TOP THINGS TO KNOW ABOUT YOUR CONTRACT

Here’s an at-a-glance look at portions of your Collective Agreement that residents most often inquire about. The information provided reflects changes to the PARO-CAHO Collective Agreement mandated in the recent Arbitration Award.

They include:

Call & Call Stipends

Following is the basic info you need to know about On Call service. This includes In House Call, Home Call, Blended Call, Weekends off, Stipends and more.

It’s important to note that you can’t be scheduled to work two or more consecutive calls, unless you’ve agreed to it with your Program Director and PARO. Also noteworthy, is the fact that if you’re not on call or scheduled for work, you aren’t expected to be available on your pager, or to be in the hospital or clinic.

Here’s a section-by-section look at Call:

In House Call (Attachment 20): The in-house maximum is 1 in 4. For a “28-31 day ("one month") rotation these maximums are:


Number of Days
Number of Calls
19-22
5
23-26
6
27-29
7
30-34
8
35-38
9
In hospital call maximums for rotations >1 month can be averaged over the length of the rotation (maximum averaging length is 3 months) with a maximum of 9 calls in any given month. The total number of calls on a rotation longer than one month can be calculated by taking the total of number of days ON service, divided by 4 and rounded to the nearest whole number (.5 rounds up).

Home Call: Home Call Max is 1 in 3, or 10 per 30, or 11 per 31.

You cannot be on home call on 2 consecutive weekends. Also, home call can’t be averaged over multiple months. Here’s how it breaks down:


Number of Days
Number of Calls
17-19
6
20-22
7
23-25
8
26-28
9
29-30
10


Shift Work: On rotations where you are scheduled in shifts, e.g. Emergency Medicine or Intensive care: Max hours = 60 hours/week, including other scheduled responsibilities (including academic half days). There must be a minimum of 12 hours off between shifts.

Blended Call-In Hospital and Home Call (Article 16.9) This is calculated using the following formula:

(Number of Home Call Assignments) x 3 + (Number of In-House Assignments) x 4 = NOT MORE than 30 over a 28 day period.

For rotations that exceed 28 days, the same formula applies with the following totals:


Number of Days
Formula Total
29
31
30
32
31
33
32
34
33
35
34
36
35
38

Weekends


  • You must have 2 COMPLETE weekends off per 28 days; including Friday night/Saturday morning as well as Saturday and Sunday
  • You cannot be on home call on 2 consecutive weekends.
  • You cannot be required to round (or perform other clinical duties) on weekends when not on call. If you are not otherwise on-call and are scheduled or required to round on weekends, and actually attend in hospital for such rounding, you will be paid the Home Call Stipend ($58)
Post Call Relief (Article 16.4) Home after Handover


You must be relieved of all clinical and academic responsibilities post call in keeping with the following guidelines:

  • Home by 24+2 hours after the commencement of the working day.
The following exceptions apply:

  • Anaesthesia (1 hour of handover)
  • OB/Gyn (1 hour of handover)
  • ICU/CCU (1.5 hours of handover)
  • Home by Noon applies to residents performing clinical work in any Surgical Program at the University of Toronto
Home Call Conversion for Post-Call (Article 16.4 (c)


If your are on out-of-hospital call, you will be relieved of your duties in either of the following situations:

  • You are called into the hospital to perform duties between the hours of midnight but before 6am.
  • You are called into the hospital to perform duties for at least 4 consecutive hours with at least one hour of which extends past midnight.
Call Stipends

Types of Call Stipends

In-hospital call stipend: $116

Home call stipend: $58

Home call conversion:   A resident on home call works more than four hours in hospital during the call period, of which more than one hour is past midnight and before 6 a.m., is entitled to be paid the in-hospital call stipend. For example, you are called in to perform clinical duties in the hospital at 23:00 and stay until 04:00, you are entitled to claim the in-hospital call stipend. If you are called into the hospital to perform clinical duties at 23:00 and stay only until 01:30, you are not eligible for a conversion and are entitled to the home call stipend.

Qualifying stipend: $58

                                Qualifying shifts are only those shifts where one full hour worked on the shift occurs between midnight and 6 a.m. For example, if you are working an ER shift 20:00-08:00, you would be entitled to a qualifying stipend.

Note that when a resident is strictly on a shift based rotation (eg. Emergency Medicine), the only call stipend applicable is the qualifying stipend.

Shift Work and Other Clinical Duties During Same Week

When a resident is on a shift based rotation (eg. Emergency Medicine), and also has other clinical responsibilities (eg. family medicine clinics) during the same week, the following call stipend rules are applicable:
  • Home call stipend if the shift does not extend beyond 11pm
  • In-hospital call stipend if the shift extends beyond 11pm
Example #1:     As a Family Medicine Resident you may have a clinic from 8am-1pm, and then are expected to work an ER shift from 4pm-midnight on the same day. In this situation you are entitled to the in-hospital call stipend for working the ER shift. If the ER shift is from 4pm-11pm then you are entitled to the home call stipend.

Example #2:     As a Family Medicine Resident you work a normal work week (Mon-Fri) engaged in clinical duties related to your Family Medicine rotation. You are scheduled for an Emerg shift on Saturday from 10am-6pm. As this Emerg shift is over and above your normal weekly clinical duties, you are entitled to a home call stipend, as the shift does not extend beyond 11pm. If the Emerg shift was from 4pm-midnight, you would be entitled to the in-hospital call stipend as the shift extends beyond 11pm.

Shorter Periods of In-Hospital Call

If you are scheduled to work a shorter in-hospital period of call on either a weekday or weekend, the following call stipend rules are applicable:
  • Home call stipend if the call does not extend beyond 11pm
  • In-hospital call stipend if the call extends beyond 11 pm
For example, you are on a psychiatry rotation and are expected to be on in-hospital call only from 5pm-midnight on a weekday. In this situation you are entitled to the in-hospital stipend as the call period ends beyond 11pm.

