Principle

The Regional Health Authorities (RHAs) in Newfoundland and Labrador (and New Brunswick) provide essential health and community services to the people of the province. As such, many departments of the RHAs must continue to operate and meet patient care needs during times of adverse conditions, including a declared State of Emergency.

Purpose

To provide a framework for the management of Postgraduate Learner attendance and Postgraduate Training Program operations during a declared State of Emergency.

Scope

• All Postgraduate Learners registered in a Postgraduate Training Program at Memorial University (Memorial).

• Visiting Postgraduate Learners competing an elective Required Training Experience at Memorial.

Definitions

Associate Dean, Postgraduate Medical Education (PGME) — The senior faculty officer, appointed by the Dean of Medicine, who is responsible for the overall conduct and supervision of PGME with the Faculty of Medicine (FoM).

Postgraduate Learner — An individual registered in a postgraduate training program at Memorial University of Newfoundland (Memorial University), or a visiting Postgraduate Learner from another institution completing an elective rotation/training experience at Memorial University.

Postgraduate Training Program — A period of training in a specific discipline of medicine prescribed by the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC) leading to certification by one of these bodies.

Program Director — The faculty member assigned responsibility for the overall conduct of the postgraduate training program in a given training program.

State of Emergency —  As defined by the Government of Newfoundland and Labrador Adverse Weather Conditions and States of Emergency Policy

An abnormal situation that requires prompt action, beyond normal procedures to minimize damages to persons, property or the environment; a real or anticipated occurrence which endangers or is likely to endanger the safety, welfare, and well-being of some or all of the population, either in a municipality or the Province. A state of emergency may be declared by an incorporated municipality or by the Province

Policy

1.0. General Provisions during a State of Emergency

1.1. Postgraduate Learners who are responsible for filling roles on a service that are deemed essential will be required to report to work. The Vice President, Medical Services (VPMS), and the Clinical Chiefs of the affected Regional Health Authorities (RHAs) will determine which roles filled by Postgraduate Learners are considered essential. This will be in consultation with the appropriate Program Director(s) (or delegates) from relevant jurisdictions and the Associate Dean, PGME (or delegate).

1.1.1. In a State of Emergency, Program Directors are responsible for communicating to their Postgraduate Learners which Postgraduate Learner roles are deemed essential and the details surrounding their individual duties and requirements to report to work.

1.1.2. As the nature of a State of Emergency evolves, the Postgraduate Learner roles deemed essential may change.

1.1.3. Postgraduate Learners are responsible for contacting their Program Director as soon as it is possible and safe to do so to assure them of their safety, well-being and availability to contribute to patient care.

1.2. Program Directors are authorized to develop a plan to redistribute the workload on a service to ensure essential roles that require coverage are fulfilled amongst all Postgraduate Learners that are available. The realignment of Postgraduate Learner training and work schedules shall be done equitably and should be reviewed by the Residency Program Committee (RPC) when possible.

1.3. Under exceptional circumstances of clinical need, Postgraduate Learners deemed non-essential may be redeployed to work on essential services. At the request of the VPMS of the RHA(s), redeployment decisions are made by the Associate Dean, PGME, in consultation with the respective Program Director, and take into consideration the Postgraduate Learner’s level of training and any special expertise the Postgraduate Learner may have. Where and when necessary, the Principles for Redeployment of Postgraduate Learners in Times of Exceptional Health System Need will be followed.

1.4. Postgraduate learners required to report to/from work are entitled to use transportation services if, and as provided, by the RHA for essential workers.

1.5. Requests for leave will be reviewed by the applicable Program Director or Associate Dean, PGME on a case-by-case basis and will be subject to service requirements and any leave provisions implemented by the applicable RHA. When a Postgraduate Learner is unable to report to work due to extenuating circumstances (i.e., family responsibilities), Program Directors (or Associate Dean, PGME) will make every effort to accommodate the Postgraduate Learner’s requests for leave.

1.5.1. Under exceptional circumstances, approved leave requests may be rescinded and without notice, to answer the exceptional needs of the health system. The decision to cancel pre-approved leave must be made in writing by the Program Director to the Associate Dean, PGME (or delegate). The PGME office will advocate for but cannot guarantee compensation for lost expenses.

1.6. Due to extenuating circumstances resulting from a State of Emergency, the hours worked by a Postgraduate Learner may exceed the maximum duty hours outlined in the Professional Association of Residents of Newfoundland and Labrador (PARNL) collective agreement. Excessive duty hours will be compensated (e.g. day(s) off in lieu; additional pay) as outlined in the PARNL collective agreement (subject to change).

1.6.1. Postgraduate Learners who are scheduled to be on call should make every reasonable effort to relieve Postgraduate Learner colleagues unless their safety would be compromised in efforts to report to work

1.6.2. Any Postgraduate Learner that works more than twenty-four (24) consecutive hours under the auspices of their training program are expected to continue to have coverage through the Canadian Medical Protective Association.

1.7. Postgraduate Learners are not to contact medical learners from the Doctor of Medicine program who are scheduled to work. Undergraduate medical learners are not deemed essential and are not required to report to work.

1.8. For those Postgraduate Learners who are scheduled to fill roles that are deemed non-essential during a State of Emergency, Program Directors will consider whether it is feasible for them to work from home (virtual care) and/or to carry out other academic activities that can contribute to their training program. This will allow Postgraduate Learners to minimize the amount of time lost during their training experience. If unable to work from home, Postgraduate Learners will receive leave with pay during the period of closure when a State of Emergency has been declared.

1.8.1. Postgraduate Learners fulfilling roles deemed non-essential during the period of closure must be available to contribute to patient care when needed and may be recalled at any time during this period. Postgraduate Learners are expected to present themselves if contacted within a reasonable amount of time, commensurate with driving conditions within the RHA at that time.

1.9. If a Postgraduate Learner is on an away training experience when a State of Emergency is declared and unable to report back to work as scheduled (e.g., travel restrictions/closures; Department of Health and Community Service directives), they are not required to take leave for the time missed.

1.10. If a Postgraduate Learner is subject to academic penalty due to a State of Emergency, the Program Director will, on a case-by-case basis, endeavour to realign the training experience at the earliest possible opportunity following the impacted training to minimize any negative impact on the Postgraduate Learner’s training schedule. If realignment is not possible, the Program Director will have to use applicable existing academic policies to address the academic consequences of missed training.

2.0 Responsibilities of the PGME office During a State of Emergency

2.1 The PGME office, where possible, will strive to maintain critical functions to support the operations of all postgraduate training programs.

2.1.1 Any inquiries from Postgraduate Learners can be sent to the PGME office via email at pgme@mun.ca.

2.1.2 Emergency directives and notices will be addressed to Postgraduate Learners via One45 email and/or the PGME webpage, when possible. Alternatively, communication of urgent matters may be made via local and social media sources.

2.2 If a State of Emergency falls during a time when interviews are scheduled for the Canadian Resident Matching Services (CaRMS) application process, the PGME office will communicate with the training programs impacted to ensure the CaRMS applicants have been contacted and notified of the changes to their interview.

2.2.1 It is the expectation that training programs will continue with CaRMS interviews in a manner which will ensure the safety of those involved.

2.3 The continuation of processing moonlighting/off-service call requests will depend on the circumstances of the State of Emergency and the capacity of the PGME office and the College of Physicians of Surgeons of Newfoundland and Labrador. Postgraduate Learners are reminded not to proceed with clinical duties without a license, regardless of the circumstances.

Procedures:

There are no procedures associated with this policy.