COVID-19 and UBC PGME

As you are aware, the situation with respect to the coronavirus disease (COVID-19) continues to evolve rapidly and the Faculty of Medicine is monitoring it closely.

The safety and wellness of our students and learners remains our top priority.  An Executive Associate Dean Education COVID-19 Advisory Working Group (EADE-COVID-AWG) has been convened to engage in contingency planning regarding the evolution of this situation and its impact on our students and learners and to provide recommendations to the Executive Associate Dean, Education.

You are also invited to visit the Faculty of Medicine’s coronavirus FAQs page for answers to common questions about the COVID-19 from our Faculty of Medicine experts.

COVID-19FAQs

The sections below address some of the most common concerns for Residents and trainees regarding COVID-19. Please email us at postgrad@postgrad.med.ubc.ca if you have questions which are not addressed here.

Residents working with COVID-19 patients (last updated: April 2)

What precautions should residents take when working with suspected, probable or confirmed cases?
Residents are healthcare workers and learners. Hence, they are expected to care for patients according to the guidelines and recommendations provided by Public Health and the Health Authority in which they are working. Updated guidelines can be found here, and Residents should familiarize themselves with these guidelines:

BCCDC

The Collective Agreement continues to govern the terms of residents’ employment.

 

Caring for a patient with COVID-19 or want to learn more?
The following resource is one (of several) which is being used by our teams:

IBCC COVID-19

 

MARCH 20 UPDATE:
If a resident has a workplace exposure to COVID-19 that is confirmed positive, they are to follow the procedures at the link below and contact the HA Workplace Call Centre to report the exposure.

HA Workplace Call Centre

 

MARCH 24 UPDATE:

Please see these additional resources on caring for COVID-19 patients below.

MARCH 31 UPDATE:

Resources for having difficult conversations when patients are at high risk of dying:

Tools for COVID Conversations

 

Memo for postgraduate trainees with respect to the care of confirmed COVID (or suspected COVID) patients in intensive care (and high acuity) areas:

APRIL 2 UPDATE:

UBC Internal Medicine COVID-19 primer:

Certification Examinations (last updated: March 20)

Are there any special considerations for residents attending certification and/ or Medical Council of Canada Examinations in the Spring

Residents are expected to follow procedures and protocols as per above and follow Public Health recommendations. Program directors / Program Committees often provide rotations prior to examinations based on Residents’ needs, opportunities for study and other factors that optimize chances of success at examinations. This level of consideration should continue taking into account program and residents’ needs. MCC, RCPSC and CFPC are monitoring the situation closely and have committed to providing updates to examination candidates as decisions are made regarding examinations.

 

MARCH 20 UPDATE:

Medical Council of Canada (MCC) have postponed the Qualifying Examination (MCCQE) Part I session scheduled from April 15 to May 15, 2020, and the MCCQE Part II scheduled for May 2 and 3, 2020. At this time, they are asking candidates for the MCCQE Part I to wait before changing their scheduled exam appointment with Prometric. Further information on new dates will be provided as soon as possible.

For more information please see below:

MCC Examinations

The Royal College of Physicians and Surgeons of Canada has postponed the delivery of its written exams to September 2020 at the earliest, with a goal to follow with the postponed spring oral/OSCEs in the same fall period (September – November 2020).

For more information please see below:

Royal College Examinations

The College of Family Physicians of Canada (CFPC) have announced the postponement of the spring 2020 Certification Examination in Family Medicine. This postponement applies to both the written (SAMPs) and performance (SOOs) components of our certification examination at all locations.

For more information please see below:

CFPC Exam Postponement

 

CPSBC registration for final year residents (last updated: March 27)

Residents' travel (last updated: March 16)

Can Residents travel to do electives or attend conferences? What are the restrictions?

With respect to academic activities, program electives, conferences and meetings, PGME programs and Residents must follow recommendations provided in the Government of Canada Active Travel Advisories.

The latest information can be found here:

Latest travel health advice

Elective rotations and conferences are considered non-essential travel.

MARCH 16 UPDATE:
Health care workers who return from travel outside Canada and are not essential to the delivery of patient care should self-isolate at home for 14 days.

Health care workers who return from travel and are essential to the delivery of patient care may return to work but should take additional precautions to reduce the risk to their patients, colleagues, and the public should they become symptomatic. If residents are deemed essential to return to work by their Program Directors and are asymptomatic, they must follow the reverse PPE recommendations of the PHO as outlined on March 15, 2020 in this letter for Health Care Workers.

MARCH 13 UPDATE:
Electives – The escalating situation with respect to COVID-19 has necessitated the following changes concerning electives:
Out of Province Electives (incoming and outgoing) – All electives that have not yet started are cancelled effective immediately until further notice. Those electives that have started at this point may finish.
International Electives (incoming) – All incoming international electives are cancelled until further notice.

Meetings, academic sessions and half days

Are there any restrictions on Program Meetings? Are there any restrictions on academic sessions and half-days?