Rounding on Weekends When Not on Call

If you are not scheduled for call and are required to round on a weekend day, and actually attend in-hospital for such rounding, you are entitled to the home call stipend of $58

Evening Clinics

No stipend is payable when you are required to work an evening clinic up to 8pm.

OB Call

Where a Family Medicine Resident carries a pager for obstetrics call to fulfill the requirements of the resident’s training program, you are only entitled to claim either the home or in-hospital call stipend depending on the time in attendance at a delivery. If you not required or expected to respond to the page (eg. you can opt out of carrying the pager on certain evenings), there should be no call stipend paid. Please note that if you respond to a page and are required to go to the hospital to perform clinical care, the normal conversion rules apply for post-call days.

Post-Call Day Conversion Rules

Where a resident is on home call, they are entitled to a post-call day in either of the following two situations:

i) commences work in the hospital after midnight but before 6 a.m.; or
ii) works for at least four (4) consecutive hours at least one hour of which extends beyond midnight.

- After being on call for 24 hours residents shall be relieved of their duties after ensuring adequate handover of patient care responsibilities, and no new patient responsibilities will be assigned.
- The handover period will not exceed two hours following the end of the 24 hour in-hospital call period.

If the home call does not qualify as in i) and ii) above - then the resident would be at work as per regular clinical hours the next day.

Don’t Miss the Deadline!

Call stipend claims must be submitted to the person(s) designated by the hospitals to receive such claims within 30 days following the end of the month in which the call was worked.

Keep a Record

When submitting your stipends, be sure to keep a printed record as proof.
If submitting via fax, print a fax receipt
If submitting via email, print a copy of the sent email
If submitting through an online system, grab screen captures of each page

Travel reimbursements

As a resident, you are entitled to certain travel compensations. Just remember that you will need to provide receipts in order to get reimbursed.

Taxi charges

Residents on home call may be reimbursed up to $70 per month for taxi charges if:

  • The resident is on home call and can respond within the hospital's Medical Advisory Committee (MAC) approved response time.
  • The resident does not have a parking pass.
  • The resident is called in for clinical duties after 6pm and before 6am.
Parking

When residents are required to travel between sites or return to a site for clinical duties, the resident will be reimbursed for the cost of parking associated with the time spent at the second or subsequent sites, provided that the distance travelled between sites exceeds 1 km.

Vacation Times and Leaves

Holidays — as well as professional leave — are built into your contract. When it comes to vacation time, we recommend you decide when you’d like to book time off within the first three months of your residency.

Vacation (Article 11)

Residents are entitled to 4 weeks of paid vacation per year.

  • A week of vacation is defined as five (5) working days plus two (2) weekend days
  • Vacation time may be delayed only where necessary having regard for professional and patient care responsibilities
  • Housestaff may arrange for their vacation to be taken in one (1) continuous period or in one or more segments of at least one (1) week in duration provided professional and patient responsibilities are met
  • Requests must be made in writing at least 4 weeks in advance of the requests start day of the vacation. All requests must be confirmed or denied in writing within 2 weeks of the request being made. If denied, alternate times for vacation must be agreed to within 2 weeks
  • There can be no blanket policies restricting the amount of vacation in any rotation. Any blanket policies should be reported to PARO
  • You cannot be post call on the first day of vacation
Professional Leave (Article 12)

  • Maximum of 7 working days per year (Note: weekends are not considered “working days” for this purpose)

  • Residents DO NOT need to be attending a seminar, course or conference to take a professional leave day, and the resident does not need to provide proof of what the day was used for
  • Residents are entitled to take paid leave for the purpose of taking any Canadian or American professional certification exam. This leave time shall include the date(s) of the exam and reasonable travel time to and from the exam site. This leave is in addition to other vacation or leave time
Holidays and Lieu Days (Article 13)

All Housestaff are entitled to the following recognized holidays:


  • New Year’s Day

  • Family Day

  • Easter Friday
  • Victoria Day

  • Canada Day

  • August Civic Holiday

  • Labour Day
  • Thanksgiving Day

  • Christmas Day

  • Boxing Day

  • One Floating Holiday*
*A floating holiday is a paid holiday taken at a time chosen by the resident. A program CANNOT tell a resident when to take their floating holiday.

All housestaff are entitled to 5 consecutive days off during the 12-day period encompassing Christmas Day and New Year’s Day. These 5 days account for Christmas Day, New Year’s Day, Boxing Day and two weekend days. Each resident must get either Christmas or New Year’s Day off. Residents do not get additional lieu days for working on either of the statutory holidays during the period.
PARO does not set the dates for when the holiday period is. The Holiday Block dates (Christmas and New Year Period) are set by the program/service/ PGME office.

Lieu Days

Where a resident works any part of one of the recognized statutory holidays, they are entitled to a lieu day to be taken at a time mutually convenient within 90 days of the holiday worked. This includes residents working home call for any portion of the 24 hours of the date of the holiday.

No lieu days for Christmas Day, New Year’s Day & Boxing Day (this is included in the 5 days off over the holiday period).

Religious Holidays

If you observe religious holidays that are not specifically listed in the Collective Agreement, your program may have a duty to accommodate your religious practice to the point of undue hardship (“undue hardship” may include a number of factors, such as patient safety, the hospital’s service requirements, and the resident’s educational/training requirements). It is your responsibility to request accommodation, explain what measures of accommodation are required an allow a reasonable time for reply.

Questions or Concerns?  Call the PARO Office at 1-877 979-1183 or email paro@paroteam.ca








































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