Resident Program Policies and Forms

Preamble

Clinical trainees have the right to work in a safe environment during training.  The purpose of this document is to provide a policy regarding workplace safety for postgraduate trainees in Obstetrics and Gynecology at the University of Ottawa and to demonstrate the commitment of the residency /clinical fellowship programs to the protection and safety of its Postgraduate trainees.

The responsibility for resident safety is jointly shared between the resident, clinical fellow, the Department training programs, the Faculty of Medicine at the University of Ottawa, affiliated health centres and all teaching sites.

This policy complies with the Royal College accreditation standards A2.5 and B3.1.9 and does not supersede the Postgraduate Medical Education Resident Wellbeing and Safety Policies viewed at the following links:

University of Ottawa, PGME – Policies (includes PGME Safety Policy)

University of Ottawa PGME – Wellbeing Policy

University of Ottawa – Global Health Program

The Ottawa Hospital – Safety Policy Statement

Scope

This policy covers resident safety in the areas of travel, patient encounters, after-hours consultations and patient transports.  It also includes Occupational Health and Safety as well as workplace environmental health and safety.  This policy encompasses all postgraduate trainees, both residents and clinical fellows.  This policy applies during residents’ medical education activities that are related to the execution of residency duties.

• Residents should not assess violent or psychotic patients without the backup of security or a supervisor and also an awareness of accessible and safe exits.
• Residents must not perform any patient transports in private vehicles or make unaccompanied home visits.
• A supervisor must always be present if the resident is seeing a patient in an ambulatory setting after hours. This does not apply if the patient is being seen in the emergency room/labor and delivery or on a hospital ward.
• Pregnant residents should be aware of specific risks to themselves and the fetus in the training environment, and request accommodations where indicated. Residents should consult the Occupational Health site office for information.
• Residents working in areas of radiation exposure must:
  • carry radiation dosimeters
  • follow radiation-safety policies
  • minimize their exposure according to current guidelines
  • wear radiation protective garments if using fluoroscopic equipment.
• On-call rooms and lounges provided for residents must be clean, smoke-free, located in safe areas; and have adequate lighting, a phone, fire alarms and smoke detectors, and lockable doors.
• Residents planning a global health elective outside of Canada must adhere to the PGME Global Health guidelines.
• Residents travelling to other Community Hospitals they must adhere to the PGME and Training Program safety policies and procedures.
• Approved international electives/experiences must occur only in countries with a stable political environment with a qualified preceptor designated to provide appropriate supervision. Additionally, there must be a Canadian Consulate in that country.
• Residents are not expected to participate in air transports (EHS Life Flight) in terms of physically retrievingor returning high-risk obstetrical or gynecologic women/patients.
• When transporting patients via ambulance between Hospital Sites, residents must be accompanied by an ambulance paramedic.  In the event of a possible pre-term delivery, someone from NICU should also accompany the resident.
• Clinical trainees must observe universal precautions and isolation procedures, when indicated, as defined by the policy and procedure directives at each respective training site. 
• Clinical trainees should be familiar with blood and body fluids exposure procedures, which are in place at all teaching sites.
• If a resident/clinical fellow has any concern about their physical safety in relation to a hostile patient/patient family situation in Labour and Delivery (or elsewhere), Security should be paged/contacted to escort the trainee to and from the call room as needed.

1. The clinical trainee must participate in required safety sessions including fire safety, workplace hazardous materials information and safety (WHMIS), infection control and follow the safety codes of the site in which they are training.This includes policies and procedures for infection control and protocols following exposure to contaminated fluids, needle stick injuries and reportable infectious diseases.

   Teaching Hospital Setting- Needle stick Policy

   The careful handling of any potentially infective material and the strict adherence to the policy of universal precautions are extremely important and mandatory.

   Postgraduate trainees are encouraged to familiarize themselves with each hospital policy at all times. Individual hospital policies are available through Hospital Employee Health Services or from the office of each Medical Education Department.

   Contact persons listed below can be reached anytime during the day.

   Immediate care is required. Do not delay.  Initial management involves cleaning the site, the identification of risk and possible early therapeutic intervention.

   Proceed to the Emergency Department of the hospital and identify yourself as a member of the house-staff. Indicate the type of injury sustained (i.e. needle stick). The Infectious Diseases consultant on call may be notified and will either see you in the E.R. or speak to you by telephone to address your immediate questions and concerns. If required, you will receive a two or three day PEP pack to initiate therapy until you can fill a prescription at the pharmacy.

   Documentation and notification are essential. Call the office of Medical Education affiliated with the University of Ottawa (at The Ottawa Hospital – see contact info below) during office hours, who will help you to ensure that you have taken the necessary steps and precautions. You must also contact the appropriate person (listed below) of the hospital where the injury was sustained.

