安省即要進行醫療改革

藥劑師也非常不容易。護士怎樣？本科學曆的人在多倫多2年就可以拿下本科護士學曆，registered nurse，這個絕對不用擔心失業。楓下論壇有人討論同樣的問題，很多人都是學醫背景。

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

安省即要進行醫療改革，劃出4個新的中高級醫療職業：

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)
＜本文發表於: 相約加拿大:楓下論壇 www.rolia.net/forum ＞
Physician Assistant是現在美國最熱門的一個行業， 除了本科學曆外還要繼續學兩年的PA school。 PA其實就是醫師助理，能做一些診斷以及開一些藥。

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就是注冊護士在拿到更高級的certification後可以協助專科醫生做大腸內窺鏡。

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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手術第一助理，這個高級的注冊有可能是隻提供給注冊護士的。

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)

底下是關於安省Radiation Therapy Advanced Practitioner的網址。 該計劃也是由安省政府支持的，所以進程很快。 現階段是中級的Advance Practitioner，除了開藥，order診斷，簽字，等原醫師權利外還可以直接決定部分腫瘤病人的放療方案（比如藥量小的皮膚癌）。 而後階段的計劃是Consultant Practitioner，建議學位是Doctorate（也就是professional Dr.學位，Doctor of Radiation Therapy），不僅同有Dr.的頭銜，而且還有跟醫師差不多的權利，比如直接決定腫瘤病人的放療方案（現在是radiation oncologist的職責）。 美國和安省的advanced practitioner proposal其實都是參考的英國的方案。

“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也分很多種，除了MD和DO外其他醫生（包括dentists，optometrists）都不是physician。 此doctor類型是和optometry，audiology，Pharm.D，Psy.D，chiropractor，vet，naturopathic，dentistry，DOT，DPT，DNP等是一個種類的doctor，也就是non-physician practitioner的doctor。

薪水預測（按現在的市場預測）：

Physician Assistant在美國的全國平均薪水是8萬，要比美國的Nurse Practitioner低一點。 如果是在安省的話估計會和Nurse Practitioner差不多，估計在6w5-8w5左右。

Nurse Endoscopist由於做的是侵入性procedure，所以薪水應該高於現在的Nurse Practitioner， 估計薪水在7-9萬左右。

Surgical First Assist我不太清楚，但估計能有8-10萬吧。

Clinical Specialist Radiation Therapist (Radiation Therapy Advanced Practitioner) 的半官方salary expectation是8-10萬。 但現在沒有consultant practitioner （Doctor of Radiation Therapy）的半官方salary expectation，但個人估計應該是在10-12萬之間。

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