PARO Work Alert #3

March 25, 2020 – Message from Dr. Anthea Lafreniere, PARO President

I will provide you with concise periodic updates on issues that affect Ontario residents as we work and train together during the COVID-19 pandemic.

PARO has launched a specific COVID-19 web page where we will provide answers to your questions as well as other important information. Updates or changes in policies or recommendations will be posted daily – so please check back often. For example, we have updated our PARO-endorsed COVID-19 Back-Up Call Scheduling Model.

Below are important new highlights:

Ontario Government Order

This weekend the Ontario Government issued a temporary order enabling Hospitals to implement measures that are not consistent with collective agreements. This order applies to the PARO-CAHO Collective Agreement.

PARO Staff and legal counsel are examining the order to determine how this might impact you. If there are any measures taken that we think are unreasonable, PARO will, as always, advocate on your behalf to either your PG Dean or the Hospital.

You should continue to follow the directions of your Hospital and/or Program Director.

We continue to connect with PG Deans and hospitals and to review redeployment plans as they become available.

If you have concerns about your health and safety, including the sustained ability to provide service as a result of any measures that are implemented, please send an email to

Personal Protective Equipment

We are receiving a lot of questions about Personal Protective Equipment. Here is what you need to know:

  • you must be given training on how to use PPE;
  • you must be provided with and use required PPE;
  • you have the right to refuse work if you aren’t provided required PPE, provided that refusing work does not directly endanger the life, health or safety of another person;
  • you must follow the Hospital’s directives on the appropriate use of PPE;
  • you must do your part to ensure that you don’t contribute to diminishing supplies;
  • if you are aware of a risk of a shortage of PPE, then raise the concern with your supervising staff, program director, occupational health or the Hospital Administrator on call.

As doctors, we know that with a new pathogen, emerging knowledge may contribute to frequent changes in expectations on adequate PPE for patient investigation, contact, or procedures.

CPSO and Provisional Licenses for Exam-Eligible Candidates

As soon as we learned that the CFPC, RCPSC and MCC exams were being postponed, we were in touch with the College of Physicians and Surgeons of Ontario to discuss ways to mitigate the impact on our members. Like every provincial regulatory authority, the CPSO is bound by provincial legislation which sets out their powers. Dr. Whitmore, the Registrar of the CPSO, immediately understood our concerns and tasked her staff to find ways that they could mitigate the impact while still operating within provincial legislation. Emergency meetings were called of relevant committees and teams and a solution has been identified.

The CPSO is able to issue a provisional license to any resident who has finished their training and is exam-eligible. This license has to be limited to 6 months, but we understand that this can be renewed or extended if need be.

Restricted licenses for exam-eligible candidates require supervision. However, the CPSO has confirmed that they can adjust the requirements so that a supervisor will be permitted to supervise many physicians at any given time (as opposed to the 1:1 ratio that existed prior). The other significant change is that a supervisor can be off-site or even remote. This step will make it possible for those of you who have made or plan to make arrangements to provide locum coverage. The Registrar also has a directive that will allow the approval of provisional licenses to be streamlined rather than being sent to the Registration Committee for full review. We learned earlier today that the online CPSO Application Package contains a paragraph that says you should not make any firm commitments at this point with respect to a starting date for medical practice. We have spoken with the CPSO and learned that this is a standard paragraph included in all applications to ensure that applicants appreciate that an application can’t be processed overnight. This language is not specific to this year’s graduates and is not intended to discourage you from arranging to make plans to start practice. Finally, the CPSO has amended their policies so that no additional fees will be charged when you apply for an independent license.

Thank you for your on-going work serving Ontario’s patients during these extraordinary times.