Remote Work
Toolkit

Information for Residents

UPDATED: MAY 27, 2020 | 12:16 PM EST


The scenario is rapidly evolving, all attempts are being made to provide as current information as possible to all NOSM residents.

Webinar: May 27, 2020: Psychological PPE: Exploring Compassion Fatigue and Learning How to Keep Ourselves Psychologically Well
Register here

Orientation Information – Incoming PGY1s

We are excited to be welcoming a new cohort of PGY1 residents in July. This memo from Dr. Robert Anderson, PGME & Health Sciences Associate Dean outlines how we are preparing for the new class in light of COVID-19 and the various supports we are offering.

Principles Related to the Potential of Extended Training Due to a Pandemic

NOSM PGME, and all Ontario PGME Offices, are united with PARO in supporting the following principles related to the potential of extended training due to a pandemic:

  • Being as judicious as possible in determining whether a resident has been able to sufficiently achieve the competencies in the context of measures needed to ensure the health and safety of residents and the public, including, but not limited to, time spent redeployed, in quarantine, self-isolation, or due to time off to care for children or dependents;
  • Being willing to focus promotional decisions on the entirety of a residents training competencies and performance with a decreased focus on minimum or maximum time spent on certain rotations, particularly for those senior residents not currently enrolled in a CBME-program;
  • Recognizing that this cohort of residents are obtaining training in medicine during a pandemic where unique competencies can be achieved that should be recognized and factored into promotion decisions;
  • Recognizing that competencies achieved while redeployed will be considered as applicable and transferrable for rotations where those competencies are relevant.

NOSM programs will help to operationalize these principles and we count on the support of our faculty and training sites to recognize the challenges facing residents particularly those close to graduating. We continue to advocate with the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada on the move to competency-based training rather than time-based measures for advancement, particularly during this time.

Letter to Residents – March 25, 2020

General Principles for the Reassignment of Residents in Times of Exceptional Health System Need

Updates on Certification Examinations & Provisional/Restricted Licensure

Family Medicine Residents – Please see the latest update from the CFPC about the certification exam.

Royal College Residents – Please see the latest update from the RCPSC about the certification exam.

Both Colleges have waived oral examinations for this graduating cohort of residents and are working on plans for written examinations in the Fall. NOSM PGME and CEPD are assessing what type of exam preparation support may be helpful to offer our graduates who will be sitting their exams this fall. Further information will be shared once available.

The College of Physicians and Surgeons of Ontario process for final year residents whose certification exams have been postponed is available here.  PARO also released further information for residents regarding Ontario licensure which provides more helpful information on the supervision requirements. The PGME Office, residency program leadership and NOSM’s Faculty Affairs unit will be working with NOSM graduating residents who may need assistance in locating a supervisor in Northern Ontario. Residency program contacts are first reaching out to all our graduating residents as a starting point to ascertain the level of support required.  Many final year residents have already sourced potential supervisors and we express appreciation to our faculty for continuing to provide support to this group.

The attached memorandum sent to all exam eligible final year residents from the PGME Office describes the process/support for submission of information to the medical regulatory authorities for residents who are in progress to apply for provisional/restricted licenses.

All upcoming Medical Council of Canada qualifying exams have also been postponed and the MCC is working out options and contingencies again to be communicated once available.

Update on Resident Registration Processes – New and Returning Residents

In response to challenges presented by the COVID-19 pandemic, the NOSM PGME registration processing will be completed via electronic documentation only.

Returning Residents

  • All returning and new residents are advised to submit your registration documents electronically as PDF or JPEG files as outlined in reappointment packages.

New/Incoming Residents

  • VSS/PVSC – Once obtained from your local police station, please submit electronically as PDF file. At this time, we are asking you to retain the original copy as it may be requested in the future.
  • All other registration documents should be submitted electronically.
  • Further details are included in your registration packages.

Orientation: We are continuing to plan for orientation to occur on Monday June 29, 2020. Further details will be released as they are available.

