- Background: PA Training in Canada vs. the U.S.
- Certification Bodies
- Can a Canadian PA Get ASCP Certified?
- Visa and Work Authorization Considerations
- Practical Realities
- Advice for Canadian PA Students Considering the U.S.
Introduction
If you’re training or working as a Pathologists’ Assistant (PA) in Canada, you may be wondering: Can I take my skills south of the border and work in the United States? This is a common question, and the answer isn’t simple. Canadian programs are rigorous and NAACLS-accredited, so graduates are eligible for ASCP certification. The real challenge, however, comes with immigration. Securing the proper visa, finding an employer willing to sponsor, and navigating recent changes to U.S. work visa rules make cross-border practice difficult. This article outlines both the certification and immigration hurdles you need to know about.
Background: PA Training in Canada vs. the U.S.
Canadian PA training is available through four NAACLS-accredited master’s-level programs:
- University of Alberta
- University of Calgary
- University of Toronto
- Western University (London, Ontario)
Graduates typically pursue certification through the Canadian Certification Council of Pathologists’ Assistants (CCCPA).
In the U.S., there are over 13 NAACLS-accredited PA programs at the master’s level. Graduates are eligible to sit for the ASCP (PA-ASCP) Board of Certification exam.
While Canadian and U.S. programs cover very similar topics, the certification bodies differ – and that’s where the barrier lies.
Certification Bodies
- Canada: Certification through the CCCPA
- United States: Certification through the ASCP Board of Certification
Canadian employers prefer/require CCCPA certification. Some may recognize ASCP certification.
U.S. employers almost universally prefer/require ASCP certification. Without it, applying for PA positions in the US will be difficult. They do not recognize CCCPA certification.
Can a Canadian PA Get ASCP Certified?
Canadian graduates are eligible to sit for the ASCP PA certification exam, due to the fact that Canadian training programs are NAACLS accredited. This eligibility only extends to those that graduate from a NAACLS-accredited program.
After graduating from one of these programs, you’ll have up to 5 years to obtain your ASCP certification.
Graduating from a program that does not have NAACLS accreditation or receiving on-the-job training will not qualify you to write this exam.
This means:
- Canadian-trained PAs from a NAACLS program can directly challenge the ASCP exam
- There is no certification advantage to attending a US-based program over a Canadian-based program, assuming both are NAACLS accredited
- You must write the ASCP exam within five years of graduating
Visa and Work Authorization Considerations
Canadians still need proper work authorization if they don’t have a US permanent resident card or their spouse is not an American. Two options exist:
- TN visas under the USMCA agreement (only for Canadians and Mexicans)
- H-1B visas for specialized occupations
If you are a Canadian (ie you are a citizen – Permanent Resident status isn’t enough) you may be able use the TN1 visa route.
TN1 Visa
The TN1 visa will give you a 2-3 year period to work in the US and you can continually renew before it expires. There is no limit on how many times you can renew. This can be inconvenient to do every few years but this is a popular and flexible option for those that are eligible. One thing to be aware of is that there is a list of eligible job titles that can use this route and “Pathologists’ Assistant” is not on the list.
You may be able to apply through the MLT stream if you have the proper title and credentials (you may have an MLT title but still work in a gross room in hospital settings).
Fair warning: the USCIS will check your education background to see if it matches with your job title. PA certification is not the same as MLT certification so this may not be a viable option.
H-1B Visa
The other option is the H-1B visa. This a more traditional route which lets you work in the US for 3-6 years – the first period is 3 years but you can renew for another 3 years with the option to obtain permanent resident status. But this comes with significant challenges.
The H-1B visa requires employer sponsorship (your employer files the petition), may involve a lottery in some cases, and as of September 2025 comes with a major new restriction: employers must now pay a $100,000 USD fee for every new H-1B petition (White House announcement). This fee does not apply to renewals or current H-1B holders, but it makes new applications extremely difficult. Because individuals cannot reasonably pay this $100K fee without hospital sponsorship, pursuing this visa independently is essentially unrealistic.
Unless you attend a U.S.-based PA program (in which case the $100k fee will be waived), most Canadian-trained PAs will likely find it difficult to find hospital employers willing to justify the sponsorship cost.