As a result of Vancouver Coastal Health’s recommendation to that ” all essential group meeting (for example, educational rounds) should be suspended”, didactic teaching sessions, including in-person classes, small or large group sessions should be replaced fully with on-line learning alternatives whenever possible. As Residents are all employees of the Health Authorities and we want to ensure safety and fairness for everyone, this applies to all UBC Residents, regardless of training site.

Such alternative learning experiences within programs may include, but are not limited to:

• recorded (archived) lectures

• lecture streaming

• virtual histology and anatomy

• virtual case-based learning

• facilitated small group sessions

• simulation

• revisions to curriculum, where appropriate, to make up missed material

Resident scheduling and re-deployment (last updated: March 17)

Is there a protocol for covering call / services when residents cannot attend because they are ill / under quarantine?

Clinical coverage contingencies are expected to be managed in the same way they have been in the past when a Resident is unwell, unable to attend work, or unable to do call irrespective of the reason.

MARCH 16 SCHEDULING UPDATE:
We recognize that events have been rapidly changing related to COVID-19 and greatly appreciate all the UBC PGME community’s efforts during these challenging times. There have been many implications of recent decisions regarding changes to hospital patient priorities and recommendations from the Provincial Health Officer. As Resident scheduling is the responsibility of Programs, please contact the Resident’s Program if uncertainties arise. PGME will support programs throughout this process. Given that we expect events to unfold whereby either programs or Health Authorities request residents be re-deployed to care for patients, we have developed this UBC PGME statement on resident scheduling and re-deployment. This is to serve as a guide for programs and residents.

This statement has been shared with the Tri-Party committee (HEABC, Resident Doctors of BC and UBC) as this committee is involved with scheduling for residents.

If a Resident is not assigned duties on a given day (ie. cancellation of an operating room), the site is to contact the Resident’s Program and it is the Program which decides whether the resident is re-assigned or has alternate responsibilities (i.e. study day).

Residents with symptoms (last updated: March 24)

What steps should Residents showing symptoms of sickness take?

Residents with flu-like symptoms should not be at work, but should recuperate at home on sick leave. This approach not only allows ill residents to get well, but also protects staff and patients.

A sick Resident who completes a period of self-isolation directed by public health authorities will be provided with documentation clearing them to return to work, when they are recovered and no longer infectious. Sick Residents who have not been directed to self-isolate should return to work when symptoms cease.

 

MARCH 20 UPDATE:
If you are concerned that you are experiencing the symptoms of COVID-19, please contact your regional health officer:

  • Fraser Health – 1-604-527-4806
  • Interior Health – 1-866-457-5648
  • Northern Health – 1-250-565-2000
  • Vancouver Coastal Health – 1-604-527-4893
  • Island Health – 1-800-204-6166

 

MARCH 24 UPDATE:

Current BCCDC guidelines applicable to residents as of March 23, 2020

For details, see: BCCDC Website

Residents returning from COVID-19 affected regions

What should Residents returning from designated COVID-19 affected regions do?

The BCCDC directs that travelers returning from Hubei province in China, Iran and Italy stay home and self-isolate for 14 days while self-monitoring for symptoms of illness. Residents returning from these regions, or other areas as updated by BCCDC, should contact 8-1-1, their primary care provider, or local public health office, and follow any directions given.

Those Residents self-isolating at home on the direction of medical authorities should be on a paid general leave of absence (i.e., not sick leave) for the duration of the recommended isolation period, except in circumstances where it is feasible for an asymptomatic resident to work from home during self-isolation (see below under the heading: Under what circumstances should and can a Resident work from home?).

Residents concerned about exposure (last updated: March 20)

What should a Resident who believes he/she has had exposure irrespective of travel do?

Similarly, Residents who are asymptomatic and have not recently returned from designated COVID-19 affected regions, but believe they may have been exposed to COVID-19 should be directed to contact 8-1-1, their primary care provider, or local public health office, and follow direction given to them by those sources.

If a Resident is instructed by a qualified medical practitioner to self-isolate at home, such a period of self-isolation should be treated as a paid general leave of absence for the duration of the recommended isolation period, except in circumstances where it is feasible for an asymptomatic resident to work from home during self-isolation (see below under the heading: Under what circumstances should and can a resident work from home).

If the Health Authority where the resident is working has the ability to refer its employees, including Residents, directly to a Medical Health Officer for assessment, Residents with community exposure concerns may be directed to seek assessment by a Medical Health Officer in order to be eligible for paid general leave.

Residents should be directed to keep their Residency Program updated regarding the status of any medical assessment or direction they receive from a qualified medical practitioner. Residents awaiting medical direction or COVID-19 test results should be placed on a paid general leave of absence, provided they are being responsive to the Residency Program’s requests. If a Resident is not responsive or if there is concern about the need for self-isolation, Residency Programs should contact the PGME, who will liaise with HEABC for advice.

MARCH 18 UPDATE:
If a resident has been advised by public health or a medical practitioner to self-isolate or modify duties due to COVID-19 risk (not exposure), they would need to contact their Program Director to discuss their options, which could include working from home.