Potential of Service Delays:

  • We recognize that there may be challenges in obtaining certain immunization and police record check documentation. We will provide updates as we are made of any service disruptions and the impact on registration; please continue with the documentation requirements as outlined and advise us directly of any challenges.

If you have any questions or concerns regarding your registration or re-registration with NOSM’s PGME Office please email pgregistration@nosm.ca for assistance.

CPSO Registration Update: New Applicants

  • CPSO Application and Forms
  • The College of Physicians and Surgeons of Ontario has updated their website to allow for electronic applications for new resident applications. All completed applications, supporting documentation and third party documents should be sent to credentials@cpso.on.ca

Further information can be found in the attached document.

Electives Outside of NOSM for NOSM Residents

Commencing in July, many Medical Schools nationally are re-opening postgraduate medical education electives (along with core rotation agreements at other Schools). Not all Medical Schools are able to open due to PPE availability and other local capacity issues at their sites.  Decisions to accept electives are entirely subject to the protocol of the receiving university and following any self-isolation and screening protocols in place in various hospitals and jurisdictions. It is recommended that residents review the receiving university elective web-sites for availability and follow the application guidelines early. Site protocols may change and vary, and residents should consider what a back-up plan might be if the situation changes. Residents can also anticipate needing to follow screening protocols upon arrival and throughout their elective and if screening isn’t passed at the site then their rotations may potentially be disrupted.

Core and Elective Rotation Travel Within Northern Ontario for NOSM Residents

Residents scheduled for rotations within Northern Ontario are able to move among communities. There are some exceptions which mandate a 14-day self-isolation period upon arrival. Presently this is the case for Thunder Bay Regional Health Sciences Centre (TBRHSC) for travel from outside of Northwestern Ontario, Sault Area Hospital for travel from outside the Algoma region, and Sioux Lookout for travel outside of Northwestern Ontario. All residents are asked to send questions on scheduling matters to their program contacts including any COVID-19 screening questions. All residents must continue to report any daily absences from training due to screening issues or travel self-isolation factors to their program contacts for tracking and follow up.

Resident Travel Claims

The Finance Unit would like to thank you for your ongoing patience and understanding while we operate remotely. We want to reassure you that claims and payments for reimbursement, invoices and other financial transactions continue to be prioritized and processed.
 
We are working hard to process your claims as quickly as possible; however given the large volume of requests, current working arrangements and limited access to systems, you may encounter delays in processing times. Many of NOSM’s financial transactions are still paper-based requiring finance staff to take scheduled turns coming into the office to process documents. This has resulted in additional delays beyond our control.
 
We ask for your continued patience and that you refrain from calling or sending emails regarding payment status at this time, as these inquiries only compound delays. Be assured we have received your claim and will process as soon as possible.
 
Finance staff will reach out directly if they have questions or require additional information related to your claims.
 
In particular, we are receiving a large number of inquiries related to travel expense reimbursements affected by COVID-19. The following is a collection of FAQs that we have received that you may want to reference:
 
FAQ’s RELATED TO TRAVEL EXPENSE REIMBURSEMENT AFFECTED BY COVID-19
To help guide those individuals who had booked travel or conferences and had those plans interrupted by the COVID-19 outbreak, Finance has put together a guide to help you submit for reimbursement.
 FLIGHTS
I booked a flight but had to cancel. What do I do? How do I submit?
You must either cancel your flight directly with the airline or contact Red Tag if you booked through Red Tag.
 
You can submit for full reimbursement of the original cost of the flight to NOSM Finance through the online Expense Reimbursement submission portal.
 
Include your airline cancellation information in your travel claim. If you have already submitted for your flight, send a copy of the cancellation to accountspayable@nosm.ca with your expense submission tracking number.      
 
If you booked through Red Tag, they will track your credit for you. If you booked personally, it is your responsibility to track your own credit.
 
