2019-20 PGMEAC
Agendas, Minutes & Attachments
June 26, 2020
1. Resident Report
S. Willmott provided an update on PARO activities:
- PARO sent out the RDoC Accreditation survey to all Toronto residents in May and a reminder in June. Responses will continue to be monitored
- On June 24th, the Toronto Team held a PARO Zoom orientation for incoming Toronto PGY1 residents, which was very successful with over 100 attendees. Now PARO is working directly with programs to send out call kits
- PGME will provide an update to all Programs once they receive the information from the MoH regarding trainees vacation and how it will be managed next year (carry over or pay out)
2. PAAC Report
B. Baumgart provided an update on PAAC activities:
- The PAAC Award Nominations closed June 30, 2020
- There are 20 nominees for the Administrative Excellence and Leadership Award and 3 nominees for the Innovation award.
- The Awards Subcommittee is currently reviewing and ranking the nominations
- The award recipient will be announced in early September and we hope to celebrate with the awardees in the new academic year – pending covid protocol
- All other projects and surveys are ongoing. The PAAC will meet again on July 14th to review current activities
3. COFM/HUEC
COFM
- Many decisions around electives. UG has postponed all electives for the upcoming academic year. PG has postponed electives for all Medicine programs across the country only for blocks 1 to 3 with no decision on future blocks to date, all other programs can proceed as planned
- CaRMS interviews will be virtual this year. National working groups will develop guidelines and best practices for early July
- Incoming trainees arriving from outside of Canada must self-isolate for 14 days prior to starting clinical duties
HUEC
- Ten-day return to Clerkship course for UG trainees as they have been out of the hospital setting since March due to pandemic – this will be completed prior to their July 6th start date
- PPE virtual and in-person training is mandatory for all PGY1 residents and must be completed prior to July 2nd. Hospitals are responsible for providing in-person training and an attestation will be required from each trainee that they completed it. This will be submitted to PGME and then sent to programs for their records. The online modules can be found here
- Refreshers and SIM training for PGY2s and up is ongoing and available
- ATLS/ACLS training needs have been identified by each program
4. Redeployment
G. Bandiera provided an update that all trainees have submitted their selection of one block of redeployment and we now have a roster of trainees for each site for the whole year. Programs have been involved with the streamlined decision-making of placements at sites
5. Accreditation 2020
L.Probyn provided an update on Accreditation 2020, which included:
- The November 2020 accreditation visit will be virtual and will take place over a two-week period on November 22 – 27 + 1 week (before or after)
- RC Pre-Survey Visit will be on Friday July 24th
- CFPC Pre-Survey Visit will be on Tuesday August 11th
- Revised documents are still be uploaded to the AMS
- There will be workshops at the end of August/early September for Program Directors to prepare them for the accreditation visit – four dates will be offered to select from
- There will be workshops in early October for Program Administrators to prepare them for the accreditation visit – four dates will be offered to select from
6. BPEA
The overall entrustment scale has been refined with new labels and descriptors, which now reflect the specific encounter and does not confer overall entrustability as that decision is made at the Competency Committee. These new scale labels will be updated this week and will replace the old ones
7. Visa Trainee Update
- With the assistance from the IRCC, international trainees can come to Canada without the biometrics completed prior and it will be done at port of entry.
- 411 incoming international trainees
- Trainees must self-isolate for 14 days, prior to starting clinical activity
- International trainees arriving without previously made housing arrangements can seek assistance through PGME by contacting: lisa.bevacqua@utoronto.ca
- Extensions provided to almost 100 trainees who have needed to stay to complete their training past June 30th due to the pandemic; or cannot get back to their country due to airports not open. Funding to support some of these extensions was provided by the generous donation of the Temerty fund
- Both MCCEE and MCCQE1 will be accepted from international applicants in keeping with other Canadian schools
- PGME continues to receive applications from international trainees. We appreciate your willingness and flexibility to review
- PGME will extend the deadline for applicants to PGY1 positions to provide flexibility (mid-August)
- In keeping with last year, the PG National Deans will institute principles and deadlines for 2021 offers for visa sponsored trainees, including PGY 1, MSM, PSM and FM-ES. These will be communicated when final
8. Continuous Improvement Working Group
A. Matlow shared the purpose of the CI Working Group which is to provide advice regarding the support and oversight of continuous improvement activities at U of T Learning Sites to improve the educational experience. The following recommendations to optimize oversight and management of CI activities at learning sites.
