PHPM Orientation Manual 2014-2015 finalphpm.pgme.utoronto.ca/.../09/PHPM-Orientation-Manual-2014-2015-f… · This program orientation manual, like the residency program, is always

PHPM ORIENTATION MANUAL JULY 2014

PHPM Orientation Manual July 2014

!

2 !

Contents WELCOME FROM THE PROGRAM DIRECTORS!..........................................................................................................!4!

PROGRAM CONTACT INFORMATION!...........................................................................................................................!5!

TRAINING OVERVIEW!......................................................................................................................................................!6!

Family Medicine Rotations (Year 1-2):!..........................................................................................................!6!Academic Training/Graduate Studies (Year 3-4)!...........................................................................................!7!Field Rotations (Year 4-5)!..............................................................................................................................!8!

!

ACADEMIC HALF DAY!...................................................................................................................................................!10!

RESIDENT EVENTS!..........................................................................................................................................................!12!

Program Exams!.............................................................................................................................................!12!Annual General Meeting (AGM)!..................................................................................................................!12!Resident Research Day!.................................................................................................................................!12!Media Day!....................................................................................................................................................!12!Career Day!....................................................................................................................................................!12!

!

RESIDENT LEADERSHIP AND VOLUNTEER OPPORTUNITIES!...............................................................................!13!

Chief Resident!..............................................................................................................................................!13!Residency Program Committee (RPC)!.........................................................................................................!13!Curriculum Sub-Committee!..........................................................................................................................!13!Selection Sub-Committee!.............................................................................................................................!13!Paro Representative!......................................................................................................................................!13!Treasurer!.......................................................................................................................................................!14!DLSPH Governing Council Representative!.................................................................................................!14!Public Health Physicians of Canada (PHPC) Representative!.......................................................................!14!CaRMS Selection!..........................................................................................................................................!14!

!

PROGRAM ANNUAL AWARDS!......................................................................................................................................!15!

COMMUNICATION!..........................................................................................................................................................!16!

Blackboard portal!..........................................................................................................................................!16!Public Health and Preventive Medicine Listserves!.......................................................................................!16!Program website!...........................................................................................................................................!16!

!

RESIDENT SAFETY AND WELLNESS!...........................................................................................................................!17!

OTHER EDUCATIONAL OPPORTUNITIES!...................................................................................................................!18!

Resident Education Funding!.........................................................................................................................!18!Extra Courses!................................................................................................................................................!18!Conferences!..................................................................................................................................................!18!Memberships/Professional Affiliations!.........................................................................................................!19!

!

APPENDIX A: ROYAL COLLEGE CANMEDS OBJECTIVES FOR PHPM!..................................................................!20!

APPENDIX B: UNIVERSITY OF TORONTO PHPM PROGRAM POLICIES!...............................................................!27!


!

3 !

PHPM Residency Program UofT CanMEDS Goals and Objectives!............................................................!27!Resident Evaluation!......................................................................................................................................!29!Resident Safety Policy!..................................................................................................................................!30!Leave and Waiver Policy and Procedure!......................................................................................................!32!Terms of Reference: Chief Resident!.............................................................................................................!34!

!

APPENDIX C: PGME POLICIES!......................................................................................................................................!37!

Guidelines for Residency Leaves of Absence and Training Waivers!...........................................................!37!Moonlighting Policy!.....................................................................................................................................!40!Postgraduate Medicine Policy on Academic Appeals!...................................................................................!41!

!

APPENDIX D: RESIDENT PROFILES!.............................................................................................................................!44!

APPENDIX E: PROGRAM GRADUATES!.......................................................................................................................!49!


!

4 !

WELCOME FROM THE PROGRAM DIRECTORS Dear Residents, Welcome to another exciting year in the Public Health and Preventive Medicine Residency Program at the University of Toronto. Residency is the transformative penultimate chapter in every physician’s personal and professional life where we finally complete the transition from student to specialist. For Public Health and Preventive Medicine trainees, there are many additional challenges – the many role transitions within the program, the amorphous nature of public health practice and the overwhelming breath and scope of the knowledge required to be a competent public health specialist. Being aware of these challenges, preparing for them, and sharing your experiences with colleagues and faculty will ensure that you learn and grow throughout your training. Postgraduate medical education is a unique educational environment, with its emphasis on work-based learning, clinical/field supervision as a predominant method of training, performance-based assessment, and the challenge of simultaneously delivering education, training and service. Residency education follows an adult learning model, and as such, we are your partners in this process that is ultimately directed and driven by you – the learner. Our primary role as program directors is to direct, facilitate, mentor and support you in becoming competent public health physicians. Please help us help you by communicating with us regularly, preparing and planning each stage of training well in advance, and providing us with positive and negative feedback. In many ways, the program is what you make of it - as individuals and collectively. Please contribute to the program, the school and the Faculty of Medicine by serving on committees, teaching and leading other initiatives. Our program is dynamic, always adapting and improving in order to meet the educational needs of residents, the service needs of our partner organizations and to fulfill our social responsibility to train the best public health physicians in the world. This year, like most others, the many changes within (new PDs, new residents, new chiefs) and outside (new Faculty of Public Health, IHPME integration, new division) the program create new opportunities to become even better. There are also challenges that we will face and overcome together. As program directors, our virtual doors are always open. This program orientation manual, like the residency program, is always a work-in-progress. Please ask us, or your colleagues, if you have any questions about it, or anything else. We looking forward to continuing to learn with you,

Barry Pakes and Onye Nnorom


!

5 !

PROGRAM CONTACT INFORMATION Program Director: Dr. Barry Pakes [email protected] Associate Program Director: Dr. Onye Nnorom [email protected] Program Assistant: Linda D’Souza

416-946-0952 [email protected]


!

6 !

TRAINING OVERVIEW General Overview: PGY1 Family medicine rotations PGY2 Family medicine rotations

Academic/research project CCFP Exam/LMCC Step II Apply for graduate training (if applicable)

PGY3 Graduate training (UofT and other summer practicum(s) may be combined with public health rotation)

PGY4 Field rotations Apply for royal college exam

PGY5 Field rotations Royal college exam

**Note** This generic timeline is for planning purposes only and does not take into account individual circumstances such as waiving graduate training, part-time training or leaves of absence.

FAMILY MEDICINE ROTATIONS (YEAR 1-2): The Royal College requires 12 months of clinical training and accepts a second 12 months as credit towards the five year training. The PHPM residency program at the University of Toronto requires that residents complete 24 months in family medicine training to achieve this component.

“Family Medicine is a discipline ...utilizing prevalence based approach. In a given population, family physicians are aware of common diseases in that population…. The skills that a family physician must possess include practicing preventive medicine”.

Program Goals:

! The program will graduate public health and preventive medicine specialists with competent clinical family medicine knowledge and skills to assess and manage patient health issues within communities and populations. The program will ensure that all graduates can make independent, evidence informed, community responsive, accountable clinical decisions to maintain and improve health overall and reduce health inequities.

! The program will prepare all trainees to be able to serve as local medical officers of health. However, recognizing

the need for public health and preventive medicine specialists in many roles and the variety of career paths graduates may chose, the program will support trainees to gain clinical certification in Family Medicine and to have opportunities to enhance knowledge and skills including community oriented primary care in focus areas such as sexual health, TB, travel and addictions.

! The program will ensure that residents are provided with sufficient learning and assessment opportunities to meet

the requirements to become certified by the College of Family Physicians. In addition, the program will provide support to help residents tailor their family medicine training towards community oriented primary care through guidance on FM site selection, electives, rural family medicine placement and second year research projects.

Resident Responsibilities: � Ensure timely submission of family medicine POWER evaluations � Complete PGCorEd modules � Complete research/academic project


!

7 !

� Attend PHPM program events when possible including academic half days, research day, annual general meeting, media day, and others.

Examples of public health focused electives: In general, these could be sites such as STD/sexual health clinics, TB clinics, HIV clinics, travel clinics, etc. Some specific examples include:

! Occupational Medicine Clinic at St Michael's Hospital ! TB clinics at TWH, SMH, HSC or West Park (the latter sees much of the MDRTB in the province) ! Hospital-based infection control (contact Allison McGeer, Michael Gardham or Mary Verncombe) ! Methadone clinics (including one at the Works at Toronto Public Health ) ! Aboriginal Health Services: Anishnawbe Health Centre ! Toronto General Hospital’s Tropical Medicine Clinic – Dr. Jay Keystone ! Evergreen Clinic (for street-involved youth) ! SHOUT clinic (street youth) – Dr. Karen Weyman from SMH ! Clinics for those experiencing homelessness – Seaton House, Salvation Army shelter, Inner City Health

Associates (ICHA) ! Hassle Free Clinic (STD Clinic) ! STD Clinics at Toronto Public Health ! HIV Clinic – SMH, TGH ! Community Health Centres ! Environmental Health Clinic at Women's College ! Research at ICES or PHO

Family Medicine Projects: Family medicine training at UofT involves quality improvement and resident research projects. PHPM residents are encouraged to engage in research and projects that relate to the goals and objectives of public health training and practice. Junior residents should consult senior residents, program directors and faculty for support and examples of integrated FM-PHPM projects.

ACADEMIC TRAINING/GRADUATE STUDIES (YEAR 3-4) The Royal College requires 12 months of training in the sciences of Public Health and Preventive Medicine. The majority of Toronto residents complete an MPH during this time frame. Residents interested in pursuing graduate opportunities outside of the University of Toronto are required to meet the 12 months expectation and ensure that the core of epidemiology, biostatistics, health system, health promotion and research methods are included at an appropriate level of depth and breadth. Program Goals:

! The program will graduate public health and preventive medicine specialists with competent knowledge and skills to assess and manage health issues within communities and populations through the successful completion of academic courses in epidemiology, biostatistics, surveillance as well as understanding the health system and research methods. The program will ensure that all graduates can make evidence informed decisions to maintain and improve health overall and reduce health inequities.

! The program will prepare all trainees to be able to serve as local medical officers of health through the achievement of graduate competencies. However, recognizing the need for public health and preventive medicine specialists in many roles and the variety of career paths graduates may chose, the program will support trainees to have opportunities to enhance knowledge and skills in graduate areas of research, education, environment health, public health administration and global health.

! The program will ensure that residents are provided with sufficient learning and assessment opportunities to meet Royal College, program and personal objectives and support residents’ self-direction and self-assessment as well


!

8 !

as flexibility in the demonstration of achievement of competency through flexibility in choice of graduate program and future flexibility within the U of T MPH.

Resident responsibilities:

� Discuss plans for graduate/academic training with program directors well in advance of graduate school application deadlines.

� Ensure that graduate training (and course selections) meets Royal College and UofT PHPM program requirements.

� Provide program director with graduate transcript by six months after completion of program � Attend PHPM academic half days (if not conflicting with class schedule) � Attend PHPM core event days (e.g. AGM, research day, media day, etc.)

FIELD ROTATIONS (YEAR 4-5) The Royal College requires 18 months of training in public health related field rotations. Many residents have 18-24 months or more for field rotations depending on the length of their graduate training and previous experience. The UofT PHPM program includes 15 months of core field rotations and 3 months of elective rotations. Core rotations include:

! 3 months of Communicable Disease ! 3 months of Environmental Health ! 3 months of Planning, Policy and Chronic Disease Prevention ! 6 months of Senior Management and Administration

A 1-2 month “Orientation to Public Health” rotation may be available for residents at the beginning of PGY4. Core rotations must be completed at a University of Toronto affiliated site. Electives may be completed at any accredited site. Residents may spend a maximum of 3 months at an unaccredited site. Core and elective rotation supervisors should have Fellowship Certification in Public Health and Preventive Medicine and a faculty appointment with Dalla Lana School of Public Health or UofT Faculty of Medicine. Exceptions to this rule may be made in discussion with program directors and with an appropriate supervision and assessment plan in place. Field rotations are guided by the PHPM program policy document “Field Rotation Expectations and Evaluation Form”. Program Goals:

! The program will graduate public health and preventive medicine specialists with competent knowledge and skills to assess and manage health issues within communities and populations through learning and application in core and elective field rotations.

! The program will ensure that all graduates can make independent, evidence informed, community responsive, accountable decisions to maintain and improve health overall and reduce health inequities through learning and assessment opportunities during core field rotations.

! The program will prepare all trainees to be able to serve as local medical officers of health through provision of some/all core rotations in local public health agencies and the opportunity to network with local MOHs at meetings and on the list serve. However, recognizing the need for public health and preventive medicine specialists in many roles and the variety of career paths graduates may chose, the program will support trainees to gain field experience and to have opportunities to enhance knowledge and skills in focus areas of research, education, environment health, public health administration and global health through the provision of provincial, federal, and academic rotation opportunities.


!

9 !

! The program will ensure that residents are provided with sufficient learning and assessment opportunities to meet

Royal College, program and personal objectives and support residents’ self-direction and self-assessment as well as flexibility in the demonstration of achievement of competency through the development and tracking of personal objectives throughout the core and elective rotation opportunities.

Resident responsibilities:

� Discuss field rotation interests, preferences, supervisors, and sites with program directors well in advance of each field rotation block.

� Inform the program assist of site, supervisor and dates in a timely manner. � Developing rotation goals and objectives in collaboration with supervisor and/or program directors. � Timely submission of ITERS, site and supervisor evaluations � Attend PHPM academic half days (rounds and Topic of the Week) unless there are urgent service

needs or learning opportunities at the field rotation site. � Lead Topic of the Week as part of academic half day when possible. � Attend and help coordinate PHPM core event days (e.g. AGM, research day, media day, etc.)

Field Rotation Sites: The Royal College allows training sites to be designated as either accredited or non-accredited. The practical implication of this is that residents are limited to 3 months of field training at non-accredited sites. Accredited sites must undergo a review and sign an agreement of affiliation to the program to be designated as accredited. Accredited training sites currently include:

! Toronto Public Health ! Peel Public Health ! Durham Region Health Department ! Halton Region Public Health Unit ! Simcoe Muskoka District Health Unit ! Middlesex London Health Unit ! Ontario Ministry of Health and Long Term Care's Public Health Division ! Public Health Ontario (PHO) ! Public Health Agency of Canada (through the University of Ottawa only)

Non-Accredited Sites include:

• Canadian Partnership Against Cancer • Cancer Care Ontario • World Health Organization

! In addition, residents may complete training at accredited training sites of the other Canadian Public Health and

Preventive Medicine Residency Programs with agreement of both programs and electives at other University of Toronto affiliated sites. These include sites affiliated with Memorial University in St. John’s, Newfoundland and Capital Health Public Health Services in Halifax, Nova Scotia


!

