2018-2019 PGMEAC

Agendas, Minutes & Minutes

April 26, 2019

1. Resident Report

PARO is preparing for the new residents who will start in July.  Plans are underway for the Toronto new resident orientation where call kits will be handed out and a post-event social to welcome the incoming residents.
PARO is collecting feedback on best practices for hospital sites that do registration and onboarding and will have the information ready to share at HUEC later this month.
PARO is collecting more information about call room requirements for residents on home call and will report back on final decisions.
PARO 24/7 Helpline that is completely confidential and staffed by Crisis Workers trained to work with medical residents. http://www.myparo.ca/helpline/

2. PAAC Report

PAAC Award 2019 winner was Ed Ang from Family Medicine which was presented at the PA Appreciation Event on April 24th.
The PAAC committee will review the criteria for the award and explore possible expansion, which would include overall support to the program/residents and one for innovation.
PA Appreciation Event was well attended with over 75 participants.
New Project is underway with a working group on strengthening the relationship between Hospital Medical Education offices and Program Administrators to ensure that information is streamlined and efficiently sent in a timely manner to both groups.  The working group will also look at creating a standard template for registration at all sites.
PAAC Executive Changes include: Bernice Baumgart, Chair (replacing Bryan Abankwah); Savannah Clancey, Vice Chair (replacing Bernice Baumgart); Catherine Wong, Secretary (replacing Paula Nixon) – membership updates effective September 2019.

3. Accreditation 2020

Probyn provided an update on preparation for Accreditation 2020.
AQs have been sent to all programs and are due back to PGME by October 15, 2019.
Accreditation Workshop Dates: May 21, May 31, June 18 and June 21 – more details to follow soon!

4. CBME/BPEA

Onboarding total as of July 1st this year will be 23 programs; 13 of those will be new programs to CBD.
Tool building and ITARs are underway.
Elentra Faculty and resident development is ongoing.
Elentra Bulletin will start going out to all faculty, residents, PDs and PAs bi-weekly.
CBME Learner Focus Groups are underway with two completed and one more in the next week.
CBME Faculty Focus Groups are underway with one completed and two more taking place next week.
EPA completion rates are being studied currently.

5. Policies/Guidelines

BPEA Guideline: Reporting on Assessment Results was approved.
Wellness Subcommittee Terms of Reference were reviewed and approved with one addition of adding a PAAC member to the committee.

6. BOE Update
Hynes provided an update on their role in assisting residents in academic difficulty.  Full details can be found in the attachment.
CPSO Renewal Application: residents have to self disclose remediation for Professional, Collaborator, Communicator.

7. PGME Innovation Opportunity
McDonald, a resident at Western shared and innovation opportunity that she is a part of with other trainees in Ottawa.  My On Call pager app (MOC) is a simulated pager program. An educational tool for trainees in addition to helping programs to monitor/assess safety of autonomy.
Cost is free for 2019-20 pilot year; then $750/program for question development ($50/hr x 15 hrs paid question development) and a project coordinator.

8.CCME Update
CaRMS is rolling out a new feature for how programs select whether candidates will be interviewed or not.
BPAS Implementation was shared and PGME will assist with the progress.

Attachments

March 29, 2019

1. Resident Report
The call room audits for the specific sites are ongoing. Isolated issues have been brought to site leads. It was agreed that PGME will look into specific issues related to availability of call rooms with the OHA as part of the OHA/PARO agreement.
PARO is pleased to hear that the resident registration matters are being addressed.
A number of fun events are planned for the Spring including a Jazz Night and others.

2. PAAC Report
PAAC Award Nominations are now closed with 28 nominations. The award recipient will soon be announced and presented at the PA Appreciation event on April 24th.  All nominees will be recognized at the Appreciation Event.

