines

(e.g. poison control)• Direct care provider

Hospital:• Emergency • Intensive care • Operating room • Post-surgery • Maternity • Cardiovascular • Oncology (cancer) • Psychiatry • Pediatrics (children) • Palliative (dying people) • Geriatrics (seniors)

navigating the nursing field

By Grace Kennedy

now is the right time to be a nursing

student. By 2016 there will be more

opportunities than ever for young

nurses to get their foot in the door

of the health care industry, thanks to retiring Baby

Boomer nurses. If you are thinking about a career

in nursing or have just started your bachelor, by

the time you graduate you will be one of the most

in-demand graduates in Canada.

Where the Jobs are: communitY and specialtiesAccording to the president of the Canadian

Federation of Nurses Unions, Linda Silas, nurses

working currently have filled over 12,000 full-time

equivalent positions just in overtime work, repre-

senting an immense shortage of registered nurses

in the system.

Most of these shortages are in specialist occupa-

tions and community nursing outside of hospi-

tals. This trend is due in part to Canada’s aging

population and the changing demographics of

hospital patients.

“We’re certainly seeing a trend to shorter, more

intense hospital stays for very, very acutely ill

people,” says Kathleen MacMillan, director of the

Dalhousie University School of Nursing. “More

people are coming in for day surgery and recuper-

ating at home, so you need a community nurse to

come in and make sure that they are recovering.”

It used to be that 70 to 80 percent of nurses

were concentrated in hospitals, MacMillan says,

but now nurses are everywhere. Their role has

been “rebalanced to show equally a focus on sick

people and on nursing the well, and making sure

that we keep them well.”

With more seniors entering Canada’s health care

system, MacMillan says that they are encouraging

students to look into long-term care and gerontology.

“It may not necessarily be institutional,” she says.

“It may be geriatric daycare or community visiting

to do with the frail elderly. It’s not an area that

people normally think about, but it can be a really

rewarding area where expert nurses can really

make a difference to people’s independence and

family care burden.”

According to Silas, the idea of the “visiting nurse”

is also more in-demand, where nurses visit

patients in their home for follow-ups related to

chronic disease or preventative care. She also

stresses the importance of nurses working in

mental health and the benefits they can have

for the community.

As a nurse, you can also look into population,

rather than individual, care. Public health nurses

have spearheaded initiatives such as increasing

the use of bike helmets and informing the public

on the dangers of leaving children unattended in

baby walkers. They also work with governments

on policy issues.

If community work isn’t for you, there are more

specialized positions that are projected to experi-

ence labour shortages. MacMillan cites shortages

of nurses working in mental health, cancer and

perioperative care (working with patients undergo-

ing operations and other invasive procedures), as

well as in emergency. However, nurses working

in these fields are traditionally not fresh gradu-

ates, she says, “because people generally didn’t

get into critical care, for example, until they’d had

some experience, so demographically the people

who are in the specialty areas are older and will

be retiring sooner.” She notes that new grads will

likely need post-graduate education in order to

have the right skills to fill these specialty positions.

“Different specialties are like taking a different job in

nursing,” Silas says, which is one of the reasons she

thinks nurses are lucky to have so many options.

specialization and advancement optionsIf you’re thinking about entering critical care or

another specialized area, you should expect to

require some post-graduate education.

You can gain certification for various specialities

through a variety of different avenues: the Canadian

Nurses Association offers certification exams for

emergency, perinatal, occupational health, commu-

nity health, critical care pediatrics, perianesthesia and

gerontology, among others. Colleges, universities and

teaching hospitals also offer certification courses.

Planning your career path while doing your

bachelor’s degree can help a lot with entering the

field, says MacMillan. Talk to faculty about doing

as many varied placements as possible, as well as

where you can do those placements, as they can

add substantially to your background experience.

Nurses should also think about working in a rural

community to gain wider experience and boost

their job prospects. “In rural communities, often

you get a much broader experience and you get

to do more things than you do in an urban centre,”

MacMillan says. For example, nurses could work

in the emergency room, obstetrics and out-patient

surgery—all in the same week.

