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PGMEAC Meeting Materials

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The following sections provide agendas, minutes and attachments for PGMEAC meetings from the 2010-11 academic session to the current academic session.

2020-21 PGMEAC Agendas, Minutes & Attachments

1. Resident Report
The Community Building Fund

At our March General Council meeting, PARO discussed that current PGY1s are feeling particularly isolated during the pandemic as they were off for months before starting residency and since then have had little opportunity to meet their colleagues in person to be able to bond. To mitigate this challenge, the PARO Board has approved a specific initiative which provides us with the ability to organize and fund targeted events specifically for current PGY1s, (i.e., 2020-2021), the Community Building Fund. While the Toronto PARO GC team is currently brainstorming events to host using this fund, proposals for events can also come from general PARO members and programs.  If your program is interested in hosting a virtual event for current PGY1s using this budget, please contact Sarah Reyes (sreyes@paroteam.ca), to obtain more information and the proposal form.

In addition, PARO would like to emphasize the importance of programs hosting socials for the incoming PGY1s. This will help create those social connections and bonds amongst residents in the program early on.

PARO Face Masks
As mentioned at the last PGMEAC meeting, PARO has produced 3-ply non-medical face masks that we are distributing to all residents. To date we have delivered face masks to most Toronto hospitals, with the last remaining hospitals of Toronto General, Sunnybrook, Princess Margaret, and Humber River, receiving the face masks next week. We want to thank everyone for your help delivering these face masks to Toronto residents.

PARO Awards Celebration for University of Toronto
The upcoming PARO Awards Celebration is being held virtually over two evenings to recognize U of T award winners on Tuesday May 4, and Thursday May 13, 2021. Awards include: Resident Teaching Award, Medical Student Citizenship Award, Clinical Teaching Award, Program Excellence Award, and the Dr. Robert Conn Resident Advocate Award for a Clinician.

2. PAAC Report

  • PAAC held their annual appreciation event on April 28, 2021 in a virtual format. The PAAC Awards for 2020 and 2021 were presented. Congratulations to all the winners and nominees – you are all so vital to all we do!
  • Award Winners:
  • 2020 Administrative Excellence & Leadership
    • Karianne Mintz, Education Coordinator, Department of Psychiatry, Sunnybrook Health Sciences Centre
  • 2021 Administrative Excellence & Leadership
    • Sandra Gauci, Education Coordinator, Department of Ophthalmology and Vision Sciences, U of T
  • 2020 Quality Improvement and Innovation
    • Robert Gardin, Postgraduate Officer, Department of Psychiatry, U of T
  • 2021 Quality Improvement and Innovation
    • Andrea Donovan, Postgraduate Assistant, Department of OHNS, U of T
  • An inaugural award in memory and recognition of Dan Stojimirovic’s exemplary commitment and program support as a Program Administrator will be presented to a long service Program Administrator (15 years+) who embodies similar attributes in their service to the trainees and program. The award will be presented in 2022.
  • PAAC has received their accreditation results / feedback and the new executive will be looking at opportunities to address the gaps/areas for improvement in the next two years.
  • PAAC is looking forward to receiving the final report of our survey on Information Sharing and Collaboration between Hospitals Medical Education Office and the Postgraduate programs. The information is currently being evaluated and will be presented to PAAC at our May meeting.
  • PAAC is recruiting Program Administrators as committee members for a two-year term. If you believe your Program Administrator would be interested, please let the PAAC executive know.

3. COFM/HUEC
COFM
No official meeting since the last PGMEAC meeting, but the PG Deans continue to correspond weekly with updates and best practices.

HUEC

  • The Guideline on Managing Disclosures about Learner Mistreatment were shared with the committee to ensure everyone was acquainted with them, which is already proving to be a well-served document.
  • Ongoing efforts to advocate to hospitals to make onboarding for redeployed trainees as streamlined as possible.
  • TFOM has agreed to reimburse redeployed trainees who have incurred duplicate parking costs.

4. Accreditation Follow Up/IRC Update
An update on accreditation follow up and IRC activities included:

  • The Accreditation committees for both the RC and CFPC are meeting on May 3 and 4 to discuss all the programs that were reviewed in November of 2020.
  • PG will receive the final reports a few weeks following these meetings – no expected changes to AFIs, but if there are, PG will notify as required.
  • IRC has been reviewing the Action Plan Outcome Report (APOR) programs (11 out of 13 have been reviewed) to determine the minimum evidence required to demonstrate that the AFIs have been addressed collaboratively with each program. These programs will receive letters with the action plan and suggestions for changes with a response turnaround in a timely, yet flexible time frame due to the demands of the current pandemic situation. The last two programs will be reviewed at the June IRC meeting.
  • IRC has met with all the programs (5) who require a follow up by an external review and two programs with an intent to withdraw after an external review to ensure all issues are being addressed with an action plan and follow up. These seven programs will have an internal review in the fall of 2022.

G. Bandiera provided full narrative on the institutional review and requirement of an Action Plan Outcome Report (APOR), updating the committee on the rationale behind the AFIs and PGME’s action plans.

5. CaRMS 2021 Results for PGME
The CaRMS Match showed favourable results including:

  • U of T was the only school to fill all 407 positions in first iteration, and the U of T MD match rate after first iteration was 96% (vs 94% nationally)
  • All students unmatched in the 2020 cycle obtained positions in the 2021 match
  • There are 249 vacancies in the second iteration
  • Canadian medical schools have decided that there will not be any visiting electives for the 2021-2022 year

6. COVID Updates
Medical Resident Redeployment Program
A formal announcement from the MOH as a result of an Orders in Council, and in collaboration with OHA and PARO that hospitals can now hire residents and any other licensed professional to do work on their behalf that aligns with COVID needs (i.e. covering extra call, working a shift on the weekend, etc). This work must be done outside of the residency program, must not interfere with residency training responsibilities, and does not replace residency work. Residents are allowed to travel across the province to meet the pandemic needs at other hospitals and will be organized through HealthForce Ontario – more details to follow in the next week from PARO and MOH. This Order in Council will be in effect until July 31, 2021.

Redeployment

  • Leadership continues to meet weekly to evaluate the redeployment system to discuss the needs and ensure the residents are redeployed as equitably as possible and only to the areas that have need. The areas that have need are part of these discussions and will continue to meet weekly until the pressures from the pandemic settle down.
  • All leadership and staff recognize and are grateful for the efforts of the PG trainees being redeployed during this ever-changing situation.

Parking Reimbursement

For all of our postgraduate trainees who have been redeployed to an alternate site and incurred additional parking costs, the Dean’s COVID Priority Fund is now providing reimbursement for their parking expenses associated with the redeployed hospital. Trainees can email lisa.bevacqua@utoronto.ca with the receipts from parking expenses incurred at their base hospital and the additional parking expenses incurred at their redeployment site.

Vaccination Status of PG Trainees – Reminder

  • If your trainees have received both doses of the COVID Vaccination, please ask them to email postgrad.med@utoronto.ca with an attestation that they have received the full vaccination (please provide date of final dose).
  • If your trainees have received the first dose and have a second dose scheduled, please also let us know (include date of first dose and anticipated date of second dose). If any trainees are experiencing barriers to receiving one or both of their vaccination doses, please let us know so we can advocate on their behalf.

