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.
Requirement for Successful Completion of Part 2 of the MCCQE – CPSO Pandemic Exemption
Current resident eligibility for the exemption:
- You need to have been eligible for any of the sittings for the MCC Part 2 May 2020 onwards (so PGY2s and greater as of May 2020) – even if you did not register or were denied- the key is whether you were eligible to apply and write the exam.
- The exemption rule will be applied to residents when they apply for an independent license.
- All PGY2 Family Medicine once you have taken the CFPC exams this spring.
- All Royal College residents who are currently in their PGY3 or above (with not more than 24 months of training left prior to completion of training/ certification) – can apply for the exemption once you have passed the exams and completed training (for primary certification such as IM or general peds) – even if the MCCQE2 exam is offered in your last one to two years of training.
- Those who are unsuccessful on their certification exam, you will still be eligible for the MCC 2 exemption once you have passed the Royal College/CFPC exam, even if the MCC exam is being offered.
- Residents who have been unsuccessful for the MCC Part 2 exam in the past must be reviewed at the registration committee- before the exemption will be applied (no way around that)- the Registration Committee will review your training, you will require support by PD and RC/CFPC certification.
- USMLE exams do not automatically substitute for the MCCQE2 but you are encouraged to call CPSO to discuss your situation if you have completed USMLE examinations.
General Principles for the Reassignment of Residents in Times of Exceptional Health System Need
- Please see the attached document regarding the General Principles for the Reassignment of Residents in Times of Exceptional Health System Need.
Updates on Certification Examinations & Medical Council of Canada Qualifying Exams
As vaccine distribution begins to occur, residents are seeking information on the plan for NOSM residents to receive COVID 19 Vaccination. As a broadly distributed School of Medicine without a single unifying academic health care system of hospitals, we expect residents will be vaccinated at training sites once available and many vaccinations for residents are now in progress. There is not one centralized process. While NOSM does not coordinate or distribute vaccines, we are working with our partners to ensure that all NOSM residents receive timely access as front-line health care workers.
Given the mobility of residents as well, there may be timing issues with receiving the second dose should you move sites and if residents encounter this challenge with receiving one dose and then moving to another site, we ask you to contact firstname.lastname@example.org or your program coordinator who will connect with us to seek advice and support of the PGME Office for potential options such as funding support for travel back to the site of your first dose and support to connect with another PGME Office in Ontario. If you need to travel to obtain your second dose, the time off will not be deducted from any protected leaves. The programs and the PGME Office will work to support time off requests in order for residents to receive their second vaccines and must travel as a result.
We will continue to advocate for a cohesive plan for NOSM residents and seek your patience in the meantime and continued contact with our office to submit updates on vaccinations you may receive at the training site.
At this time vaccination is not mandatory. Some activities are currently restricted to those who are vaccinated (such as the remote FN vaccination initiative) and as time passes we expect that more restrictions may be placed on unvaccinated providers. We will make such decisions in partnership with our clinical institutions and public health experts and government. Until such time as vaccination is mandatory, individuals will need to make decisions that make sense to them. We encourage all to be as fully informed as possible, including the various implications of each decision on training/work placements.
PARO and RDoC COVID Updates for Residents
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
The changes to NOSM Housing operations during the pandemic have been extended to the end of June. Please review the attached communication from NOSM Housing on the processes related to the potential of sole occupancy and additional funding.
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 until February 1, 2021, 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 .
5 Steps to Accessing NOSM Campus Libraries
- 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
- 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
- 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.
- 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.
- 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:
- Instructions to add a bookmarked Safari website to your home screen on an iPhone.
- Instructions for adding a Chrome bookmark to your Android 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 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.
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 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.
Reporting of COVID symptoms or exposure
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.
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 email@example.com or
- Jaimy Kiiskila our Resident Wellness Coordinator for information and logistical assistance (firstname.lastname@example.org 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
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.
- 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
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
- Monday, Tuesday, Wednesday, and Thursday at 8:00 pm-8:30 pm.
- Offered via Zoom
- See link for details: https://www.deptmedicine.utoronto.ca/sites/default/files/physician_mindfulness_brochure_.pdf
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.
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 email@example.com, firstname.lastname@example.org or specifically from your program director or other program contact.
Global messages to the entire NOSM community will come from the Dean’s Office.