co
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 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
Career OptiOns HealtH Care Winter/spring 2014 5
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
Career OptiOns HealtH Care Winter/spring 2014 7
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.
10 Winter/spring 2014 CareerOptiOnsmagazine.COm
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
Career OptiOns HealtH Care Winter/spring 2014 11
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
12 Winter/spring 2014 CareerOptiOnsmagazine.COm
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
Career OptiOns HealtH Care Winter/spring 2014 13
Career OptiOns HealtH Care Winter/spring 2014 13