Attachments

1. Associate Dean, Postgraduate Medical Education Position

Applications are invited for the position of Associate Dean, Postgraduate Medical Education, Temerty Faculty of Medicine at the University of Toronto.  This is a five-year term appointment effective September 1, 2021, renewable once following a favourable review. The closing date for applications to this position is Wednesday, April 21, 2021, 12:00 p.m. (EST). For any questions about this position, please contact Prof. Patricia Houston, Vice Dean Medical Education (patricia.houston@utoronto.ca). The Advisory Committee for the appointment of Associate Dean, Postgraduate Medical Education invites applications. Interested individuals must submit a letter of interest and CV to Vice Dean Medical Education, Prof. Patricia Houston, c/o Andrew McLeod, search coordinator at md.vicedean@utoronto.caFull job description is available online.

2. Resident Report
Lounge Review

After the last PGMEAC meeting results from PARO’s lounge review was shared with the committee, a couple of hospital sites have gotten back to us to thank the team for their hard work, but to also ask what residents feel is an example of a good lounge. We took this question back to our GC team and we created a list of what residents would like to have included in their ideal lounge. Please note that this is for lounges in non-COVID times when residents do not have practice physical distancing.

  • Computers should be in lounges, as the call rooms with computers can be far away.
  • A fridge and microwave are essential.
  • The square footage and the size of the lounge is important. It should be large enough to allow comfortable use by many residents.
  • The location is also important. Some sites have the resident lounges in the furthest location of the hospital, which discourages residents from using it.
  • Good lounges are either associated with call rooms, so people on call can use the lounge, or program specialty lounges. Standalone general resident lounge ends up not being used because of location.
  • Making lounges have badge access would be helpful instead of asking residents to learn various codes.

Call Room Review
This year, PARO is conducting a province-wide review of the resident on-call facilities to ensure that the rooms are in keeping with requirements under Article 18.2 of the PARO-CAHO Collective Agreement. The review will be taking place over the next few months and once it is complete, we would be pleased to share the results of our review with the hospitals.

PARO Face Masks
PARO has produced 3-ply non-medical face masks that we are distributing to all residents. If the learners at your hospital did not receive a mask , please contact Sarah Reyes (sreyes@paroteam.ca)  and we will work together to get them delivered to your location.

Redeployment
Again, we wanted to reiterate the importance that PGME make every effort to be transparent and flexible in redeployment needs, as we have heard from residents how much they would appreciate regular updates from PGME regarding COVID and redeployment.

3. PAAC Report

  • PAAC Accreditation Feedback Survey was conducted early February and PAAC is looking forward to receiving the results shortly.
  • PAAC Awards Adjudication Committee recently met and have simplified the PAAC award criteria and nomination process, which includes only a nomination letter submission is required. Information about nominating for the 2021 awards will be emailed within the next few days. The nomination deadline is Wednesday, April 14th.
  • PAAC held a virtual wellness session on Friday March 26, 2021. Over 60 Program Administrators, Education Coordinators participated.  We focussed on PA collaboration between programs / institutions, organizing a program / hospital PA committee for local issues, wellness and professional development. We also had a short presentation on Zoom Fatigue followed by breakout discussions on wellness, working remote and combating zoom fatigue.
  • PAAC is currently planning a virtual appreciation event which will be held Wednesday, April 28th. The presentation to the PAAC awardees for 2020 and 2021 will occur as well as other activities. More details coming soon. All education admins will be encouraged to attend.

4. COFM/HUEC
COFM
Important updates included:

  • Combined UG and PG committee meeting took place recently with the Ministry of Health, where the MOH presented on HHR Planning – no new data released, but we are on target with physician numbers in the province with no compelling need to increase spots. The Deans have been lobbying with the Minister around increased UG and PG spots – these discussions are going quite well, but no final decision yet.
  • Resident redeployment discussions around the principles of resident learner response in times of crisis including pandemics and other situations. This detailed document highlights the important role of the PD and their involvement in decision-making for redeployment as the license is tied to program activities.
  • PARO reps thanked all who advocated for the CPSO to temporarily exempt the cohorts of residents from taking the MCCQEII.
  • CPSO movement to increase the rigour and parameters around extra clinical training for people who want to change their scope of practice – similar to the Colleges’ movement towards putting extra training and supervisory obligations on physicians entering practice, there is a movement to move that into an academic setting under the auspices of a university training program. Leadership has flagged numerous concerns about capacity, conflict of interest, impact of current PG learners, etc More details will be shared once a decision is made.

HUEC
No meeting since last PGMEAC. The TASHn education group continues to meet weekly about vaccinations and redeployment.

5. Accreditation Follow Up/IRC Update
An update on accreditation team activities included:

  • Accreditation preliminary program reports have been sent to programs with returned factual corrections. RC and AFC reports submitted March 1st; FM reports sent March 31st
  • The Internal Review Committee (IRC) resumed meeting at the beginning of March.  Membership has changed to fill the spots of those whose terms ended; will be adding a diversity role member in line with EDI goals; call for resident membership will be later in the spring; currently updating the terms of reference and will be presented to PGMEAC at a later date.

6. COVID Updates
Redeployment

  • The third wave is much more dramatic than the first two waves. ICU admission numbers are going up very quickly and the patients seem to be sicker and much younger, which creates different challenges for the caregiving team this time around.  There are two dedicated groups meeting regularly to plan for CTU and ICU needs and what skill sets are required to fulfill these needs.  PGME is matching needs with program availability of trainees and their skills.
  • PGME will continue to provide a report to programs on redeployments at the end of each block.

Vaccination/Isolation Requirements

  • PGME is centrally working on the impact of vaccinations on isolation requirements. Nationally and local hospitals are currently requiring 14-day isolation after exposure to an outbreak. The need to re-visit this policy has been brought to the IPAC leads for further discussion.
  • PGME and TASHn leads will draft a letter with Barry Pakes to send to the Chief Medical Officer and the Premier’s office about how significant an issue this is and the need to have consistencies in place.

7. Elentra for CBD Enhancements
An update on the enhancements in Elentra include:

  • Real-time progress of a program’s learners’ completion of their EPAs
  • Detailed information of completed EPAs
  • Detailed information of outstanding EPA requirements; stage completion; program statistics
  • Learner dashboard

8. BPEA Update
An update on BPEA quality improvement activities include:

  • A QI project on Competence Committee documentation review – the results were shared and are in the attached slides
  • A different QI survey is planned for April consulting residents and frontline faculty who have completed three or more assessments in comparison to the survey done last year

9. VOTR Survey
The Voice of the Resident survey is in the field right now – response rates are a bit low – a reminder to encourage learners to complete.