In the future when the credit is used, you will provide that information again to Finance. These flights were paid by NOSM and should be used for future NOSM business.
CONFERENCE FEES
 
Many people were planning on attending conferences, such as CCME and Northern Constellations, and had already registered and paid.
 
In the case of CCME, the organizers have determined to refund all attendees 75% of their registration and offer online content.
I submitted my conference registration fees to Finance and have already been reimbursed. Now I have a refund for the fees. What do I do?
 
Please contact accountsreceivable@nosm.ca and arrangements can be made to repay this refund or create a credit to be applied against future NOSM reimbursements. Please provide your original expense submission tracking number, the amount of the refund and proof of the refund amount via your credit card statement.
 
I have already submitted my conference registration fees to Finance but have not been reimbursed by NOSM Finance yet. What do I do?  
  
If you have not received a refund for your conference fees, then do nothing at this time. NOSM Finance will process your claim in full. Once you receive the refund for your conference registration fees, please follow the steps above.
 
If you have received your refund, then please contact accountspayable@nosm.ca as soon as possible. Please provide your original expense submission tracking number, a copy of and the amount of the refund via your credit card statement and your claim will be adjusted accordingly.
 
I have not submitted a claim to NOSM Finance for my conference registration fees.  What do I do?  
 
If you have not received a refund for your conference registration fees then you may choose, if you wish, to submit for the full reimbursement now. You will then follow the steps above once you receive your refund for the conference registration fees
 
If you have received a refund for your conference registration fees, then please submit your claim through the online Expense Reimbursement submission portal.   Please include both your original payment information and refund information in the submission
PREPAID HOTEL OR AIRBNB RESERVATION

Prepayments and refunds of any hotel reservations will be processed in the same way as the conference registration fees above.

If you have any questions please contact accountspayable@nosm.ca and include your expense submission tracking number.
On behalf of the Finance Unit, thank you for your understanding during this unprecedented situation.

Vacation Leave

Scheduled Vacation:  We encourage residents to consider deferring vacation and other leaves if possible and understand there may be a need to mandate rescheduling of vacation if there will be a demonstrable negative effect on patient care. These decisions will be made by the Program Director on the basis of program and site clinical needs.

We anticipate all unused vacation days that are disrupted due to the pandemic will be available for future use and we will adhere to the PARO Collective Agreement in all such incidences.

Exam Study Leave

CFPC Exam Leaves: All CFPC exam leaves are cancelled and residents will be scheduled back into clinical time, unless otherwise off on leave or in self-isolation etc. If the SAMPS do move forward for June, exam leave can be rescheduled four weeks prior to this written exam. Further details will come from the FM program directly to the FM residents.

Do I have to go to work during a pandemic or crisis?

Residents have dual roles as both trainees and health-care providers. As members of the medical profession, we are all called upon to provide care to the best of our ability during a crisis. Sometimes this means taking on elevated personal risk.

Specific depts in various hospital and clinic sites will determine levels of procedures involving residents. Individual residents also have the right to refuse unsafe work. Certain residents may be considered higher risk, including those who have chronic respiratory disease, those who are immunocompromised, those who are pregnant, and those who cohabitate with any of the above. You are not expected to serve if you fall ill or become a vector for infection.

Residents must have all the PPE and safety supports that are required to do their work at their site. We are following and support the Residents and Public Health Emergency Preparedness Guidelines.

The clinical supports required for patient care may be unpredictable over the coming weeks and residents could be deployed to areas of care that are within their scope to help support the care of patients. Again, all efforts will be made to minimize the risk to residents and optimize the care of patients.

I am receiving conflicting messages from my training site and NOSM regarding travel screening procedures, which do I follow?

Always follow the screening protocols at your site. As of March 13, 2020 anyone returning to a Northern Ontario training site following international travel is required to identify to the PGME Office using the NOSM screening form or in conjunction with Occupation Health procedure at your training site and self-isolate for fourteen days. Your program contacts will support and track self-quarantine time and make every effort to assign study or non-clinical work.