10 !

ACADEMIC HALF DAY Academic Half Days (AHD) are the core formal curriculum of the PHPM program. They occur Friday mornings between 8:30 and noon in room 574 (DLSPH). The structure of our academic half days is generally as follows:

8:30 – 9:20 Topic of the Week (ToW) 9:30 – 10:45 Rounds 11:00 – 12:00 Field Notes

Topic of the Week ToW is an opportunity for more informal resident-to-resident teaching. The original concept was that it was to be similar to internal medicine “morning report” in which residents interactively review a critical topic or framework without a formal PowerPoint presentation. All residents are welcome to lead ToW, however, it is primarily an opportunity for senior residents to teach junior residents. The topics covered complement and supplement those covered in formal rounds, and the format is often case-based. Examples: Measles case management on call; PH investigation of water quality breach, framework for food safety (HAACP); Baltimore classification of viruses. Rounds Rounds presentations are the more formal aspect of AHD. The topics are core public health topics, including hot topics in the field of public health. For 2014-2015 rounds have been divided into thematic areas. Residents may select the rounds topic they wish to present, within the assigned theme, according to their interests, their field or clinical rotations. Program directors and faculty should be sought out to support residents in researching and preparing their rounds. Rounds may take a variety of formats including: resident presentations, journal club, expert faculty presentations and interactive workshops. Residents are expected to present a certain number of times according to their post-graduate year.

PGY 1-2 1 presentation (independently or in conjunction with a senior resident)

PGY 3 1 presentation (independently)

PGY 4-5 2 presentations

Chief residents are in charge of rounds scheduling and topics. To sign up to deliver rounds, speak to the chief residents and/or visit: https://docs.google.com/spreadsheet/ccc?key=0AqE3HxGTPJsYdDN5eWROVkQyek04WWs0TUdxNUdEMHc&usp=drive_web#gid=9 Resident Expectations:

� Consult with a faculty member on presentation topic, content and resources. � Invite a faculty member with specific topic expertise to consult and be present for the presentation. � Submit a coversheet (template is on portal) with a summary, objectives, and readings to the program assistant the

Monday before the presentation. � Submit the slides to the program assistant by noon the day before the presentation


!

11 !

Field Notes Field notes are the main forum for communication and experience sharing in the program. Field notes are structured as a weekly committee meeting of the residents, chaired by the chief resident, during which issues that arise within the program are resolved, events are communicated, and decisions made. It provides an opportunity to provide immediate feedback on the most resent rounds and conduct a brief practice question. Program announcements and a summary of field notes is circulated on the program listserve and also posted on Blackboard.


!

12 !

RESIDENT EVENTS 2014/2015 At a Glance:

Sept/Oct Program exams (oral and written) Nov 21 Research Day Nov 28 Annual General Meeting (AGM) February Program exams (oral and written) Mar/April Media Day June Career Day and Graduation

PROGRAM EXAMS The program exams are held twice yearly on consecutive weeks in the fall and spring. They consist of a written exam (3hrs) as well as an oral exam (4 questions) which are intended to simulate Royal College exams and assess resident progress. Residents are required to sit at least 2 written exams and 2 oral exams and demonstrate interval improvement. PGY4-5 are expected to participate in the exam. Depending on space and availability of faculty (for oral exams), PGY1-3 are encouraged to sit the exams.

ANNUAL GENERAL MEETING (AGM) The annual general meeting is a formal opportunity for residents to discuss the overall functioning of the residency program in the absence of any faculty members. This is an opportunity to engage in dialogue about program issues, concerns and strengths. The meeting occurs instead of rounds on a Friday morning in the Fall. The Chief Resident will request agenda items prior to the meeting and record minutes that will then be circulated among the residents and Program Directors. These minutes are discussed at a residency program committee meeting held subsequent to the retreat. Beginning in 2011, a ‘Spring Retreat’ was added to the yearly cycle, providing residents with an added opportunity to discuss training and professional issues.

RESIDENT RESEARCH DAY The annual resident research day is an opportunity for residents to present research projects or activities with which they have been engaged. The resident research day occurs instead of rounds on a Friday morning in the Fall. There is a separate resident research day committee that organizes the day and has faculty advisors review the abstracts. The purpose of residents research day is to share research ideas and results with colleagues, gain experience and receive feedback on presentation effectiveness, and meet the scholar objectives of Royal College including those relating to research methods and evidence-based practice.

MEDIA DAY The PHPM Media Day is held in collaboration with the Ryerson Journalism Program. The day is coordinated by 1-2 resident volunteers and is meant to provide PHPM residents with an opportunity to practice their communication skills in a supportive environment. The day typically includes the opportunity to participate in a practice television and/or radio interview on a pre-determined topic. The day also provides residents with an opportunity to interact with Ryerson media students and develop an appreciation for the training and perspectives of media students/professionals.

CAREER DAY The PHPM Career Day is held annually in June. It is coordinated by the Chief Resident(s) or his/her delegate. The day involves a panel of public health physicians from a variety of backgrounds and that have incorporated different opportunities for public health practice into their careers.


!

13 !

RESIDENT LEADERSHIP AND VOLUNTEER OPPORTUNITIES

CHIEF RESIDENT The program has a Chief Resident or co-chiefs at all times. A Terms of Reference was created for the Chief Resident in 2014 and approved by the Residency Program Committee (RPC) in June 2014. Senior residents are nominated, and vetted by the Program Director, elected by the resident group, and appointed by the RPC. The Chief Resident term is a minimum of 6 consecutive months and is renewable for an additional 3-6 month term depending on program and resident circumstances. Chief Residents receive a small additional pay stipend. The chiefs share one vote at the RPC.

Roles and responsibilities of the Chief Resident: support and guidance for junior residents, coordination of academic half day content and schedule (including topic of the week, rounds, and journal club), chairing field notes and circulating minutes, submitting resident educational claims to the DLSPH finance, participating on program committees, participating in selection and orientation of residents, organizing an annual general meeting and career day, and attending other program meetings as needed.

RESIDENCY PROGRAM COMMITTEE (RPC) In addition to the Chief Resident membership on the RPC, a resident is elected for a one year term by the resident group to represent resident issues, interests and concerns in the residency program planning, supervision and organization. The residency program committee is mandated by the RCPSC to assist the Program Director in the planning, organization, and supervision of the program. Committee functions include accreditation, CaRMS selections and review of resident placements. The resident rep has one vote at the RPC.

Roles and Responsibilities of resident representative: resident voice on RPC, attend regular (at least quarterly) RPC meetings, solicit resident input for RPC decisions.

CURRICULUM SUB-COMMITTEE In addition to the Chief Resident membership on the curriculum sub-committee, one to two additional residents may volunteer to participate. This committee is tasked with ensuring general oversight for academic half days, public health field rotations, resident resources, and other learning opportunities.

Roles and Responsibilities of resident volunteers: attend quarterly meetings, solicit resident input for committee decisions.

SELECTION SUB-COMMITTEE Residents may volunteer to participate on the selection sub-committee, which is tasked with coordinating the recruitment and selection of PHPM candidates.

Roles and Responsibilities of resident volunteers: attend quarterly meetings, contribute to committee decisions.

PARO REPRESENTATIVE The PARO general council consists of representation from each specialty in Ontario. There is one position for Public Health and Preventive Medicine residents from Toronto on the PARO general council. PARO requests nomination of this position in the summer of each year. The first PARO general council meeting occurs in September. Most meetings occur in Toronto approximately every six weeks on a Friday afternoon/evening. In the past, the Public Health and Preventive medicine representatives have become further involved by seeking nomination and election to the PARO executive council.

Roles and Responsibilities of the PARO representative: attending PARO general council meetings, organizing an alternate if you are unable to attend, inquiring about current issues/concerns from the Public Health and Preventive medicine residents prior to each meeting, updating the general council about Public Health and Preventive medicine


!

14 !

issues, reporting back to Public Health and Preventive medicine residents about PARO issues, participating in PARO working groups.

TREASURER The PHPM residents began to manage their own funds for academic and educational activities through resident treasurers as of 2009. There are two treasurers at any given time who each have two-year terms that overlap.

Roles and responsibilities of treasurer: to report to the residents on spending and lead the discussion on budget at the resident annual general meeting; liaise with the program director and UT accountants regarding resident fund issues; and administer the funds. This is a relatively new, but important role for residents who are interested in participating in the residency program with many opportunities for leadership and advocacy.

DLSPH GOVERNING COUNCIL REPRESENTATIVE The DLSPH governing council includes a resident representative from the PHPM/Occupational Medicine programs. The governing council works to provide governance and oversight on faculty/school-wide issues and members of council represent their respective departments at general meetings. Roles and Responsibilities of the DLSPH representative: attending governing council meetings 3 times per year, informing residents of relevant decisions/discussions.

PUBLIC HEALTH PHYSICIANS OF CANADA (PHPC) REPRESENTATIVE PHPC is a professional organization specifically for Public Health and Preventive Medicine Specialists. Each PHPM residency program has a representative on the resident council and nationally 1-2 residents are elected to represent the resident group towards the PHPC council. There is also an opportunity for a resident to act as the resident representative on the PHPC continuing professional development sub-committee which runs the annual CPD day for PHPM Fellows as well as creating and delivering other educational resources. Roles and responsibilities of the resident representative: the resident voice on the PHPC council, participating in monthly PHPC teleconferences, keeping residents informed about national level activities, maintaining the national listserv, and promoting PHPC membership. Recent opportunities have included the initiation and administration of the CMR website, Canadian student representation on the JASP scientific sub-committee, resident representation at the national CM program directors meeting.

CARMS SELECTION Each year there is an opportunity for residents to participate in the CaRMS selection process. In the past, residents have been involved with reviewing application packages, applicant interviews, attending an informal applicant luncheon and assisting medical students interested in Public Health and Preventive Medicine to arrange electives. The chair of the selection sub-committee will request volunteers for these roles during the fall.


!

15 !

PROGRAM ANNUAL AWARDS In June of every year, three different program awards are presented to selected residents. In addition, a faculty member is selected by the resident group to receive the faculty award. C.P. Shah Award The C.P. Shah Award is named and endowed by Dr. Chan Shah the first Program Director at UofT. It is to be awarded annually to the resident enrolled in the Public Health and Preventive Medicine Residency Program whose field or written research report has been judged as the best and of sufficient quality by the appropriate committee appointed by the Director of the program. The awardees will be encouraged to submit their report for publication in an appropriate peer-reviewed journal and to make an oral presentation of their work at an appropriate academic forum. Recipients will not be eligible in subsequent years. The first award was given in 1988. Resident Service Award The Resident Service Award was initially established to honour Dr. Harvey's distinguished service as University of Toronto Public Health and Preventive Medicine Program Director from 1996 to 2006. It is open solely to Public Health and Preventive Medicine Residents at the University of Toronto. The first award was issued in 2006 at the Annual Program Luncheon. The award is made annually to the resident who has made a substantial contribution to the social and intellectual life of the Residency Program, and who has demonstrated those qualities of volunteerism, activism, leadership, humanism, integrity, professionalism, scholarship, and collegiality fostered and exemplified by Dr. Harvey. The awardees are selected by the appropriate committee of residents and faculty members appointed by the Residency Program Director. The award will only be presented if an appropriate candidate has been nominated and will not necessarily be awarded every year. Nominations should be submitted in writing to the Residency Program Director by April 1 each year. Recipients will not be eligible in subsequent years. The award is presented at the Annual Residency Program Luncheon. The awardees will receive a Certificate and his or her Name on the Group Plaque. Resident Educator Award The resident educator award was established by Dr. Ian Johnson in 2007 and supported by Dr. Jeff Kwong after his acceptance for inaugural award. Faculty Educator Award The Faculty Educator Award is to honour the faculty members for their excellence in the education of Public Health and Preventive medicine residents. The awardees are nominated and chosen by the Public Health and Preventive Medicine residents.


!

16 !

COMMUNICATION E-mail and the portal Blackboard are our main methods of communication within the program. Rounds and other program announcements are made by email, and rounds presentations, field notes, and program policies are posted on Blackboard. You must have a utoronto email account that is not forwarded in order to post to uToronto listserves. Please read your e-mail regularly and keep your address up to date. Please send any change in your email address to the program assistant.

BLACKBOARD PORTAL http://portal.utoronto.ca Log onto the portal with your utoronto username and password. The Public Health and Preventive Medicine page will be listed under ‘My Courses - Public Health and Preventive Medicine Residency Program’.

PUBLIC HEALTH AND PREVENTIVE MEDICINE LISTSERVES [email protected] This listserv includes all residents currently in the program, as well as the program director, associate program directors, and recent graduates for one year after graduation. Only the Chief Residents, the Program Directors, and the program assistant have access to post to this listserve. [email protected] This listserv includes ONLY current residents. All residents should have access to post to this listserve via their utoronto email. Chief Resident Email Account [email protected] Use this email account to get in touch with the current Chief Resident(s). Suggestions for use: For rounds: Send all rounds cover sheets and presentations to the program assistant, who will then send it to the listserv and post on Blackboard. Large files (slides or photos) can take up space in UofT email boxes and should be avoided when using the listserves. Large PowerPoint slides should be converted into pdf documents for sending and posting on Blackboard. The space limit for a file on Blackboard is 8MB.

PROGRAM WEBSITE The current program website (http://portal.utoronto.ca) is managed through the portal Blackboard. It is a resource for residents, serving as a “live” program manual and a repository for past rounds. The website is maintained by the program assistant and as well as a resident representative. The website contains the mandatory PGCorEd modules, contact information for members of the program, rounds information, field notes, practice questions, useful resources for residents and information about the program. The portal page also contains links to your utoronto webmail, POWER, and can be used to send emails to individuals or groups in the program through Communications. A new program website is being planned in collaboration with PGME. Interested residents are encouraged to speak to the program directors or chiefs if they are interested in participating in this exciting initiative. All residents must have and use their utoronto email address (without forwarding) for communications through the portal. Instructions for setting up your account can be found at: https://weblogin.utoronto.ca.


!

17 !

RESIDENT SAFETY AND WELLNESS Resident Wellness

Residents are provided link to PGME Wellness and encouraged to seek assistance in confidence. The Program Director routinely offers this excellent service to residents in confidence during 1-1 meetings.