9. Learner Environment

Attachments

1. Resident Report
Redeployment

  • With these latest redeployment there is a growing concern for Resident Wellness, mental health and risk of burnout. Is there anything PG or the programs can do to support residents?
  • Toronto GC reps have heard from residents that they would appreciate and find it helpful to receive more regular updates from PG in regards to COVID and redeployment
  • PARO advices that, where the hospital can honour existing vacation and leave requests and/or approve requests in keeping with their responsibilities under the PARO-CAHO Collective Agreement, they should continue to do so. Being able to take vacation will prevent resident burnout and fatigue and improve resident wellness
  • Ensuring residents are provided the choice to attend longitudinal clinics/protected academic time from their base program while redeployed
  • Continuing to try to prevent unnecessary extension of training as a result of redeployment (See PARO’s Extension of Training Principals)

Vaccinations

  • Some programs have a disadvantage when it comes to the “first come first serve” policy some hospitals have employed for vaccination sign-up. For example, as surgery residents are in the OR all day they are unable to register for vaccinations quickly and often miss the opportunity before the list fills-up. A new type of registration system should be considered for the next round of vaccinations.
  • It is important for resident vaccination to consider not just where residents are (rotation, site) but where they are going (ie next rotation in ICU though right now on rheumatology). In addition, some residents have encountered barriers and confusion in coordinating vaccination sign-up between different hospital sites. For example, if a resident is at St. Michael’s on Friday, but rotates to SickKids on Monday, should they register for the vaccination at St. Michael’s or SickKids?
  • It is important for programs to be accommodating in clinical coverage for residents to leave for 1-2 hours to receive the vaccine at their assigned time, especially for their rescheduled times for the second dose.
  • It is important to remember to include DME residents – ensuring they are appropriately included in vaccination rollout plan
  • Consider how redeployment plan impacts who needs to be prioritized for the vaccine

Hospital IPAC Regulations
In relation to the COVID19 pandemic residents have noted that different IPAC regulations at each hospital, and specifically, different COVID-19 protocols, leads to confusion (for example at some hospitals you have to wear face shield, at others you do not). It would be helpful if all hospital IPACs have consistent regulations.

Lounge Review
In 2018-2019 the PARO GC team reviewed 29 resident lounges at all hospital sites. We hope to share/email the results of this lounge review with all committee members.

2. PAAC Report

  • PAAC circulated a survey in December with a reminder going out last week. The purpose of the survey is to determine how trainee rotation/block scheduling information is shared between the programs and the Hospital Medical Education Offices.
  • Another survey is being drafted to send out to Program Administrators for feedback on Accreditation – focusing on preparing the AQ and the meetings they had with the survey team. The results will be shared with Laura Leigh and the PGME team.
  • The Award Adjudication Committee met last week to review the PAAC award criteria and nomination process for this year. Information about the nomination process should be sent out within the next couple of weeks.
  • We have been planning a couple of upcoming virtual sessions for education administrators which include a wellness session to be held in late March and an appreciation event in April focusing on Zoom fatigue and a panel discussion from our peers to share some tips and tricks for working from home.

3. COFM/HUEC
COFM
Important updates included:

  • Continue to lobby with the Ministry of Health for increased residency spots. The Deans are confident there will be some increase in the near future – not sure in which directives will be included (i.e. geographically or specific specialties), but this will improve the UG to PG ratio of spots. More details to follow.
  • CPSO informed that they are in receipt of a recommendation to eliminate the requirement of the MCCQEII exam as a route to restricted registration, which would increase the pool of residents eligible for that.
  • CPSO is contemplating an alternative route for full licensure for this coming year for those who are not able to take the MCCQEII exam. Still reviewing the processes and policies related to this.
  • PARO/OHA negotiations resume in February.  PG Deans were asked to provide input to contract/financing issues including leaves and time away from clinical training and how tight it is to fit in the curriculum.  PG Deans requested to be included in the discussions if the amount of time is going to be extended.

HUEC
A presentation by the Director of Sexual Violence university office provided an overview of the resources available and presented it to hospital partners should they need help or advice.

4. Guidelines for Managing Disclosures of Learner Mistreatment 

These new updated guidelines were circulated prior to the meeting for committee members input.  This guideline was approved by all PGMEAC members with minor changes.

5. Accreditation Follow Up – AFI Summaries

  • The top 10 most common requirements were presented
  • There are 56 programs with follow-up in 8 years at the next regular review (RR), 13 with follow-up in 2 years by Action Plan Outcome Reports (APOR), 5 with follow-up in 2 years by External Reviews and 2 with follow-up in 2 years on Notice of Intent to Withdraw
  • The Internal Review Committee (IRC) will reconvene in March. The committee will review the reports and determine what follow-up is required to help programs prepare for their follow-up

6. COVID Updates
Redeployment

  • The ICUS are being hit hard during this second wave with a shifting landscape and the needs will likely change with redeployment to meet this demand.  In summary, very little redeployment in the first six blocks, but an increase has been since in block eight. With 10 different departments involved in their residents being deployed shows the breadth of impact and response to the needs.  PG is working closely with specific departments and experts on the ICU to work out the needs with the aim to fill the gaps of the cascading effects.
  • The goal is to maintain trainee vacation requests to ensure wellness and rest, but with the increased need and ensure that nobody is disproportionately disadvantaged more than they need to be.  Trainees are expected to take their vacation this academic year as there is no guarantee that the Ministry of Health will pay out unused vacation this year.
  • Trainees are encouraged to still maintain the educational continuity (attend academic half days, etc) to the extent possible.
  • PG has asked PDs to advise of any of their at risk trainees for vaccinations so that PG can advocate on behalf of programs for those who need it the most
  • P. Houston shared she is advocating to the Academic Recovery Table that it would be very difficult to support the ongoing expanded critical care needs if there is not an concerted effort to decrease the surgical loads so that surgery and anesthesia trainees and faculty are available to help with hospital needs to lift the burden of those currently carrying the load for almost one year now.

7. Operation Remote Immunity
The Temerty Faculty of Medicine is assisting Ornge to promote opportunities, as a volunteerinitiative, for  teams to participate in Ornge’s Operation Remote Immunity initiative with the goal of delivering and administering COVID-19 vaccines to 31 of Ontario’s Northern Indigenous Communities that are remote and/or only accessible by air. Vaccination planning has been completed for each community in conjunction with a community leader. Each multidisciplinary team will consist of 3 Ornge personnel (a Lead, Associate Lead and an Administrator) as well as 3 to 4 medical personnel – 1 Clinician and 2 to 3 MD Clerkship Students, Residents and/or Fellows. Teams will be scheduled for one-week deployments into the remote Indigenous Communities. More details to follow.

Attachments

1. Resident Report

  • The RDOC pre-accreditation survey was sent out to all the Toronto residents in May 2020 and the report has been compiled by PARO, sent to RDOC and will be used by the survey team at the upcoming accreditation
  • PARO sent a message to all trainees outlining the process for the onsite virtual surveyor meetings and the steps that will be taken to ensure confidentiality during these meetings
  • In 2018 – 2019, PARO General Council had reviewed 29 resident lounges throughout the city at all the different hospital sites.  Their findings will be brought to PGMEAC in January after accreditation

2. PAAC Report

  • At the last PAAC meeting, the committee prepared for the accreditation meeting with the surveyors
  • PAAC Awards will be announced in the near future

3. COFM/HUEC

COFM

Important updates included:
A collective letter was sent to the CPSO Policy Branch around supervisory relationships in medical education. This document is meant to replace the two separate current documents (UG and PG) by harmonizing all of the provision and guidance into one document for both groups.  Both UG and PG Deans provided consolidated feedback to the CPSO as part of the consultation process from the Deans.

