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Urgent Advice for PGME Trainees

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What is the “PGME Urgent Advice Button”? It’s intended as a quick reference for postgraduate medical trainees at the University of Toronto who find themselves in an urgent situations of various kinds (the major scenarios are listed below).

 

Note: The Urgent Advice Button provides information and links to resources, but does not connect you directly to assistance.

 

For advice, choose the description below that best fits your situation:

Personal crisis

There may be a time in your residency when your personal or professional circumstances and responsibilities, or the combination of the two, overwhelm your ability to manage everything on your own. At these times, please remember that you are not alone. There are many people who can help you get through and possibly in the process enhance your coping skills to prevent or minimize issues from reaching the tipping point in the future.

How to Access Help

If this is an emergency please go directly to the nearest emergency department to you as all are equipped to manage psychiatric emergencies. A list of crisis services available in Toronto is available on the Canadian Mental Health Association website.

During daytime working hours:

Office of Resident Wellness, PGME

The Office of Resident Wellness offers free, confidential, short-term counseling and referral services to currently training Residents and Fellows. Appointments and information can be gained by contacting the Wellness Coordinator, Diana Nuss: pgwellness@utoronto.ca or 416-946-3074.

The office offers two resources:

Dr. Julie Maggi, Director of Resident Wellness
(Available Tuesdays and Wednesdays):
Dr. Maggi

offers assistance with transfers, accommodation, remediation planning, career uncertainty, leave of absence and return to work planning, and research assistance and guidance.

 

Chris Trevelyan, Counselling/Psychotheraphy & Education
(Available Monday – Friday. Please contact the office for available times):
I have worked as a counselor/psychotherapist in a variety of settings with a wide range of people, diverse in identity and presenting concerns. I aim to facilitate a process of self-reflection and skill-building for trainees so that they feel better able to navigate and overcome whatever challenges they are facing. I incorporate a number of therapeutic approaches into my work, tailoring these to the individual or couple, including cognitive and behavioural perspectives, relational psychotherapy, and mindfulness.

The OMA Physician Health Program

1-800-851-6606
Visit the Physician Health Program website.

A confidential service providing assistance on issues, such as stress, burnout, mental health, and substance use issues, to both physicians and their families. They offer expedited referrals to third party providers with expertise in physician health.

 

Your family physician’s office

Most family physician offer same day or urgent care services. Please contact your physician’s office for availability

 

After Hours:

PARO Distress Helpline

24-Hour Hotline: 1-866-HELP-DOC (1-866-435-7362).
Visit the PARO website.

The PARO 24 Hour Helpline is available to residents, their partners and family members, as well as medical students.

 

ePhysician Health

ePhysicianHealth.com is the world’s first comprehensive, online physician health and wellness resource designed to help physicians and physicians-in-training become resilient in their professional and personal lives.

Your safety in clinical teaching sites affiliated with the Faculty of Medicine at the University of Toronto is a priority of both the University and the health care facilities in which you learn and work. Because residents have the dual status of being learners at the University of Toronto and employees of the affiliated sites, it is important that you are aware of, and adhere to, the relevant health and safety policies and procedures of your hospital/ training site. In turn, the teaching sites must follow the requirements of the PARO-CAHO collective agreement, unless specifically exempted.

 

In considering your health and safety, we include:

General resources for health and safety

  • PGME Health and Safety Guidelines
  • The safety policy of your specific training program. This is an accreditation standard and all programs have one or make reference to one.
  • The Occupational Health and Safety policies and procedures of the site where you are training
  • How to contact your training site’s Occupational Health Office
  • The PARO contract

Please see the PGME Health and Safety Guidelines and the Protocol for Workplace Exposure/Injury.

 

Please also see the ‘I am concerned about my safety at work’ section for further information.

The University of Toronto, Faculty of Medicine, places the utmost importance on the safety and well-being of its trainees and their right to learn in an environment of professionalism, collegiality, and respect. The following documents serve as reference material for addressing issues of intimidation, harassment and unprofessional or disruptive behaviour in the postgraduate medical education environment.

 

We encourage trainees to report incidents of mistreatment to any of the Education Leads identified in the protocol which includes a Program Director, site director, site VP/Director, Education, the Director, Resident Wellness, the Vice Dean or the Associate Dean Equity and Professionalism.

 

If at any time you are uncertain as to what your options are or require guidance in the process, please contact your program’s wellness lead/advisor if available or the Office of Resident Wellness at pgwellness@utoronto.ca or 416 946-3074.

Please see the Guidelines for Residency Leaves of Absence and Training Waivers for details.

 

For guidance on taking a leave of absence, appointments to speak with Dr. Julie Maggi, Director of Resident Wellness can be made through the Wellness Coordinator, Diana Nuss, at pgwellness@utoronto.ca or 416-946-3074.

