COVID-19 Frequently Asked Questions

During these challenging times, the PGME office is committed to providing individuals involved in postgraduate medical education with the most up to date information regarding the delivery of residency programs, as it becomes available.

Below please find some of the most common concerns for residents regarding COVID-19.
 
Hello Everyone,
 
I trust by now most of you are aware of the self-isolation requirements set to be enacted effective December 21.  Judging by the nature of the queries we have received, I am fully aware of how anxiety provoking this ‘one more thing’ is, on top of everything else we have all endured the past nearly 2 years.
 
I am hoping the following provides some clarity regarding our response and our directives, while subject to change as the situation evolves. The spirit of the directives is to allow programs maximum flexibility to tailor academic program delivery in a safe manner, balancing clinical care needs of the system.
 

Leave:

We are unaware of any rescinding of previously approved leave. Please take stock of your personal well- being and reasons for travel. It is the individual learner’s duty to ensure that arrangements for the required self-isolation period have been made PRIOR to your departure. Please communicate directly with your program director and rotation supervisor/stream lead, as applicable.
 

Self-isolation and academics:

Learners who are away or will be away and returning, are asked to follow public health guidelines in effect for the general public. Time spent in isolation can be used to deliver virtual care and/or attend to academic requirements as decided on by the Program Director; lack of specificity here is to provide maximum flexibility to programs to respond to the challenges in their own context. All academic requirements must be attended to and accounted for so that it may be reviewed by the program when making promotion decisions. Learners on self-isolation are expected to be available to work and must be responsive to communication from the program/supervisors. Alternatively, learners may choose to take personal leave during the isolation period, but will not be exempted from the minimum rotation requirement.
 

Block 7 rotation requirement (aka 2/3 - 1/3 rule):

PGME is temporarily suspending the 2/3 - 1/3 rule for all learners not on leave and who must self-isolate as a result of holiday travel. This is effective immediately and will automatically revert at the end of  Block 7 (January 16) unless otherwise noted by PGME. Learners on remediation plans are not exempted from the minimum rotation requirement, as are learners who choose to be on personal leave during the isolation period. Those who are ill, must follow Occupational Health directives (EH or local RHA if away). Sick leave may be used and minimum rotation requirement exemption will apply for this block.
 

Academic half-day and other training experiences:

All offerings for the duration of Block 7 are to revert to virtual. We await guidance on CLSC and other program offerings as the situation evolves and will provide that guidance as soon as it is available.
 

Academic travel:

All international university-related travel is suspended, in line with Memorial University’s directives.
 

Electives:

Unless canceled by the host institution, all electives away from Memorial may continue as scheduled. All visiting electives continue to be offered, pending approval of the respective PGME offices of their learners’ new self-isolation requirement.
All rotations throughout the Province will proceed as scheduled.
 

Essential Worker status:

Many of you will recall the multitude of attempts at clarifying if postgraduate learners are ‘essential workers’ over the past two years. Please do not conflate the essential contribution to the health system postgraduate learners provide with the self-isolation requirements attached to that status. A postgraduate learner role may be deemed essential if there is a significant impact on the health system should those roles be unfilled. The role may change hour to hour/day to day in line with the health system’s needs and is not attached to a specific individual.
  • Regional Health Authority, with support from PGME, may request deeming some roles essential for service continuity.
  • Weyeton
  • Program Directors are encouraged to touch base with their administrative residents to ensure up to date knowledge of service coverage.
  • there is a risk of a significant impact to service delivery (based on the isolation requirements or illness), Program Directors must communicate this urgently with the Clinical Chief of the service. Clinical Chiefs may facilitate communication with the RHA leadership regarding clinical coverage for the service.
 

Feeling ill/symptoms:

If you are feeling unwell, DO NOT REPORT TO THE BUILDING(S). Inform Occupational Health in your local RHA (e.g. Eastern Health) as well as your supervisor and Program Director. If able to work from home, providing virtual care (where deemed feasible by the Program) then you will not have to request leave for this period. Otherwise, please follow Occupational health guidelines.
 
Some unique situations will present themselves and I suggest learners approach their Program Directors first, and if need be, guidance from PGME can be sought. I get it: you’re all tired and just want to move on. We’ve persevered before and we will again.
 
Stay safe and happy holidays!
 
 
Sohaib Al-Asaaed
Associate Dean
Postgraduate Medical Education
Faculty of Medicine | Memorial University
St. John’s | Newfoundlland & Labrador | Canada
 

 


 
Eastern Health Essential Worker Guidelines and Exemption Process  
Further to our earlier communication regarding sick leave, PGME pursued a reconsideration from the Medical Services office who have graciously agreed to the following process/clarification for learners asked to self-isolate due to symptoms:
 
  1. Follow all Occupational Health instructions regarding testing, isolation, etc. 
  2. If you are well enough to continue with virtual care provision and/or your academic requirements, you are expected to do so. You must communicate your physical absence urgently to your Program and follow all instructions and meet all expectations therein. Sick leave will not be required.
  3. If you are unwell and cannot participate in virtual care/academic programming, you are expected to communicate this urgently to your program and rotation supervisor. You will be required to use sick leave.
  4. Annual leave may be used if no sick leave is available.
  5. Unpaid leave requires advance prior approval by the Associate Dean, PGME and will not be granted outside of exceptional circumstances.
 