HUEC
TASHN operations now has a harmonized agreement on how to manage trainees during an outbreak. This guideline will be referred to by all TASHN hospitals. Undergrad is currently working on a process and aligning it with PG wherever possible
The Guideline for Managing Disclosures of Mistreatment was discussed with considerable feedback provided.

4. Guidelines for Managing Disclosures of Learner Mistreatment 

These new updated guidelines were circulated prior to the meeting for committee members input.  The document will be shared at a variety of groups including Vice Chairs Education and the Diversity Advocacy Group as well as input from PARO and the legal department.  The guideline will be brought back to this committee in January for approval.

5. Accreditation 2020

  • Reminder to review and familiarize yourself with the updated Briefing Note for all committees and groups that will be meeting with the reviewers will be sent out shortly. It provides relevant information to help you with questions you may be asked by the reviewers – the questions are going to be based around the Indicators
  • All preparation workshops with PDs, PAs, residents, Chairs, Division Heads, VC Education are complete
  • Institutional schedule is confirmed and invitations have been sent

UG Accreditation Update

  • Part one of the UG virtual accreditation was completed the first week of November
  • The reviewers will be back for a one-day follow up visit in the first week of December
  • A final update will be provided after the second part of the review is complete

6. COVID Updates

Redeployment

In preparation for the second wave, the redeployment lists will be used on a block-by-block basis as needed over the coming months, addressing the hospitals, the service involved and the needs as they arise.  PGME is committed to consulting broadly with program directors, hospitals and leadership to co-create a solution for every situation of redeployment.  We will continue to do our best to minimize any negative effects on the training, balance service needs with impact on the residents’ needs, their well-being and their educational continuity.

Remuneration for Resident Work

G. Bandiera addressed the important issue of remuneration for resident work. PGME is aware this has been happening and it has been addressed broadly to stop immediately. Restricted registration is allowed, and the application process is very swift with a 48-hour turnaround.  Secondly, G Bandiera reminded the committee that redeployment must align with residents’ competencies and scope of practice, it must have the program’s involvement, and the reassignment must balance service to education needs for the system in order to not disrupt regulatory constraints.

PG Trainees Vacation Payout

PG is still awaiting an update from the Ministry of Health regarding payout for unused vacation.  Once the MOH confirms the funding package and timelines, PG will send out an update.

Outstanding Registration Requirements for PG Trainees

The TB Testing results and Mask Fit results grace period ended September 30th.  A reminder that all trainees must complete their TB test and Mask Fit results as part of their registration requirements as soon as possible.

Attachments

1. Resident Report

Virtual Events
Given the continuing increase in COVID-19 cases in the province, as of September 25, 2020, the PARO Board has determined that the responsible course of action is to continue to not to hold any in-person PARO events, including local social events.

Residents have continued to work through the spring and summer caring for patients across the country. Though we continue to go to work and interact with others – many of us are in fact socially isolated. As we move into fall and winter, social isolation will be an even more pressing concern, and PARO will help foster the wellbeing of our members by facilitating opportunities to connect with one another. As a Site Team we are planning and facilitating virtual events that will help to mitigate feelings of loneliness and isolation, especially with the arrival of winter and second wave.

Accreditation
From May – September 14, 2020 PARO sent out to all Toronto residents the RDOC pre-accreditation questionnaire. Over 1000 responses were gathered from residents and a summary of the comments and information were collected and will be a part of the information provided to the RDoC resident representatives/surveyors. All responses were confidential and not shared with the program, university, RCPSC or CFPC. PARO is also helping to prepare residents for the on-site review process, including helping them prepare for the meeting with the surveyors.

Access to Food While On-Call
Based on an environmental scan conducted last year, looking at which hospitals provide food to residents when on call, a formal report with suggested changes will be provided to PG with follow up to have 24/7 access to food.

2. PAAC Report

  • No PAAC meeting since last PGMEAC although our sub-committees have been active.
  • The PAAC award judging is underway and the awardees will be announced at our next meeting on October 27, 2020.
  • The PAAC Committee will be participating in Accreditation on Tuesday, November 24, 2020. Dr. Bandiera will be meeting with the PAAC on October 27th to provide a presentation about the upcoming institutional review.
  • We continue to plan a virtual admin retreat in January 2020.  As Accreditation is now two weeks in length, it was determined the next session should be in January, so we have something to look forward to after the winter break. The Committee is discussing various ideas for the event and more information will be sent out once determined.
  • ICRE was well attended by affiliated program admins.  Several of Toronto Program Administrators including a PAAC member – Massih Bidhendi – have been active participants on the ICRE 2020 PA Steering Committee and presented at the conference.

3. COFM/HUEC

COFM

Important updates included:
Discussion around harmonized approaches to vacation and trainee extensions related to COVID.  Most programs/schools have a good approach that works for them (along with working with PARO).

COFM province-wide policy on learners identifying workplace mistreatment.  All schools now have a rigorous approach for how to deal with it locally that refers to specific structures individual schools have in place.  COFM has sunsetted this policy as schools address any matters within their institution now.

Full COFM Deans and stakeholders met recently and they continue to advocate for the return of the reduced residency spots in Ontario as well as the promised expansion from years back with an ask to the Ministry.  A renewed business case was submitted addressing the observations and vulnerabilities in the system that have been exposed by COVID to re-emphasize the importance of a robust physician workforce, including the numbers, the type and the distribution.

The CPSO has committed to having a solution for individuals on a restricted licence because they were unable to write their exams. The Medical Council of Canada (MCC) have had to cancel the MCCQEII iteration at all sites because they won’t have a reference cohort due to cancellation at some large sites to write.  The CFPC had data issues and the inability to provide a passing score on their exam and are working through it.  PGME continues to support those individuals who are affected by these, including the Postgraduate Wellness Office.  PGME continues to advocate with the MCC to go virtual with their exam delivery and it appears they have rededicated some work to find a solution.  The CPSO continues to provide solutions for individuals to continue to work until this matter is resolved.

HUEC

Ongoing efforts continue to manage the pandemic, trying to keep sites functional, trying to preserve educational continuity to the extent possible for trainees.  Redeployment is underway due to the recent outbreaks.  There remains heterogeneity in terms of the approach that certain occ health offices take and with the interpretation of the comprehensive pathway document about how to manage certain scenarios and issues are being worked through.  Sites will be contacting all individuals through contact tracing, and PGME has sent correspondence to all trainees with instructions on the procedure process.  The key principle for trainees is if they don’t know what to do, contact the hospital they are working at to seek advice and when doing so, to provide as much information as possible.

4. Guidelines for Accommodations for PG Trainees with a Disability

These newly developed guidelines to accommodate PG trainees with a disability were presented at September’s meeting.  PARO provided input and the revised version was presented today for approval. All members accepted the changes, and this guideline was approved.