The Office of Resident Wellness employs a full time Wellness Consultant who offers counselling and education services to all residents, with particular focus on managing stress for optimal academic and workplace performance, adapting to the multiple transitions of residency and the physician lifecycle, exam and performance anxiety and managing the stress associated with academic difficulty. The Director, Resident Wellness is available for short term counselling as well as providing support for disability and accommodation issues, academic difficulty, career uncertainty, and planning for maintenance of well-being throughout the program. The Office maintains a list of family physicians for U of T residents as well as some consultant GP-psychotherapists and psychiatrists. The Office maintains a website with resources available through PGME, the University and the community, and literature, pod casts, and self directed activities for stress management and physician well-being. Residents have access to services, offered by the Physician Health Program of the Ontario Medical Association. This includes access to mental health and substance abuse practitioners as well as monitoring. Appointments with staff of the Office of Resident Wellness are available in person, by telephone or Skype. There are a limited number of regular after-hours appointments offered with a Wellness consultant for counselling. Workshops on managing stress for optimal well-being and performance and managing stress associated with transition and change are available to individual programs through the Office of Resident Wellness. Residents will be able to seek advice from the University Sexual Harassment Officer, the Ombudsperson or the University’s Anti-Racism and Cultural Diversity Officer for issues related to intimidation and harassment or others. The PARO Helpline is a 24-hour confidential service provided by the Professional Association of Residents of Ontario jointly with the Distress Centres of Toronto. This line offers crisis intervention as well as advice and resources. PARO’s Residents Well-Being Committee keeps a log of family physicians and health professionals willing to see Residents on a fairly urgent basis. Resident Safety

In addition to our program safety policy, the Postgraduate Medical Education (PGME) Office developed Resident Health and Safety Guidelines in March 2009. The Guidelines are available on the website at http://www.pgme.utoronto.ca/Assets/PGME+Digital+Assets/policies/Health+and+Safety+Guidelines.pdf. These Guidelines apply to all Residents. The University, hospitals and affiliated teaching sites are accountable for the environmental, occupational, and personal health and safety of their employees; in addition, all teaching sites must meet the requirements of the PARO-CAHO collective agreement. Residents must adhere to the relevant health and safety policies of each rotation’s training site. The PGME Guidelines set out reporting procedures where there has been or may be a personal safety or security breach, which may include reports to the immediate supervisor at the training site, Program Director, and/or Director of Resident Wellness.

Urgent Resident safety issues will be brought to the attention of the Vice Dean, Postgraduate Medical Education, as well as, the relevant field rotation site coordinators as appropriate


!

18 !

OTHER EDUCATIONAL OPPORTUNITIES RESIDENT EDUCATION FUNDING PHPM residents, not currently in their clinical/family medicine training, are entitled to funding support for educational expenses (e.g. books, learning materials, conferences). The amount is determined by the resident group at the Annual General Meeting in the fall of the same year. Original receipts and a signed reimbursement claim form should be submitted to the treasurer and signed off by the Program Director before submitting to the DLSPH Business Manager. Fax copies of the reimbursement forms will not be accepted. The reimbursement claim form is available on Blackboard. EXTRA COURSES Canadian Field Epidemiology Program (CFEP) PHPM residents may apply to attend the CFEP Epi in Action training course. This is a three week course based in Ottawa that provides an overview on outbreak investigations and other aspects of practical epidemiology. Applicants must have completed their core rotation in communicable disease prior to the course. Application forms are typically circulated during the spring months via the Program Director. Dr. Rachlis’ Policy Course A mini policy course for PHPM residents has been offered by Dr. Michael Rachlis for the last several years. The course is typically held on Friday afternoons in March. Interested residents should contact Dr. Rachlis directly if they are interested. Immunization Education Competencies Program (ICEP) PHPM residents are typically offered free attendance to the ICEP, hosted by the Canadian Pediatric Society in May. Residents from any year may apply. An announcement is circulated in the spring and interested residents asked to apply.

CONFERENCES Follow the link to check out upcoming public health conferences! http://www.cpha.ca/en/conferences/all.aspx Family Medicine Forum (FMF)

- Nov 13-15, 2014, Quebec City - Attendees: family physicians, family medicine residents - FMF website: http://fmf.cfpc.ca/

Association of Local Public Health Agencies (alPHa) Symposia

- Dates and locations TBA - High yield: Council of Ontario Medical Officers of Health (COMOH) meeting - Attendees: Board of Health members, public health unit staff, MOHs, AMOHs, PHPM residents - alPHa website: http://www.alphaweb.org/

The Ontario Public Health Convention (TOPHC)

- Date and location TBA for 2015 - TOPHC website: http://www.tophc.ca/Pages/home.aspx

Canadian Public Health Association (CPHA) Conference

- May 25-28, 2015, Vancouver - High yield: the Public Health Physicians of Canada (PHPC) typically holds a day of Continuing Professional

Development talks on a pre-conference day, as well as the PHPC Annual General Meeting - Attendees: public health professionals, researchers, public health students, PHPM physicians, PHPM residents - CPHA website: http://www.cpha.ca/en/default.aspx - PHPC website: http://www.nsscm.ca/en/events/upcoming-phpc


!

19 !

MEMBERSHIPS/PROFESSIONAL AFFILIATIONS

Organization Cost for residents

Comments and Link

Canadian Public Health Association (CPHA)

~ $100 per year Organization that includes public health nurses, inspectors, and physicians among others. Many residents end up not joining this however partly due to the cost. You can still attend the CPHA conference if you are not a member. http://www.cpha.ca/en/default.aspx

Public Health Physicians of Canada (PHPC)

None It seems that most residents join this group and it is recommended. It originally began as the specialist society for public health and preventive medicine specialists but is now also open to other physicians who practice public health. www.nsscm.ca/en/about

Ontario Medical Association (OMA)

~$200 per year if done together

Similar to medical school, not required but many residents do maintain these two memberships. They also have sections / interest groups you can be a part of, including public health and family medicine. www.oma.org www.cma.ca

Canadian Medical Association (CMA)

College of Family Physicians of Canada (CFPC)

$56 yearly as a resident, more as a family physician

May be required during your family medicine residency. www.cfpc.ca

Royal College of Physicians and Surgeons of Canada (RCPSC)

This organization has a resident affiliate role that is available. http://www.royalcollege.ca

Canadian Medical Protective Association (CMPA)

Varies each year Required for medical practice www.cmpa-apmc.org/index.htm

College of Physicians and Surgeons of Ontario (CPSO)

~$310 yearly as a resident, more as a family physician

Required for medical practice http://www.cpso.on.ca/


!

20 !

APPENDIX A: ROYAL COLLEGE CANMEDS OBJECTIVES FOR PHPM The Royal College of Physicians and Surgeons of Canada (RCPSC) has developed a set of objectives for public health and preventive medicine specialty training which serve to define our specialty and provide a metric for the Royal College Examination. These objectives are currently (and almost always) undergoing revision, but at a very slow pace not usually relevant to current residents. Previous iterations of the objectives (2005) were more granular and provided residents with more direction in their field rotations and exam preparation – these previous objectives can be found on the PHPM Portal. The most current objectives (which apply to residents beginning the program in July 2014) are available on the Royal College website at http://www.royalcollege.ca/cs/groups/public/documents/document/y2vk/mdaw/~edisp/tztest3rcpsced000887.pdf DEFINITION

Public Health and Preventive Medicine is that branch of medicine concerned with the health of populations. The Public Health and Preventive Medicine specialist uses population health knowledge and skills to play leading and collaborative roles in the maintenance and improvement of the health and well-being of the community. Through inter-disciplinary and inter-sectoral partnerships, the Public Health and Preventive Medicine specialist measures the health needs of populations and develops strategies for improving health and wellbeing, through health promotion, disease prevention and health protection. The Public Health and Preventive Medicine specialist demonstrates skills in leadership; development of public policy; design, implementation and evaluation of health programs and applies them to a broad range of community health issues. GOALS

The Public Health and Preventive Medicine specialist can engage in a number of careers, for example: a. the practice of public health at a local, regional, national or international level; b. the planning and administration of health services, whether in institutions or in government; c. community-oriented clinical practice with an emphasis on health promotion and disease prevention; d. the assessment and control of occupational and environmental health problems; e. Teaching and research.

Residents in Public Health and Preventive Medicine must develop a comprehensive knowledge of the sciences of Public Health and Preventive Medicine, and the skills to apply this knowledge to a broad range of community health issues in the socio-political and cultural contexts in which they occur. They must demonstrate the knowledge, skills and attitudes relating to socio-economic status, gender, culture and ethnicity of the populations with which they work. In addition, all residents must demonstrate an ability to incorporate these factors in research methodology, data presentation and analysis. During training, all residents will be expected to acquire a substantial knowledge of and necessary skills in: concepts of health and illness and their determinants, methods in community health, health services organizations, trans-organization collaboration, community health programs, communication and advocacy. In addition, candidates are encouraged to develop a higher level of expertise in one of these fields, and to acquire knowledge in other academic subjects relevant to their own interests. In particular, residents who successfully complete the program will be able to:

a. assess the health needs, concerns and capacities of a population; b. investigate potential or existing health issues occurring in a population c. assess sociopolitical realities and be able to take and advocate appropriate action to improve health in the light of

that assessment; d. plan, implement and evaluate health programs and/or other strategies to deal with these needs, concerns and

issues; e. contribute to the formulation of public policy and assess its impact on health;


!

21 !

f. communicate, consult, collaborate and build partnerships with the public, physicians and other health professionals, volunteers, service provider agencies, elected and appointed officials and the media;

g. demonstrate ethical attitudes and behaviour and a critical approach to ethical issues in their work; h. contribute to the body of knowledge of community health through scholarly activity and research; and i. Demonstrate leadership and management skills.

COMPETENCIES At the completion of training, the resident will have acquired the competencies included in, but not limited to, the lists that follow, and will function effectively as a: Medical Expert/Clinical Decision-Maker Specialists possess a defined body of knowledge and procedural skills which are used to collect and interpret data, make appropriate clinical decisions, and carry out diagnostic and therapeutic procedures within the boundaries of their discipline and expertise. Their practice is characterized by up-to-date, ethical, and cost-effective management and effective communication in partnership with individuals (patients and clients), other health professionals, community leaders and the community at large. The role of medical expert/clinical decision-maker is central to the function of specialist physicians, and draws on the competencies included in the roles of scholar, communicator, health advocate, manager, collaborator, and professional. General Requirements:

• Demonstrate diagnostic and therapeutic skills for ethical and effective interventions at the individual, group, organization and population levels.

• Access and apply relevant information to the practice of Public Health and Preventive Medicine. • Demonstrate effective consultation services with respect to assessment and interventions at the individual, group

and population levels.

Specific Requirements: 1. Diagnostic and Therapeutic Skills

(a) Assessment • Assess and describe the health of a population. • Identify those conditions or population characteristics that lend themselves to surveillance and be able

to select the most appropriate method. • Use a variety of methods to collect information relevant to the clinical setting and situation at hand. • Select and interpret relevant social, demographic and health indicators from a variety of data sources. • Identify and interpret biological risk markers, e.g. age, sex, genetic makeup. • Identify and demonstrate an understanding of social and economic environmental factors, such as

immigration policies and distribution of wealth. • Identify and demonstrate an understanding of physical environmental factors, including noise,

pollutants and hazardous industrial processes, that are relevant to the given clinical context (individual, local, regional, global).

• Identify and interpret the impact of health behaviours of individuals, groups and populations, particularly with respect to nutrition, physical activity, use of tobacco and other substances, sexuality, risk taking, vaccination and participation in recommended screening programs.

• Identify and demonstrate an understanding of factors that influence the potential for change in a given context or population.

• Use computers or information technology in epidemiological investigations and data analysis. • Interpret epidemiologic studies and assess their validity and applicability to a particular situation. • Describe and apply guidelines for determination of causality (Koch, Hill)


!

22 !

• Understand the principles of infectious disease epidemiology and apply them in the investigation and management of infectious disease.

• Conduct a communicable disease outbreak or disease cluster investigation • Describe the major environmental health hazards and diseases, and the interaction of air, water and

soil characteristics with them. • Carry out a health risk assessment of an environmental hazard. • Use quantitative and qualitative methods including (but not limited to) participant observation, key

informant surveys, nominal group, focus group and Delphi process, to explain differences in health and health related behaviours.

• (b) Interventions

• Manage a communicable disease outbreak. • Know the natural history, epidemiology, risk factors and health burden of the major communicable

and non-communicable (including injury) diseases of public health significance, and apply this knowledge in the development, implementation and evaluation of appropriate surveillance and control programs.

• Describe the main methods of dealing with common environmental hazards, including (but not limited to) water and sewage treatment, milk hygiene, and quality control of water, soil, air and food.

• Manage individually, or in a team, health risks from environmental or occupational exposures • Understand and apply the principles of harm reduction, stages of change, health protection (including

legal, technical, economic and educational approaches) and health promotion. • Develop, implement and evaluate approaches to community health issues that incorporate health

protection, disease prevention (primary, secondary and tertiary) or health promotion strategies as appropriate.

• Identify those conditions that are amenable to population-based screening, and calculate and interpret screening test characteristics. Understand, interpret and apply as appropriate, the methods and recommendations of relevant practice guideline processes. Contribute to the development of a community emergency preparedness plan, including measures to prevent and manage biological, chemical and radiological agents .

2. Information Access • Identify access and critically appraise data from a variety of sources, including individuals,

administrative databases, the internet and health, epidemiological and social sciences literature.

3. Effective Consultation • When called upon for advice, clarify the nature of the request and establish (negotiating where

required) the desired deliverables. • Efficiently collect the information appropriate to the request. • Formulate clear and realistic recommendations. • Communicate the assessment and recommendations in a manner (oral and/or written) that is most

suitable to the client and given circumstances. Communicator To provide humane, high-quality care, specialists establish effective relationships with patients and a variety of clients (groups and communities), other physicians, other health professionals, and service providers from non-health sectors. Communication skills are essential for the specialist, and are necessary for obtaining information from and conveying information to, the individuals and groups the specialist interacts with. Furthermore, these abilities are critical in eliciting clients’ beliefs, concerns and expectations about their health and illnesses, and for assessing key factors impacting their health.


!

23 !

General Requirements: • Establish relationships with patients and families, groups and communities, and other

physicians, health professionals and service providers, decision and policy makers and the media, appropriate to the setting.