3. COFM
PARO is interested in identifying leading practices in fatigue risk management. PG deans emphasized that, while they will champion centralized policies and discussions, this will require a major culture change that will require some time, likely years, to improve.
CAHO is interested in identifying best practices in resident wellness. Ari Zaretsky will reach out to wellness offices to collate current initiatives.
PARO did a provincial call room audit and almost all were compliant.
PARO requested support in adhering to both ‘leave after call’ policies, and in managing vacation requests. Vacation can ONLY be denied to a resident if service delivery cannot be met and an alternative must be offered in the same rotation. Threatening to evaluate the rotation as ‘incomplete’ is inappropriate. Though residents who do take major time off during a rotation are at risk of failure/incompletion, this can only be determined at the end of the rotation when performance is assessed against goals and objectives.
Maximum of 8 weeks of electives in a single discipline cap in all Canadian UG programs moving forward. Logistics being sorted by UG deans, final version to be completed hopefully at CCME. Will take effect in 2021. Programs will need to adjust their expectations that applicants will have multiple electives in their discipline (because they won’t be able to anymore).
The MOHLTC presented confidential new health human resources modelling data.  The data includes projections based on both their Needs Based Model and supply models.  Further discussions are required between MOH and PG deans to understand the implications of their modelling on quotas implications.

HUEC

Standardization of Teaching Evaluations is a new working group led by Drs. Bandiera and Houston to make recommendations regarding the possible and appropriate standardization and enhancements of faculty teaching assessment across the MD and Post MD Education Programs.
PGMEAC guideline on Assignment of Medical trainees to sites that had been approved at PGMEAC last month was endorsed by HUEC.
HUEC was updated on accreditation preparation for both UG and PG programs, both of which are scheduled for 2020.
HUEC was updated on the 2019 CaRMS results, fewer undergraduates went unmatched from U of T this year, and more U of T students received interviews at U of T. The percentage that matched to U of T, however, was similar to past years.

4. Internal Review Committee (IRC)
Probyn presented the current status of IRC activity for both Postgrad and Family Medicine.

5. Accreditation 2020
Probyn provided an update on preparation for Accreditation 2020.
Bandiera has been meeting with all the Department Chairs to review the programs’ needs.
PGME will share the Accreditation Questionnaires (AQs) with Vice Chairs and VPs Education for all hospitals to ensure that everyone is on the same page and able to address any needs.
Tip Sheet is a guide for programs to assist with the wording for the AQs, and can be added to by programs as needed.

6.CBME/BPEA
Implementation of CBD in Elentra is going very well.  Programs values the features offered.  Much of April/May will be spent building tools for launched and newly launched programs as part of the migration to core Elentra.  Checklists to assist programs in onboarding to Elentra, either as a full launch program or to pilot will shortly be available online on the PGME website.
Family Medicine is using Elentra as field notes now.
Tableau is a data visualization platform to inform Competency Committees on assessment data with over 10 programs using it now.  Some hospitals were experiencing access issues to Tableau due to their firewalls, and this issue is now almost fully resolved.

7. Policies/Guidelines
The following Guidelines are approved and can be accessed on the PGME website via this link: https://pgme.utoronto.ca/about-pgme/policies-guidelines/
Assignment and Removal of Trainees from Teaching Sites
Program Support for PDs and PAs 
Post MD Education Goals will be adopted and created to align with PGME following the UG Education Goals.  More details to follow.
BPEA Guideline: Reporting on Assessment Results was discussed but due to time constraints, will be carried over for more discussion at the April meeting.

8. CaRMs Update
Abrahams provided an update on the first iteration of the CaRMS match.

9. PGMEAC Membership
The Terms of Reference were reviewed and approved.
Membership will be shared with the Department Chairs to decide who will represent core and subspecialty programs.

Attachments

January 25, 2019

Summary

1. Resident Report
PARO has had a full General Council and a Toronto site meeting.  The goals this year are to help residents navigate what to do if an issue arises (contract violations, etc).  Quality of Life for residents is a main focus (solutions for common badge, registration, repetitive modules, etc). The call room audits for the specific sites are complete. Social events are ongoing.