PGME should:
- Develop and distribute a summary document for stakeholders including department chairs and site education leads (e.g. vice-chairs of education, education directors) to outline the data and reports that are currently available in POWER and other sources (e.g. VOTR survey, internal review (IR) findings etc.). Clarify data ownership, access and reporting structures.
- Develop guidelines that outline the expectations for learning sites as relevant to Institutional Standard 9. Interpretations of the requirements and practical examples…should be provided.
- Develop guidelines that clarify when a residency training program (e.g. program director, site director etc.) should inform the learning site (e.g. vice-chairs of education, education directors) of relevant site-specific issues identified.
- Ensure upcoming improvements to Elentra with regards to rotation and teacher evaluations are informed by the expectations of learning sites relevant to Institutional Standard 9.
Review and consider:
- The frequency of site-specific Internal Review Summary Reports
- The frequency of TES and RES summary reports
- Consider adding site-specific alerts to POWER and determine how best to relay relevant information to site education leads.
- Determine whether the information currently available to learning sites is sufficient to meet the minimum requirements of Institutional Standard 9.
- Determine reporting expectations from sites to PGME to monitor that Institutional Standard 9 requirements are being met.
All recommendations were approved by the PGMEAC members and next steps to carry out the recommendations will be planned in the near future.
9. Registration/Onboarding Update
- Updated integrated privacy and cyber bullying module is in place at all hospitals so that the trainee only has to complete it once
- HUEC approved a three-month grace period to the end of September for TB testing to be completed by trainees – due to the pandemic
- Online registration is in place for all incoming and continuing trainees reducing the requirement to come into the PGME office as protective safety measures are still in place to reduce in-person contact
Attachments
March 27, 2020
1. Resident Report
S. Willmott provided an update on PARO activities:
- PARO Site Chairs across the 6 medical schools in the province have been maintaining open communication to better understand what is happening within the province
- PARO has created a dedicated COVID19 website at myparo.ca, to provide useful information and to answer many of the questions we are receiving. We are committed to only provide information that we know to be accurate or believe to be helpful.
- PARO has also been sending regular email updates to our members and postgraduate offices across the province as part of our commitment to ensure clear and open communication.
- PARO will be happy to hear from PGME of things you feel we could be doing to be of assistance during COVID-19.
- We are committed to assisting our members to help provide safe, excellent care to the patients of Ontario.
- PARO has been working closely with RDoC to determine the most appropriate time to issue the RDoC pre accreditation questionnaire to residents at Toronto. To be clear, the survey has not sent as of yet, and will be on hold until further notice and direction from RDoC.
- At our last PARO General Council meeting we voted in our new President-Elect who is a Toronto resident – Dr. Ryan Giroux (PGY3 Paediatrics) will be stepping into the role of PARO President for the 2020-2021 academic year.
2. PAAC Report
B. Baumgart reported that the committee has paused organizing the Program Administrator appreciation event until a new date post-COVID is released. Postponing awards deadline and keeping the application submissions open.
3. COFM/HUEC
COFM
Focused discussions and efforts, where possible, on harmonized approaches to things so that residents are not disadvantaged in one school: elective travel, managing absences, preparation for trainees coming and those scheduled to leave July 1st, ways to approach common issues for residents (wellness accommodation requests) as it is better when there is consistency across the province.
Ministry working on extending and providing licensure for trainees who have not written exam or need to extend their training due to this crisis.
All exams postponed to the fall. Residents are expressing concern about the delay. The Colleges are working on a plan for the exams.
Meeting every other day with national PG Deans discussing the ongoing issues. CPSO Provisional licenses for 6 months only so that they don’t have to go before the registration committee as per the regulations.