• Obtain and synthesize relevant information. • Listen effectively. • Convey information clearly in formats appropriate to the recipient (patient or other individual, family, group, other

service provider, community and media) that is relevant to the purpose at hand. Specific Requirements: • Interpret and present epidemiological data and risk information to affected individuals, the public, other professionals

and the media using a variety of modalities. • Develop and implement a communication plan about a public health issue, including a media component. • Respond effectively to public and media enquiries about specific health issues. • Effectively communicate with members of an interdisciplinary team for the purpose of information exchange, conflict

resolution, and the provision and receipt of feedback. • When called upon for advice, clarify the nature of the request and establish (negotiating where required) the desired

deliverables. • Efficiently collect the information appropriate to the request. • Formulate clear and realistic recommendations. • Communicate the assessment and recommendations in a manner (oral and/or written) that is most suitable to the client

and given circumstances. Collaborator Specialists work in partnership with others who are appropriately involved in the care of individuals, groups or communities. It is therefore essential for specialists to be able to collaborate effectively with patients, clients, groups and communities, and a multidisciplinary team of expert health and other professionals for provision of optimal care, education and research. General Requirements: • Consult effectively with other physicians, other health care professionals and service providers from other sectors. • Contribute effectively to interdisciplinary team activities.

Specific Requirements: • Identify individuals, groups and other service providers who can contribute meaningfully to the definition and

solution of an individual, group or community level public health issue, and education task or research question, including (but not limited to) social services agencies, mental health organizations, the not-for-profit sector, and volunteers.

• Employ a variety of means to engage and enable the participation of identified key stakeholders. • Clearly articulate the goals and objectives of a given collaborative process. • Identify and describe the role, expected contribution and limitations of all members of an interdisciplinary team

assembled to address a health issue, educational task or research question, and work effectively within such a team. • Describe the organization of community health and social services, including the not-for profit sector, volunteers and

other service agencies, in at least one province. Manager Specialists function as managers when they make everyday practice decisions involving resources, co-workers, tasks, policies, and their personal lives. They do this in the settings of individual patient care, practice organizations, and in the broader context of the health care system. Thus, specialists require the ability to prioritize and effectively execute tasks


!

24 !

through teamwork with colleagues, and make systematic decisions when allocating finite health care resources. As managers, specialists take on positions of leadership within the context of professional organizations and the Canadian health care system.

General Requirements: • Utilize resources effectively to balance professional demands, learning needs, and outside activities. • Allocate finite health care resources wisely and ethically. • Work effectively and efficiently in a health care organization. • Utilize information technology to optimize patient care, life-long learning and other activities.

Specific Requirements: • Use knowledge of the Canadian health system defining legislation, funding and organizations, to analyse community

health issues. • Use an economic analysis in the assessment of a health issue and proposed intervention options. • Describe the public health legislation in at least one province and how it relates to other relevant legislation at the

municipal, provincial and federal levels. • Describe the organization of workplace health services. • Design, implement, manage and evaluate a program. • Design, implement and evaluate a change management process. • Develop and implement a strategic plan. • Participate in common human resource management functions, including (but not limited to) hiring, firing and

performance appraisal of staff. • Develop and manage a budget. • Understand the impact of various leadership styles and apply them appropriately in a variety of community and

organizational settings. • Understand and use the techniques of conflict management, including negotiation and arbitration. • Understand and use a variety of quality improvement techniques as appropriate to the organization and setting. Health Advocate Specialists recognize the importance of advocacy activities in responding to the challenges represented by those socio-cultural, environmental and biological factors that determine the health of individuals, groups, communities and society. They recognize advocacy as an essential and fundamental component of health promotion that occurs at the level of the individuals, family, community and society. Health advocacy is appropriately expressed both by individuals and the collective responses of specialist physicians in influencing public health and policy. General Requirements: • Identify the important determinants of health affecting individuals and communities. • Contribute effectively to improved health of individuals and communities. • Recognize and respond to those issues where advocacy is appropriate. Specific Requirements: • Describe the distribution and determinants of health status of a specific population. • Conduct a policy analysis. • Describe mechanisms of policy development and methods of implementation, including legislation, regulation and

incentives. • Recognize situations where advocacy is required and define strategies to effect the desired outcome. Scholar Specialists engage in a lifelong pursuit of mastery of their domain of professional expertise.


!

25 !

They recognize the need to be continually learning and model this for others. Through their scholarly activities, they contribute to the appraisal, collection, and understanding of health care knowledge, and facilitate their own personal education as well as that of their students, patients, community and others. General Requirements: • Develop, implement and monitor a personal continuing education strategy. • Critically appraise sources of information relevant to the practice of Public Health and Preventive Medicine. • Facilitate learning of patients and clients, residents, other health professionals and the community. • Contribute to development of new knowledge. Specific Requirements: • Pose a research question and participate actively in the complete research process from grant preparation through to

dissemination of findings. • Describe the elements of quantitative, qualitative and action research, including study purpose, design, conduct,

analysis, interpretation and reporting. • Describe sampling methods as well as the estimation of appropriate sample sizes, including a consideration of type 1

and 2 errors. • Select and apply descriptive and analytical methods appropriately, • Recognize potential source of bias in research and describe methods to reduce the impact of such bias through design

and/or analysis • Adapt educational and training strategies to the needs of the learner(s). • Calculate and interpret measures of frequency (rate, ratio) and of risk (relative risk, attributable risk, odds ratio,

etiologic fraction, preventive fraction) • Identify, access and critically appraise data from a variety of sources, including individuals, administrative Professional Specialists have a unique societal role as professionals with a distinct body of knowledge, skills, and attitudes dedicated to improving the health and well-being of others. Specialists are committed to the highest standards of excellence in clinical care and ethical conduct, and to continually perfecting mastery of their discipline. General Requirements: • Deliver highest quality care with integrity, honesty and compassion. • Exhibit appropriate personal and interpersonal professional behaviours. • Practise medicine ethically consistent with obligations of a physician

Specific Requirements: • Continually evaluate one’s abilities, knowledge and skills, and know one’s professional limitations, seeking advice

and assistance where appropriate. • Identify ethical issues arising in the course of Public Health and Preventive Medicine practice, such as consent,

confidentiality, privacy, resource allocation, conflict of interest, public safety and individual choice, and apply appropriate strategies to address them.

• Recognize, analyze and know how to deal with unprofessional behaviours in clinical practice, taking into account local and provincial regulations.

• Adopt specific strategies to heighten personal and professional awareness and explore and resolve interpersonal difficulties in professional relationships.

SPECIALTY TRAINING REQUIREMENTS

(These specialty training requirements apply to those who began training on or after 1 June 1995.)


!

26 !

Five years of approved residency training, which must be undertaken within or under the aegis of a residency program accredited by the Royal College. Practical expertise will be developed in applied community settings in which the candidate must assume responsibility appropriate to her/his developing expertise. Although these placements will often be outside the confines of a University Health Sciences Centre, it is essential that they offer adequate supervision and regular evaluation from the residency program. This period must include: 1. One year of basic clinical training.

2. a. Three years in a Royal College approved, university-sponsored program that includes course work in the sciences of Public Health and Preventive Medicine and experience and responsibility in Public Health and Preventive Medicine. This will include the equivalent of:

i. One academic year of course work in Public Health and Preventive Medicine; ii. One year of field placements. Appropriate settings will include public health departments, health

planning authorities, government departments of health, environmental health settings, occupational health departments in government and industry, and clinical departments with a commitment to practice and research in preventive medicine. It is essential that candidates gain experience in a broad range of such placements, although it is recognized that a single placement will often provide experience in more than one subject area;

iii. One additional year, which may include: • additional academic preparation or research experience • additional field placements in applied Public Health and Preventive Medicine settings as in

2(a)ii, above; • additional field placements relevant to the candidate's training e.g., toxicology, aerospace

medicine, social services, nutrition, genetics; b. One further year of training, in a Royal College approved, university-sponsored program which may include:

i. Residency in a clinical specialty relevant to the practice of Public Health and Preventive Medicine (normally internal medicine, pediatrics, obstetrics or psychiatry); or with selective clinical experiences related to disease prevention and health promotion for specific populations or groups.

ii. Additional training as in 2(a) iii, above. NOTE: EXAMINATION Applicants who have completed residency training in Family Medicine, acceptable to the College of Family Physicians of Canada for residency-eligibility for their examinations, may be deemed to have fulfilled the training requirements under sections 1 and 2(b)i. NOTE: PURPOSE OF THE TRAINING The purpose of the training required under Section 1 of the training requirements is to give the resident a degree of independent responsibility for clinical decisions; an opportunity for further development of the skills required in making effective relationships with patients; the consolidation of competence in primary clinical and technical skills across a broad range of medical practice. The purpose of the training required under Section 2 is to give residents an opportunity to develop the knowledge and skills to function as a Public Health and Preventive medicine specialist. The scope of practice is broad. It requires knowledge of clinical medicine and the basic sciences of community health; the ability to develop effective relationships with individuals and communities; and knowledge of the health care system within its socio-economic and political environment.


!

27 !

APPENDIX B: UNIVERSITY OF TORONTO PHPM PROGRAM POLICIES PHPM RESIDENCY PROGRAM UOFT CANMEDS GOALS AND OBJECTIVES Approved by RPC June 18, 2010

The program will graduate community medicine specialists with competent knowledge and skills to assess and manage health issues within communities and populations. The program will ensure that all graduates can make independent, evidence informed, community responsive, accountable decisions to maintain and improve health overall and reduce health inequities. The program will prepare all trainees to be able to serve as local medical officers of health. However, recognizing the need for community medicine specialists in many roles and the variety of career paths graduates may chose, the program will support trainees to gain clinical certification in Family Medicine if desired and to have opportunities to enhance knowledge and skills in focus areas of research, education, environment health, public health administration and global health. The program will ensure that residents are provided with sufficient learning and assessment opportunities to meet Royal College, program and personal objectives and support residents’ self direction and self assessment as well as flexibility in the demonstration of achievement of competency. Residents will be responsible for their own learning path through the program with the assistance of a personal learning plan, mentor and guidance from Program Directors and other faculty. Residents will be accountable for the timely submission of their Portfolio to the Program Director for review by a committee at the beginning of PGY4 to guide the planning for the final 2 years and at the half way point of PGY5 to assist in the preparation of the FITER and program completion. Residents will be accountable to each other through participation in all aspects of program activities; in particular demonstration of peer teaching and assessment and program leadership and management. The program will prepare specialists who meet the seven CanMEDS roles as incorporated into the Royal College Objectives of Training and Specialty Training Requirements in Community Medicine (2003). These objectives are the basis for the ITER and FITER evaluations of residents. Key objectives are summarized below. Medical Expert:

• Communicable disease epidemiology; • Biological risk markers; • Impact of behaviours on the health of individuals, groups and populations; • Natural history, epidemiology and risk factors for the major communicable and non-communicable diseases of

public health significance; • Health protection and health promotion strategies for these diseases; • Population based screening; • Environmental factors that affect health; • Health hazard identification, risk assessment and risk management; • Disease surveillance; • Population health status assessment.

Communicator

• Interpret and present epidemiological data and risk information; • Develop and implement a communication plan;


!

28 !

• Effectively communicate with the media, public and other health professionals; • Formulate clear and realistic recommendations.

Collaborator

• Function effectively as members of interdisciplinary teams; • Understand the organization of community health services; • Clearly articulate the goals of a given consultative process; • Consult, collaborate and build partnerships with the public, physicians and other health professionals, volunteers,

service provider agencies, elected and appointed officials, and the media. Manager:

• Design, implement, and evaluate health programs to deal with public health issues; • Develop a strategic plan; • Develop and manage a budget; • Understand and use quality improvement tools; • Understand the impact of various leadership styles; • Understand and use techniques of conflict resolution; • Design, implement and evaluate a change management process; • Participate in common human resource management functions; • Manage a communicable disease outbreak; • Manage an environmental health hazard; • Contribute to the development of a community emergency preparedness plan.

Health Advocate:

• Describe the determinants of health and their distribution in a specific population; • Conduct a policy analysis; • Recognize situations where advocacy is required to effect a desired outcome; • Assess sociopolitical realities and be able to take and advocate appropriate action to improve health in the light of

that assessment; • Contribute to the formulation of public policy and assess its impact on health.

Scholar:

• Develop research questions and participate actively in the complete research process; • Interpret research results; • Understand epidemiological principles of causality; • Identify, access and critically appraise available data; • Calculate and interpret basic statistical measures in epidemiology; • Describe the elements of quantitative, qualitative and action research; • Contribute to the body of knowledge of community health through scholarly activity and research.

Professional:

• Knowledge of public health legislation and other relevant legislation at the municipal, provincial and federal levels;

• Self directed learning, self-knowledge and continuing education; • Identify ethical issues in community medicine practice and apply appropriates strategies to address them; • Recognize, and know how to deal with unprofessional behaviours; • Ability to resolve interpersonal conflicts in professional relationships.


!

29 !

RESIDENT EVALUATION Approved by RPC, June 2008, revised and approved 2011 Background The In Training Evaluation Form (ITER) exists to help standardize formative and summative resident evaluation. The ITER is: 1) A template for possible structured mid rotation feedback 2) A final record of your performance in a rotation. This record of performance contributes to the Final In Training Evaluation Report (FITER) that the Program Director submits to the Royal College when determining eligibility for fellowship certification. According to Postgraduate Medical Education, the purpose of the ITER is:

" To provide a framework for the assessment of the Trainee's knowledge, skills and attitudes by a Supervisor; " To facilitate feedback to the Trainee by a Supervisor or the Program Director; " To serve as a record of the strengths and weaknesses of the Trainee for the Program Director; " To enable the Program Director to assist future Supervisors in ongoing supervision; " To assist the Program Director in providing a final in-training evaluation of the Trainee for the RCPSC, [the

CFPC, or the CPSO;] and " To establish the basis for progress and promotion.

