安省即要进行医疗改革

药剂师也非常不容易。护士怎样？本科学历的人在多伦多2年就可以拿下本科护士学历，registered nurse，这个绝对不用担心失业。枫下论坛有人讨论同样的问题，很多人都是学医背景。

ZThttp://www.rolia.net/f/post.php?f=0&b=10&c=1150&tno=546418&pno=4742440&

安省即要进行医疗改革，划出4个新的中高级医疗职业：

Physician Assistant,
Nurse Endoscopist,
Surgical First Assist,
& Clinical Specialist Radiation Therapist (Radiation Therapy Advanced Practitioner)

by dosimetrist (dosimetrist) at 2008.10.4 17:02 (#4742440@0)
＜本文发表于: 相约加拿大:枫下论坛 www.rolia.net/forum ＞
Physician Assistant是现在美国最热门的一个行业， 除了本科学历外还要继续学两年的PA school。 PA其实就是医师助理，能做一些诊断以及开一些药。

Physician Assistant：
Assists supervising physicians to deliver medical services, such as conducting patient interviews, histories, physical examinations; performing selected diagnostic and therapeutic interventions; ordering and interpreting patient laboratory and radiological results; and counselling patients on preventive health care.

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Nurse Endoscopist就是注册护士在拿到更高级的certification后可以协助专科医生做大肠内窥镜。

Nurse Endoscopist：
A registered nurse with extended specialized education (in anatomy, physiology and pathophysiology) who works with a physician to perform flexible sigmoidoscopies (diagnostic procedure used to screen for abnormalities in the lower third of the colon).

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手术第一助理，这个高级的注册有可能是只提供给注册护士的。

Surgical First Assist
Works with the surgeon and the rest of the operating room team to ensure the safe outcome for a surgical patient before, during and after surgery. A registered nurse can perform this role with an additional certification in surgical assistance.

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Clinical Specialist Radiation Therapist (Radiation Therapy Advanced Practitioner)

底下是关于安省Radiation Therapy Advanced Practitioner的网址。 该计划也是由安省政府支持的，所以进程很快。 现阶段是中级的Advance Practitioner，除了开药，order诊断，签字，等原医师权利外还可以直接决定部分肿瘤病人的放疗方案（比如药量小的皮肤癌）。 而后阶段的计划是Consultant Practitioner，建议学位是Doctorate（也就是professional Dr.学位，Doctor of Radiation Therapy），不仅同有Dr.的头衔，而且还有跟医师差不多的权利，比如直接决定肿瘤病人的放疗方案（现在是radiation oncologist的职责）。 美国和安省的advanced practitioner proposal其实都是参考的英国的方案。

“The College of Radiographers (UK) has recommended that the master’s of science degree is an appropriate educational level for advanced practice therapy radiographers and that consultant level therapy radiographers should be educated to the doctoral level or equivalent.”
“The top level (consultant) is associated with a high level of educational achievement (up to a doctorate degree).“

需要注意的是，doctor也分很多种，除了MD和DO外其他医生（包括dentists，optometrists）都不是physician。 此doctor类型是和optometry，audiology，Pharm.D，Psy.D，chiropractor，vet，naturopathic，dentistry，DOT，DPT，DNP等是一个种类的doctor，也就是non-physician practitioner的doctor。

薪水预测（按现在的市场预测）：

Physician Assistant在美国的全国平均薪水是8万，要比美国的Nurse Practitioner低一点。 如果是在安省的话估计会和Nurse Practitioner差不多，估计在6w5-8w5左右。

Nurse Endoscopist由于做的是侵入性procedure，所以薪水应该高于现在的Nurse Practitioner， 估计薪水在7-9万左右。

Surgical First Assist我不太清楚，但估计能有8-10万吧。

Clinical Specialist Radiation Therapist (Radiation Therapy Advanced Practitioner) 的半官方salary expectation是8-10万。 但现在没有consultant practitioner （Doctor of Radiation Therapy）的半官方salary expectation，但个人估计应该是在10-12万之间。

http://www.cmrto.org/home/default.asp