Public Consultation: Draft Practice Direction for the supervision of Physician & Clinical Assistants

January 09, 2024 |


CPSM seeks feedback from registrants, stakeholders, and the public regarding the DRAFT Practice Direction - Practice Supervision Requirements for Clinical and Physician Assistants, and Physician Assistant Students.


CPSM is currently reviewing all policies and Practice Directions related to registration to update, revise, and better organize them into single-source documents that are easier to access and understand.

The public consultation runs from January 10 – February 11, 2024.



In Manitoba, Clinical Assistants (ClAs) and Physician Assistants (PAs) must practice under a Contract of Supervision with a physician (regulated member). Supervision requirements are complex; this complexity is amplified due to practice requirements for ClAs and PAs being spread out in the Regulated Health Professions Act, the CPSM General Regulation, the Practice of Medicine Regulation, and the Practice Direction Registration and Qualifications. Users of the contracts have also expressed concerns about the length of supervision contracts.


The proposed Practice Direction streamlines these requirements and adds explanatory language and expectations. Doing so will allow us to reduce the length of contracts and support the accessibility and transparency of the process. The proposed Practice Direction is not intended to change current requirements significantly.


About the Practice Direction


Many of the requirements set out in the Practice Direction are not new and match already existing expectations.  

The Practice Direction addresses:

  1. Certificates of practice.
  2. General requirements for practice descriptions and contracts of supervision.
  3. Supervision of CIAs and PAs.
  4. Title restrictions.
  5. Performance of reserved acts and delegation of reserved acts.
  6. Collaborative care.
  7. Continuing professional development.

The Practice Direction adds criteria for the supervising physician's role, responsibilities, and duties. The criteria are primarily based on current, standardized contracts of supervision.

Additionally, guidance for billing procedures when CIAs or PAs are involved in providing care is attached to the Practice Direction as contextual information. 


Consultation Process

The draft Practice Direction is being distributed to the public, CPSM registrants and stakeholders for input.

Feedback from all our stakeholders is valued and contributes to holding registrants accountable to high standards of medical care. This includes all Manitobans, registrants, regulated health professions, the government, and other organizations.

We ask that you share the Practice Direction with other stakeholders who could provide valuable perspectives.


How to Submit Your Feedback

  1. Review the DRAFT Practice Direction here.
  2. Submit your comments in writing by email to:

The deadline for feedback is February 11, 2024.  

We thank you in advance for your time and input.

You can find more information about our public consultation process here