May see movement on what the exams look like (delivery onsite at universities as opposed to at an exam centre, whether there will or will not be oral exams) G. Bandiera is in full support of all creative options to get trainees getting their licensures as long as trainees do not have to write exams in the next three months as it would cause anticipation of time off for trainees to study and prepare for their exams as we will need them on the front lines during this pandemic.
HUEC
- Revised Internet Guidelines were approved, no concerns or further edits were requested. Can be broadly circulated.
- HUEC reviewed the PG COVID redeployment guidelines and provided input. Guidelines and a broad redeployment strategy will be distributed to programs. This endeavor is expected to be collaborative.
- MD Program accreditation has been postponed until further notice.
4. Accreditation 2020
L. Probyn provided an update on Accreditation 2020, which included:
- Pre-Survey Visit: April 28 – 29, 2020 – new options under discussion to determine how and when information that the RC and CFPC will need from programs will be sent as this visit will not be done in person
- Hidden Curriculum Workshop – postponed until further notice
- All Accreditation preparation workshops will be delivered in an online format
5. CBME
C. Abrahams provided an update CBD Implementation timelines/processes with COVID19:
Lots of work going on in the background.
- Moving forward with implementation but trying to “minimize” asks of Programs for documents
- Providing additional assistance with Assessment Tool templates
- Relaxing timelines and deadlines – adding another 4 to 6 weeks if programs require more time
- Also extended timelines for initiation of pilot projects
- EPA Tableau Dashboards are continuing to be produced based on Competency Committee Schedules
Elentra System Enhancements – Deferred
- Eliminate blank form option for EPAs – developed but implementation deferred
- Discussion ensued that blank form option could be implemented shortly and ideally to coincide with a new block
- EPA form expiry after 7 days – developed but implementation deferred
- Testing underway for next version of Elentra to feature:
- Assessment Plan Builder (CC Dashboard within Elentra)
- Rotation Scheduling*
- ITERs/ITARs, Teacher Assessments and Rotation Assessments*
* Pilot for Rotation Scheduler with FM/ObGyn will involve extensive testing for extended period rather than planned deployment for July 2020
Upcoming Elentra and Tableau Training Sessions (Virtual by Zoom!)
- Thursday, April 2nd from 9 to 10:30 AM
- Tuesday April 7th from 1 to 2:30 PM
- Wednesday April 8th from 1 to 2:30 PM
6. BPEA
No updates as meeting was postponed.
7. COVID-19 Update
G Bandiera shared that PGME is doing its best to keep everyone informed on key decisions, a centralized system has been set up to provide answers to questions with various team members responding based on the content. General communications are continually going out as required.
Redeployment principles are in place and will be implemented next week.
CBD assessments and exams: could there be a waiver of the exam or part of the exam so that trainees can get out and practice during these unprecedented times.
TASHNe: Educational leads team is meeting daily to plan and discuss issues within the hospitals and with a focus on education as they arise during COVID.
Attachments
February 28, 2020
1. Resident Report
PARO had their site meeting in February and their social schedule was planned for the year, which includes: Night at the ROM, Night at Ripley’s Aquarium, Paint Night, Yoga and many others. On June 25th, there will be an evening social for all incoming residents following the New Resident Welcome Reception.
2. PAAC Report
PAAC Awards Nomination forms have been sent out. This year PAAC has expanded the award to two awards, one for Administrative Excellence/Leadership and a second for Quality Improvement/Innovation. Deadline for submission is March 25th.
A full-day wellness session was held this week for PAs with a strong attendance and positive feedback.
New PA Intro Session will be held on Thursday March 5th. If you’d like to register, you can do so via this link:https://facmed.registration.med.utoronto.ca/search/publicCourseSearchDetails.do;jsessionid=B5D44325FCDF811F8B3BF1DF1265F08E?method=load&courseId=1745521
3. COFM/HUEC
COFM
HHR planning – still no approval from the Ministry of Health for this year’s quota submission from the schools.
International Visa Trainees – increase in diversity of trainees. Saudi Arabia Cultural Bureau will be visiting Toronto in March with PGME and others. Contract negotiations are still underway.
The Pandemic Planning document was reviewed.