We hope the above provides programs and learners with maximum flexibility to tailor the approach to self-isolation period to the needs of the learner at that time. While we aim to minimize disruption to your training, we recognize that scheduled elements of your training may have to change to ensure any missed clinical training experiences/requirements are appropriately addressed and completed at a later date.
 
Thank you for all that you continue to do and your essential contributions to the health system of our Province.
 
Happy holidays.
 
Sohaib Al-Asaaed
Associate Dean
Postgraduate Medical Education
Faculty of Medicine  |  Memorial University
St. John’s | Newfoundland &Labrador | Canada

 
Residents who have been directed to self-isolate by Public Health officials (including Occupational Health) are not to report to work and will be on a paid general leave of absence (i.e., not sick leave) for the duration of the recommended isolation period, except in circumstances where it is feasible for an asymptomatic resident to work from home during self-isolation. 

Similarly, if there are no clinical duties required of residents in certain specialties as a result of clinic closures/reduced hours, they may be sent home. 

Program Directors will consider whether it is feasible for applicable residents to work from home instead of implementing their general paid leave of absence. Working from home can provide residents the opportunity to carry out other homebase academic activities to contribute to their training program and will allow residents to minimize the amount of time lost during their rotation/training experience.

 

As clinical services continue to escalate back to pre-pandemic era levels (or near the same levels), residents may be required to return to in-house service provision. Program Directors will continue to alert and update learners on the status of their rotations.

Memorial University has continued with a hybrid/In-teaching remote teaching approach for all academic half-days and other   follow. CLSC and other clinical skills based sessions no longer require prior approval of PGME but significant lead-time and advance notice to the appropriate administrative office (e.g. CLSC) is strongly recommended.

 
The MUNCAT user workflow (especially regarding PIN-endorsed submissions) is back to normal operations.
At the end of the day the observer will receive an email that will contain the activity assessments that the observer participated in from that day. If the activities are legitimate then no further action is required. If you notice an activity that you did not participate in please contact the program administrator for your discipline immediately.

Please see this link to view the MUNCAT App FAQ.

If you have any questions or require support, please feel free to email muncat@med.mun.ca.



 

 
 

Licensing of 2020 Graduating Cohorts

On March 24, 2020, the Federation of Medical Regulatory Authorities of Canada released the following information: Graduating residents will be eligible for a provisional / temporary / restricted license in a Canadian province, provided that:
a. they have confirmation that they completed their postgraduate training program in Canada;
b. they have received notice of eligibility to take the certification exam (from the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada); and
c. they understand that they must take the certification exam at the earliest opportunity.

For up to date information on any other requirements or conditions, please visit the College of Physicians and Surgeons of Newfoundland and Labrador website: https://www.cpsnl.ca/web/cpsnl






 
Regarding PGME’s position on the ability of postgraduate learners to complete different types of call, please note the following:
 
We continue to use the ‘off-service ‘call form and continue to enforce accompanying policies. This is what is generally referred to as Moonlighting, and supervision by a most responsible physician (MRP) is expected. This includes the need to ensure an 8-hour break prior to commencing regular duties (in lieu of post call). This is irrespective of whether or not a learner is expected to be physically present in a hospital building(ex. Research block). You may use vacation/leave days if needed, to allow for the required ‘post call’ period.
 
For requests whereby the learner is the MRP: these will be approached differently during the Pandemic: final year locum and emergency licencing.
 
Final Year Locum: The moonlighting policy and associated forms are to be used and PGME is to be notified immediately of the learner’s application. The locum may be completed during previously approved vacation. Alternatively, if there is dire need for this service to be fulfilled and the programis supportive of the locum, a request for 3 days of vacation may be approved. The Moonlighting policy continues to apply. For Emergency licences: These are granted by CPSNL at the request/sponsorship of the Regional Health Authority and are deemed outside the purview of the academic curriculum and hence PGME is not involved. It is the learner’s duty, IMMEDIATELY upon being granted this license to notify PGME. The learner’s academic status would be suspended – akin to a leave of absence – for the duration that the licence is held/active. This will result in a halt in residency-related pay/benefits/duties. This may result in extension of training, especially for time-based programs.
 
Applicable to all MRP roles: If a learner is required to self-isolate due to exposure while on duty as MRP/vacation, they will be required to complete this outside the scope of their academic role and will be unpaid (as a resident). The time spent while in self-isolation will not count toward their academic requirements; this will likely require an extension of training.
 