I am quarantined following screening measures or otherwise, do I need to apply for short term sick leave or provide documentation to return?

Residents who are asymptomatic and have been quarantined must report the absence to their program coordinator following normal absence procedures, however, you will not be asked to provide a medical note to return to work. Your program and/or a member of the PGME Office will be in routine contact with you and once the quarantine period is over you will return. Residents who are ill would be assessed on a case by case basis regarding clearance to return. Vacation days etc will continue to accrue during any periods of quarantine etc.

What happens to my course of training?

NOSM’s goal is to make every effort to continue academic programs with minimum disruption. Your site director, program director or program coordinator will issue updates in the event of any disruption to academic and clinical schedules. Every effort will be made to provide alternatives in the event of clinical or academic disruption that is appropriate to training level and program resources. If you are quarantined and asymptomatic, your program will likely have expectations for some continued study or scholarly work. This will be communicated directly to affected residents.  All efforts will be made to avoid an increase in length of training however extensions may be necessary in some cases and will be supported.

Are academic events cancelled?

Academic events are not presently cancelled but changes to delivery are underway. PGME has mandated that academic events and program meetings that require faculty or resident travel in March and April will be delivered through videoconferencing and/or web-ex allowing participants to join remotely or they will be rescheduled to a later date. Any cancellation costs for travel tickets already purchased will be reimbursed. Program directors and academic coordinators are monitoring potential impact to any procedural based academic sessions that cannot be delivered by web-ex over the next two months and updates will be communicated within programs directly.

Do the PARO-CAHO Collective Agreement rules still apply?

Every attempt will be made to respect the conditions outlined in the agreement. Work hour limits can be waived during a pandemic situation, if absolutely necessary.

Could there be interruptions in salary or vacation?

Salary, benefits, and stipend entitlements continue during any pandemic. Due to extraordinary patient care needs, certain vacation requests may be denied. Vacation days will continue to accrue as usual.

What should I do if I get sick?

If you have symptoms associated with a respiratory infection it is important that you stay home. Do not report to work and follow procedures for contacting a health professional or health unit. Follow the usual leave procedures for reporting sick leave to your program. You will not face repercussions for being ill and programs will err on the side of supporting residents through program disruptions and time off related to COVID-19.

How can I protect myself at work?

Always follow universal precautions, like handwashing, before and after each patient encounter and upon entering and leaving the hospital or clinic. Always strictly follow additional precautions for each patient including contact, droplet or airborne precautions. Use dedicated equipment for patients or thoroughly wash equipment after patient encounters. Avoid unnecessary encounters by rounding comprehensively. If you are uncertain how to approach a patient, contact your supervisor or infection control. Always review the specific protocols at your training site.

N95 mask fit

Keep your N95 mask fit card on you at all times. All residents are expected to be up to date with your mask fit test as previously outlined by the PGME Office. If you know that you cannot be fit properly due to religious or health reasons, contact your site director or program director now to understand how this will affect you work and training. Familiarize yourself with all site-specific protocols at your training site.

I feel stressed, who can I turn to?

The PGME Resident Wellness Office

The PGME Resident Wellness Office is fully operational and has worked under physical distancing since it came into existence – at anytime just send an email

  • for direct support contact the Wellness Lead Clinician residentwellness@nosm.ca or
  • Jaimy Kiiskila our Resident Wellness Coordinator for information and logistical assistance (pgewellness@nosm.ca Office number 807-766-7458

If you have an underlying condition that puts you at high risk of severe COVID disease you can contact us to discuss some restrictions on certain types of work

Clinical Psychologist

Ms. Caroline Charette, professional psychologist, has been contracted to NOSM to support residents. She is taking referrals – just email the Wellness Lead Clinician  or the Resident Wellness Co-ordinator for individual therapy.  She also offers small and large group sessions.