Choosing the H-1B route also shapes your job search strategy. Leading hospitals such as Mayo Clinic and Massachusetts General Hospital typically state in their postings that they do not sponsor applicants, as they have a large pool of qualified U.S. candidates. Private laboratory services may offer higher salaries, but for international applicants they are often less viable because, even if the employer is willing to sponsor, you must still go through the H-1B lottery process.
The H-1B lottery exists because there are far more applications than visas available each year. Here’s how it works:
- You must already have a job offer and an employer willing to sponsor you
- All sponsored applicants enter the lottery pool
- Roughly 1 in 9 applicants are selected. The rest must wait until the next cycle to reapply
- If you hold a U.S. master’s or PhD degree (degrees from Canada do not qualify), you enter a separate lottery with slightly better odds, about 1 in 4
This system adds significant uncertainty, even if you have a sponsoring employer ready to hire you.
Cap-exempt employers, such as university-affiliated hospitals, nonprofit research institutions, and government research centers, can sometimes provide a more realistic route for Canadian PAs. These employers are not subject to the annual H-1B cap, allowing applicants to bypass the lottery system. In some cases, they may also avoid the new $100K fee requirement. While salaries at public university hospitals may be lower than those at private laboratories, this pathway can make visa sponsorship more attainable for international applicants.
In short, obtaining a work visa involves significant barriers: employer willingness to sponsor, navigating complex visa categories, and now steep financial costs for H-1B applications. If working in the U.S. is your long-term goal, consider these hurdles early, and discuss them directly with potential employers before making career decisions.
| Visa Type | Duration | Key Advantages | Major Limitations |
|---|---|---|---|
| TN Visa | 2–3 years, renewable | Easier to obtain for Canadians; renewable indefinitely; flexible job changes | PA not explicitly listed as eligible occupation; no pathway to permanent residency |
| H-1B Visa | 3 years (renewable to 6) | Standard pathway for specialized professionals; potential for permanent residency | Requires employer sponsorship; subject to lottery; new $100k fee makes new petitions extremely unlikely |
| Cap-Exempt H-1B | 3 years (renewable) | University-affiliated hospitals and nonprofits can bypass lottery; sometimes avoid fee | Limited to specific employers (academic/ nonprofit); often lower salaries than private labs |
Practical Realities
For Canadian PAs, immigration is often a bigger challenge than certification when it comes to working in the U.S. The main hurdle is visa sponsorship:
- TN visas do not clearly list Pathologists’ Assistant as an eligible profession, which complicates eligibility.
- H-1B visas now carry steep costs and often require navigating the lottery, making employer sponsorship less likely.
Put simply, even if you are eligible to sit for the ASCP exam, securing a U.S. job offer comes down to whether you can find an employer willing and able to sponsor a visa. This creates a significant barrier for most Canadian-trained PAs. As a result, immigration issues often overshadow certification concerns and should be your main focus if you are seriously considering a move to the U.S.
Advice for Canadian PA Students Considering the U.S.
If your ultimate goal is to work in the United States, keep immigration challenges front and center:
- Start conversations with employers early. Ask directly if they are willing to sponsor international applicants, and clarify whether they are a cap-exempt institution (such as a university hospital). This will give you a realistic sense of your options.
- Write the ASCP exam promptly after graduation. Having your certification in hand makes you more competitive, even if immigration is the bigger barrier.
- Gain experience in Canada first. A Canadian job provides stability while you manage the lengthy visa process, which often requires final transcripts and other documentation not immediately available at graduation.
- Stay informed about policy changes. Visa rules can shift quickly. Monitor updates from USCIS, ASCP, and professional networks so you aren’t caught off guard by new requirements.
Conclusion
So, can Canadian Pathologists’ Assistants practice in the United States? Yes, but with major caveats. While Canadian graduates from NAACLS-accredited programs are eligible to sit for the ASCP exam, the real challenge lies in immigration. The need for visa sponsorship, the high costs and uncertainties of the H-1B process, and the lack of clear TN eligibility make crossing the border for work difficult. Success depends heavily on finding an employer willing to navigate these barriers with you.
Thank you to Li Hao for the extensive information you provided regarding the cross-border working requirements!