March 18th, 2020 – Message from Dr. Anthea Lafreniere, PARO President
As events have continued to unfold this week, I have continued to be inspired by our members’ tireless dedication to their patients, their colleagues, and their communities. Ontario’s residents have truly risen to the occasion of this unprecedented challenge and it is a privilege to serve as your President.
PARO is working hard to support you. Our team is continuing to respond to your enquiries, ensuring that we only provide up-to-date, expert-informed guidance. We are in daily communication with our colleagues at Resident Doctors of Canada and at other Provincial Housestaff Organizations across the country. We are connecting regularly with the PGMEs at all six Universities, as well as our colleagues at CAHO. We remain available to help and support you with individual challenges you may be facing during this time.
As I committed to you in my last message, PARO will only provide you with information that we know to be accurate and will continue to update you in the event that the information you need changes as the situation continues to evolve.
In this message we are going to address three more issues. The information that we provide below is the most current information and may be different than what we have communicated previously.
Given the extraordinary circumstances that are unfolding related to the COVID-19 pandemic, it is very important that residents comply with any directions you receive to report to work.
We have reports that some hospitals or services are canceling scheduled vacations. If you have been required to cancel your vacation, comply with the direction to report to work and let us know the details by emailing email@example.com
PARO is monitoring the situation and we are actively looking into what options might be available should you be unable to take vacation or have it canceled.
As this pandemic unfolds it is likely that, in addition to increased demand on healthcare resources, growing numbers of healthcare workers may be placed on self-isolation or quarantine. We saw this during the SARS outbreak in 2003 and, to help services manage increased work with fewer resources, PARO permitted programs and services to implement a back-up call model.
We advise programs use a similar strategy with the following criteria:
- if a resident scheduled for back-up call is notified by 1700 hrs the day of the call that they are not required, the call will not be counted in the calculation of their duty hour maximums nor will it be eligible for a call stipend
- if the resident is not notified by 1700 hrs and completes the back-up call, then it will count in accordance with the provisions of the PARO-CAHO Collective Agreement.
For reference, please see the following relevant articles of the PARO-CAHO Collective Agreement:
Article 16.1 – Maximum Duty Hours
Article 16.4 (c) – Relief of Duty Post-Call for home call
Article 23.2 – Call Stipend Entitlement When Call Converts
We encourage anyone scheduling call to recognize that some residents, such as those with young children who would need to arrange for childcare on short notice, may face additional challenges in being placed on back-up call. PARO encourages programs or services to work to alleviate undue stress for residents who are going above and beyond in these challenging times by employing strategies such as minimizing the need for residents to be on back up call or by offering support or financial reimbursement for those requiring childcare arrangements.
Back-up systems should be designed to be equitable. Calls worked should be tracked and the schedule revised if some residents are activated more frequently than others. If programs are able to utilize a sign-up process where residents can identify preferences in how they are scheduled for back-up call, this may mitigate conflicts like childcare, etc.
Restricted Registration for Residents
A number of members have reached out to us to ask about Restricted Registration (RR) licensing in order to help out in critical care and community settings during this time. As you may know, the application process to obtain an RR certificate can be lengthy. However, PARO has been collaborating with the College of Physicians and Surgeons (CPSO) to develop an expedited submission and review process in recognition of the increased need due to COVID-19.
It is important to keep in mind that you must obtain an RR certificate to work extra shifts for pay outside of your residency training program.
Thank you for your continued dedication and hard work.
Dr. Anthea Lafreniere