   Community Setting

   If you are in a community setting, present yourself to the closest hospital Emergency Department for immediate care and management

   University of Ottawa – Teaching Hospitals

   The Ottawa Hospital
   Medical Education
   613-798-5555 ext. 10917

   The Ottawa Hospital – General Campus
   Occupational Health & Safety
   613-737-8899 ext. 78391

   The Ottawa Hospital – Civic Campus
   Occupational Health & Safety
   613-798-5555 ext.14161

   The Ottawa Hospital – Riverside Campus
   Occupational Health & Safety
   613-738-8400 ext. 88250

   Children’s Hospital of Eastern Ontario
   Occupational Health & Safety
   613-737-7600 ext. 2278

   Royal Ottawa Hospital
   Occupational Health & Safety
   613-722-6521 ext. 6491

   Rehabilitation Centre Ottawa Hospital- General Campus
   Occupational Health & Safety
   613-737-8899 ext. 78391

   Hôpital Montfort
   Occupational Health & Safety
   613-746-4621 ext. 2211

   Elizabeth Bruyère Health Centre St-Louis Residence
   Occupational Health & Safety
   613-562-4262 ext. 4037

   St. Vincent Hospital
   Occupational Health & Safety
   613-562-4262 ext. 3333

2. Clinical trainees should keep their immunizations and TB skin test up to date.Overseas travel immunizations and advice should be organized well in advance when traveling abroad for electives or meetings.
3. Clinical trainees traveling for clinical or other academic duties by private vehicle should maintain their vehicle adequately and travel with appropriate supplies and contact information.If individuals feel that it is unsafe to travel (ie due to extreme weather conditions, or inadequate rest) for clinical or other academic assignments the trainee is expected to notify the chief resident or clinical supervisor and the Department’s Education office immediately so their clinical assignment can be revised.
4. Clinical trainees doing home call and arriving after hours should assess their environment for safety before leaving their car.Have a cell phone available to contact Security if an escort is required.
5. Clinical trainees should not provide any personal contact information to patients, for example, cell phones, pager number, and home phone.
6. Clinical trainees must adhere to Provincial/North American/International laws regarding the use of cell/mobile phones while operating a private motor vehicle for clinical or other academic duties.

• To ensure information sessions on WHMIS and Occupational Safety is available for clinical trainees at all teaching sites.
• To ensure specialty and site specific orientation sessions are available.
• To follow-up with Health Centres if a concern re: trainee safety arises so issues can be addressed in a timely fashion
• Ensure that each training site remains compliant with the program policy.

Revised: May 2020

How to protect yourself

At this time, the public health risk associated with COVID-19 is low for the general population in Canada but this could change rapidly. There is an increased risk of more severe outcomes for Canadians:

• aged 65 and over
• with compromised immune systems
• with underlying medical conditions

Public Health authorities recommend that even if you do not have symptoms, it is recommended to self-isolate for 14 days if:

• You have travelled anywhere outside of Canada (including the United States of America).
• You live with, provided care for, or spent extensive time with someone who has:
  • Tested positive for COVID-19, OR is suspected to have COVID-19, OR who has respiratory symptoms (fever, cough, or shortness of breath) that started within 14 days of travel outside of Canada.
• Monitor your health for fever, cough or difficulty breathing

Public health experts continue to state that self-hygiene is key to mitigating the risk linked to the spread of COVID-19.

To reduce the spread of germs, including the flu and COVID-19, Ottawa Public Health recommends that you:

• Wash your hands often with soap and water, or use a hand sanitizer.
• Avoid touching your eyes, nose and mouth unless you have just washed your hands with soap.
• Cover your cough and sneeze with a tissue or into your arm, not your hand.
• STAY HOME

Social distancing

Together, we can slow the spread of COVID-19 by making a conscious effort to keep a physical distance between each other. Social distancing is proven to be one of the most effective ways to reduce the spread of illness during an outbreak. With patience and cooperation, we can all do our part.

This means making changes in your everyday routines to minimize close contact with others, including:

• avoiding non-essential gatherings
• avoiding common greetings, such as handshakes
• avoiding crowded places such as concerts, arenas, conferences and festivals
• limiting contact with people at higher risk like older adults and those in poor health
• keeping a distance of at least 2 arms-length (approximately 2 metres) from others

Personal Protective Equipment (PPE)

• Residents must wear full PPE - (goggles, mask, gloves, gown) - for all patient encounters. 

COVID Vaccinations:

• Residents are to follow all local Hospital policies and Public Health policies for Health Care Workers in relation to the evolving circumstances surrounding COVID. 

As recommended by the Government of Canada

Useful Links

Ontario Public Health

https://www.ontario.ca/page/how-ontario-is-responding-covid-19

Ottawa Public Health

https://www.ottawapublichealth.ca/en/public-health-topics/novel-coronavirus.aspx

TOH Occupational Health: 2019-nCov@toh.ca

Revised: May 2020

The following is outlined in the PARO-CAHO Agreement regarding educational leave:

Professional Leave

Article 12.1 In addition to vacation entitlement, residents shall be granted additional paid leave for educational purposes. Such educational leave, up to a maximum of seven (7) working days per annum, shall be consecutive if requested by the resident, and shall not be deducted from regular vacation entitlement. Such leave may be taken by house-staff at any time, provided only that professional and patient responsibilities are met to the satisfaction of the hospital department head.