If you want to go even further in your education,

you can complete a master’s degree. Nurses

with a master’s can go into nursing management

and administration, take on senior executive

positions in care organizations, and become

Clinical Nurse Specialists, or Nurse Practitioners.

Clinicians are often consultants with specialized

knowledge for the care of certain diseases or

techniques, while the nurse practitioner spans

the roles of physician and nurse, ordering tests

and prescribing medications for patients.

After your master’s degree, you could go on to get

your PhD in nursing, leading to a career in research

or education. MacMillan is keen to get more

students to consider a career in academia. “We’re

concerned about nursing faculty, because like every-

body else, the faculty are aging and we’re concerned

about supplies of people to teach nursing,” she says.

MacMillan says there is a push to get students

straight through their education if they think they’ll

have an interest in nursing academics. “We used

to encourage [nurses to work in the field before

getting their doctorate] because our perception

was that people really needed a strong practice

background, but what we find is that people get

used to a paycheque and then they’re less likely to

come back,” she laughs.

While entry-level nursing faculty are not always as

well paid as registered nurses, MacMillan thinks

that students should consider the option. “If you’re

nurses could Work in the emergencY room, obstetrics and out-patient surgerY— all in the same Week.

nursing bY the numbers• 7 to 9: Percentage of male nurses• $41,000 to $86,000: Salary

range—depending on experience,

location and specialization• 25%: Increase of available seats

in nursing programs in 2005• 32: Nursing master’s programs

in Canada • 15: Nursing doctoral programs

in Canada

really passionate about research and scholar-

ship, you’d be happier here than you would be at

practice, so I think it’s choosing what fits for you.”

She notes that benefits for full-time faculty are very

good, and competitive at the senior levels.

advice for aspiring nurses“I can tell anybody that’s thinking about nursing,

if you’re getting it from television, you’re getting a

pretty skewed view of the universe,” MacMillan

says. “So most of our students come in here think-

ing that they are going to put on the white shoes and

the stethoscope and work in the emergency depart-

ment, and that’s a very small aspect of the job.”

This romanticized view of nursing is something that

young nurses should get out of their head.

“If you don’t like old people, nursing is probably

going to be a little bit difficult for you, because

when you look at who gets sick in our country

today, it’s often the frail elderly, it’s the people

with a lot of different health challenges, the

people that have mental health conditions,” she

says. “You have to have a passion for wanting

to help people be the best they can be and be

the healthiest they can be, and work with them.”

But for new graduates looking for a way in, there

are plenty of opportunities both inside and outside

the common perception of nursing.

“Whether you’re a young man or a young woman

who’s considering a career [in nursing], do a little

bit of research and find out where nurses are and

what they’re doing,” MacMillan says. “I think peo-

ple will be surprised at the various career options

that come out of having a nursing background.

You know, whether they want to be an academic,

or they want to be an administrator, or you want to

be a policy maker or a public health professional—

these are all things that a nursing education can

be a way into.” co

grace kennedY is a journalism student at the University of

King’s College in Halifax, Nova Scotia. She has done freelance journal-

ism on both the East and West coasts and has a particular interest in

science journalism.


What is a phYsician assistant?

there’s a new profession in Canada’s health care landscape

that could help solve many of the problems experts say are

heading our way. It’s a story we’re hearing over and over again:

as the massive cohort of Baby Boomers age, more people will

need health care services just as many current health care workers are

retiring—which will put a huge strain on doctors, nurses and other health

care providers. Physician assistants could help take some of the pressure

off. While the position is not widely implemented yet, it holds promise for

the future as a great career for people who want to work in the health care

industry without the full commitment of years and dollars involved

in becoming a physician.

the backgroundPhysician assistants are highly trained health care providers who support

physicians in all health care settings. The difference between PAs and physi-

cians is that the former works under a doctor’s supervision.

It’s a relatively new position in Canada, but PAs have been successfully

implemented in the U.S. health care system for decades. As in the U.S.,

Canada’s first PAs originated in the military. They are widespread in the

Canadian Armed Forces, but are just recently being introduced into our civil-

ian health care system. Manitoba was the first province to introduce PAs in

1999, and Ontario, New Brunswick and Alberta have followed suit.

