In Canada, while there are many primary care functions typically performed by a doctor that a Nurse Practitioner (NP) can also perform, like diagnosing illnesses and prescribing medications, it is a doctor’s extensive education and training that is the biggest difference between the two. This education and training allow a doctor to perform complex procedures such as surgeries and treat medically complex patients, which an NP cannot. Doctors can also pursue a wider range of specialized training, such as in obstetrics, while NPs can only provide prenatal care while the patient is pregnant.

NPs can practise independently or in collaboration with other health-care providers, including registered nurses, doctors, social workers and others. They provide comprehensive health services in various settings such as hospitals, community care, acute care, and long-term care facilities.

What can an NP do?

Ontario’s Nursing Act, 1991 regulates exactly what an NP can do. For example, they can:

• assess, diagnose and treat illnesses, and formulate treatment plans;
• order and interpret lab results;
• order diagnostic tests, such as MRI or CT scans and X-rays;
• make referrals to specialists;
• prescribe medications (including opioids, provided they have completed the required education to prescribe controlled substances); and
• manage a patient’s overall care.

Other things an NP can do include:

• take a patient’s medical history
• perform physical exams
• diagnose and treat sexually transmitted infections (STIs)
• perform Pap smears
• prescribe birth control
• insert or remove IUDs
• certify people for the disability tax credit (DTC)
• sign medical certificates for sickness benefits and three EI caregiving benefits (the compassionate care benefit and family caregiver benefit for adults and children).

What is the difference between a Registered Nurse and a Nurse Practitioner?

An NP has additional education (master’s level or higher), training and nursing experience that a Registered Nurse (RN) does not. NPs have an expanded scope of practice that includes many primary care functions typically performed by a doctor, such as diagnosing and treating illnesses, and prescribing medications. RNs provide and coordinate care, administer treatments, and make nursing diagnoses (a clinical judgment about a client’s response to actual or potential health problems, as opposed to a medical diagnosis, which identifies a disease). In some provinces, a RN can prescribe medication, but only after completing specific, provincially approved education and training.

Education and training

Nurse Practitioner: It takes about six to eight years to become a Nurse Practitioner in Canada. This includes:

• Obtaining a four-year Bachelor of Science in Nursing (BSN) degree, AND
• One to two years for a Master of Nursing (MN) degree, OR
• Two years for a post-master’s certificate.

Candidates must also:

• Hold a registered nurse (RN) license
• Complete an approved graduate-level Nurse Practitioner program
• Pass a recognized NP licensing examination
• Meet language proficiency and other regulatory requirements

Registered Nurse: Typically, a 4-year bachelor’s degree in nursing.

Doctor: While admission requirements vary across the 18 medical schools in eight provinces in Canada, a candidate must meet the following general guidelines to become a doctor:

• Complete a bachelor’s degree,
• Score well on the Medical College Admission Test (MCAT),
• Graduate from a 4-year medical school,
• Pass the Medical Council of Canada Qualifying Examination (MCCQE) Part I,
• Complete a residency program (2-7 years),
• Be on the Canadian Medical Register, and
• Obtain provincial/territorial licensing.

Who regulates NPs?

In Ontario, Registered Nurses and Nurse Practitioners are regulated by the College of Nurses of Ontario (CNO) which is responsible for:

• Setting entry-to-practice requirements
• Establishing scopes of practice
• Registering and licensing NPs
• Investigating complaints and managing discipline

Doctors are regulated by the College of Physicians and Surgeons of Ontario (CPSO).

Upcoming changes – NP classification

In Ontario, NPs can receive specific specialty classifications, such as NP Primary Health Care, NP Adult, or NP Paediatrics. However, many provincial regulators are working with the Canadian Council of Registered Nurse Regulators (CCRNR) to make changes to NP regulation, developing a national framework for a single NP classification based on common entry-level competencies and a national exam. This new, single classification would mean that NPs are educated and licensed to practice across all client ages and all health settings. The new model for Nurse Practitioner regulation is expected to be implemented in some provinces beginning in 2026.

According to CCRNR, “NP applicants currently write the Pediatric, Adult or Family/All Ages Exam, but starting in 2026, applicants (with the exception of Neonatal NPs) will write a new, single-entry national Nurse Practitioner (NP) exam.”

For more information, visit the CCRNR website.

More info

For the most up-to-date information the role of Nurse Practitioners and what they can do, view the legislation or visit the provincial regulator website.

								
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