Article 12.2 Each resident shall be entitled to paid leave for the purpose of taking any Canadian or American professional certification examination; for example, Royal College examinations, LMCC, ECFMG, CFPC. This leave shall include the exam date(s) and reasonable travelling time to and from the site of the examination. This leave shall be in addition to other vacation or leave.

Maxumum Duty Hours

Article 16.3 - Should a resident be away from the hospital, department, division or service for any reason whatsoever for any part of the calculation period referred to in 16.1, the maximum number of duty periods during such calculation period shall be based on the pro-rated number of working days present.

Additional guidelines are necessary to ensure that all residents have similar opportunities to have educational leave approved:

• Conference leave is limited to 7 days per academic year; requests for additional time will be reviewed by the Program Director prior to approval.Consideration will be given to the need to take vacation to facilitate conference leave exceeding 10 working days per academic year (July 1-June 30).
  • If residents are interested in attending multiple conferences during an academic year, such a request should be confirmed in writing with the Program Director.If a vacation request has also been submitted, the impact that the total time off will have on the rotation experience needs to be considered.In general, residents are mandated to take a total of one week of leave per rotation block.
  • Conference leaves require prior approval from the Program Director.
  • If additional financial support from the Department is sought then expected expenses must be submitted with the application.
  • If funds are available and/or attached to a resident research project – application to utilize those funds must be made to the resident Research Preceptor with a copy to the Program Director and Academic Manager.
• For conferences where multiple residents express interest in attending (e.g. SOGC), the following guidelines will be used to determine approval of leave:
  • Priority should be given to residents presenting research
  • PGY5 residents who are not presenting research or active on a committee will be given the lowest priority for conferences that take place following the Royal College exam (e.g. SOGC)
  • If requests to attend a conference exceed the number that can feasibly attend, the Chief Administrative resident will review the requests and recommend approval to the Program Director.The final decision regarding approval rests with the Program Director.
    • For the SOGC Annual Clinical Meeting, the deadline for abstracts is generally in January.As this inevitably guides who will be presenting research at the ACM, all requests to attend SOGC could be submitted by December 15^th.The decision as to which residents will be attending SOGC will be made by the end of December which will allow for residents to consider attending alternate conferences if desired (APGO/CREOG).

The Department of Obstetrics and Gynaecology has always supported postgraduate education.  Attendance at postgraduate courses and conferences are an important part of the educational program. Each year the Department of Obstetrics and Gynaecology will attempt to commit funds designated for postgraduate travel – for which these Guidelines will be reviewed annually by the Department Finance Committee.

Designation of Funds

All postgraduate resident trainees are entitled to the following Canadian funds to attend courses and conferences as detailed below subject to prior approval by the Program Director, Rotation Supervisor and Chief Administrative Resident.

PGY1 and PGY2 Resident Trainees

• Educational travel to attend Introduction to Research Course in Toronto (APOG) in December or for participating in the ALARM Course ($1,000/resident/year)
• Any funds left over can be used towards another conference, workshop or meeting if approval has been received to attend

PGY3 and PGY4 Resident Trainees

• Educational travel ($1,000/resident/year)

PGY5 Resident Trainees

• Making A Mark ($1,500/resident/year)

Guidelines

• Travel funds include expenses related to attending conferences, workshops and meetings and include airfare, taxis, accommodation and food.
• Funds not used in one academic year may not be carried over to the next academic year.
• Residents are responsible for making their own travel arrangements.
• Requests for travel funds for residents who are presenting posters or papers at National or International Conferences must be made to the Program Director in writing, who will in turn request funding to the Finance Committee.Based on the recommendation of the Program Director a final decision will be made by the Finance Committee.
• Residents presenting research must first enquire if funds are available for travel to present research from Research Preceptor.
• Undergraduate teaching funds may be used (if available) for travel to attend conferences, workshops or meetings, and should be requested separately to the Academic Manager.
• Transportation between Hospitals and/or parking at Hospitals for medical education purposes for residents will be paid for by the Employer (University of Ottawa) as per the PARO Agreement.
• Residents are asked to share accommodations and/or travel when possible.
• Dues for membership, journals, etc are the responsibility of the resident.
• Residents are not permitted to solicit/accept financial support from Industry.

Rules For Submitting Requests For Reimbursement

• Request for reimbursement must be made using Travel Expense Reimbursement Claim Form – remembering to include the following details:
  • Name of Conference, Workshop or Meeting
  • Location of Conference, Workshop or Meeting
  • Dates of Conference, Workshop or Meeting
  • Home Address
• Original receipts must be submitted for reimbursement to Academic Manager
• One photocopy of claim form and receipts must be included in submission
• A record of each resident allocation of funding will be maintained by the Academic Manager
• Academic Manger will process reimbursement request and submit to the Department Finance Manager who will forward reimbursement as a transfer (if banking information has been set up) or forward a cheque directly to their home address