HUEC
Presentations have been made to all departments regarding the Learner Environment survey results and addressing any issues. A new Professional Values statement is in its near final version being led by Pier Bryden.
The Optimizing Learning Environment recommendations are being implemented by both UG and PG.
The Streamlined Onboarding Working Group is still underway and will provide updates in the near future.
4. Accreditation 2020
Programs are in the process of returning updated versions of their AQs to PGME.
PARO, in conjunction with RDocs, held two accreditation workshops last week for residents to prepare them for what is expected of them during accreditation.
A Timeline document was shared
Pre-Survey Visit: April 28 – 29, 2020
On-site Review: November 22 – 27, 2020
5. CBME
C. Abrahams reported that we are on track with 23 programs launched in CBD and 17 programs confirmed for 2020-21 Launch with half of them piloting now. Mini-Conferences are underway and continuing with success. New efforts are underway to engage residents and program administrators through the creation of advisory groups.
6. BPEA
At the last meeting in January, it was decided to remove the blank form option from EPAs and to expire EPAs after 7 days – this will take place in April. Entrustment scales are still under discussion.
A Target Guidelines for EPAs document was drafted, but now under review based on recent comments by the Royal College related to the inclusion of contextual variables on EPA assessments.
7. Guidelines on the Appropriate Use of the Internet, Electronic Networking and Other Media
This document (in conjunction with Undergrad) was shared showing the additional principles for PGMEAC to review and approve. The document will be revised with the approved edits and returned to HUEC for approval in March; then to Faculty Council for final approval in April.
8. UG Course Objectives and Case Logs
S. Bernstein presented the document that is used in undergrad for their students to meet specific encounter requirements in line with Accreditation.
9. Elentra Rotation Scheduling and Teacher Assessment Pilot
C. Abrahams shared an overview of a new pilot in Elentra for rotation scheduling and assessments including clerkship and resident assessments together with teacher and rotation assessments. It will be tested by two departments in the 2020-21 academic year.
10. Resident Leadership Update
A Matlow and L. Probyn provided an update on the leadership activities that have been happening with senior and chief residents. They include: Chief Resident Leadership Workshop, Resident Leadership Forum, Concierge Lecture Series, PGME Leadership Certificate Program with Fireside Chats.
11. COVID-19 Update
G. Bandiera shared that there may be restrictions on elective students who are coming to Toronto from areas affected by the COVID-19 virus. More details will be shared as they come.
Attachments
November 29, 2019
1. Resident Report
There continues to be an environmental scan of food options at hospitals. PARO is hosting a social for all residents at the Toronto Christmas Market.
2. PAAC Report
The new Awards sub-committee Terms of Reference will be completed in December.
The new Spotlight Appreciation project’s first publication will be released in January 2020.
3. COFM/HUEC
Full COFM
HHR planning – still no approval from the Ministry of Health for this year’s quota submission from the schools.
Resident remediation declaration to CPSO has ceased and it is no longer on the questionnaire that resident’s must complete.
Call Stipends: A province-wide review of call stipend submissions is underway. Most schools exceed their allocated call stipend allocation but remain within their overall funding envelope with the Ministry. However, some schools are getting very close to hitting their funding cap due to call stipends and it is important for schools to remain within the cap. Accordingly, PGME asks all programs to notify us before implementing any new call models.
PGME will no longer provide copies of the Final AVP form to Touchstone – only to CPSO.
HUEC
No Updates.
4. Accreditation 2020
Programs will receive their AQs back in mid-December. Corrections are due back to PGME in January.
5. CBME
CBD Launch Status was provided: 23 programs currently in CBD and 17 programs confirmed for 2020-21 Launch.
There are currently 7 of 17 July 2020 launch programs confirmed to pilot.
Many Elentra projects are underway including: Assessment Plan, Rotation Scheduler, ITARs, Rotation Evaluations, Teacher Evaluations and Case Logging.
The team is continually working on Elentra enhancements. Some recently implemented are: the management of multiple programs in My Learner section, ability to include/exclude milestones in data extract. Updates on enhancements will continue to be communicated as they roll out.
Elentra and Tableau quarterly training sessions are underway and more will continue in the new year.