A “1 Fails to Meet Expectations” on the overall assessment of performance at the bottom of the ITER will be interpreted by the Program Director as a failed rotation. If the overall assessment is a “2” or if there are several “1”s on the individual items in the ITER, then the Program Director will initiate further discussion about items that need improvement. The context and previous performance of the resident will factor into this discussion. The program director can interpret this as a failed rotation. Residents need to consider whether they are longitudinally meeting objectives that are marked as “not applicable” in a particular rotation. Recurrent “not applicables” in the same domain would be a cause for concern and inability to complete the FITER. Suggestions for a Successful Evaluation Process

Principles Residents and supervisors should negotiate the rotation objectives prior to the beginning of the rotation with the ITER in mind. Completion and submission of an ITER in a timely manner is a shared responsibility of the supervisor and the resident. Ideally the ITER for a rotation should be completed at the end of the rotation. After two weeks of reasonable efforts following the rotation, if a resident is having difficulty obtaining the ITER at the end of the rotation, the resident must ask the Program Director and the Site coordinator for assistance. Resident Task and Check list

• Send your draft objectives (includes BOTH program and personal objectives) to your supervisor prior to starting the rotation

• Schedule a meeting with your supervisor in the first two weeks of the rotation to finalize your rotation objectives. It may help you to develop concrete and measurable objectives if you have the rotation-specific objectives in CanMEDS format and the ITER in front of you during this meeting.


!

30 !

• In the first week of your rotation, schedule an appointment with your supervisor during the last week to ten days of your rotation for a final evaluation. You are more likely to have a completed ITER by the end of your rotation if you schedule this appointment well in advance.

• Email a copy of your finalized rotation objectives to the Program Director within the first month of your rotation. • Schedule a mid-rotation evaluation discussion with your supervisor. A written midterm evaluation is required for

rotations longer than 3 months. For three month rotations it may be beneficial but is not necessary if there are no serious concerns articulated by your supervisor. If your supervisor indicates that they have serious concerns about your performance, written documentation of these concerns is required and MUST be submitted to the Program Director. You should also develop a written action plan to address your supervisor’s concerns. You may ask the Program Director for assistance in developing the action plan. The midterm evaluation does not necessarily need to be part of your rotation file if the action plan succeeds in improving your performance and you achieve expectations

• Keep a copy of your ITER and submit the original to the Program Director. • Complete an evaluation of your supervisor and submit it to the Program Assistant • Complete an evaluation of your rotation site and submit it to the Chief Resident with a copy to the Program

Assistant

RESIDENT SAFETY POLICY Approved by RPC June 8 2012

1. BACKGROUND The Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada have collaborated in developing national standards for Residency programs. Standard B 1.3.9 states that: “3.9 The residency program committee must have a written policy governing resident safety related to travel, patient encounters, including house calls, after-hours consultations in isolated departments and patient transfers (i.e. Medevac). The policy should allow resident discretion and judgment regarding their personal safety and ensure residents are appropriately supervised during all clinical encounters. 3.9.1 The policy must specifically include educational activities (e.g. identifying risk factors). 3.9.2 The program must have effective mechanisms in place to manage issues of perceived lack of resident safety. 3.9.3 Residents and faculty must be aware of the mechanisms to manage issues of perceived lack of resident safety.” The document, “University of Toronto, Faculty of Medicine, Postgraduate Medical Education Resident Health and Safety Guidelines” available at: http://www.pgme.utoronto.ca/Assets/PGME+Digital+Assets/policies/Health+and+Safety+Guidelines.pdf?method=1 provides background to the relationship between the University and all clinical teaching sites with respect to resident safety. Procedures for reporting and responding to specific circumstances are contained in that document. The PHPM residency program formally acknowledges, endorses and agrees to adhere to these guidelines. 2. PURPOSES OF THIS POLICY - To augment the above PGME guidelines by identifying program-specific safety risks - To describe the mechanism in place at the program level for addressing, reporting, and/or reducing unsafe events and conditions - To establish that residents have the right to use their judgment when deciding if, when, where, and how to engage in clinical and/or educational experiences that they perceive to involve safety risks 3. SCOPE AND RESPONSIBILITY


!

31 !

- The University and all (fully and partially) affiliated teaching sites as well as ambulatory, outpatient and private practice locales are accountable for the environmental, occupational, and personal health and safety of their employees. -Residents must adhere to the relevant health and safety policies and procedures of their current teaching site. - All teaching sites must meet the requirements of the PARO-OHA collective agreement. - The PHPM residency program is responsible for identifying and communicating foreseeable safety risks related to education carried out within the program, educating residents about risk minimization strategies, and for making decisions about educational experiences that take into account, among other things, the educational benefit relative to any safety risk. This policy outlines the provisions to address safety concerns related to educational activities undertaken as part of the PHPM residency program. 4. POLICY STATEMENT

a) Reporting of, and response to, all manner of incidents related to Environmental Health, Occupational Health, and Personal Health and Safety will be addressed as outlined in the document, “University of Toronto, Faculty of Medicine, Postgraduate Medical Education Resident Health and Safety Guidelines.”

b) The PHPM residency program requires residents to engage in the following specific situations that may pose a safety risk: - house calls or home call with a local public health agency - work in isolated or poorly protected environments - exposure to potentially dangerous environments - exposure to potentially harmful bodily fluids - exposure to environmental hazards - encounters with potentially violent or aggressive patients or community members - exposures to potentially dangerous equipment and/or high risk transportation

c) The program commits to providing residents with a full disclosure of foreseeable potential risks associated with these activities. The program will ensure that residents receive education and preparation for these activities using best available evidence and practices AND assess residents for appropriate understanding PRIOR TO involvement in these activities.

d) Residents will not be required to see patients alone in any of the above situations if not appropriately

supervised.

e) Residents must immediately notify their supervisor, program director, or more senior resident of perceived safety concerns

f) It is recognized that, at times, a resident may be called upon to respond to an acute situation involving a

patient which poses a risk to the resident’s personal safety and wellbeing. Residents are expected to consider the effect on themselves and the patient when deciding on a course of action. Every effort should be made to consult more experienced health care providers or staff and seek assistance, support or alternative courses of action. Ultimately, residents should use their best judgment when deciding if, when, where, and how to engage in clinical and/or educational experiences. Should a resident fail to engage in such an experience (or (engage in a manner other than what has been requested or previously expected of them) due to perceived safety concerns, the resident will report this to their site supervisor immediately AND to the residency program director at the earliest reasonable time.

g) Residents involved in safety-related events or who have safety concerns are encouraged to contact the office

of resident wellness, PGME


!

32 !

h) A resident should not encounter negative repercussions for decisions they made in good faith related to personal safety concerns.

i) The residency program committee will review all concerns brought forth and take steps to minimize future

risk.

j) Should there be a situation in which a resident repeatedly fails to engage in an activity that can be reasonably considered part of their specialty practice, that is a mandated component of the residency training, and for which all means of risk reduction and education have been instituted by the program, the residency program committee will review the circumstances in the context of the specialty-specific and general CanMEDS physician competency frameworks. Disputes or appeals of decisions made by the residency program committee will be referred to the Vice Dean or Associate Dean, PGME.

LEAVE AND WAIVER POLICY AND PROCEDURE Approved by RPC June 18, 2010

The UofT PHPM Residency Program supports resident leaves from the program to meet resident personal and educational objectives. Residents highly value the opportunity to incorporate clinical medicine in their future careers with public health and often use leaves of absence to consolidate their skills and knowledge. In addition to supporting all legislated leaves, this policy provides support for re-entry following leave, timely program completion and effective program management. This policy is to provide guidance to residents, program directors and the RPC on leave and waiver of training requests. Refer to the attached April 2009 PGMEAC Policy. Policy on Granting a Leave of Absence The Royal College and the Collège des médecins du Québec (CMQ) expects that all residents must have achieved the goals and objectives of the training program and be competent to commence independent practice by the completion of their training program. It is understood by the RCPSC and the CMQ that residents may require leaves of absence from training. The university determines the circumstances that would qualify residents for leaves of absence. It is anticipated that any time lost during a leave will be made up upon the resident’s return. Policy on Granting a Waiver of Training:

• The postgraduate office may allow a waiver of training following a leave of absence, in accordance with university policy and within the maximum time for a waiver determined by the RCPSC and the CMQ. A decision to grant a waiver of training can only be taken in the final year of the program but cannot be granted after the resident has taken the certification examinations.

• Each university will develop its own policy on whether or not it is willing to grant a waiver of training for time taken as a leave of absence; however, in the case where waivers of training are acceptable to the university, they must be within the acceptable times listed below. In addition, regardless of any waived blocks of training, the decision to grant a waiver of training must be based on the assumptions that the resident will have achieved the required level of competence by the end of the final year of training.

• A waiver of training can only be granted by the Postgraduate Dean on the recommendation of the resident’s Program Director.

RCPSC and CMQ Maximum Allowable Times for Waivers:

• It is the responsibility of the Royal College of Physicians and Surgeons of Canada (RCPSC) and the Collège des médecins du Québec (CMQ) to set maximum allowable times for waivers of training that would maintain eligibility for certification.

• The following are the maximum allowable times for waivers: Five year program – three months

Educational Leave


!

33 !

• Residents should begin to discuss any plans of a potential leave with the Program Director as soon as possible and preferably within nine months of an anticipated leave so that the Program Director can seek the advice of the Residency Program Committee (RPC).

• The Resident must submit a written request for leave to the Program Director (PD) with a clear explanation of how the education activity fits with personal and program objectives (using the personal learning plan). The resident must include details of how they will keep connected with the program during the leave at minimum every 6 months such as through rounds attendance and assisting in the new resident selection process. The leave request must also outline plans for how the resident will reintegrate into the program when they return from leave. Educational leave for further clinical training such as Family Medicine PGY-3 fellowships or for additional graduate training (for example PhD) will only be granted if the resident can demonstrate how that training will fit with the career path they envision for themselves in Public Health and Preventive Medicine. Extensions to a 12-month educational leave are not possible as per PGME policy.

• The PD will meet with the resident to discuss their leave request and submit the leave request to the RPC for their advice with a recommended disposition of approval or disapproval.

• The PD will consider the timing of the request, the planning with respect to program completion on return from leave and the commitment to stay connected to ensure smooth re-entry in making a decision re disposition. It is expected requests that comply with this policy will be approved.

• The PD will submit the leave request to the Vice Dean of Postgraduate Medical Education (PGME) for approval. The Program Director’s submission to the Vice Dean will include information about the advice of the RPC and the PD. The PD will inform the resident of the decision of the Vice Dean.

• The resident can appeal the decision of the Vice Dean through the University of Toronto appeal process. Personal/Compassionate Leaves Up to 3 months leave request

• Residents must request and gain approval from the PD who will inform the Residency Program Committee (RPC) six months prior to the anticipated start of the leave. If circumstances requiring compassionate leave arise urgently, the resident is not expected to meet the six-month timeline.

• For personal leaves residents must submit a written request to the PD with a clear explanation of how the activity fits with personal and program objectives, how the resident will keep connected with the program during the leave and the plans for the return to the program at the end of the leave. A leave request that is granted approval by the PD will be communicated to the resident in writing. The PD will also inform the Postgraduate Education office and the RPC through the planning table. If the PD chooses to deny the request, the determination will be communicated to the resident in writing. The resident can appeal denied personal/compassionate leaves to the RPC, then the Vice Dean for their consideration.

Request for more than 3 months up to 12 months

• Residents must request and gain approval from the PD six months prior to the anticipated start of the leave. If circumstances requiring compassionate leave arise urgently, the resident is not expected to meet the six-month timeline.

• For personal leaves residents must submit a written request to the PD with a clear explanation of how the activity fits with personal and program objectives, how the resident will keep connected with the program during the leave at minimum every 6 months such as through rounds attendance and assisting in the new resident selection process, and the plans for the return to the program at the end of the leave. A leave request that is granted approval by the PD will be communicated to the resident in writing. The PD will also inform the Postgraduate Education office and the RPC through the planning table. If the PD chooses to deny the request, the determination will be communicated to the resident in writing. The resident can appeal denied personal/compassionate leaves to the RPC, then the Vice Dean for their consideration.

Requests for additional leaves

• Effective July 2010, residents who have taken prior unpaid leave (within this policy approval) can request additional leave such that the total leave time follows the above directions. For example, a resident who has taken a one-month leave can request an additional 2 months under the 3-month leave section. A resident who has taken


!

34 !

3 months leave and requests additional 9 months will follow the 3-12 month policy. The over all maximum unpaid leave time that can be granted is 12 months except under extenuating personal circumstances.

• Requests for additional unpaid leave for personal reasons beyond the 12 month period will only be considered in extenuating personal circumstances such as family illness, career uncertainty or significant personal debt with a written request to the PD.

• PD will submit the leave request to the RPC for advice with a recommended disposition of approval or disapproval. The PD will also submit the leave request to the Vice Dean for approval with information about the advice of the RPC and the PD. The PD will inform the resident of the decision of the Vice Dean. The resident can appeal the decision of the Vice Dean through the PGME appeal process.

Waivers of training

• Residents are required to complete the full five years of training. Residents who have not completed the full five years of training by June of their final year must be offered and sign back a contract for the outstanding time. NB Residents can apply to sit the Fellowship exams in their final year provided they would have completed the five years by December 31 of that year.

• Decisions to waive up to 3 months of training will be considered after the FITER is signed and submitted to the Royal College and prior to writing of the Fellowship exams.

• The Resident must submit a written request for a waiver of training to the PD immediately after the FITER is signed and NO LATER than the end of April of the final year. Using the CMRP personal learning plan, the waiver request must include a clear explanation of how the resident will have completed the Royal College, program and personal objectives without need for the waived time. PD will submit the waiver request to the RPC for advice with a recommendation on whether the waiver should be approved.

• The PD will submit to the Vice Dean for approval with information about the recommendation of the RPC and the PD. The PD will inform the resident of the decision of the Vice Dean. The resident can appeal the decision of the Vice Dean through the appeal process.

NB: Leave requests can be submitted and considered by current residents only. The program will not consider requests from applicants or new accepted residents without signed contracts.

TERMS OF REFERENCE: CHIEF RESIDENT Approved by RPC on June 20, 2014 1. Introduction: The position of Chief Resident is mandated by the Royal College of Physicians and Surgeons of Canada for residency programs in Canada. Within the Public Health and Preventive Medicine (PHPM) residency program at the University of Toronto, the position of Chief Resident is governed by the Professional Association of Residents of Ontario collective agreement as well as applicable policies passed by the Residency Program Committee. The Chief Resident represents the interests of the program as a whole and works primarily as a liaison between the program and the residents. For PHPM residents, the position of Chief Resident it is an opportunity to participate in the leadership and management of the PHPM residency program and fulfill CanMeds requirements in leadership, management, communication, and advocacy, as outlined by the Royal College. The purpose of this terms of reference is to outline the selection, reporting and term of the Chief Resident and to clarify/articulate roles and responsibilities associated with this position. 2. Selection, Reporting Relationships and Term: 2.1 The PHPM program will have one or two Chief Resident(s) concurrently. The decision to have either one or two

Chiefs will be dependent on the number of residents available and interested to take on the position.


