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Learner Assistance

Postgraduate Learner Health & Safety Guidelines

Date of original approval: March 2009
Date of last revision and approval: April 23, 2026
Date for next review: April 2028

Note: This Postgraduate Learner Health and Safety Guidelines are for PGME Learners and an update to the Postgraduate Learner Health and Safety Guidelines approved by PGMEAC in May 2017. These Guidelines represent updates and additions that harmonize the definitions of what constitutes health and safety. Accreditation standards as well as language throughout the document have been updated accordingly to align with Temerty Faculty of Medicine standards and practice.

These centralized guidelines are intended for program-specific additions and/or variations as appropriate.

Important: This Guideline is NOT for emergency use

Learners with reasonable concern about imminent health and safety should call 911 or seek immediate assistance from onsite security or other authorities. For urgent situations, University of Toronto learners, staff, and faculty can contact Campus Safety at 416-978-2222. For non-emergency situations, Campus Safety can be reached at 416-978-2323.

Table of Contents

  1. BACKGROUND
  2. PURPOSE OF THE GUIDELINES
  3. SCOPE
  4. RESPONSIBILITIES
  5. PROTOCOL AND PROCESSES
  6. APPENDICES

1. BACKGROUND

The University of Toronto Temerty Faculty of Medicine is committed to promoting and supporting the health and safety of learners across all training environments, including University settings and affiliated placement sites1.

The University, placement sites, and learners are jointly responsible for supporting a culture promoting health and safety and preventing injury and incidents. Safety is understood to encompass multiple domains relevant to the postgraduate learning environment, including physical, psychological, cultural, and professional. 

In the course of their training, learners may be exposed to hazardous agents and communicable pathogens. Accidents, incidents, and environmental exposures occurring during training will be reported and administered according to the reporting policies and procedures of the University, program, or placement site. 

In the context of their training, learners may have differing relationships with the University, their placement site(s), and other interest-holder(s) (e.g. a sponsor or funding source); their status with each entity and, thus, the applicable legal framework, may vary according to the type of learner and the policies and contractual instruments that govern the relationships.  These guidelines have been informed by key standards, policies, and legislation, including (but not limited to) CanERA's accreditation standards, Accreditation Canada standards, and the University of Toronto Health and Safety Policy, the University’s Affiliation Agreements and other placement agreements, and the Faculty’s data relating to adverse events involving learner and individuals in learner teaching, though not all of these examples necessarily apply to every postgraduate learner. Refer to Appendix 1.

Further, these guidelines are informed by, complement, and do not replace or limit the legal and ethical standards established by law; professional or regulatory bodies; the policies and procedures at placement sites; or other applicable University or Faculty standards, guidelines, policies, and procedures, including those referenced throughout this document and listed in Appendix 2.

DEFINITIONS

CULTURAL SAFETY 

An outcome based on respectful engagement that recognizes and strives to address power imbalances, institutional discrimination, colonization and colonial relationships as they apply to healthcare and health education so that the providers can work to dismantle the inherent hierarchy. Culturally safe practices require critical thinking and self-reflection about inherent power, privilege and racism in educational and clinical settings. It goes beyond cultural competence (e.g., in improving indigenous health outcomes) and results in an environment free of racism and discrimination where people feel safe learning and working in an environment and when receiving healthcare. 

LEARNER 

Refers to postgraduate trainees, including residents and clinical fellows, throughout their training at Temerty Faculty of Medicine, Postgraduate Medical Education.

MISTREATMENT 

Please refer to the Learner Mistreatment Guideline.

PHYSICAL SAFETY 

Safety against physical harm. It includes, but is not limited to, protection against biological risks. These protections can include immunization, radiation protection, respiratory protection, and protection against exposure to body fluids. It also includes protection against risks associated with physical spaces, with care provided during home visits, with travel, and in encounters with aggressive patients.

PLACEMENT SITE 

Locations where learners from Temerty Medicine engage in educational and training activities. These include, but are not limited to, hospitals, clinics, schools and school boards, other post-secondary institutions, and community settings. The term is used collectively to refer to the diverse environments in which learners gain practical experience.

PROFESSIONAL SAFETY 

Safety against threats to professional status. It includes, but is not limited to, fair and transparent academic processes (e.g., equitable opportunities, fair assessment practices); protections from, and support in the setting of, allegations of malpractice, disclosure assistance, and academic and professional record confidentiality; and support regarding reporting procedures where confidentiality is necessary and to help ensure freedom from reprisals to anyone reporting in good faith.

PSYCHOLOGICAL SAFETY  

Safety from threats to psychological wellbeing. It includes, but is not limited to, prevention and protection of trainees’ psychological safety. It also includes access to resources to counter the risks of psychological distress, intimidation, and harassment, as well as access to educational supports to address situations causing impairment (e.g., fatigue, stress, alcohol or substance use). For greater clarity, psychological safety provides opportunities for interpersonal risk taking and that trainees will not be subject to ridicule or humiliation for asking questions, making suggestions or identifying mistakes.