Some residents have, or develop during their training, health conditions that potentially impact their ability to participate or perform in their training program. Certain situations may require programs to assess and determine whether short or long term accommodations are advisable or feasible to allow the resident to complete their training.  Notwithstanding that each situation is unique, please refer the following documents for PGME’s general principles on accommodation and procedures to address the accommodation of residents with special training needs:

  • PGME’s Statement of General Principles on Accommodation
  • Process to Address Accommodation of Residents With Special Training Needs
  • Information on the Board of Medical Assessors

 

For further advice on accommodation, appointments to speak with Dr. Julie Maggi, Director of Resident Wellness can be made through the Wellness Coordinator, Diana Nuss, at pgwellness@utoronto.ca or 416-946-3074.

The Office of Resident Wellness is unable to maintain a referral service for primary care practitioners but recommend the following:

For postgraduate trainees with OHIP

Health Care Connect is a Ministry of Health and Long-Term Care (MOHLTC) program which helps Ontarians without a family health care provider find one. Anyone without a family health care provider is referred to a family doctor or a nurse practitioner who is accepting new patients in their community.  The registrant must have a valid OHIP card and not presently have a Family Physician. To register for the Health Care Connect program or to find out more information on how they can assist you and your family find a physician, call 1-800-445-1822. Further information about the program as well as information on how to sign up for the service online, visit the MOHLTC website.

 

Some Family Medicine Units at the teaching hospitals are able to accept Pg trainees as patients. Contact the Unit at your site, or one close to where you live to inquire as to whether they are able to accept you.

 

Occasionally we get the name of a practice or physician accepting new patients. These fill quickly and don’t come along that often but you can try contacting Diana at pgwellness@utoronto.ca and she will pass on any names that become available.

For international trainees with UHIP*

*The University Health Insurance Plan (UHIP) is a mandatory insurance plan that provides basic coverage for most medically necessary services and supplies while you and your accompanying family members are in the three month waiting period for OHIP. With the exception of a few designated sites which take UHIP up front, most sites (including family physicians) treat UHIP like most insurance plans meaning you will likely be required to pay the cost of your medical care and then apply to UHIP for reimbursement. It can be difficult finding a regular primary care doctor in Toronto prior to getting OHIP and being able to access Healthcareconnect so we recommend the following:

 

Please ensure you have seen your primary physician prior to your departure to Toronto and ensure:

  • Your immunizations including those required for practice are up to date
  • Your children’s immunizations including those required for school are up to date.
  • You have a 3 month supply of medications that you require for any chronic condition

Some Family Medicine Units at the teaching hospitals are able to accept Pg trainees as patients. Contact the Unit at your site, or one close to where you live to enquire as to whether they are able to accept you.

 

If you need emergency treatment, go to any emergency department and you will receive care.

 

If you need urgent treatment and do not yet have a family physician, you can access urgent care centres and walk in medical clinics and be reimbursed by OHIP.

 

You should apply for your OHIP card as soon as your arrival to Toronto. The eligible start date of your OHIP card will be dated at exactly 3 months after you arrival date. Once you have your OHIP card, you can find a family physician through Health Care Connect.

 

If you find a doctor accepting new patients, or are a graduating family medicine resident, please be sure to let us know at the Office of Resident Wellness to expand our roster!

If you are considering transfer to another program or university, please know that the University of Toronto policy differs slightly from the rest of the other Ontario universities so we encourage you to review them both (link). While acceptance rates can vary among programs and sites, it is important to understand that the likelihood of success of transfer for all U of T residents is quite low, averaging somewhere around 25% and is limited primarily by the capacity of programs to accept more trainees.

 

What you can do to improve your chance of success:

 

Seriously consider the program you are trying to transfer into. Traditionally, residents who are certain they want to go TO a certain discipline because they have carefully considered their interests and skills and have determined they are well matched, do better than residents who  are more concerned with getting OUT OF a program they don’t like. Take the time to think intentionally about this, talk to your friends and family, your colleagues and your mentors to get their opinions regarding whether they agree that you ‘fit’ your desired new specialty. Listen to their responses.

 

Try and get an elective in the desired specialty before transferring. This allows you to try it out, not as a final year clerk rotating through 6-8 weeks of something but with a view to a residency training program and career in that chosen specialty. The post clerkship perspective is very different. It also gives you and the accepting program a sense of ‘fit’ for the specialty.

 

Contact the program director or assistant of the specialty you are interested in and ask what they would recommend to improve your chances. You may or may not get a response but it lets them know you are interested and they may outline their program transfer process, even in a formal letter email, that may help.

 

Please remember that the central PGME Office does not have influence over how many or who the programs choose to accept for transfer. Numbers of positions are determined by capacity and then each program follows a standard process to determine who, if any, of the candidates applying they will accept. Offers for transfers are not binding like CARMs.

 

Please see the following transfer policies for details:

For further questions regarding the transfer policy or transfer requirements please contact Maureen Morris.

 

If you have questions regarding career indecision, appointments to speak with Dr. Julie Maggi, Director of Resident Wellness, can be made through the Wellness Coordinator, Diana Nuss.

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