6. BPEA
There is continued monitoring and advising on observations and issues which include: blank forms, EPA assessment form expiry and EPA Entrustments scales. All details are in the attached slides.
Next steps include consultation plans, clarification on current issues with CBD implementation, consideration of options (technology, resident and faculty development and more).
7. Touchstone Presentation
A Frisina presented on behalf of Touchstone and shared how they want to ensure they provide a smooth and formative transition to training for International Medical Graduates and
Visa Trainees. He provided information about their programs, and feedback from trainees who have completed the program, while consulting with PGMEAC to understand and incorporate our feedback into their programming.
8. Joule Practice Management Curriculum Seminar Presentation
J. Kaser from the CMA presented on their practice management seminar offered to trainees which focuses on the business side of medicine. More details can be found via this link: https://joulecma.ca/learn/practice-management-curriculum
9. VotR Results
The results of the Voice of the Resident survey were presented. Highlights included:
- 988 respondents (49%)
- 59% residents had an excellent or very good residency experience – smaller proportion than previous years
- 61% of residents rate their educational/learning progress in the past academic year as excellent or very good
- 55% of residents agree they have a mentor who supports their development
- 64% of residents say they were subjected to at least one form of incivility in the past academic year
- 54% of residents say they experienced discrimination and/or harassment this past academic year
- 56% of residents describe their overall health as excellent or very good
- 33% of residents feel excited about their future career path
Vice Deans of PG and UG are presenting these individual results to all Chairs of departments.
Attachments
October 25, 2019
1. Resident Report
PARO just completed their first workshop of the year. There is currently an environmental scan underway of food options at hospitals.
2. PAAC Report
A new Awards sub-committee has been formed and they are reviewing the Terms of Reference for the two awards, which will be presented at the November 12th PAAC meeting.
The 2019-2020 PA Information Series has been launched. We will be starting with two sessions on November 8 with presentations by the Royal College and CaRMS.
The new Spotlight Appreciation project is underway. The Spotlight is aimed to be launched in the next few months.
3. COFM/HUEC
Full COFM met and discussed HHR planning – still no approval from the Ministry of Health for this year’s quota submission from the schools. There is much advocacy from the Deans to get the 25 CMG spots back. No change to unblended streams in the second iteration. No change or increase in the submission of applications by Saudi trainees.
HUEC Subcommittee: Learner Onboarding survey is expected to be launched in the near future. The committee is asking for input from trainees.
Modules are being updated all throughout TaHSN. The goal is to update the modules across all the hospitals.
4. Accreditation 2020
L. Probyn provided an update on preparation for Accreditation 2020, which included:
AQs deadline of October 15, 2019 has passed. The accreditation team is reviewing all the AQs ensuring standardized responses for each program. Programs will receive their AQs back between mid-November to mid-December.
Workshops will be offered in the near future to prepare for onsite review.
5. CBME/BPEA
CBD Launch Status was provided: 24 programs currently in CBD and 16 programs confirmed for 2020-21 Launch.
CBD Mini-Conference Series have begun and will continue throughout the year to programs who are launching in July 2020 (Stream 1). Stream 2 series focuses on the continued launch programs and addresses changes/updates to the model, systems, etc.
If a program wishes to pilot prior to launch, they must meet certain criteria and deadlines (slide 6).
6. Policies/Guidelines
The Wellness Guidelines for PG Trainees were reviewed and approved with a few minor corrections. The guidelines will be available on the website once finalized.
7. CaRMS Enhancements
CaRMS has introduced an enhancement to interview selections, which includes a “selected to interview”, “not selected to interview” or “waitlisted” option which must be entered for each applicant. The question was raised if applicants will be informed of these enhancements – C. Abrahams will follow up with CaRMS.
8. Continuous Improvement Working Group
This working group provides advice, support and oversight of continuous improvement activities at UofT learning sites. The working group consists of representatives from fully-affiliated and community-affiliated sites and residents.
9. Postgraduate Wellness Office Update
J. Maggi provided an update on the Postgraduate Wellness Office. The name and branding is complete. There has been a slight increase in visits to the office each year. There are many projects underway including research projects, Voice Of The Resident/Fellow (VOTR) survey, guideline development and collaboration with Faculty of Medicine teams.