2. PAAC Report
PAAC Award Nomination submission deadline is: Friday March 1st.  The award recipient will be announced at the PA Appreciation event in April. PA Appreciation event plans are underway.

3. COFM
Call Room Audits are difficult to track. Suggested model plans with more flexibility.
PARO/CAHO issues – PG Deans wrote a letter to CAHO/PARO expressing their desire to have more input on this matter.  Dialogue is ongoing.
CPSO is looking at registration processes and ways to expedite where they can.  Some recommendations were put forward to allow straight forward cases to be reviewed at the assessor/manager level, rather than having to go to Registration Committee. This decision will reduce the volume by 20% and will decrease delays for programs who have trainees awaiting decisions from Reg Comm.
SAEGIS is a wholly-owned subsidiary of CMPA whose mission is to protect the professional integrity of physicians and promote safe medical care in Canada. They offer many workshops, programs, and professional development for physicians
and healthcare professionals. For more information please visit https://saegis.solutions/en

HUEC
Interoperability of Systems was discussed and HUEC expressed interest in taking an initiative to help reduce barriers for learners to both onboard at hospitals and carry out their work through better coordination and harmonization of IT systems and registration processes.
Guideline: Assignment and Removal of Trainees from Teaching Sites was reviewed and a few additional principles were added for PGMEAC to review and approve. The document will be revised with the approved edits and be returned to HUEC for final approval in March.

4. Internal Review Committee (IRC)
Probyn presented the current status of IRC activity. Self-study reports were distributed to programs in mid-January. Sessions on the new Accreditation Standards are ongoing. (slides attached)

PGME External Review Update 
Bandiera summarized the report from our external review that was held on November 7 & 8 2018.  The Areas for Improvement (AFIs) and persistent weakness will be the main focus of the PGME in preparation for the upcoming Accreditation in 2020. (slides attached)

5. Accreditation 2020
Accreditation Management System (AMS) The University of Toronto residency training programs will be held to the new accreditation standards at our upcoming on-site visit in the Fall 2020. In preparation for this accreditation visit there will be a new accreditation questionnaire (replacing the old PSQ) that corresponds to the new standards for each program to complete. Timelines regarding the questionnaire can be found in the attached slides.

6. CBME/BPEA
Elentra “Core” Reminder that PGME is switching back to the “core” version of Elentra for the 2019-20 academic year.  The version we launched in 2018-19 was highly customized for U of T needs, but does not offer certain features (i.e. being able to preview a form before triggering it for completion). In moving back to the core version we will be able to easily take advantage of system enhancements contributed by all consortium partners.
BPEA will have sample mock reports in Tableau to share at the PGMEAC meeting in March.

7. Translational Research Program
Ferenbok presented the Master program at UofT, the Translational Research Program. He is reaching out to trainees and faculty who might be interested in improving their translational skills while earning an MHSc in Translational Research. Please visit the website at https://trp.utoronto.ca for more details.

8. Registration Update
Morris presented on the registration process throughout the academic year, including important date reminders. The dates for the next CMPA Resident Symposium can be found in the attached slides.

9. PGMEAC Membership
To ensure full representation of all training programs (PGY1 entry and subspecialties), we will be reviewing the PGMEAC membership identifying gaps.  Further discussion on this issue at the next PGMEAC meeting in March.

10. MBA Opportunity for Residents
Professor William Mitchell met with Dr. Bandiera about securing support for residents to undertake a full time MBA. Rotman is willing to offer TWO Dean’s Fellowships to cover $90, 000 of the $110, 000 tuition. Program details and application details are in the attached briefing note. Please circulate to all eligible residents.

Attachments

October 26, 2018

Summary

1. Resident Report
PARO’s first Toronto site meeting is next week and they will be planning social and wellness events for the year. Call room audits at various hospitals will be complete by the end of this month.