MARCH 20 UPDATE:
If a resident feels they are at an increased risk for serious complications with COVID-19 exposure, they are to contact their Program Director and/or the Postgraduate Deans (Dr. Sonia Butterworth and Dr. Ravi Sidhu) to discuss.

Do I attend work if I have concerns? (last updated: March 16)

If I am concerned do I have to attend work?

Although concerns about potential exposure in the community are understandable, Residents who do not have symptoms of illness or who are not actively seeking direction from a qualified medical practitioner are expected to attend work as usual.

Residents, as Registrants of the College of Physicians and Surgeons and employees of HEABC have a duty to provide care consistent with their licensing and status as a health care provider. If a resident is absent from clinical duties without leave, the Program is to report this information to the PGME Office.

Working from home

Under what circumstances should and can a Resident work from home?

Asymptomatic Residents who have been directed to self-isolate by a qualified medical practitioner are not to attend work. Residency Programs should consider whether it is feasible for any such resident to work from home and, where it is, facilitate such arrangements instead of a general paid leave of absence.

Asymptomatic Residents who have not been instructed to self-isolate may request work from home arrangements. In those cases, Residency Programs should consider requests and may apply any policies currently in place.

Resident Leaves (last updated: March 17)

Effective March 13th, residents who wish to cancel scheduled time off in the next 60 days may do so at their discretion and will be able to bank this cancelled vacation time for use during the following academic year. Requests to cancel leaves of absence outside this 60 day period are subject to the provisions of the collective agreement.

Resident Wellness (last updated: March 25)

Throughout this outbreak of COVID-19, we recognize that you may be experiencing a lot of uncertainty, stress, and anxiety.

The Resident Wellness Office is available to support residents and will be prioritizing appointments for residents who are directly impacted by COVID-19. Please visit their online booking site or email resident.wellness@ubc.ca to schedule an appointment with a counsellor.

RDBC has also compiled a great list of resident wellness resources, available on their website.

Residents beginning training in July (last updated: March 30)

Is the residency start date still going ahead as planned for July 1, 2020? 

View response

There has been no change in the expected start date of July 1, 2020. It is hoped that all on-boarding and orientation activities can occur for this date. We will be updating our incoming class directly as needed. Please be aware that the match is still underway and we will not have our incoming residents finalized until after April 15 (Second Iteration R-1 Match Day).

 

If a resident’s arrival is delayed (for example due to restrictions of flights), what are the implications for residents if they are not in BC in time for the residency on-boarding? 

View response

Any delay in residents starting will be managed at the time based on circumstances. Given the dynamic nature of the situation, these circumstances are difficult to predict three months in advance. However, it is expected that all incoming residents will follow recommendations by the Provincial Health Officer. Any system, government, health authority, or UBC related delays will be managed for all learners in a similar fashion. Individual delays will be managed individually. Right now, determinations of training extension or salary implications cannot be predicted. As the time nears, all potential options will be shared with the incoming residents. This will require coordination between UBC and the residents’ employer.

 

With the MCC having suspended LMCC Stage 1 examinations, many students have been asking about how that will impact residency training. Is there a sense of what this may look like? 

View response

There is no requirement to have passed the MCCQE 1 in order to be a resident at UBC (if you are a Canadian Medical Graduate); hence, this can be written any time after residency has begun.

 

Some students are also facing challenges completing certain requirements for residency (e.g. ACLS courses) with cancellations due to COVID-19. Are there any plans for how to adapt to this?

View response

For mandatory courses such as ACLS, PGME will work with programs, providers, and Health Authorities to provide courses for those who were unable to complete them. This may be around the time of on-boarding but, if this is not logistically feasible, extension of deadlines and further courses in the summer or fall will be considered.

 

This page will be updated as information becomes available. Incoming residents with additional questions are encouraged to contact the UBC PGME office at postgrad@postgrad.med.ubc.ca.

Clinical Fellows and Postgraduate Trainees (last updated: March 31)

This page will be updated as information becomes available. If you have additional questions you are encouraged to contact the UBC PGME office at: pgme.electivesandfellows@ubc.ca.

 

What is the latest with respect to travel restrictions for Clinical Fellows and Postgraduate Trainees?

An exemption from travel restrictions has been granted by the Federal Government for Temporary Health Workers and Learners. This includes VISA Clinical Fellows, Postgraduate Trainees and Residents.   The College of Physicians and Surgeons of BC will start to process the applications in place for those trainees to begin in July 2020. Please see the Government of Canada website here for up to date information relating to temporary workers.

 

Where can I get further information on immigration relating to the ongoing COVID-19 situation?

Please see the Government of Canada advisory website here for up to date information.

How was this protocol developed?

How did the PGME develop these procedures (related to leave) and response to COVID-19?

The UBC Faculty of Medicine worked with HEABC to ensure that the answers set out above are consistent with the Resident Doctors’ Collective Agreement and with the approaches being applied by health authorities with respect to other health care workers.