Attachments
September 20, 2019
1. Quotas Allocation (See attached)
The QA Committee’s recommendations for assignment of the 407 residency positions by PGY1 program for 2020 intake were reviewed and approved. There will be no change in the 70 positions allocated for IMGs at UofT, compared to 2019 other than a redistribution in Lab Medicine programs. The distribution of the 9 position cuts by program over the last 5 years was presented. Government HHR planning data by specialty was reviewed, identifying specialties in need and those in over-supply. A provincial summary chart was presented reflecting the allocation of the 1,188 residency positions across the 6 schools for the 2020 PGY1 match. DFCM is considering offering positions for the Department of National Defense. Discussions are underway for a joint NOSM/UofT position in Ob/Gyn.
2. Resident Report
PARO is engaged in its strategic planning exercise and is focusing on transition to practice programming and compiling information on funding of its members doing graduate programs. The call room audit report will be released, and an audit of resident lounges is also underway. Resident representatives will be engaged in the working groups/committees reviewing orientation and on-boarding programs at hospitals.
3. PAAC Report
Topics for this year’s information sessions have been agreed upon. A Wellness Retreat is planned. The PAAC awards will be expanded to include a focus on leadership and community service. Committee members will participate in the learner environment/hospital on-boarding working groups.
4. COFM/HUEC
– At HUEC, working Groups have been formed to review the on-boarding experience in hospitals and Teacher Assessment. A pilot for a new model for Teacher Assessment will be launched in January.
– At COFM, Emergency Preparedness Guidelines outline the role of residents.
– The COFM Immunization Policy states that the flu vaccine is mandatory during the flu season. There were concerns on how to operationalize and record this requirement.
5. Accreditation 2020
– L. Probyn provided an update on preparation for Accreditation 2020
– The last meeting of the Internal Review Committee is next week
– AQs have been sent to all programs and are due back to PGME by October 15, 2019
– Save the Date: Sunday November 22, 2020 – evening reception for Program Directors to meet their surveyors
6. PGMEAC Program Representation
Probyn reviewed the Committee’s membership to ensure all programs had a representative at the table, that members understood their role in bringing forward concerns of the programs they represent, and also disseminating PGMEAC discussions and decisions.
7. CBME/BPEA (See attached)
Regular communications on CBME implementation tools and resources are sent out 2x/month, and are available on the PostMD website. Training in Elentra and Tableau is available, and faculty/learner development support in Elentra is ongoing. 70% of the assessments in Elentra were completed in less than 24 hours after act completion, triggered by faculty.
8. Policies/Guidelines
Maggi reviewed the newly developed Accommodation Guidelines for Learners and requested members for input on the content and work flow.
The Wellness guidelines were also presented, outlining the resources of the PG Wellness Office and considerations/questions to guide programs developing their own Wellness programming.
The Guidelines on Appropriate Use of the Internet Electronic network and Other Media were developed in 2008 specifically for learners. The question raised at HUEC was whether they should also be applicable to Faculty members. The question and guidelines will be referred to Dr. Bryden in her role as Director, Professional Issues in the faculty.
9. Medical Assistance in Dying
Tan reviewed the development of the MAID project. The accommodation of resident requests to gain experience/do a rotation in MAID was discussed. A Learner Request Form has been developed but approval must be sought from a learner’s current supervisor to “attend”.
10. Teaching Effectiveness Scores/Rotation Evaluation Scores
Probyn reported that assessments in both areas in POWER have decreased from the previous year. L. Probyn is speaking directly with PDs or VC Ed. of those programs with low completion rates to discuss strategies for improvement. With the introduction of Elentra, Faculty will be seeking alternative assessment methods.
11. Other
Accommodation re mask fitting for learners with beards was discussed. The committee was reminded that mask-fit is a requirement of hospitals who are implementing Ontario Ministry of Labour specifications. The expectation is that all residents will fulfill employer requirements unless exempt for specific reasons such as religious or medical. The matter will be brought forward to HUEC.
Attachments