!

35 !

2.2 Residents may nominate themselves or be nominated by others when a Chief position becomes available. The

candidates will be approved by the Program Director to ensure that they are in good standing with the program. A vote will be held by the resident group to select among multiple candidates. The selected resident(s) are recommended by the Program Director and appointed by the Residency Program Committee.

2.3 The Chief Resident(s) will be in PGY3 or greater. 2.4 The Chief Resident(s) will report to the Program Director and his/her associate Program Directors. 2.5 The term of the Chief Resident(s) will be 6 consecutive months, renewable for up to one additional 6-month term. 3. Roles and Responsibilities: 3.1 Leadership Responsibilities:

- Serve as liaison between the Program Director(s) and residents - Meet with PHPM residents and/or Program Director(s) as required - Serve as a mentor/teacher and resource for junior residents - Participate as a full member of the Residency Program Committee - Participate as a full member of the Curriculum Sub-committee - Coordinate and facilitate the PHPM Resident Annual General Meeting - Bring resident-generated issues to the Residency Program Committee and/or Program Director as necessary and

assist with their resolution - Represent the program to external parties (as required) - Participate in other committees as required by the program (or delegate to other residents)

3.2 Teaching Responsibilities:

- Organize and facilitate Topic of the Week during Academic Half Day - Coordinate facilitation of Journal Club - Assist in organizing other educational sessions (e.g., Field Trips, Media Day)

3.3 Administrative Responsibilities:

- Facilitate Field Notes at weekly Academic Half Day including circulation of program updates to residents and Program Director(s)

- Assist in the scheduling and coordination of Rounds at Academic Half Day - Coordinate and submit monthly call-stipends for senior residents (to be phased out when new electronic call-

stipend system becomes active) - Assist the Program Director(s) in providing orientation for new residents - Facilitate updating and distribution of the annual program Orientation Manual - Prior to completing his/her term as Chief Resident, meet with the incoming Chief Resident(s) to review the roles

and responsibilities of the Chief Resident and provide handover on current issues 4. Program Support: 4.1 The PHPM residency program facilitates the Chief Resident(s) to have one half day per week to assist with Chief

Resident activities. The PHPM Program Director will notify the rotation supervisor(s) of this prior to the resident rotation.

4.2 The Chief Resident(s) will be supported to attend the annual PGME Chief Resident orientation session as well as

facilitate other leadership learning opportunities. 4.3 The Program Director or his/her associates will provide the Chief Resident(s) with a letter of recognition at the

completion of his/her term


!

36 !

5. Terms of Reference Renewal: These terms of reference will be reviewed and evaluated following 1 year of implementation.


!

37 !

APPENDIX C: PGME POLICIES

GUIDELINES FOR RESIDENCY LEAVES OF ABSENCE AND TRAINING WAIVERS University of Toronto Faculty of Medicine, Postgraduate Medical Education April 2009 1. BACKGROUND The training requirements of residency programs define specific time requirements. While these requirements are generally completed in sequence, it is recognized that a resident may need to interrupt training for a number of reasons. Such interruptions are referred to as leaves of absence. This guideline is intended to provide guidance to program directors on a range of issues relating to leaves of absence taken during residency training including the granting of leaves, salary level implications, and impact on certification exam eligibility. Related documents: A number of important documents govern leaves and their impact on certification exam eligibility. This guideline is not intended to supersede these documents, but will serve to assist Program Directors in their interpretation and application. PARO-CAHO Collective Agreement. The PARO-CAHO agreement outlines the employment relationship between residents and the Ontario teaching hospitals. This agreement establishes entitlements relating to pregnancy and parental leaves, sick leave, vacation, and professional leave. This agreement can be obtained at www.PARO.org Council of Ontario Faculties of Medicine (COFM) Leaves from Ontario Postgraduate Residency Programs, May 2007. The COFM leaves policy provides direction on a number of issues including return to the program after training and granting of unpaid leaves. This policy can be obtained at http://www.pgme.utoronto.ca/policies/absence.htm Royal College of Physicians and Surgeons of Canada (RCPSC) and the College des medecins du Quebec (CMQ) Joint Policy on Waiver of Training After a Leave of Absence from Residency. The policy, outlined in the RCPSC Policy and Procedures for Certification and Fellowship states that: “residents must successfully complete all training requirements of their program, including duration of training, normally in sequence, and competence as assessed by the university. The university will set policy for the circumstances that would qualify residents for leaves of absence. Acting on university policy, the Postgraduate Dean, on the recommendation of the residents’ Postgraduate Program Director, may grant interruptions in training. It is anticipated that the time lost or rotations missed would be made up with equivalent time in the residency program upon the resident’s return.” This policy can be reviewed at Section 4.3.2 at the following weblink: http://rcpsc.medical.org/residency/certification/policy-procedures_e.pdf The College of Family Physicians of Canada (CFPC) states that Family Medicine residents must complete 24 months of training to be eligible for the Family Medicine certification exam. Waivers of training of 4 weeks may be granted at the discretion of the Program Director. This and other eligibility requirements can be reviewed at: http://www.cfpc.ca/English/cfpc/education/examinations/family%20medicine/default.asp?s=1#resident 2. DEFINITIONS: A leave of absence is defined as an approved interruption of training for any reason. Leaves may be taken for a variety of reasons, but are generally categorized into leaves with pay and leaves without pay. In all cases, the Program Director, in discussion with the returning resident, should determine:

• the training level to which the resident will return following the leave; and


!

38 !

• the necessary educational experiences required for the resident to complete the residency requirements and goals and objectives of the training program.

Unless required by the Program Director or for purposes of the Record of Employment, leaves of one week or less are not required to be submitted to the central Postgraduate Medical Education Office. Paid Leave a) Pregnancy and Parental Leave: Entitlement to pregnancy and parental leave is addressed in Section 15 of the PARO-CAHO Agreement. b) Medical/Sick Leave: Residents are entitled to 6 months of paid sick leave. Further details on Long Term Disability and other entitlements regarding illness or injury are addressed in Section 14 of the PARO-CAHO Agreement. c) Professional Leave: The PARO-CAHO Agreement describes Professional Leave as 7 days per year in Section 12, as well as time to take Canadian or American certification examinations. This time will not be considered to be a leave for the purposes of this guideline or reporting to the College of Physicians and Surgeons of Ontario (CPSO), or granting of waivers of training. d) Vacation: Residents are entitled to 4 weeks of paid vacation per year. There is no adjustment to vacation entitlement for residents who take pregnancy leave or parental leave e.g. the resident who has taken a one-year pregnancy and parental leave will return with 4 weeks of vacation entitlement. The 4 weeks vacation time must be taken within the academic session and cannot be rolled over or “stockpiled” to the next year, or counted towards waived training time. In addition, vacation time should not be carried over when the resident enters a sub-specialty program. Hospitals may not restrict the amount of vacation a resident can take in a rotation, but do have the right to delay a vacation request with regard to professional and patient care responsibilities. e) Emergency, Family, Bereavement Leave A resident may request a leave due to a death in the immediate family or a person with whom the resident had a close relationship. A leave may also be requested due to family illness, injury, medical emergency, or other urgent family matters to which the resident must attend. Five consecutive working days may be granted by the Program Director for this paid leave. This guideline should be interpreted with proper sensitivity.1 Unpaid leave a) Educational Leave: A resident may request an unpaid educational leave on the basis that the time away from the residency program is relevant to his/her current program. This must have the support of the resident’s Program Director, and the approval of the Postgraduate Dean or designate. The maximum educational leave period is usually one year. Leaves beyond one year will be assessed by the Residency Program Committee, Program Director and the Postgraduate Dean or designate. b) Personal/Compassionate Leave A resident may request an unpaid leave of absence due to a personal situation or career uncertainty. These leaves will be considered on an individual basis by the Program Director in consultation with the Postgraduate Dean or designate. The maximum leave period in this category is normally 6 months.2 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1!see!Employment!Standards!Act,!2000.!Section!XIV!refers!to!unpaid!leaves!of!absence!entitlement!at!http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_00e41_e.htm#BK68!.!Also,!see!Canadian!Labour!Code,!Section!200,!reference!to!3!consecutive!days!of!paid!bereavement!leave!for!federal!employees!http://laws.justice.gc.ca/en/L-2/!!2!from!the!Council!of!Ontario!Faculties!of!Medicine!(COFM)!document,!Leaves&from&Ontario&Postgraduate&Residency&Programs,&May&2007.!See!section!on!Compassionate!Leave.!


!

39 !

3. SALARY CLASSIFICATION: Residents will normally advance to the next pay level at the successful completion of 12 months of training. Residents who have taken a leave of absence of more than one month during the training year, will proceed to the next level only at the discretion of the Program Director. Factors to be considered in promotion to the next level will include the resident’s full completion of the goals and objectives of the training year as measured by ITERs, and all other evaluation tools such as in-training exams, case logs, and completion of academic projects. Program Directors may also decide to re-appoint residents to the next pay level at the beginning of an academic session to allow them to stay with their cohort, and require them to make up the leave in their final year of training. 4. RETURN TO TRAINING: Residents returning after medical leave will provide a written medical certificate from their treating physician indicating the resident’s capability and fitness to return to the program. The Program Director or the Postgraduate Dean or designate may wish to request an additional independent medical opinion to ensure the resident’s capability to resume his/her residency program, or the case may be referred to the Faculty of Medicine’s Board of Medical Assessors. Residents returning to training after a prolonged absence may need to return to an earlier level of training and/or require a modified educational program. For specialty residents, no assurance can be given that all training taken prior to the interruption will still be acceptable, even though previously recognized by the RCPSC.3 In order to decide on the appropriate training level and program structure, residents will be assigned a 4-12 week period of assessment, similar to the Assessment Verification Program (AVP), structured and organized by the Program Director in consultation with the Residency Program Committee and educational programming resources. The Program Director, in consultation with the Residency Program Committee, will review the results of the assessment program and submit a recommendation to the Postgraduate Dean regarding the resident’s re-entry to training. If approved, the Program Director will discuss with the resident the modified program structure, training level, the evaluation process, and expected outcomes. In exceptional circumstances, it may not be appropriate for a resident to return to the program. The Postgraduate Dean will communicate with the resident when a Program Director and Residency Program Committee decide against a resident’s re-entry to the training program. Appeals of this decision will follow the normal Faculty and University Appeals process. 5. WAIVER OF TRAINING Both the RCPSC and CFPC state that residents must complete all of a program’s training requirements including duration and competence. However, the University is free to set policies regarding granting leaves of absence and the criteria by which waivers of training time (if any) may be granted. To meet the CFPC certification exam eligibility requirements, Family Medicine residents must make up any leaves of absence to ensure the full duration of 24 months training is completed. Waivers of training may be granted in certain circumstances to a maximum of 4 weeks during the 2-year program, as determined by the Program Director and approved by the Postgraduate Dean. The CFPC must be notified of the waiver prior to submission of the completion of training notice to the College. Where a resident in a RCPSC program will have achieved the required level of competence by the end of the final year of training, a waiver of 4-12 weeks may be granted at the Program Director’s discretion, referring to the maximum allowable time for waivers outlined in section 4.3.2 in the RCPSC Policies and Procedures for Certification and Fellowship.

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!3!RCPSC!Policy!and!Procedures!for!Certification!and!Fellowship,!October!2008.!See!Section!4.2.1.!!


!

40 !

In Internal Medicine and Paediatrics, where residents are undertaking 3 core years and 2 subspecialty years, a maximum of 6 weeks may be waived in the first three core years and a maximum of 6 weeks in the final two subspecialty years. The first 3 core years are to be treated separately for the purpose of considering a training waiver. All core requirements are to be completed before a resident will be released to pursue his/her subspecialty-training program. Completion of training includes not only meeting all specialty training requirements of the RCPSC, but also all of the program’s required rotations and items such as in-training examinations, research and/or quality improvement projects, case logs, portfolios and other assessments. Each program is expected to establish the criteria by which they will allow waivers. Such criteria should be made available to residents, preferably on the program’s portal or website. To reconcile the need for residents who must make up leave time and the annual exam schedule, the RCPSC allows residents to write the Spring exam and complete their residency training requirements by December 31 of that year, or February 28th for the Fall exams. 6. REPORTING: The Postgraduate Medical Education Office will notify the College of Physicians and Surgeons of Ontario (CPSO) of all interruptions in training greater than one week, as reported by the Program Director. Residents must be aware of their professional obligations to report leaves to the CPSO when applying for or renewing licenses. Failure to disclose leaves from the training program may result in delays in license renewal as a result of investigation and/or disciplinary action. 2 from the Council of Ontario Faculties of Medicine (COFM) document, Leaves from Ontario Postgraduate Residency Programs, May 2007. See section on Compassionate Leave. 3 RCPSC Policy and Procedures for Certification and Fellowship, October 2008. See Section 4.2.1.

MOONLIGHTING POLICY Two Moonlighting Policies are listed at PGME website site (http://www.pgme.utoronto.ca/Assets/PGME+Digital+Assets/policies/rcpsp+moonlighting.pdf) One was issued by the Royal College of Physicians and Surgeons of Canada, and the second was issued by the Council of Ontario Faculties of Medicine (COFM). Both policies are listed below : The Royal College of Physicians and Surgeons of Canada Moonlighting Policy The Royal College of Physicians and Surgeons of Canada defines moonlighting as the independent practice of medicine during residency training in situations that are not part of required training in the residency program. The RCPSC neither condemns nor condones the practice of moonlighting during residency training. However, if moonlighting does occur, the following principles should be considered: 1. Moonlighting must not be coercive. Residents must not be required by their residency program to engage in moonlighting. 2. The moonlighting workload must not interfere with the ability of the resident to achieve the educational goals and objectives of the residency program. All program directors have an obligation to monitor resident performance to assure that factors such as resident fatigue from any cause are not contributing to diminished learning or performance or detracting from patient safety. Program directors should bring to the attention of all residents any factors which appear to detrimentally affect the performance of the resident.


!

41 !