Regardless of the situation, learners are NOT TO COMMENCE CLINICAL DUTIES WITHOUT CONFIRMATION OF LICENSING by the CPSNL.
 
As healthcare workers and trainees, residents are expected to care for high-risk patients within the scope of their competence and according to the guidelines and recommendations provided by Public Health officials and their Regional Health Authority. Residents are responsible for familiarizing themselves with the necessary information specific to their clinical unit(s) to keep themselves and others safe.

Junior residents who may face frontline airway management of patients with known/suspected respiratory infectious symptoms should request the direct involvement of their attending staff physician/specific COVID-19 airway management team.

For up to date information regarding COVID-19 and specifically, information regarding healthcare professionals, please visit the Government of Newfoundland and Labrador COVID-19 Information website: https://www.gov.nl.ca/covid-19/

Personal Protective Equipment (PPE) and Fit Testing

Residents must wear appropriate PPE to assess and treat high-risk patients. For information on the use of PPE, please see COVID-19:  First Responders and the Novel Coronavirus. A short video outlining the proper procedure to put on and take of PPE is also available on the Eastern Health LEAP portal: https://login.easternhealth.learningnl.ca/

If you have questions or concerns around fit testing, please speak to your Program Director or email  mysafety@easternhealth.ca, Tel: 709 777-7777, line 3, line 3. Priority areas have been identified for Fit Testing and will be targeted first during the week of March 30th. 
Although concerns about potential exposure to COVID-19 are understandable, residents who do not have symptoms of illness or who are not actively seeking direction from a qualified medical practitioner/occupational health are expected to attend work as usual.
Residents who are feeling sick and/or experiencing flu-like symptoms should not come to work. Please reach out to Eastern Health’s Central Occupational Health at 709-777-7777, line 3, then line 2, or email: occhealth@easternhealth.ca. Residents should also contact their Program Director, and their program’s administrator immediately. The program is expected to inform PGME at their earliest convenience.

Residents are directed to keep their Program Director updated regarding the status of any medical assessment or direction they receive from a qualified medical practitioner. If a resident is not responsive or if there is concern about the need for self-isolation, Program Directors should contact the PGME office.

At the request of a Regional Health Authority, the CPSNL may issue an Emergency Licence to a physician to provide medical services in relation to the current public health state of emergency. Of note, full licensure of a resident physician implies working outside the auspices of a training program and without the supervision inherent therein. This will effectively place the learner’s training on hold and a Leave of Absence is assumed to be taken. This may result in an extension of training for a postgraduate learner.


Electives (Inbound):
As of July 1, 2021, all travellers are permitted to enter Newfoundland and Labrador. Memorial University continues to accept visiting postgraduate learners. Please refer to the province's Travel Restrictions to see if any are applicable to you.

Note, should a visiting postgraduate learner be required to self-isolate, they are not permitted to particpate in clincal activity during this time. In such cases, home program directors of visiting residents must state in writing to PGME that they understand their resident will not be participating in clinical activity during any required period of self-isolation. Pre-existing requirements, as outlined on our website, must also be met.

Electives (outbound):
Effective July 1, 2021, PGME will approve all out of province elective requests. This will be subject to change with little/no notice depending on the public health situation. Note that the Faculty of Medicine will NOT be responsible for any costs related to recall of learners or last minute cancellation of electives at any point during the pandemic.

Residents wishing to proceed with out of province elective requests are reminded that they are not to miss greater than 1/3 of any rotation, regardless of the need to complete an elective out of province.

All residents departing the province are to ensure they meet all provincial entry requirements upon return. Complete details are available on the government’s website.





 
Provincial public health requirements for travelers to NL (NL Resident):

All postgraduate physicians returning to Newfoundland and Labrador from outside the province or the country are required to follow public health directives in force at that time. Public health requirements are continuously evolving and it is incumbent upon the learner to ensure they remain up to date with the requirements at home (NL) and their destination. 

Those learners who require isolation upon return must ensure appropriate measures are taken prior to departure to avoid academic penalty. All PGME requirements normally applicable to leave continue to be enforced. Residents are to note that missing greater than one third of a rotation will deem that rotation incomplete and require it to be repeated.

 

Granting of leave currently follows normal processes and procedures, with no pandemic-related limitations imposed by either Eastern Health or PGME. All PGME requirements normally applicable to leave continue to be enforced.

For the sake of your wellbeing, PGME encourages learners to avail of personal leave time. Learners are reminded not to assume that any leave will be eligibile for ‘banking’ and use at a later date.

Each Regional Health Authority reserves the right to cancel postgraduate learners’ annual leave should they be required to be present and available for work. These restrictions may be instituted with little notice during the pandemic.
 

Restrictions have lifted for university-related travel outside Canada; however, certain requirements must still be met. Please refer to the University's website for complete details.



 


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