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

FoM COVID-19 FAQs

The sections below address some of the most common concerns for residents and postgraduate 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: June 24)

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

 

JUNE 24 UPDATE:

Questions concerning access to PPE?

Doctors of BC have a resource listing contacts in each health authority region in BC for questions about supply and distribution of PPE.

JUNE 17 UPDATE:

3M 1870+ N95 respirators
The provincial stock of 3M 1870+ N95 respirators is nearly depleted and 3M is no longer shipping this model of N95 to Canada. For those residents that are located within Vancouver Acute Hospitals that are only fit tested to the 3M 1870+ must transition to a new model of respirator. If you need repeat fit testing, please email EmployeeSafety@vch.ca and include:
1) Name
2) Department they are normally deployed to
3) Preferred email address

MARCH 31 UPDATE:

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

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

 

Certification Examinations (last updated: June 3)

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

APRIL 9 UPDATE:

The Royal College of Physicians and Surgeons of Canada has postponed the delivery of its written exams to September 2020 at the earliest. The Royal College has released an update regarding Spring 2020 Examinations.

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

 

APRIL 27 UPDATE:

The Royal College of Physicians and Surgeons of Canada have today announced an update on the delivery of fall sub-specialty exams. See the full statement here

For more information please see FAQ below:

Royal College fall sub-specialty Examinations

JUNE 3 UPDATE:

As a result of the rescheduling of exams, all graduating residents will continue to have UBC library access enabled for the remainder of 2020 regardless of your completion date. No action is required to enable this extension.

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

Residents' travel (last updated: June 17)

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.

JUNE 17 UPDATE:
Electives – Out of Province Electives at UBC may recommence effective July 1 2020 if there is willingness from the program to support out of province trainees. Similarly UBC PGME programs may allow existing residents to pursue out of province electives. All trainees wishing to do electives from July 1 are advised to have back-up or alternate plans, should the elective need to be cancelled. All provincial self-isolation requirements will need to be fulfilled.

Please note that an exception to the July 1 recommencement of electives apply within all levels of core Internal Medicine and medicine sub-specialties, where incoming and outgoing electives are cancelled across Canada for blocks 1 – 3 of the 2020/21 academic year. Some exemptions to this may be possible. Please approach your home Program Director for more details.

Please see an announcement from The UBC Department of Medicine relating to this here

JUNE 10 UPDATE:
All incoming postgraduate trainees and fellows arriving from outside Canada will be required to self-isolate prior to commencing their training and submit a self-isolation plan, the following documentation is intended to assist trainees with this process:

Carefully review the information provided in the UBC PG Trainee COVID-19 package
Carefully review the information provided in the UBC PG Trainee Self-Isolation Plan
Carefully review the information provided in the BC Self-Isolation Plan

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 (last updated: May 7)

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

There is a Federal Order that all travelers from outside Canada are directed to quarantine (self-isolate) for two weeks. There currently are no restrictions or requirements for those arriving from other parts of Canada.

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: May 14)

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.

MAY 14 UPDATE:
Please see the BCCDC guidelines below which includes criteria to assess risk for health care workers exposed to COVID-19 patients as well as information about returning to work after exposure or illness.

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: May 5)

As a result of concerns regarding a surge of COVID-19 patients this spring, residents, along with other healthcare workers, were invited to cancel scheduled time off that was booked in advance of March 13, for the period between March 13, 2020 and May 12, 2020. Vacations cancelled during this period could be banked for use at a later date during the academic year or in the following academic year. The Collective Agreement provisions for scheduling vacation apply to rescheduling the vacation time.

Residency Program directors should, where feasible, facilitate the rescheduling of vacation for residents before the end of the academic year.

Residents who cancelled prescheduled vacation between March 13, 2020 and May 12, 2020 and who are graduating at the end of June, 2020, may have their vacation paid out at the end of June 2020, when they graduate, provided their residency program determines they meet the following conditions:

i) The resident cancelled vacation within the period from Friday, March 13, 2020 to May 12, 2020 to assist with the COVID-19 response.

AND

ii) The Residency Program determines that the Resident’s cancelled vacation cannot be rescheduled before June 30, 2020 for the following reasons:

a. The resident is essential for service provision as part of the COVID-19 response (i.e., the resident is providing services that are considered critical to preserving life and health public safety; this includes residents who are filling service gaps in their home service or who have been redeployed to areas of patient need) until their graduation date at the end of June, 2020.

OR

b. In order to meet or for the Residency Program to assess the resident’s competencies, the resident must be actively engaged in residency training until the end of June, 2020.