2.COFM & HUEC Updates

COFM
Quotas Ministry of Health has not reached a decision yet regarding additional positions for the PGY1 match. Members will be informed of any updates. Touchstone has revised the Canadian Medicine Primer course for international learners entering training. PGME is considering how best to prepare incoming trainees and the role Touchstone will have for UofT in the future. MOH announced a recent re-organization. The HHR Workforce Planning Unit has been restructured and is now part of the Capital and Capacity Planning Branch. David Lamb is still the Director. AFMC report re Unmatched Students issue suggests unblending of IMGs and CMGs in second round of match. This means CMGs and IMGs would compete separately for specific CMG and IMG positions. Dialogue is ongoing.

HUEC
Support and Resources for Breastfeeding Mothers Across Teaching Sites Survey was recently conducted for an environmental scan of what hospitals are currently doing. From the report, the recommendations were: 1) If something is in place at a hospital to support this, make sure it is known to trainees. 2) If nothing is in place at a hospital, work on something being put in place to ensure the support is happening. Incident Meetings with hospital HR and a Trainee As these meetings can be intimidating for a trainee, they can now request a representative from PG Wellness office for support and to attend the meeting with them.

WSIB Coverage for Fellows was discussed regarding the issue of a fellow on rotation at various hospitals. Coverage of the clinical fellows and responsibility for WSIB premium payments is schedule for discussion at the Fellowship Education Advisory Committee and results will be discussed at a future meeting. Common Badge & standardization across sites still does not have a resolution as it an operational matter at hospitals. There was a previous survey of hospital procedures regarding badge production. It was recommended that the Edu Deans office
update the survey and the results discussed at a future meeting.

3. Internal Review Committee (RC)
L. Probyn presented the current status of the IRC activity. There have been four separate workshops on the new Accreditation Standards and more will be offered in the near future. Newsletters with information and status updates to Accreditation will be
sent out to all programs shortly.

4. CBME/BPEA
G. Bandiera shared that the second set of mini-conference/workshops are complete, organized for programs onboarding next year.
CBME Leads met with the Royal College at the recent ICRE conference. There continues to be net migration away from e-Portfolio and schools are either using Elentra or a home grown IT Platform. Work around Tableau as an application to report on assessments is underway. Use of the Tableau software is free via the University license. PGME staff will offer a base configuration of assessment reports in Tableau to residency programs implementing CBME. PGME is switching back to the “core” version of Elentra for the 2019-20 academic year. The version we launched in 2018-19 was highly customized for U of T needs, but does not offer certain features (i.e. being able to preview a form before triggering it for completion). In moving back to the core version we will be able to easily take advantage of enhancements. Vice Chair Education meetings continue with Dr. Bandiera and Dr. Susan Glover Takahashi to provide CBD updates and ensure support is in place for all programs.

5. PGME External Review
Our PGME External Review preparations continue and are almost finalized and ready for the review meetings which will be held on November 7th and 8th.

6. Guideline: Assignment and Removal of Trainees from Teaching Sites were due for review. Suggested changes or comments are due back to the Associate Dean by Friday, November 2nd.

7. PG Wellness Office Update
J. Maggi presented on the current status and updates in wellness. The Resident Wellness Office name has changed to Postgraduate Wellness Office to reflect that they serve residents and clinical fellows. There is a Wellness Subcommittee that meets quarterly. An invitation will be sent out shortly to residents/fellows to sit on this committee. Docs for Docs is a project in the works to match each trainee with a family doctor. Multiple wellness workshops are available throughout the year. For more details on each workshop, please visit the Postgraduate Wellness Office website.

8. Saudi Trainees
G. Bandiera shared that the situation is evolving quickly. Conditional offers have been sent to trainees and funding contracts for MSM trainees will be honoured.

9. Relations with Industry Module
J. Goguen shared a DRAFT module that all faculty will need to complete in the near future. It will provide scenarios and what to do if there is a conflict in a variety of situations. This is in keeping with the University’s Conflict of Interest and Relationships with Industry policies. More details to follow in the near future.

Attachments