5. Accreditation 2020

  • The schedules are in the process of being finalized and they will be sent to the RC and the CFPC for approval
  • Document review files for programs will be uploaded via SharePoint – the deadline for upload is Wednesday, October 28th 
  • PGMEAC will be meeting with the RC review team on November 26th at 11:15 am – 12:15 pm
  • PGME Leads continue to meet with programs’ RPC meetings
  • Workshops continue for Program Administrators
  • Specialty Committee will send their comments to PGME around November 9th with a one-week turnaround for programs to respond with any comments
  • Briefing Note for all committees and groups that will be meeting with the reviewers will be sent out shortly. It provides relevant information to help you with questions you may be asked by the reviewers – the questions are going to be based around the Indicators

6. BPEA Update

The committee met last week to discuss a proposal to create action plans based on feedback from the user data (both qualitative and quantitative) from faculty and residents.  Also reviewed data from the Elentra system in terms of EPA completion numbers and the impact of the new expiry after 7-days feature. Specific actions that PGME will be implementing based on consultation with residents and faculty with their experiences in CBD, include:

  • Establish a Resident Advisory Working Group on faculty development (co-chaired by Evan Tannenbaum and Sue Glover Takahashi)
  • Entrustment scale changes for EPA assessments will continue to be monitored for impact due to that change
  • Continued work on system improvements (i.e. completion rates, clarity, etc)
  • Audit samples of Competency Committee documentation to ensure they’re consistent with PGMEAC and BPEA guidelines
  • Review the impact of EPA completions and the numbers that were expiring

7. MD-PGME Data Management Advisory Group

As part of continuous improvement, the Data Management Advisory Group (DMAG) was formed to align with the social accountability mandate. The advisory group serves as a forum for coordinated discussion, consultation and development of recommendations regarding the collection, evaluation/analysis and reporting of MD and PGME learning experience/environment data in a harmonized and aligned manner.

Key responsibilities of the group are:

  • To recommend operational principles, guidelines and processes
  • To enable and support harmonized and aligned learning experience environment, data collection, evaluation/analysis and reporting
  • Development and revision to data collection tools (“Voice of The” surveys) and co-ordinated and transparent reporting
  • Examine the methodology of the learning environment and standardize the learning tools in the MD program and PGME
  • Reviewing the reporting structures, permissions and the pathways for dissemination and disclosure of data
  • Data management roles and responsibilities
  • Support the ongoing communication on what is available and how it is used
  • Ensure consistency across the Temerty Faculty of Medicine and with UofT policies and guidelines

8. Guidelines for Managing Disclosures of Learner Mistreatment

This newly revised guideline on managing disclosures of mistreatment for PG learners was presented for consultation and to inform on the processes in place at the Temerty Faculty of Medicine. The revised guidelines will be sent to PGMEAC members for input and relevance to their environments (university-based and hospitals), with an accompanying briefing note and a feedback form. We want to ensure these procedures don’t create new disparities or widen disparities. The guideline will be re-visited at the November meeting for review/discussion and final approval at the January meeting.

Overview:

  • Last guidelines were reviewed in February 2016
  • Change to title
  • Updated definitions for mistreatment to align with MD Program
  • Greater clarity to who is counted as a learner in PGME
  • Aligned guided principles after discussion with PG-SMART, building on the work done in the MD Program
  • More clearly delineated process for intake of learner concerns, trying to centralize it where possible so that we can have consistent application of procedures

Improvements:

Built on the existing review and management steps that could be undertaken when an investigation is required whether lead by a university, clinical program, or hospital.  Caveats include:

  • Strive for diverse and representative members on investigational committees
  • Unconscious Bias training for members prior to participation in the investigation
  • Committee should meet in advance with the complainant and respondent to pre-specify the steps and planned actions
  • Reviewed the potential resolution mechanisms and clarified the recommendations
  • Outlined a more clear appeals process
  • Created a companion document to address the steps learners may want to pursue

9. Online Asynchronous Video Interview

Guest speaker, Dr. David Latter presented his experience with online asynchronous video interviews.  The virtual interview process allows equal accessibility to all applicants, even more so with the restrictions during the pandemic. This cost-efficient method proved itself beneficial in many ways including: allowing increased number of applicant interviews, ensure a fair process, interactive town halls with applicants, opportunity to practice for applicants where they learned the format of the interview and answered a practice question to prepare for the actual interview.  The amount of preparation and practice offered reduced the number of “failed interviews”.  An objective rater reviewed the interviews and provided their ratings.  The third-party provider will record the interviews. The stations assess the applicants’ response to one of four topics: Ethics, Values, Collaboration and Reflection.  Their maturity and professionalism and communication are also assessed.  The reliability is comparable to in-person interviews.  Feedback from applicants and raters was very positive overall.

Attachments

1. Resident Report

  • The RDoC Pre-Accreditation survey that was sent to all Toronto residents in May 2020, (and new PGY1s in July 2020), was closed on September 14th. The Survey results are now being compiled into reports to be sent to RDoC.
  • PARO is also in the process of helping residents prepare for the virtual on-site accreditation review.
  • Dr. Ari Cuperfain, Dr. Shannon Willmott and Dr. Sejal Doshi will help present the RDoC Pre-Accreditation Review presentation on Thursday September 24th

2. PAAC Report

  • The PAAC award deadline was extended. Judging is underway and the award winners will be announced shortly.
  • Will soon be releasing the survey on “Information Sharing between Postgraduate Programs and Hospital Medical Education Offices. This is an environmental scan PAAC will send out to get an understanding of how trainee rotation/block scheduling information is shared between Postgraduate programs and Hospital Medical Education offices. All program admins will be sent the survey, and we hope they participate.
  • Planning an admin retreat in December/January after Accreditation. Details will be sent out once they are confirmed.

3. COFM/HUEC

COFM

Three major items were discussed:

  • Quotas Allocation – the MOH was looking at the aggregate proposal across the six schools in Ontario for trends.  Still awaiting approval on submitted proposal.
  • Statement regarding electives was submitted by the UG and PG Deans across Ontario around no travelling electives this current year, which protects from inequities of those who can travel and those who can’t.  This decision also created shifts in how candidates are reviewed and assessed for suitability in residency programs. Due to the decrease in ability to access electives, the concern that students may use non-traditional means to gain access to programs and PDs (attending ward rounds, call shifts on weekends) is also an inequity and a safety/liability issue, so a statement was sent from PG stating that this is not allowed.  Activities “open to the public” (city-wide rounds, academic rounds, virtual curricular activities) can be available to candidates as long as it doesn’t interfere with core activities in UG.
  • One-on-one formal discussions with candidates must be an “all or nothing” principle to ensure equity amongst all candidates.
  • Principles of redeployment and engagement of residents during a pandemic – addressing the concerns were brought forward by PARO around accommodation and continuity of training to ensure that training is not unnecessarily prolonged.  PG has a principle document guiding this to ensure needs are met at both hospital sites and for trainees.