The Canadian Association of Physician Assistants (CAPA) is working to

implement the position across the country through awareness campaigns

and stakeholder outreach. “Although it’s starting out slowly, we’re hopeful

that eventually PAs will be practising in all provinces across the country,” says

Natalie St-Pierre, CAPA communications and marketing manager. “CAPA is

working hard with stakeholders and partner groups to try and progress the

profession in other provinces. We are hopeful that in a few years time that

the profession will be fully integrated throughout Canada.” Right now, there

are approximately 300 PAs working in Canada, with 160 students enrolled

in programs; CAPA expects this number to grow as the profession advances.

What does a pa do?“A PA is very similar to a physician in regards to what they do day-to-day,

except they have to practise under a physician’s supervision,” says Chris Rhule,

president of CAPA and the first civilian PA regulated in Canada. Rhule works

in cardiac surgery—one of many options for PAs.

By Jordan Adams


Nancy Aza is an emergency medicine physician

assistant and the academic coordinator of the

McMaster PA program. “As an ER PA, I work

a variety of all shifts in the ER (days, evenings,

nights, weekdays and weekends),” she says.

“I see patients of all acuity levels, do full assess-

ments on those patients, order tests (bloodwork,

imaging, etc.) and interpret those tests. I do a

variety of procedures in the ER, from suturing

and casting to lumbar punctures to endo-

tracheal intubation. Upon discharge, I provide

detailed discharge instructions and arrange

necessary follow-ups. Every day and every shift

is different for me, which is one reason why I

love the emerg!”

St-Pierre says that physicians benefit from the

collaboration: “They enjoy working with physician

assistants because they’re able to maintain control

over their patient population while still improving

the care that’s delivered to their patients.”

hoW does this impact the sYstem?“So far what we’ve seen here in Manitoba is the

ability to decrease wait times to get procedures or

to get into appointments, because adding PAs into

the mix increases the efficiency of the program or

the physician, and allows for them to see patients

quicker or even double up because the PA sees

some of the patients and the physician sees

some,” says Rhule.

“It increases retention of physicians, too,

because now they’re not as overworked as they

were before. We help share the on-call burden

and those kinds of things to make their practice

environment much better,” he says. “And we’ve

actually been able to recruit specialist physicians

and surgeons easier because we have PAs that

help them out.”

PAs can also have a huge impact on providing

care to rural communities, Rhule says. “You can

have a PA working in a rural area, like we have

in Manitoba, and the physician may not even be

in the same town as them, and so they supervise

from a distance,” he says. “That provides the

ability to give medical care to a community that

otherwise wouldn’t have a physician. It also helps

staff in rural ERs and rural hospitals.”

hoW can i become a pa?Four schools in Canada currently offer PA training:

the Canadian Forces Health Services Training

Centre, the University of Manitoba, McMaster

University and the Consortium of PA Education

(University of Toronto, Northern Ontario School

of Medicine and the Michener Institute of

Applied Sciences). All four programs are accred-

ited through the Canadian Medical Association’s

Conjoint Accreditation Services.

St-Pierre stresses that it isn’t just an alternative

career for those who don’t get into medical school.

“It is competitive to get into the program, and

really, people that are coming into the program

don’t want to be physicians,” she says. “They

want to practise medicine but without all of the

responsibility included that a physician has.” As

the CAPA website puts it, “Physician Assistants

want to be Physician Assistants.”

Most of the programs ask for a background in health

sciences, though they all have different require-

ments. McMaster, for example, takes students

from a variety of backgrounds, says St-Pierre.

Education aside, Rhule says communication,

decision-making and empathy are three essen-

tial skills for aspiring PAs. Aza lists similar skills:

“Interprofessional practice is the nature and

benefit of our health care system, so a good PA

must work well in a team environment and have

effective interpersonal communication skills,”

she says. “Strong critical-thinking and problem-

solving skills are a requirement, as well self-

motivation towards continuing medical education

and self-improvement, so we can provide the best

care possible to our patients.”

If you do manage to get into one of the programs,

your employment prospects after graduation are very

good. The Ontario and Manitoba governments, for

example, have been supportive of the PA profession

by creating jobs for new graduates as they’re com-

ing out of school, says St-Pierre. While a job is not

guaranteed, “the chances are very high,” she says.