2. PURPOSE OF THE GUIDELINES

These guidelines aim to:

  1. Promote a safe and healthy environment that minimizes the risk of injury at all University of Toronto and affiliated placement sites. 
  2. Confirm the University of Toronto Temerty Faculty of Medicine’s commitment to the health, safety, and protection of its learners. 
  3. Identify and clarify the roles and responsibilities of the University and placement sites. 

These guidelines are intended for program-specific additions and/or variations as appropriate. 

3. SCOPE

These guidelines apply to all learners throughout their training at Temerty Faculty of Medicine.

All placement sites are responsible for ensuring the safety and security of learners in their facilities in compliance with their site policies and with the signed placement agreements and PARO-OTH collective agreement, as applicable. https://myparo.ca/your-contract/

4. RESPONSIBILITIES

Responsibility of the PGME Office 

PGME is responsible for ensuring compliance with the terms of the affiliation agreements as it relates to postgraduate medical education learners.

Responsibility of the Program and/or Placement Site 

  • All placement sites must adhere to the requirements of the PARO-OTH Collective Agreement for residents unless specifically exempted in the agreement. 
  • All placement sites must adhere to the requirements of the clinical fellows’ employment contract.
  • As per the PARO-OTH Collective Agreement, residents are entitled to secure and private call rooms and secure access between call room facilities and service areas. Residents have access to and coverage for Occupational Health Services (including TB tests, immunizations and follow-up, post-exposure prophylaxis and management, personal protective equipment) on the same terms as applicable to other hospital employee groups. 
  • Residency training programs are required to have their program safety policy approved by the Residency Program Committee that include physical, psychological, cultural, and professional Safety as per requirement 5.1.2 of the General Standards of Accreditation for Residency Programs.
  • As per the General Standards of Accreditation, accredited programs must have program specific safety guidelines. 
  • Programs and placement sites must ensure learners are appropriately oriented to current best practices for workplace safety guidelines, the Learner Mistreatment Guideline, and the confidential resources and supports available to learners through the Office of Learner Affairs. 
  • Programs and learners share a responsibility to identify safety risks specific to each location and to the extent possible, will work together to assess safety risks specific to each rotation. 
  • Where safety risks exist or are uncertain, programs may choose not to require learners to see patients in hospital, clinic or at home, during regular or after hours, without the presence of a supervisor and/or security personnel. 
  • Programs must ensure learners are capable of assessing site and situation specific safety risks. 
  • Learners must be made aware of alternate options when exposing oneself to workplace risks or during travel to and from the workplace (i.e., driving a personal vehicle when fatigued). https://pgme.utoronto.ca/safe-ride-home-program
  • Placement sites must endeavour to safeguard learners’ personal information.

https://temertymedicine.utoronto.ca/equity-diversity-and-inclusion-temerty-faculty-medicine

Responsibility of the Learner 

  • Learners must participate in required safety sessions as determined by, and adhere to the relevant health and safety policies and procedures of, their program and placement site. This includes occupational health and safety policies and procedures and the use of all necessary personal protective equipment, precautions, and safeguards, including back up from supervisors, when engaging in clinical and/or educational experiences. 
  • Learners and programs share a responsibility to identify safety risks specific to each location and to the extent possible, will work together or through the Office of Learner Affairs to assess safety risks specific to each rotation. 
  • Learners must exercise judgment and be aware of alternate options when exposing oneself to workplace risks or during travel to and from the workplace (i.e., driving a personal vehicle when fatigued). https://pgme.utoronto.ca/safe-ride-home-program 
  • Learners must use caution when offering personal information to patients, families, or staff. When calling patients, learners are expected to use a hospital or clinic telephone line. The use of personal mobile phones for such calls is discouraged. If used, the call blocking feature should be enabled. 
  • Learners must maintain Canadian Medical Protective Association (CMPA) or equivalent as appropriate for professional liability and malpractice coverage.
  • Learners must promptly report any health and safety concerns (e.g., risk of needle stick injuries, fatigue, etc.) to their supervisor. Any personal injury, high risk health exposure, or incidence of work-related trauma must be reported to Occupational Health or equivalent department at the placement site and their supervisor. Unsafe training conditions must be reported according to the protocol outlined below.
  • All learners are expected to adhere to Temerty Faculty of Medicine’s Commitment to Equity, Diversity and Inclusion. 

5. PROTOCOL AND PROCESSES

Reporting Protocol for Breaches of Safety

6. APPENDICES

Appendix 1: Accreditation Standards

Appendix 2: Additional Resources

a. University of Toronto

b. Temerty Faculty of Medicine

c. Other

1 See guidelines for individual affiliated sites. 

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