Remote Work
Toolkit

Information for Residents

The scenario is rapidly evolving, all attempts are being made to provide as current information as possible to all NOSM residents. External links related to matters such as qualifying examinations and other updates are continuously updated.

Updates on Certification Examinations & Medical Council of Canada Qualifying Exams

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.

Medical Council of Canada Exams – Latest updates.

Vaccinations

NOSM’s COVID 19 Vaccination Policy for Learners in Clinical Settings was approved in compliance with the Ministry of Health Directive #6.  This is a NOSM-wide policy approved by the NOSM Executive Group.
Thank you to all resident who have worked with the PGME Office to provide vaccination receipts in order for NOSM to update its credentialing processes with clinical sites and to meet MOH requirements.
Clinical Site Credentialing
In accordance with this policy, NOSM PGME will be communicating directly with any sites and residents where a resident is either unvaccinated or partially vaccinated for next steps related to the provision of antigen test results to postgrad@nosm.ca and any hospital education modules. We will communicate with the relevant parties on a case-by-case basis to ensure we meet the site’s frequency for testing and communication of results.
There remain to be a few outstanding responses and we have exceeded deadlines and reminder strategies to receive this information. These scenarios will also be followed up on directly.
For residents who have supplied their vaccination records and/or definitive response on their vaccination status, you can rest assured that the PGME Office is the record keeping interface with your clinical sites and you should not need to replicate information within Northern Ontario.
Electives Outside of Northern Ontario – Attestation Letters
For the purposes of elective rotations outside of Northern Ontario, each resident will receive a customized attestation letter outlining the vaccination records that NOSM is holding. The COVID-19 vaccination policies of the receiving institution take precedence, and our hope is that this letter may make the process more streamlined for you.
Access to NOSM Campus
NOSM has also released a return to campus framework. Some programs are resuming in person academic events on campus later this fall, and in advance program coordinators will be ensuring residents receive specific instructions related to screening and access modules that must be taken. If residents wish to access campus as well for other ad hoc reasons such as using the NOSM library, it’s recommended that you are in touch with your program coordinator to review access steps. We recognize residents are infrequently on campus and the entirety of the ‘Return to Campus’ documentation may be confusing to residents. Program Coordinators are your best front-line support to navigate this.

 

Any questions on these policies may be directed to postgrad@nosm.ca and we will reply within 24 hours during business days.

Core and Elective Rotation Travel Within Northern Ontario for NOSM Residents

Residents scheduled for rotations within Northern Ontario are able to move among communities. 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.

NOSM Housing Pandemic Exception

As of July 01, 2021, NOSM has returned to a shared accommodations model. This affects all NOSM learners performing core mandatory and elective clinical placements within the NOSM catchment area.

The NOSM Community Relations Unit (CRU) will continue to monitor the evolution of the pandemic and determine if alternative housing arrangements (such as a re-activation of the COVID Housing Reimbursement Protocol) are necessary for the overall safety of the learners.

Where unique housing alternatives are required:

In cases where housing alternatives are required for unique circumstances, the CRU will work with a resident’s Program Coordinator to find alternative arrangements on a case-by-case basis. Where isolation restrictions are required (as dictated by Public Health) in certain northern Ontario communities, Programs are to connect with the CRU (email jleduc@nosm.ca and cc: housing@nosm.ca) to discuss other housing/funding possibilities (based on the concept of the COVID Housing Reimbursement). We will continue to work with the Programs (Undergraduate Medical Education, Postgraduate Medical Education and Health Sciences, Physician Assistant, NODIP) to ensure that all learners are safe and supported while in the community.

Resident Access to NOSM Campus and Libraries

All NOSM buildings continue to be closed during the pandemic and key card access is required for entry for anyone with authorization to be on campus. Only those who are pre-approved to be on campus and have completed the mandatory training and attestation will be provided with a key card and/ or will have their current key card activated for entry into the NOSM building. This process is coordinated and monitored to mitigate potential risks and to ensure NOSM complies with Government directives and policies of the host universities. NOSM will continue with this approach unless otherwise directed by the Government of Ontario or the Dean, President and CEO of NOSM.

Under what circumstances can NOSM residents currently access NOSM campuses?

  • For program arranged mandatory on-site academic sessions
  • For approved library bookings (steps outlined below in 5 Steps to Accessing NOSM Campus Libraries)
  • For all other purposes, residents must request authorization to be on campus in advance of their requested access/entry date through their Program Coordinator. In this request, residents must clearly outline the reasons why they need to access the NOSM campus and why this access would be deemed essential. Programs will work with the PGME Office to grant the approval of the PGME Associate Dean for access, if deemed appropriate under the School’s current guidelines and in line with School’s capacity guidelines for the date/time/campus requested.