“With the amount of Baby Boomers that are

coming into the system, there’s going to be an

increased demand on our health system,” says

St-Pierre. “And because there is a limited number

of physicians, they can’t possibly be expected to

take on all of the patients without having some

sort of help and assistance.” co

Jordan adams is an editor

and writer for Career Options

and a Carleton University

journalism graduate.

What does a phYsician assistant do?It varies depending on their agreement

with the physician, but some duties

can include:• Conduct patient interviews, histories

and physical examinations• Perform selected diagnostic and

therapeutic interventions• Counsel on preventative health care• Assist in surgery• Order and interpret tests• Write prescriptions

Source: Canadian Association of Physician Assistants

earn more about being

a physician assistant at capa-acam.ca


i often get asked what my work as a medi-

cal transcriptionist is all about. I will say

this: it’s the perfect career for anyone

who wants to be a part of the health care

industry without toiling away in med school for

half a dozen years. Here’s the lowdown on this

rewarding, flexible profession.

an overvieW of the medical transcription processWhat exactly does an MT do? Doctors, with the

help of voice-recording software, record the details

of every patient meeting, including the physi-

cal examination and medical problems, any lab

and diagnostic tests that were requested or their

results, diagnosis, plan of treatment and instruc-

tions given to the patient. The MT transcribes this

audio file into a report or record.

training/educational requirementsIn order to become an MT, you would ideally com-

plete an associate degree or enroll in a diploma

program after high school. Many vocational

schools and colleges offer training and some,

such as CareerStep, also offer online courses

that you can complete in as little as four months.

Coursework for medical transcription includes

subjects such as anatomy, pathophysiology,

pharmacology, medical terminology, and English

grammar. To be a really good MT, your skill set

must include: strong attention to detail, excellent

written English, typing speed, computer skills, and

an ear for accents (in Canada, you’ll find doctors

come from many cultures!).

You can also choose to obtain certification,

although it’s not mandatory. But certification

shows a potential employer your dedication

toward your calling. Certifications are main-

tained by the AHDI (Association for Healthcare

Documentation Integrity) and are known as RMT

(Registered Medical Transcriptionist) and CMT

(Certified Medical Transcriptionist). Fresh gradu-

ates with little or no experience under their belt

can take the RMT exam, whereas the CMT exam

is for experienced MTs who have worked in a

medical specialty such as acute care.

Job duties of an mt• MTslistentothevoicerecordingsofdoctorsor

nurses and then transcribe them into referral let-

ters, diagnostic test results and other documents

as necessary. These documents eventually form

part of the patient’s medical record.

• Thetranscribedreportsmustcomplywithlegal

policies and adhere to patient confidentiality.

• MTsmayconsultmedicaltermsandproce-

dures to verify for inconsistencies.

• Theymayhavetofollowupwiththedoctor

if they find any discrepancies within the

voice recordings.

• Theymustkeepalogofallthetranscribed

reports, perform quality checks on them and

submit them to the doctor for approval.

tYpical Work environmentMTs usually work in hospitals and doctors’ offices.

Or they can work in offices for corporations that

provide transcription services for hospitals, medi-

cal centres, and health care establishments.

MTs can also telecommute (work from home),

either as an independent contractor or an

employee of a firm or doctor’s office.

Job outlook/paY rate According to statistics, the job outlook for medical

transcription is bright and there’s a huge potential

for growth. The compensation is fairly high: $21 an

hour is the median wage, so if you’re really good

at what you do and have enough experience, you

can earn as much as $27.50 an hour.

Medical transcription doesn’t require extensive

training and it could be the ideal choice, especially

if you are looking to work from home. If you’re

truly interested in making this your career choice,

look for reputable schools that offer on-the-job

training. Good luck! co

tiara Wells is a successful African-

American medical transcriptionist who

has lived in Canada with her husband for

the past six years. Since her accident in

2010 she refused to be discouraged by

her disability and continued to seek career

options that allow her to work from home.

She now heads a team of five medical

transcriptionists and enjoys writing in

her spare time.

medical transcription 101

By Tiara Wells



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Winter / Spring 2014 - Health Care