To facilitate this, it is advisable that the program director be informed when a resident chooses to moonlight. 3. If residents do moonlight, it should not occur on the same unit or service to which they are currently assigned as a resident. For example, a resident on an ICU rotation and taking call should not also cover the same ICU as a moonlighting physician on other days of the same rotation. This has been seen to lead to difficulties in lines of responsibility and resident evaluation. Confirmation of licensing, credentialing and appropriate liability coverage is the responsibility of the employer. Approved by Accreditation Committee - 10 January 2002 The Council of Ontario Faculties of Medicine Policy on Resident Moonlighting November 2004 Moonlighting is defined as: Residents registered in postgraduate medical education programs leading to certification with the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada who provide clinical services for remuneration outside of the residency program. Moonlighting has been more recently called “restricted registration for residents”. The Ontario Faculties of Medicine do not support resident moonlighting. Moonlighting compromises postgraduate programs and undermines the educational environment.

POSTGRADUATE MEDICINE POLICY ON ACADEMIC APPEALS University of Toronto Governing Council http://www.governingcouncil.utoronto.ca/policies/appeal.htm 1. Guiding Principles The implementation of all academic appeals within the University across all divisions should be informed by the following principles:

i. Diversity, Equity, and Accommodation: Consistent with the University’s commitment to diversity, equity and accommodation, and its accompanying institutional policies, every division should be sensitive to issues of diversity, equity, and accommodation in the academic appeals process.

ii. Consistency: The purpose of the Policy on Academic Appeals within Divisions is to formalize University wide principles to ensure effective procedures for the academic appeals process are in place within divisions. The Policy is designed to set minimum standards and consistent procedures across the University.

iii. Flexibility: While the Policy is intended to establish certain essential features of a division’s academic appeal system, it recognizes that divisional size and complexity of issues have a bearing on divisional needs in this regard.

iv. Transparency and Timeliness: The University ensures that information on procedures for academic appeals are well publicized, accurate, clearly presented, and readily accessible to students, instructors, and staff. Student academic appeals should be addressed in a timely manner, using appropriate, fair and transparent procedures.

v. Fairness and Confidentiality: Throughout the process, students should have the opportunity to raise matters of proper concern to them without fear of disadvantage and in the knowledge that privacy and confidentiality will be appropriately respected. Both formal and informal resolutions for academic appeals should be available to the student.

vi. Academic Standards and Regulations: The academic appeals process and principles should be applied in a manner that maintains academic standards and contributes to the University goal of academic excellence. Detailed information about the University of Toronto’s Academic Regulations and Requirements can be found in relevant University Policies regarding academic regulations and requirements such as the Grading Practices


!

42 !

Policy, as amended from time to time. 2. The Academic Appeal

i. An academic appeal is an appeal by a student of the University:

1. Against a University decision as to his or her success or failure in meeting an academic standard or other academic requirement of the University; or,

2. As to the applicability to his or her case of any academic regulation of the University; however, 3. No appeal lies from any admissions decision.

ii. The standard of review of an academic appeal is reasonableness.

3. Guidelines for Divisional Processes for Academic Appeals

i. Divisions should decide how best to implement this policy and what additional principles, structures and procedures, not inconsistent with the spirit of this policy, may be required.

ii. Divisional processes should be broadly communicated and available in print form and electronic form. iii. Divisional processes should offer opportunities for early resolutions and should provide informal lines of

communication throughout the process. Students should be encouraged to resort to these alternatives before launching formal appeals.

iv. Divisional processes should recommend informal mediation throughout the process and parties should be encouraged to consider the possibility of resolution throughout the process

v. Divisional processes should encourage a student’s confidential disclosure of appropriate information at the earliest possible stage particularly with respect to diversity, accommodation and other personal issues that may be relevant to the disposition of the appeal.

vi. Divisional processes should set timelines for administrative decision making and student response throughout the process. Timelines should include sufficient flexibility and discretion to accommodate the particular circumstances of the appeal and to avoid inappropriate prejudice to the student or to the University.

vii. Divisional processes should provide a mechanism for periodic internal review and a reporting mechanism for an annual report to the division’s governing body.

viii. Divisional processes should refer to the fact that throughout the process, students should have the opportunity to raise matters of proper concern to them without fear of disadvantage.

ix. Divisional processes should provide a clear mechanism for responding to academic appeals. Guidelines for divisional processes should delegate the authority to determine divisional appeals to a standing committee of reasonable size (“the divisional appeals committee”). This committee should report to the division’s governing body for information. This committee should include members of the teaching staff and student body. The selection process for student members should be done with a view toward diversity and transparency.

x. Divisional processes should provide that students commencing a divisional appeal do so by a written notice that states the nature and grounds of the appeal, and which includes copies of any documents relied upon in support of the appeal.

xi. Divisional processes should ensure that the student has the right to a hearing before the divisional appeals committee in person, with or without counsel or other advisor, and to call evidence and present argument in person or by counsel.

4. Right of Appeal to the Academic Appeals Committee of the Academic Board of Governing Council

i. Divisional processes should require that any student whose appeal has been denied must be advised of a further right of appeal of the decision of the divisional appeals committee to the Academic Appeals Committee of the Academic Board of Governing Council. The existence of this right of appeal should be clearly communicated, in writing, to students for whom the appeal was denied at the divisional level.

ii. The procedures for appeals to the Academic Appeals Committee are set out in the Committee’s Terms of Reference.


!

43 !

5. Implementation and Monitoring

i. So as to provide for the fair and effective disposition of academic appeals, every division of the University is required to maintain processes for academic appeals that are consistent with this Policy.

ii. The Office of the Provost will establish a framework for the divisional academic appeal processes which reflects best practices and incorporates the principles and minimum standards set out in this policy.

iii. The Office of the Provost is responsible for monitoring the implementation of divisional appeals processes that are in compliance with this Policy. The Office of the Provost is also responsible for facilitating a periodic review of divisional processes for consistency to the Policy, for facilitating effective communication of the Policy and divisional processes, and for conveying information to the divisions about suggested best practices.

iv. The Office of the Provost will undertake to ensure that information about divisional processes is communicated in technologically relevant, up-to-date and easily accessible ways.

Approved: December 2005 To request an official copy of this policy, contact: The Office of the Governing Council Room 106, Simcoe Hall 27 King’s College Circle University of Toronto Toronto, Ontario M5S 1A1 Phone: 416-978-6576 Fax: 416-978-8182 E-mail: [email protected] Website: http://www.governingcouncil.utoronto.ca


!

44 !

APPENDIX D: RESIDENT PROFILES PGY5

Name Winnie Siu Residency Level PGY5 Clinical Markham Stouffville Hospital Graduate MSc in Health Policy, Planning and Financing at the London School of

Hygiene and Tropical Medicine (2012/2013) Field CD (TPH, Elizabeth Rae), EH (PHO, Ray Copes), PPCD (Michael Rachlis) Electives Interests global health, health policy, writing (narrative medicine, medical editing) Contact information [email protected]

Name Natalie Bocking Residency Level PGY5 Clinical Credit Valley Hospital Graduate MIPH, University of Sydney, 2004 Field CD (TPH, Michael Finkelstein), EH (PHO, Ray Copes), PPCD (Michael

Rachlis), SMR (Peel Public Health, David Mowat) Electives Epi and Surveillance (PHO, Ian Johnson), Aboriginal Health (SLFNHA),

Child Health (PHO, Heather Manson) Interests Aboriginal health, global health, primary health care Contact information [email protected]

PGY4

Name Pamela Leece Residency Level PGY4 Clinical St. Joseph's Health Centre Graduate MSc - Health Research Methodology, McMaster University (2003-05) Field CD - TPH, Dr. Herveen Sachdeva; EH - PHO, Dr. Ray Copes; Policy -

University of Toronto, Dr. Michael Rachlis Electives Program Evaluation - TPH, Dr. Rita Shahin; Addictions (Clinical) – multiple

sites Interests addictions, inner city health, research Contact information [email protected]

Name Nick Brandon Residency Level PGY4 Clinical Southlake Regional Health Centre (Newmarket) Graduate MPH Uwaterloo 2012-3, MSc as of April 2013. Previous MA in Criticism

and Theory (English Lit) 2000-1, University of Exeter (UK) Field CD (TPH), EH (PHO, Ray Copes) Electives Inner city health 2010, ophthalmology 2011, Certificate in Global Health

Education Initiative Interests Environmental health, global health, culture and health, health equity,

medical education, public health history, public health information technology, research, travelling, ecology/ecosystem health, public health in popular culture


!

45 !

Contact information [email protected]

Name Rajesh Girdhari Residency Level PGY4 Clinical St. Michael’s Graduate MBA, Schulich School of Business, York University; Also am taking

courses through the on-line MPH at the University of Waterloo Field PPCD (Michael Rachlis) Electives N/A Interests Entrepreneurship and Public Health; International Development; Primary

Care and Public Health Cooperation; Drug Addiction Control and Treatment Contact information [email protected]

Name Alanna Fitzgerald-Husek Residency Level PGY4 Clinical St. Michael's Hospital Graduate MPH, Johns Hopkins Bloomberg School of Public Health, 2013-2014 Field PPCD (CPAC, Heather Bryant) Electives Tuberculosis clinic (PGY1, St. Michael's Hospital) Interests marginalized populations; global health; interface of public health and

primary care; medical education Contact information [email protected]

Name Diane Clapham Residency Level PGY4 Clinical Toronto Western Hospital Graduate MPH, University of Waterloo Field Intro to Public Health Rotation at Peel Public Health Electives Interests Tobacco Control, Mental Health, Social Justice, Poverty Contact information [email protected]

PGY3

Name Kate Reeve Residency Level PGY3 Clinical Royal Victoria Hospital - Barrie and Toronto Western Hospital Graduate MHSc - Health Promotion - Dalla Lana Public of School Health – 2006 Field EH (PHO, Ray Copes) Electives Interests Women's health, sexual health Contact information [email protected]

Name Fareen Karachiwalla Residency Level PGY3 Clinical St. Michael's Hospital Graduate Current:


!

46 !

MPH, Hopkins Field N/A Electives Clinical medicine - Moose Factory, ON - PGY-2; Clinical shelter medicine,

sexual health clinics, HIV primary care clinics - PGY-2 Interests Equity, Social Determinants of Health, Addictions/complex mental health in

primary care Contact information [email protected]

Name Aamir Bharmal Residency Level PGY3 Clinical Graduate Current:

MPH, Hopkins Field N/A Electives Interests Equity, Social Determinants of Health, Addictions/complex mental health in

primary care Contact information [email protected]

Name Elizabeth Birk-Urovitz Residency Level PGY3 Clinical Sunnybrook Graduate Field N/A Electives Clerkship and PGY electives: Toronto Public Health (Dr. Vinita Dubey),

Public Health Ontario (Drs. Ian Johnson and Brian Schwartz); Research elective at Mt Sinai Hospital (Dr. Warren McIsaac)

Interests PHPM specific: Emergency Management, Communicable Diseases, Policy; Others: music, athletics, gaming, travelling, volunteering


Name Jia Hu Residency Level PGY3 Clinical St. Michael's Hospital Graduate Current:

Health Policy, Planning and Financing Program, London School of Hygiene and Tropical Medicine

Field Electives WHO internship in HIV/AIDS (before medical school) Interests Global health, health economics and policy, development economics, refugee

health, jogging, science fiction Contact information [email protected]

Name Jennifer Loo Residency Level PGY3 Clinical St Michael's Hospital Graduate Current:

MSc Public Health, London School of Hygiene and Tropical Medicine Field


!

47 !

Electives Medical student electives: Environmental Health, Public Health Ontario; Intro to Public Health, Peel Public Health

Interests environment and health, active transportation, the built environment, population health in medical education

Contact information [email protected] Name Jasmine Pawa Residency Level PGY3 Clinical St. Michael's Hospital Graduate Current:

Health Policy, Planning and Financing Program, London School of Hygiene and Tropical Medicine

Field Electives Interests health policy Contact information [email protected] Name Jennifer Cram Residency Level PGY3 Clinical Nova Scotia Graduate Current:

MPH, University of Alberta Field Electives Interests Contact information [email protected] PGY2 Name David Edward-Ooi Poon Residency Level PGY2 Clinical Toronto Western Hospital Graduate Field Electives Kenya Ceramic Project - Kiminini, Kenya - University of Alberta.

Traditional Chinese Medicine - Shantou, China - University of Shantou. Occupational and Environmental Medicine - Edmonton, Alberta - University of Alberta. Public Health/Environmental Medicine - Toronto, Ontario - University of Toronto. SHINE Student Run Inner City Health Clinic - Edmonton, Alberta - University of Alberta

Interests Environmental Medicine - I believe the next health care crisis will be an environmental one. Health care resource management. Teaching youth about resource use, global health, industry. Food production. Stand up comedy. Nerd culture and video games (although they are the same things!)

Contact information [email protected] Name Alex Summers Residency Level PGY2 Clinical St. Michael's Hospital Graduate Field Electives


!

48 !

Interests Health systems, active transportation, early childhood development, and analytics

Contact information [email protected] Name Genevieve Cadieux Residency Level PGY2 Clinical Women's College Hospital Graduate MSc (2004) and PhD (2011) in epidemiology, McGill University Field Electives During medical school: PHPM at Public Health Ontario (Dr Ian Johnson,

Colin Lee and Liane McDonald), PHPM at Vancouver Coastal Health Authority (Dr Meena Dawar), PHPM at Ottawa Public Health (Dr Carolyn Pim), infectious diseases at Sunnybrook Hospital (Dr Anita Rachlis), HIV/AIDS ward at St Paul's Hospital (Dr Mark Hull)

Interests Communicable diseases; surveillance; outbreak investigation and response Contact information [email protected] PGY1 Name Karalyn Dueck Residency Level PGY1 Clinical St. Michael’s Hospital Graduate Master of Public Health, University of Waterloo (2009-2011) Field Electives Interests Tobacco control, prevention, and cessation; Built environment and health;

Healthy public policy development; Prenatal and maternal health promotion Contact information [email protected] Name Kathryn Marsilio Residency Level PGY1 Clinical Markham-Stouffvile Graduate MPH, University of Guelph (1.5yrs) Field Electives Interests Mental Health, Aboriginal Health, Environmental Health Contact information [email protected] Name Mike Benusic Residency Level PGY1 Clinical St. Michael’s Hospital Graduate Field Electives Interests Professional: environmental health (industrial exposures, climate change),

health policy & economics, built environment, refugee & immigrant health, harm reduction, tropical medicine, MBSR. Personal: cycling (commuting, touring, rebuilding), bird-watching, hiking & camping, ultimate frisbee, veggie cooking.



!

49 !