HUEC

  • Ongoing efforts continue for pandemic planning with TASHN and community affiliates around PPE use and redeployment. Key points include:
    • Heterogeneity of how occupational health offices manage risk.  Every institution is responsible to make the decision for their staff but vary at different hospitals for the exact same circumstance.  Hospital CEOs are committed to trying to harmonize to the extent possible, but until a decision is made, residents must adhere to the hospital policies where they are assigned. These principles pertain to return to work after exposure to COVID-19 and back to school.
    • Preparing for accreditation for both UG and PG continues.
    • If you are having trouble accessing PPE at your site, please reach out to PGME who may be able to assist.
  • Virtual program profiling and virtual interviews are a key focus for the AFMC.  They have created an online portal for programs to showcase what they have to offer candidates. More information about the virtual program guide can be found here
  • The grace period for TB testing and Mask Fit are a mandatory registration requirement will end on September 30th. All trainees with outstanding testing will receive reminders to complete these before the deadline.

4. Recommendations – COVID App and Return to School

A formal guideline is in the works, but currently there is no provision to take leave should a trainee’s family members get sick.  PGME is encouraging programs to be flexible and explore options to support a trainee should they need to be off by allowing research work or virtual care that they could be doing from home.  Although, if this is not possible, then the leave will have to be without pay.  PARO is reviewing this matter as well.

5. FoM Expert Panel – Management for At Risk Trainees 

Guidelines were developed by Infection Prevention & control (IPAC) with a statement of recommendation for those who have an increased susceptibility to acquiring COVID-19 and are recommending that people adhere to the PPE recommendations at their site and if they feel they (or a family member they live with) are at increased risk and the application of these guidelines cannot be achieved the case will be referred to the Expert Panel for adjudication.  Please refer to this to help inform your decisions when needed.  Trainees who have been working with the PG Wellness Office for accommodations, will have their case reviewed and updated or continue as planned based on this guideline.

6. Quotas Allocation

The quotas allocation proposal was shared with the committee members for approval. The proposal was approved without changes and will be submitted to the MOH.

7. PGME-Wide Social Justice Curriculum

Guest speakers G. Lorello and L. Richardson shared their broad-based, multi-factorial initiatives to try to advance key priorities around equity, diversity and inclusion in residency training programs.

The key points included:

  • Eliminating inequitable healthcare and continual “othered categories” for all visible minorities and differently abled people and incorporating social justice issues during postgraduate training.
  • Changing the medical education system from a biomedical framework to social constructionism, humanism and transformative learning amongst the medical education community.
  • Proposing a PGME longitudinal social justice issues curriculum for trainees initiating with a needs assessment and a modified Delphi technique to determine the pertinent subject areas, followed by curricular design and implementation.  One program has implemented a longitudinal curriculum, but would like PGME to pool together resources to make this a standardized transformative curriculum across all programs.
  • Request to work with programs to develop individualized principles, provide mentorship and support for each program’s needs to improve the learning environment.

PGME has PGCorED modules in place but it is very limited. All committee members agreed that this is an important initiative to embed in the curriculum learning in the clinical environment and half-days and other forms of learning and support this impactful and engaging initiative moving to the next step of getting the right model and these principles are very sound.  A briefing note and syllabus will be shared with the PGME leadership for review and approval.

8. Accreditation 2020 (See attached)
Important information and updates were shared, including:

  • Virtual Site Visit has been extended to two weeks: November 22nd to December 4th
  • Zoom meeting links will be organized by the individual programs with support by PGME accreditation team to organize it
  • Document reviews by the surveyors (Competency Committees, RPCs, etc) will be shared via SharePoint and will be sent to the RC two weeks prior to the onsite visit
  • Accreditation meetings will take place on Monday, Tuesday and Thursday of both of the weeks
  • As the accreditation is virtual with shorter meeting times during the days, and given the various time zones of the reviewers, meetings with the individual programs will take place over two days instead of the usual one day only.
  • Reminder that this is the opportunity to provide highlights of your program including specific examples and ensuring all those involved with the program have had time to review the AQ
  • A lot of important information will be provided at the upcoming accreditation workshops for PDs and PAs and you are encouraged to attend
  • New continuous improvement accreditation standard – please ensure you provide examples of how you manage it in your program
  • Patricia, Glen and Linda are presenting to all RPCs to provide an overview of what to expect during accreditation
  • Programs will have access to Sharepoint to review their AQs in the next week or so

Full details and timelines can be found in the attached document.

9. BPEA Update (See attached)

Guidance around the updated EPA scale which was launched in early July 2020, will be sent as an accompanying document soon.  Focus of the recent meeting was to review a consultation that took place with faculty and residents about what was working, what the limits were of their experience with EPAs, the online platform or model.  This survey went to learners and assessors who had completed three or more assessments. This survey took place right before COVID started so with the shifted focus due to a pandemic, the response rate was lower than normal, and follow up analysis will take place before making any other changes.  The platform is working well with reporting and tracking as the important next steps.

10. Continuous Improvement Working Group

In compliance with the institutional standard of continuous improvement ensuring that sites receive important information and feedback on improving the learning environment.  The Data Management Committee was formed to coordinate data from UG and PG to be more efficient in collection and dissemination (what we do with the data, how we use it to make changes and how we will follow through on it).  The Data Management Committee will be presented at a future PGMEAC meeting. More information can be found in the attachment.

Attachments

2019-20 PGMEAC Agendas, Minutes & Attachments

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

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

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

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

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

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

2018-19 PGMEAC Agendas, Minutes & Attachments

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

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

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 1stThe 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

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

2017-18 PGMEAC Agendas, Minutes & Attachments

Summary

At our March 23, 2018 meeting, the following was discussed:

  1. Translational Research Program J. Ferenbok gave an overview of the Translational Research Program. Please visit the Translational Research Program website for more details.
  2. The Academy of Resident Teachers (ART) proposal was reviewed by members and comments collected and forwarded to the ART program planning committee. G. Bandiera thanked everyone for their input.
  3. Resident Report – Four key items were shared: 1) A financial program called Tax Talk is offered by PARO; 2) A PARO rep will be speaking at the PGY1 Orientation reception on June 28th and a PARO social event will follow; 3) A full General Council meeting will be held today to elect next year’s president; 4) Call Room Issue: Sunnybrook has pledged funding for new call rooms, while issues at SMH and MSH are ongoing re call rooms that are difficult to access. It was noted that appropriately equipped facilities for breast-pumping have been requested.
  4. Postgraduate Administrators Advisory Committee (PAAC) B. Abankwah shared that the Program Administrators Appreciation Event will be moved to June. The PAAC Award nomination forms will be sent out shortly.
  5. COFM – Bill 148 Fair Workplaces, Better Jobs Act G. Bandiera noted that this Bill resulted in many changes to the Employment Standards Act (ESA) such as minimum wage, sick leave entitlement, etc. Unmatched Students were discussed. The MOHLTC is discussing the issue internally. HUEC – The Faculty Strategic Plan is still being developed with external consultants.The unmatched students continue to be a topic.The common badge issue was discussed. There seemed to be interest from the hospitals. The topic will be raised again at a future meeting.
  6. Internal Review Committee (RC) – L. Probyn presented the current status of the IRC activity. She indicated the new Institutional Accreditation Standards will be presented at the All Program Directors meeting on May 25th.
  7. CBME/BPEA G. Bandiera and S. Glover Takahashi presented 5 documents for approval prepared by the BPEA Advisory Committee to assist programs in CBME implementation. The documents provided templates and guidelines for the creation of Competency Committees, selecting assessors, providing timely assessment and feedback, disclosure of learner needs, and consideration of resident self-assessment.
  8. Transfer Principles Policy – L. Muharuma highlighted the comments received on the Transfer Guidelines. The document was accepted by members with the relevant edits and the final version will be posted on the website.
  9. Advanced Cardiac Life Support (ACLS) – Currently, the PG Office reimburses residents or the centres where the residents take their first ACLS training. If the program requires the resident to obtain re-certification, the program will pay for the course/reimburse the resident. If the hospital requires it for entry to a rotation, the hospital will pay for ACLS training.
  10. Global Health Day – B. Pakes presented an outline of the Global Health Education Initiative – a program for residents delivered via in-classroom modules by a variety of faculty and field experts. This year, the PG Global Health Day event will be held on Thursday, May 31st at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital from 12:30 to 5:00 pm, including lunch. All members are urged to attend and also encourage residents to attend.
  11. All PDs – G. Bandiera encouraged all PGMEAC members to attend the year-end All Program Directors and FM Site Directors meeting on Friday, May25th. Dr. Whiteside, former Dean will be giving the annual Mickle address, and awards will be presented.
  12. Date of Hospital Orientation – The hospital orientation date for incoming PGY1s will be the first working day after July 1st.
  13. CMPA Symposium Dates for the upcoming academic year are as follows (Family Medicine dates will be released shortly):

2018
Tuesday, November 6th – Specialties
Thursday, November 8th – Specialties
2019
Tuesday, March 5th – Specialties
Wednesday, March 6th – Specialties

Attachments

Summary

At our February 23, 2018 meeting, the following was discussed:

  1. Resident Report C. Whyte Ulysse shared that the call room is still an issue, and there is no update since the last meeting, and will be brought to HUEC in March. Dr. Bernstein, Director of UG Clerkship is working on a plan that will be shared at HUEC as well.
  2. Postgraduate Administrators Advisory Committee (PAAC) shared that the Program Administrators Appreciation Event will be moved to June to accommodate scheduling conflicts that arose for the April date.The PAAC Award nomination forms will be sent out in the coming weeks.
  3. COFM AFMC – The AFMC released its report on the unmatched medical students and it included both a call for increased spots and the principle recommendation and an endorsement of the Toronto-derived BPAS report.
    Transfer Agreements – it was reported that any changes that could add to the burden of call stipends would need to be reported to PGME and also delayed.
    CBME Funds – MOH submission on who provided an analysis on cost factors that the program is responsible for is equivalent to 3 FTE/residents. PGME will need to factor that in and where the money will come from (hospital, Royal College, MOH?). IT/Admin support is a factor that will also need to considered based on program size.
    Quota Allocation Process – MOH continues to be interested and would like more involvement in this process, COFM feels their level of involvement is sufficient at this time. It will be considered at future meetings.
    Unmatched Students – PG is continuing work with the MOH to explore ways to resolution. Definitive answers will be shared once available.
  4. BPEA shared an ITAR sample in follow up to the documents discussed at the previous meeting.
    Competence Committee Minimum Standards – this new BPEA document was shared with the committee with the request for input to adpgme@utoronto.ca by March 8/18.
    Appropriate Disclosure of Learners Needs – this new BPEA document was shared with the committee as well. Members were asked to review the document and send comments to adpgme@utoronto.ca by March 8/18.
  5. Transfer Principles Policy – this policy is due for revision (last version was 2011). Committee members were asked to send their comments to adpgme@utoronto.ca by March 9/18.
  6. Registration Update – M. Morris presented on the registration process throughout the academic year, including important date reminders.The dates for the next CMPA Resident Symposium were provided as well.
  7. MCCEE NAC-OSCE Changes – L. Muharuma provided a brief summary of the changes to the MCCEE process. The most up-to-date information can be found online.
  8. Portal/Blackboard Changes – the University will be phasing out the current portal and replacing it with Quercus. Visit the Toolbox Renewal website more information on the new management system.
  9. UG Accreditation Standards – G. Bandiera reminded the committee that Residents as Teachers Module 1 must be completed by September of their first year. Another reminder that the Goals and Objectives need to be shared to the med students who are being taught by residents, and this is done by site (not program).
  10. Multi Source Feedback for Program Directors – A proposal from the Academy of Resident Teachers (ART) Program was shared with the committee. Members are asked to review and provide feedback on the proposal to adpgme@utoronto.ca by March 16/18.

Attachments

Summary

At our January 26, 2018 meeting, the following was discussed:

  1. Reminder that 2018-19 Rotation Block Dates: will return to Monday start for rotation blocks as of July 2018.
  2. PGME Strategic Plan: was presented at All PDs in December and is awaiting next steps to keep in line with Faculty of Medicine strategic direction.
  3. Medicine R4 Match Results: C. Abrahams shared the history of this process. Historically the number of positions in match for medical subspecialties based on number of eligible PGY3s in Internal Medicine plus CMRs. Prior to 2014, a small number of unmatched trainees did PGY4 year of Internal Medicine. In recent years, there has been an increasing number of trainees opting for 4th year, and therefore, planning for envelope of positions for medical subspecialties affected by increased number of PGY4s in IM and funding limitations.
  4. Resident Report: H. Hussein reminded the committee of Resident Awareness Week on February 5 – 9, 2018. PARO will be hosting a few events including a spa day, and an AGO trip on February 7th. PARO encourages all residents to nominate deserving individuals and programs for the Excellence in Clinical Teaching Awards, Resident Advocate Award and Program Excellence Award. The deadline for nominations is Monday, January 29th, 9:00 am. If anyone would like more information about the awards you can point them to the PARO website. The Toronto PARO GC reps recently had a meeting with the PARO board and two resident concerns were discussed: access to call rooms while on home/buddy call and a possible healthy food delivery service. More information and next steps will be brought forward at the next PGMEAC meeting.
  5. Postgraduate Administrators Advisory Committee (PAAC): shared that working groups have begun work on their project streams. PAAC Award working group finalized and received approval from PAAC on Positive Achievement & Appreciation Certificate (PAAC) award. Requesting recommendation from PGMEAC on selection of a PD and a trainee to participate in the selection committee. PGME will share award nomination process with trainees shortly. Deadline for submission is March 16, 2018 and the award winner will be presented at the Program Administrators Appreciation Event in April.
  6. COFM Update: Return of Service policy changes: Eligible service to begin within one year (from 3 months) as they are  no longer looking for repayment of salaries and benefits – only training co sts. Accommodations will be made for any extenuating circumstances (failure, injury, illness, etc), and deferrals can be granted one year at a time up to five years. The repayment amount will be pro-rated based on amount of training. In CBD Framework – must pass written to sit oral exam, with a minimum of 8 weeks between multiple choice written exams and oral and a minimum of 12 weeks between short answer and essay writtens and oral. Registration fees will increase as of July 1, 2018 from $700 to $735 and increase $35 annually thereafter until 2021.HUEC A. Kumagai presented a new Task Force for Valuing Clinical Teachers – more information to follow at a later date. AODA training to clinical faculty – the university’s AODA compliance office is required to fill any gaps if there are any. A survey has been sent to retrieve this information by February 5, 2018. PARO shared the issue of not having access to call rooms or not having call rooms available specifically for residents doing home call or buddy call. This has been discussed at HUEC with the recommendation for a “call room audit” to understand issues of access and peak capacity and will be discussed at the March meeting.
  7. IRC: The updated schedule was discussed including the planning of an External Review of the PGME Office and institutional standards likely for November 2018. The IRC and FM IRCSC decision numbers were reviewed.
  8. BPEA: EPA Overall Entrustment Rating scale and Assessment Tool Descriptors for Milestones were agreed upon in principle by PGMEAC members. PGMEAC also agreed on the general concept of ITARs and updating the PGME. Minimum Standards for Resident In Training Evaluation Reports document with a few changes to wording. An updated version of the will be shared at the next PGMEAC meeting. CBME: No updates at this time.
  9. BOE: Presented on the process of assisting residents in difficulty or residents on remediation.
  10. Process/Timelines for IM off-service rotations: were discussed by J. Goguen, reminding the group that all requests must be submitted via the ORBs system. Programs will receive notification of when the system will be open for this to be completed. It was stressed how important it is to submit data on the dates assigned by the DOM and only via ORBs – all other requests will not be accepted.