HEABC’s expectation is that all vacations that were cancelled between March 13, 2020 and May 12, 2020 and that do not meet the criteria in i) and ii) above will be rescheduled before the end of this academic year. If there is a compelling reason why this is not possible, please contact the PGME Office.

Requests to cancel leaves of absence outside the 60 day period from March 13, 2020 to May 12, 2020 are subject to the provisions of the Collective Agreement.

Resident Wellness (last updated: May 4)

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.

The office has compiled a COVID-19 list of resident wellness resources.

The Resident Doctors of BC also has a great list of resident wellness resources, available on their website.

Residents starting training in July (last updated: June 10)

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 on a case by base basis. 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. Depending on the recommendations in place appropriate flexibility will be on offer in terms of the ability to start, which will account for all scenarios.

 

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.

 

LMCC Part 1 Examinations for incoming residents have now been rescheduled from June to September 2020. What is the policy on protected time/leave for regulatory and licensing examinations in case a new resident has to write the exam after commencing residency? (I.e July, August, September)”

View response

Please refer to article 8.02 in the resident Collective Agreement.

If you are due to write examinations after commencing residency at UBC please notify your program in writing, stating the dates when these examinations are scheduled.

 

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.

For ACLS, incoming residents may wish to refer to blended learning opportunities available through The Heart & Stroke foundation – see link below.

The Heart & Stroke Foundation

Part 1 is online only (6 hrs approx.) and Part 2 (6 hrs approx.) is in person. Part 2 will take place once distancing restrictions have been lifted.

 

Are there any guidelines/recommendations for self-isolation prior to the start of residency?

View response

PGME are following guidelines set forth by the Provincial Health Officer with respect to self-isolation (there is nothing specific for our new residents). In BC currently only those residents who arrive from outside Canada need to self-isolate for two weeks. Those travelling to BC to attend residency at UBC from within Canada need not self-isolate at this stage, though things may change.

For those arriving from outside Canada and needing to self-isolate prior to commencing their training the following documentation is intended to assist with this process:

Carefully review the information provided in the UBC PG Trainee COVID-19 package
Carefully review the information provided in the UBC PG Trainee Self-Isolation Plan
Carefully review the information provided in the BC Self-Isolation Plan

 

How are departments adjusting the clinical responsibilities of R1/R2 residents in light of the evolving Pandemic?

View response

There is a redeployment plan in place that takes into account supervision, safety and competencies. Consideration will be made where clinical activities (e.g elective slow-downs, clinical need in specific areas) affect training and scheduling.

 

What if I can’t get SIN documentation from Service Canada or the CRA to provide to PHSA for payroll and benefits enrollment?

View response

The deadline to submit your SIN is April 20, 2020. Any questions or concerns regarding the collection of SIN or documentation required should be directed to Isra Baig at PHSA by email or phone (604-297-8634). PHSA will work with residents to determine appropriate alternate documentation if needed.

Please refer to our Payroll, Health & Benefits Forms page for additional information on payroll and benefits enrollment.

 

How do I ensure that I have the required immunizations before beginning my residency program?

View response

Residents are required to report their immunization status prior to the beginning of training via the Provincial Workplace Health Call Centre (WHCC) online self-reporting tool in June, as per the onboarding schedule below. Due to COVID-19, immunization clinics are currently suspended until further notice. However, residents are not required to have all immunizations before self-reporting. The Occupational Health Nurse from the Call Centre will provide residents with a list of recommended immunizations and where to follow up for them after self-reporting their Baseline Health Immunization status. More information on self-reporting is available on our Occupational Health & Safety page.

 

The Physician Health Program has suspended matching physicians with community GPs – if I’m an incoming resident and don’t have a GP, what can I do? 

View response

In partnership with the UBC Department of Family Practice and the UBC Health Clinic, PGME has found capacity with the UBC Health Clinic for new residents in the Metro Vancouver area. The UBC Health Clinic is located on the UBC Vancouver campus, and is a 10-15 minute drive / 25 minute bus ride from VGH.

 

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

Clinical Fellows and Postgraduate Trainees (last updated: June 10)

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.

Will I be required to self-isolate prior to starting my training?

As a result of the COVID-19 pandemic incoming postgraduate trainees and fellows arriving from outside Canada will be required to self-isolate prior to commencing their training and submit a self-isolation plan. The following documentation is intended to assist trainees with this process:

Carefully review the information provided in the UBC PG Trainee COVID-19 package
Carefully review the information provided in the UBC PG Trainee Self-Isolation Plan
Carefully review the information provided in the BC Self-Isolation Plan

COVID-19 Resource Hub (last updated: July 29)

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.