Canada - World Health Organization Regional Office for Europe

Health systems in transition Canada 97
of practice – which includes prescribing certain classes of prescription drug
and ordering some diagnostic tests – overlaps with that of family physicians.
More importantly, given the evidence of the declining comprehensiveness
of the primary care offered by physicians since the late 1980s, the range of
health services offered by nurse practitioners has been of interest to primary
health care reform advocates and provincial ministries of health (Chan, 2002b;
College of Nurses of Ontario, 2004; CIHI, 2011c). In addition to their RN
education and training, nurse practitioners must get additional training from
accredited institutions that are offered in all ten provinces. The length of these
programmes, including the clinical practicum, vary from one year to slightly
in excess of two years (CIHI, 2011a).
To practise in Canada, a pharmacist must hold a bachelor’s degree in
pharmacy from an accredited programme, pass the qualifying examination
administered by the Pharmacy Examining Board of Canada, and register with
the appropriate P/T regulatory body. Ten universities offer programmes in
Canada. All are four-year programmes, including clinical practicum, with the
exception of a five-year programme at Memorial University of Newfoundland.
There have been between 705 and 1075 pharmacy graduates a year from these
Canadian universities between 2000 and 2009 (CIHI, 2011a).
Chiropractors in Canada must have a doctorate of chiropractic (DC) from
an accredited programme, pass the Canadian Chiropractors Examining Board
National Competency Examination and register with a provincial or territorial
regulatory body as required. There are two accredited chiropractic programmes
in Canada: a four-year programme at the Canadian Memorial Chiropractic
College in Ontario, and a five-year programme at the Université du Québec à
Trois-Rivières in Quebec, which together have produced between 188 and 218
graduates a year between 2000 and 2009 (CIHI, 2011a).
Dentists practising in Canada must have a doctor of dental medicine (DDM)
or a doctor of dental surgery (DDS) degree from an accredited programme,
pass the National Dental Examining Board of Canada Written Examination
and Objective Structured Clinical Examination as well as register with the
pertinent P/T regulatory body. There are ten accredited programmes, all four
years in length. There is considerable competition for entry into Canada’s ten
dental schools, five of which are located in Quebec and Ontario. Canadians
are among the world’s highest spenders on dental care, in part due to the
prevalence of private dental insurance – largely through employment-based
benefit plans. As with physicians, a number of specializations requiring two to
three years of higher education and residency have emerged over time including