Attachments

Summary

At our November 24, 2017 meeting, the following was discussed:

  1. 2018-19 Rotation Block Dates will return to Monday start for rotation blocks as of July 2018. The PGMEAC members unanimously voted in favour of this change.
  2. Unmatched Students G. Bandiera shared an update on the unmatched students matters. A survey has been sent to all PGY1 Program Directors from the AFMC Resident Matching Committee who produced a report which addresses measures to reduce the number of, and increase support to, unmatched CMGs. They have requested PGY1 program directors to provide input in a national consultation on the first three of the report’s recommendations. The results will be shared in the new year. Dr. Patricia Houston will be addressing this issue at the All PDs meeting on December 15th and sharing updates.
  3. Resident Report C. White Ulysse shared the date of Resident Awareness Week on February 5 – 9, 2018. PGME will distribute posters from rDOCS to the Medical Education offices for display in hospitals and encourage them to plan for this important week.
  4. Postgraduate Administrators Advisory Committee (PAAC) reported that a survey has been circulated to all PAs about their ICRE experience. The results will be shared at the next meeting. Also, two sub-committees to the PAAC have been formed: 1. Communication Working Group; 2. Program Administrator’s Award – more details to be shared in the new year.
  5. COFM – Return of Service repayment decision by MOH is that trainees will no longer have to repay their salary, but will have to cover infrastructure costs at a prorated fee. ACLS training when a program requires a resident(s) to re-certify, it will be the responsibility of the program to pay the fee. PGME will continue to cover the one-time initial fee.G. Bandiera and the PGME is working with colleagues to formulate a cost funding model which will be submitted to MOH for CBME Funding. More details in the new year. HUEC – PGME Trainee Health and Safety guidelines were approved at HUEC last week. The final guidelines will be distributed in the coming weeks and will be posted on the PGME website. VOTR Survey team were commended for their outstanding work on the progress in addressing issues and recommendations of working environments for residents.
  6. BPEA had their first meeting earlier in November. Work has begun, Terms of Reference were approved and updates will be shared at future PGMEAC meetings.
  7. CBME team will be sending an email to PDs asking for any significant changes that they may have regarding the traditional request for on or off-service rotations. This email will request PDs to review previous years’ rotations and decide if/how they will look in the next year.
  8. Office of Resident Wellness presented an update on changes coming in 2018: Two members will join the ORW – Associate Director and a Counsellor will begin in January. This will reduce the wait times that trainees are currently experiencing. Wellness office has been very busy with over 1200 visits in 2016 alone – a report on 2017 results will come out later in 2018.

Attachments

Summary

At our October 27, 2017 PGMEAC meeting, the following was discussed:

  1. 2018-19 Rotation Block Dates were discussed with concern from the group about the Tuesday start. An email will be sent to solicit a vote from members who were absent at the meeting on whether to go back to the Monday start in the 2018/19 year and moving forward. Those present all agreed to go back to a Monday rotation block start. An update will be provided at the November meeting.
  2. In follow up to Dean Trevor Young’s attendance at the last meeting to discuss unmatched students, this issue is still being monitored and a UofT Task Force is meeting regularly to address the situation with a resolution.
  3. Resident Report provided an update that their first PARO Teaching to Teach Workshop that was held at ICRE in October was a success. This half-day workshop is available to all residents and programs in Ontario upon request.
  4. Postgraduate Administrators Advisory Committee (PAAC) provided an update on the increased value from attending ICRE – the workshops and plenaries about CBD were very informative. The committee has received an increased interest from PAs to join the committee. There is consideration of presenting on the PAAC at next year’s ICRE and will be discussed at their next meeting.
  5. PG Deans meeting decided on which programs will move forward with a CBD Cohort 2 launch in 2018, they are: Medical Oncology, Surgical Foundations, Emergency Medicine, Forensic Pathology, Urology and Nephrology
  6. BPEA membership has been formed and the first meeting will be held in November.
  7. CBME has created a national document on Clarifying Myths, which will be posted on the Royal College website and our PGME website shortly.
  8. PG Trainee Health and Safety Guidelines were presented for approval with revisions and input from the members and PARO. The following changes have be made: (a) Revisions to comply with new RCPSC General Standards of Accreditation for Institutions with Residency Programs will be implemented now even though they don’t officially launch until July 2019 as they are improvements that can be implemented currently. (b) PGME will be organizing Best Practice workshops for PDs on how to best orientate residents on safety, and how to create specialty specific tools to help and guide programs produce these documents.(c) Editorial revisions re PARO (new spelling) and updated reference links. (d) Change the wording to be consistent on addressing resident fatigue to reflect consistency in reporting mechanisms and collaboration on shared responsibility. The guidelines with these revisions will be sent to the group for approval and then submitted to HUEC for final approval.
  9. PGCorED Satisfaction survey results were presented. Program specific reports will be sent later in the year. All PDs can access their program summaries online. Reports accessed from the site are in real time, reflecting the most current PGCorEd module completion information. To access the site, please email pgcoredinfo@utoronto.ca for instructions.

Attachments

2015-16 PGMEAC Agendas, Minutes & Attachments

This PGMEAC meeting was cancelled.

2013-14 PGMEAC Agendas, Minutes & Attachments

The April 2014 PGMEAC meeting was cancelled.

Attachments

2012-13 PGMEAC Agendas, Minutes & Attachments

There was no PGMEAC meeting, instead members of the RCPSC visited PGME.

2011-12 PGMEAC Agendas, Minutes & Attachments

Attachments

Attachments

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