APPENDIX E: PROGRAM GRADUATES !Parisa Airia – 2014 Graduate Clinical CVH Graduate PhD, UofT Field Halton, Peel Electives Research Interests Cancer epi Contact information [email protected] Christine Navarro – 2014 Graduate Clinical St. Michael's Hospital Graduate MSc Epidemiology, University of Ottawa, 2001 Field Communicable Diseases (TPH, Vinita Dubey), Environmental Health

(TPH, Howard Shapiro), Chronic Diseases & Health Promotion (PHO, Heather Manson), Elective in Environmental Health (PHO, Ray Copes), Senior Management (Peel Region)

Electives Interests Contact information [email protected] Aaron Orkin – 2014 Graduate Clinical NOSM - Thunder Bay, Sioux Lookout, Marathon Ontario Graduate MSc, History of Medicine, Science and Technology, University of Oxford,

2010. MPH, Epidemiology, University of Toronto, 2013. Field HPAPCD: Dalla Lana School of Public Health, Supervisor Dr. Donald

Cole. CD: Toronto Public Health, Supervisor Dr. Lisa Berger. Enviro Health: Public Health Ontario, Supervisor Dr. Ray Copes. Senior Management: Toronto Public Health, Supervisor Dr. Barbara Yaffe

Electives Interests Medical and public health epistemology, rural and remote health, health

equity, disease mongering, emergency medicine/family medicine/public health interfaces, advocacy, cooking, bicycles, golden doodles.

Contact information [email protected] Nikhil Rajaram – 2014 Graduate Clinical St. Joseph's Health Centre Graduate MPH (Epidemiology), University of Toronto, 2011-2012 Field Intro to Public Health ( EH - public health ontario, Ray Copes), EH

(Toronto Public Health, Howard Shapiro), CDC (Toronto Public Health, Vinita Dubey), PPCD (Public Health Agency of Canada, Karen Grimsrud), SMR (Simcoe Muskoka DHU, Charles Gardner)

Electives Interests environmental health, other stuff perhaps Contact information [email protected]


!

50 !

JinHee Kim – 2013 Graduate Clinical St. Joseph's Health Centre Graduate Toronto Field Peel (CDC, SM), PHO (EH), Dr. Michael Rachlis (PPCD) Electives PHO (EH), PHAC (Canadian Field Epi Affiliate), ICES (research) Interests Environmental health, urban form and health, CDC Contact information [email protected] Shovita Padhi – 2013 Graduate Clinical St. Michael's Hospital Graduate MPH - University of Toronto, 2011 Field Toronto Public Health - Environmental Health, Communicable Disease,

Chronic Disease, Policy and Planning and Senior Management Electives Public Health Ontario - Emergency Management, Vaccine Preventable

Diseases, Environmental Health; Gov't of the Northwest Territories - Elective; Saskatoon Health Region - Senior Management Elective; National Collaborating Centre for Methods and Tools - Knowledge Translation Elective

Interests Early Childhood Development, Built Environment, Chronic Disease Prevention, Aboriginal Health, Newcomer Health

Contact information [email protected] Michael Schwandt – 2013 Graduate Clinical Women's College Hospital Graduate MPH, Harvard School of Public Health Field Public Health Ontario (Environmental Health, Chronic Disease, Senior

Management), Toronto Public Health (Communicable Disease) Electives Dignitas International (Malawi), Clinton Health Access Initiative

(Rwanda), various research projects Interests Global health, social determinants of health, health equity, HIV prevention,

sexual and reproductive health, epidemiology, research methodology Contact information [email protected] Ryan Sommers – 2012 Graduate Clinical Training: Dalhousie Medical School, Family Medicine, Northumberland Family Medicine Training

Unit (2006 – 2008) Graduate Training: Community Health, Dalhousie University (2000 – 2002

Field Based Rotations: CD – Capital District Health Authority, Halifax, NS, Health Policy & Chronic Disease - Capital District Health Authority, Halifax, NS, Environmental Health – Simcoe Muskoka District Health Unit, Barrie, Ontario

Electives: National Collaborating Centre for the Determinants of Health (NCCDH) – Antigonish, NS, Canadian Centre for Vaccinology – Halifax, NS

Interests: Chronic Disease Prevention, Integration of Primary Care and Public Health, Health Education / Health Promotion, Policy Analysis,

Contact: [email protected]


!

51 !

Liane Macdonald - 2012 Graduate Clinical Training: Core: Hamilton Health Sciences Centre, St Joseph's Hospital (Hamilton), Hamilton

General Hospital; Elective: Toronto Western Hospital (TB Clinic), Lawrence Heights CHC, Centre Francophone CHC, Mount Sinai Hospital Medical Microbiology

Graduate Training: London School of Hygiene and Tropical Medicine Field Based Rotations: CDC (Toronto Public Health), Environmental Health (TPH), Policy, Planning and

Chronic Diseases (Cancer Care Ontario), Senior Management and Administration (TPH)

Electives: First Nations and Inuit Health (First Nations and Inuit Health - Ontario Region / University of Toronto); Academic (LSHTM); Surveillance/VPD (Upcoming at OAHPP); Canadian Field Epidemiology Program Community Medicine Affiliate position (Upcoming)

Interests: Lots!!, including but certainly not limited to public health policy, vaccine-preventable diseases, globalization and public health


Clarence Clottey – 2012 Graduate Clinical Training: CCFP (Family Medicine) St. Michael’s Hospital Graduate Training: MPH (International Health), Harvard School of Public Health Field Based Rotations: CD -- Halton Health Region; EH - Halton Health Region, Planning and Policy –

OAHPP; Senior Management –MOHLTC Electives: Occupational Medicine (St. Michael's Hospital- Dr. Ron House) Interests: Chronic disease policy, global health, evidence-based public health, health

promotion, smoking control Contact: [email protected]

Lawrence Loh – 2012 Graduate CLINICAL TRAINING: St. Michael's Hospital (2006 – 2008)

GRADUATE TRAINING: MPH, Johns Hopkins Bloomberg SPH (2009 – 2010)

FIELD BASED ROTATIONS: Environmental Health (Ray Copes, OAHPP), Communicable Disease (Irene Armstrong, TPH), Policy, Planning and Chronic Disease (Rachel Rodin, PHAC), Senior Management (David Mowat, Peel Region), Research (Eileen de Villa, Peel and Bart Harvey, UoT) Scheduled: Senior Management (David Mowat, Peel)

ELECTIVES: China (PGY-1, FM) and Costa Rica (PGY-1, FM/PH) Pan-American Health Organisation, Health System Strengthening unit (May 2009) World Health Organisation Human Resources for Health Unit (Mar-May 2011) Foundation for the Advancement of Medical Education and Research (FAIMER, Jun 2011), New York City Department of Health and Mental Hygiene, Built Environment Unit

INTERESTS: Professional: global health, particularly human resources for health (training/education, global health careers, and health care worker retention and migration), coordination of care abroad, emergency preparedness, urban health, clinical medicine Personal: music (guitar and piano), drama, writing, running, history, geography, religions/philosophy, travelling and world affairs, politics, networking

CONTACT: [email protected] / [email protected]


!

52 !

Hamidah Meghani – 2012 Graduate Clinical Training: St. Michael’s Hospital

Graduate Training: Columbia University Mailman School of Public Health (NYC)

Field Based Rotations: CD/EH - Halton Public Health, CDPP/EH - NYC Department of Health

Electives: None yet

Interests: Sexual and Reproductive Health, HPV vaccine acceptability


Michelle Murti - 2012 Graduate Clinical Training: Women's College Hospital

Graduate Training: MPH at Uof Toronto

Field Based Rotations: EH - TPH with Dr. Shapiro; CD - TPH with Dr., PnP = Public Health Ontario, Senior Management – Toronto Public Health, Sachdeva (both of these done as a practicum placement during the MPH);

Electives: NWT with their CMOH; alPHa with Linda Steward/Dr. Sutcliffe; EH at the OAHPP

Interests: Environmental health, integration of PH and primary care, Going to CDC for EIS fellowship in Environmental Health


Donatus Mutasingwa – 2012 Graduate CLINICAL TRAINING: Family Medicine at Sunnybrook Hospital 2008-2010

GRADUATE TRAINING: Masters of Philosophy (Health Promotion) -University of Bergen, Norway PHD-UNIVERSITY OF CALGARY (EPIDEMIOLOGY)

FIELD BASED ROTATIONS: ENVIRONMENTAL HEALTH (PUBLIC HEALTH ONTARIO), COMMUNICABLE DISEASE (TPH), POLICY, PLANNING AND CHRONIC DISEASE (PUBLIC HEALTH ONTARIO), STARTING SENIOR MANAGEMENT (DURHAM REGION)

ELECTIVES: (PLANNED) ICES

INTERESTS: ABORIGINAL HEALTH, GLOBAL HEALTH, USING LARGE ADMINISTRATIVE DATABASES FOR VARIOUS PUBLIC HEALTH PURPOSES, DEVELOPMENT OF BUSINESS INTELLIGENCE TOOLS FOR HEALTH ASSESSMENT AND SURVEILLANCE Other: Worked as an Epidemiologist with Health Canada (First Nations and Inuit Health, Alberta Region), 2006-2008 , Also worked as Medical Incharge in Refugee Camps in Kigoma, Tanzania, Born in Tanzania, Married, has two lovely girls

CONTACT: [email protected]

Peter Tanuspetro – 2012 Graduate Clinical Training: St. Michael’s Hospital Graduate Training: MHSc Community Health and Epidemiology, University of Toronto


!

53 !

Field Based Rotations: CD - Simcoe Muskoka District Health Unit, EH – OAHPP, Senior, Management – SMDHU, Policy - OAHPP

Electives: Interests: Health services research, health of refugees and immigrants, mental health research Contact: [email protected]

Fiona Kouyoumdjian – 2011 Graduate CLINICAL TRAINING: FAMILY MEDICINE, TORONTO WESTERN HOSPITAL

GRADUATE TRAINING: JOHN HOPKINS FOR MPH DURING MEDICAL SCHOOL FROM 2002 – 2003, THEN DALLA LANA SCHOOL FOR PUBLIC HEALTH FOR PHD IN EPIDEMIOLOGY STARTING IN 2007

FIELD BASED ROTATIONS: HALTON PUBLIC HEALTH FOR INTRO TO PUBLIC HEALTH UNIT, PEEL PUBLIC HEALTH FOR CD, BALTIMORE HEALTH DEPARTMENT FOR POLICY, FIRST NATIONS INUIT HEALTH FOR ENVIRONMENTAL HEALTH, HAMILTON PUBLIC HEALTH FOR SENIOR MANAGEMENT

ELECTIVES: ONTARIO AGENCY FOR HEALTH PROTECTION AND PROMOTION WITH MICHAEL GARDAM WITH A FOCUS ON TB

INTERESTS: COMMUNICABLE DISEASES IN MARGINALIZED POPULATIONS, INCARCERATED PERSONS, VIOLENCE, GLOBAL HEALTH


Hong Ge – 2011 Graduate Clinical Training: Sunnybrook 2008-2010 Graduate Training: MHSc of Community Health and Epidemiology, UofT, 2000-2002 Field Based Rotations: CDC, Toronto Public Health, Dr. Irene Armstrong

Healthy Environment, Toronto Public Health, Dr. Howard Shapiro Planning and Policy, Toronto Public Health, Dr. Rosana Pellizzari Senior management: Durham Region Health Department, Dr. Robert Kyle

Electives: Research, ICES, Dr. Jeff Kwong, Durham Region Health Department, Dr. Robert Kyle Family medicine, Davenport Perth Community Health Care Centre

Interests: Professional: epidemiology, international health, information technology, public health practice in local public health units Personal: spending time with twin children and family



!

54 !

Andrew Pinto – 2011 Graduate Clinical Training: St. Michael’s Hospital Graduate Training: MSc (Health Policy, Planning & Financing) at London School of Hygiene and

Tropical Medicine and London School of Economics Field Based Rotations: CDC (TPH), HP/CD (OAHPP), Environmental health (OAHPP), Senior

Management (Peel Public Health) Electives: Research on gun violence (El Salvador); Policy/Planning (Zomba, Malawi)

Interests: global health, health equity, Aboriginal health, peace activism, political economy, ethics, food security

Interests: Research on gun violence (El Salvador); Policy/Planning (Zomba, Malawi) Interests: global health, health equity, Aboriginal health, peace activism, political economy, ethics, food security


Lynda Earle – 2011 Graduate CLINICAL TRAINING: FAMILY MEDICINE NORTH: NWO (THUNDER BAY), MCMASTER UNIVERSITY

GRADUATE TRAINING: MPH, UNIVERSITY OF WATERLOO

FIELD BASED ROTATIONS: Policy: Capital Public Health, Nova Scotia, Dr. Watson-Creed Environmental Health: Sudbury & District Health Unit, Dr. Sutcliffe CDC: Capital Public Health, Nova Scotia, Dr. Watson-Creed MANAGEMENT & ADMINISTRATION: PUBLIC HEALTH SERVICES:SOUTH SHORE, ANNAPOLIS VALLEY AND SOUTHWEST DISTRICT HEALTH AUTHORITIES, NOVA SCOTIA, DR. GOULD

ELECTIVES: NATIONAL COLLABORATING CENTRE FOR DETERMINANTS OF HEALTH, CHRONIC DISEASE & INJURY: (ALCOHOL INDICATORS): DR. WATSON-CREED, CAPITAL DHA, NS

INTERESTS: Professional: health disparities and social justice PERSONAL: MY CHILDREN AND FAMILY, READING, SAILING, COOKING AND SPENDING TIME WITH FRIENDS


!

Monica Hau – 2011 Graduate Clinical Training: St. Michael’s Hospital Graduate Training: MSc Public Health, London School of Hygiene and Tropical Medicine Field Based Rotations: Environmental Health, Toronto Public Health; Chronic Disease, Planning and

Policy, Cancer Care Ontario; CDC, Peel Public Health Electives: (Medical Student), Public Health Agency of Canada-Centre for Chronic Diseases

and Prevention Control- Dr. Gregory Taylor, MSc summer project in Gulu, northern Uganda on gender-based violence

Interests: public health education, medical student recruitment into Community Medicine, Global health, homelessness, Aboriginal and Inuit health, gender-based violence


Documents

PHPM Orientation Manual 2014-2015 finalphpm.pgme.utoronto.ca/.../09/PHPM-Orientation-Manual-2014-2015-f… · This program orientation manual, like the residency program, is always