EFAP at Morneau Shepell

  • Employee and Family Assistance Program for all residents across NOSM’s wider campus of Northern Ontario. Immediate support 24/7/365: 1-800-387-4765.
  • Offer various types of counseling and therapies including emotional support, financial advice, family counseling, fitness and nutrition counseling, etc.
  • Even before pandemic counselors were typically available by phone or video conference.
  • Best way to access is workhealthlife.com but they also have a hotline and an app you can download.

Crisis numbers:

  • The Physician Health Program, through the OMA, offers confidential support for trainees and practicing physicians through live counselors available between 9 am and 5 pm 1-800-851-6606
  • PARO 24-Hour Helpline: A confidential support service for residents, medical students, their partners and families. The toll-free number is accessible anywhere in Ontario, 24 hours a day, 7 days a week. PARO Help Line: 1-866-HELP DOC (1-866-435-7362).

Ontario COVID-19 Mental Health Network

Offer PRO BONO mental health services for Ontario COVID-19 healthcare providers. They are a volunteer network of Ontario-based mental health professionals dedicated to supporting frontline COVID-19 workers during the evolving crisis  Https://covid19therapists.com .

The Centre for Addiction and Mental Health (CAMH)

  • http://www.camh.ca/covid19gethelp Provides a self-referral form for all healthcare providers. This will allow healthcare providers to connect with CAMH services, supports, and assist them in navigating what supports they need.
  • CAMH also houses a website where they send all the support programs that they learn about so people can self-navigate if they want http://www.camh.ca/covid19HCW

MD led virtual chats

  • hosted by Dr. Kasra Khorsani and sponsored by the OMA. This is not psychotherapy.
  • Starting March 23, the Physician Health Program invites you to drop in virtually between noon and 1 p.m. each weekday to support one another during the COVID-19 pandemic.
  • Stay for one minute if you can and come back as many times as you like.
  • Everyone is welcome http://php.oma.org/virtual-chats/
  • The chats are meant to be a safe space where we can talk about how we are managing. Join Zoom Meeting Daily from 12:00-1:00

OMA-MD Resident Chat Sessions

  • free facilitated sessions to support each other during COVID19
  • Session Facilitator: Dr. Kasra Khorasani is a staff psychiatrist at U of T with over 20 years of experience working with residents in group therapy amongst other things and has generously set up an online support group for MD residents in Ontario.
  • Please feel free to drop in virtually 2-3 pm four times/week Monday, Tuesdays, Thursdays and Friday.
  • Stay for a minute or longer if possible and come back as many times as you like.
  • These sessions will be ongoing and will continue as they are needed. All are welcome.
  • This will occur via zoom and is meant to be a safe space to talk about how we are managing
  • They look forward to chatting with you starting Monday March 30th, 2-3 pm.

ECHO Ontario Coping with COVID Resources for residents:

ECHO Coping with COVID is designed for Healthcare Providers and Residents responding to the COVID-19 pandemic https://camh.echoontario.ca/echo-coping-with-covid/  Participants are invited to join ECHO sessions virtually through multi-point videoconference technology to share and learn about ways to build resilience and overall wellness through didactic lectures and case-based discussions

  • Wednesdays 2:00pm – 3:00pm Fridays 12:30pm -1:30pm
  • Starting: Friday, March 27, 2020

Apply here: https://edc.camhx.ca/redcap/surveys/?s=KXNTKXKFXY

Mindfulness

The COVID-19 pandemic is causing unprecedented levels of stress and anxiety in the workplace. Consider dropping in and learning short mindfulness practices to help find calm during challenge. Relax, recharge and learn how to incorporate moments of mindfulness into your day. This is not treatment. Optional discussion to follow. No OHIP required. Join the 30-minute physician mindfulness sessions

Where can I get up to date reliable information on NOSM’s response to COVID-19?

Information on NOSM’s response to the pandemic and any impact to your residency training program will come to you from postgrad@nosm.ca, jfawcett@nosm.ca or specifically from your program director or other program contact.

Global messages to the entire NOSM community will come from the Dean’s Office.