 

IMPORTANT NOTE:

NOSM will require all learners, researchers, faculty, staff, and visitors who intend to access the NOSM on-campus buildings in Sudbury and Thunder Bay to have received their full vaccination or the first vaccine dose by September 7, 2021 and must be fully vaccinated by no later than October 7, 2021.

Full vaccination means having received the completed series of a COVID-19 vaccine that has been approved for use by Health Canada and/or the World Health Organization. An individual is considered fully vaccinated 14 days after receiving their second dose. As such, those who are authorized to be on campus will be required to attest to their COVID-19 vaccination status prior to their return to campus by completing a mandatory training module and attestation. 

Any individual who cannot be vaccinated based on medical or other grounds recognized by the Ontario Human Rights Code can request an accommodation. Those who remain unvaccinated and who must access campus will have to follow additional strict health protocols such as: frequent testing, wearing masks and other PPE, if necessary, as well as other possible measures to be announced at a later date.

Please contact your Program Coordinator for additional information.

 

5 Steps to Accessing NOSM Campus Libraries

  1. Contact your Program Coordinator

As a continuation of our Return To Campus (RTC) Plan, residents who are requesting to be on campus for essential academic needs such as library access, must have prior authorization which will be facilitated by your Program Coordinators. Email your Program Coordinator to initiate the authorization process

  1. Get a key card or verify your current key card access

All NOSM buildings and libraries are only accessible using your key card. You are required to ensure your key card access is enabled prior to arriving for your reservation by verifying/updating your current access privileges via your Program Coordinator. The process to update an existing key or request a new card takes between 2-5 business days.

If you need a key card, please contact your Program Coordinator who will help to facilitate your request.

Note: Your key card will be tracked to you, cannot be shared and must be returned at the end of your residency

  1. Complete mandatory RTC Training Modules and Attestation

Those approved to be on campus must complete a mandatory RTC Training Module and then sign a one-time online Attestation confirming they have completed the training.

  1. Book your library seat

Following completion of the training and attestation, residents can then book their seat at the NOSM Lakehead or Laurentian campus library using the following link: https://libraryguides.nosm.ca/seats

Note: Seats are available to be booked Monday to Friday from: 8:30 a.m. to 11:30 a.m. and 12:00 p.m. to 3:30 p.m. NOTE – you will require key card access to access the building and library.

  1. Complete the Daily NOSM COVID-19 Screening Tool before coming to campus

In response to new provincial regulations, NOSM has created a new online screening tool survey that captures the required screening questions required to implement additional screening for all employees, learners and visitors who enter NOSM buildings.

Each employee, learner or visitor authorized and scheduled to be on campus must complete the NOSM COVID-19 Screening Tool each time prior to entering NOSM campus buildings.

This survey tool can be saved on your cell phone home screen:

Direction provided at the end of the screening survey must be followed. If you do not pass the screening, you will not be allowed to enter the workplace and will be required to self-isolate and follow instructions of the Public Health Unit.

Requirements and recommendations while using NOSM Campus Libraries

  • You may show up at any time during your library booking, but you are required to vacate your seat by the end of your booking. To reduce touch points in the library, you must only use your assigned seat while in the library. Access to the stacks and library printer are restricted to library staff only.
  • You must follow NOSM’s Return to Campus Plan including face mask requirements. The library is a communal space and therefore a designated area where face masks are required. Drinks are permitted; food is not.
  • If you suddenly feel unwell while on campus, follow the steps outlined in the Suddenly Feeling Unwell while on campus flow chart while also ensuring you have advised your program coordinator who will provide  next steps related to your training.
  • Lastly, it is recommended that all NOSM learners, faculty and staff download the Government’s COVID exposure notification app – COVID Alert.

Important Note: NOSM campus is not an authorized testing site for certification exams, if you are approved to be on campus and using NOSM campus space for the purpose of connectivity for an online external examination, residents assume all related responsibilities for the environmental requirements for remote examinations.

Electives Outside of NOSM for NOSM Residents

There are varying approaches to Medical Schools nationally with respect to 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 websites 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.

Working during a pandemic

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 departments 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.

Reporting of COVID symptoms or exposure

If you have COVID-19 symptoms or have been exposed to someone who is presumptive or positive for COVID-19 it is important that you stay home and seek advice immediately. Do not report to work and follow procedures for contacting a health professional or health unit. Follow the reporting procedures in the reporting flow chart. 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.

Quarantine and Leave

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.

Salary and Vacation

Salary, benefits, and stipend entitlements continue during any pandemic. Due to extraordinary patient care needs, certain vacation requests may be denied although we are not aware of any official re-deployment requests for NOSM residents at this time where vacation might be denied. Vacation days do not normally carry-over yearly and all residents are encouraged to use their vacation entitlements as per PARO and the NOSM PGME Leaves of Absence Policy.

Universal Precautions

Always follow universal precautions, like hand-washing, 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.

Wellness Resources

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 Coordinator 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

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.

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

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.