Residency training requirements are such that by the end of training specific goals and objectives of the training program must be achieved and the trainee be competent to commence independent practice. While training requirements are generally completed in sequence, it is understood that residents may require an interruption of training (leave of absence).
The expectation is that time lost or rotations missed during a leave will be made up with the equivalent time upon the resident’s return to the training program.
Circumstances that qualify residents for a leave of absence are:
- Maternity/paternity/adoption/parental leave
- Medical/Sick leave
- Compassionate leave
- Others at the discretion of the Residency Program Director in consultation with Residency Program Committee and the Associate Dean, Postgraduate Medical Education.
A Leave of Absence is an approved interruption of training for any reason. Leaves may be granted for a variety of reasons, but are generally categorized into paid and unpaid leaves as referred to in the Collective Agreement between the University of Saskatchewan and the Professional Association of Internes and Residents.
Leaves do not include vacation or educational leave or examination leave as per the parameters described in the PAIRS Collective Agreement.
Statement of Policy
1. Leaves of absence will not be granted for the purpose of generating supplemental income.
2. Salary continuation during the leave is determined by the PAIRS Collective Agreement.
3. It is understood for those residents who maintain a current level of appointment in a residency program that a resident:
a. Will return to a residency program following a leave of absence, and
b. Is still a resident of the program, notwithstanding his / her inactivity, and is still expected to maintain a standard of conduct in keeping with the standards of the residency program, the University and the medical profession
4. Failure to meet these obligations may result in the withdrawal of a resident’s appointment to the program.
5. All leaves must be approved by the Residency Program Director in consultation with the Residency Program Committee or as otherwise noted in the PAIRS Collective Agreement.
6. On the recommendation of the Residency Program Director in consultation with the Residency Program Committee, the Associate Dean, Postgraduate Medical Education may grant a leave of absence with the understanding that the promotion/graduation date will move forward by an amount of time equal to the leave.
7. All leaves greater than five days must be reported to the Postgraduate Medical Education (PGME) Office. There may be special circumstances when the Program will report leaves less than five days, for example, if there has been a pattern of days missed over a period of time.
8. The PGME Office will notify the College of Physicians and Surgeons of Saskatchewan (CPSS) and the applicable regional health authority of any interruption to residency training including a leave of absence. Only the dates of the leave and type of leave will be reported. Any additional information will only be provided with the Resident’s consent.
9. CPSS will interrupt the resident’s educational license upon notification of the leave of absence.
10. The applicable regional health authority will interrupt credentialing/privileges upon notification of the leave of absence.
11. CMPA is notified of any interruptions to residency training including leaves of absences. Residents must contact CMPA directly to determine what if any gaps in coverage will be applied.
12. University registration status is interrupted during leaves or periods of inactivity in the residency training program.
13. It is the resident’s professional responsibility to ensure that the appropriate people are notified of the leave of absence and, when possible, that appropriate arrangements for coverage have been made. Program-specific processes are also to be followed.
14. Medical leaves – A leave of absence approved for medical reasons is accompanied by the expectation that the resident must receive care and support.
a. Residents requesting a medical leave of absence must produce a medical certificate to verify that medical care is being received. The resident’s privacy is respected and information on the medical certificate will not disclose the reason for the medical leave. The medical certificate will, however, include the anticipated duration of the leave of absence.
b. If the duration of the leave of absence is uncertain, monthly medical certificates by the treating physician is required and must be submitted to the Residency Program Director.
c. If there are recurrent leaves, the Residency Program Director / PGME Office may require a physician’s note.
15. Except in extraordinary circumstances, a resident participating in remedial training shall not be permitted to take a leave of absence.
a. Should the Residency Program Director deem a leave of absence appropriate, the Remediation Program will be considered incomplete. In such event, the Remediation Program will be redesigned by the Residency Program Director, in consultation with the Residency Program Committee, upon the resident’s return, taking into account the nature of the deficiencies identified, the performance of the resident to date, and the need for continuity of clinical experience.
16. Resident appeals, remediation/probation rotations will be deferred until a trainee has been cleared to return to the Residency Training Program and CPSS educational licensure and health region credentialing/privileges are reinstated.
17. In extraordinary circumstances where a resident is mandated by the Program to be on a leave of absence pending formal assessment, the resident MUST communicate with their Residency Program Director on a monthly basis with respect to the status of the leave. Should a resident not respond, the Residency Program Director may take the initiative to contact the resident directly.
1. Requests/approvals for Leave of Absence procedures include:
a. The resident submits a written leave of absence request to the Residency Program Director.
b. Residency Program Director in consultation with the Residency Program Committee will review the request for approval. Approvals of leaves of absence must be in accordance with this policy and with the policies of the Royal College of Physicians and Surgeons of Canada (RCPSC) or of the College of Family Physicians of Canada (CFPC), as applicable.
c. The Residency Program must notify the PGME Office of leaves greater than five days or of unpaid leaves for applicable processing.
d. The PGME Office will notify CPSS, the applicable regional health authority, CMPA and University Registration of the leave of absence commensurate with the established reporting processes.
e. The resident’s educational license, credentialing/privileges, and University student registration are interrupted upon notification of the leave of absence.
f. CMPA is notified of any interruptions to residency training including leaves of absences. Residents must contact CMPA directly to determine what if any gaps in coverage will be applied.
2. During the Leave of Absence procedures include:
a. Residency Program Director and resident should communicate on a monthly basis (with the exception of a predetermined end date for the leave).
b. Residents must notify their Residency Program Director of any change requests to the previously approved leave of absence. The Residency Program Committee will consider such changes and approval.
c. Any changes with respect to the status of the leave of absence will require the Program to notify the PGME Office.
d. In the event of an extended medical leave, monthly medical certificates are to be provided by the treating physician and must be submitted to the Residency Program Director. The Program will then report updates on the medical leave status to the PGME Office.
3. Returning from a leave of absence procedures include:
a. Residents must provide adequate notice of their return to the Residency Program Director as required by the Program and/or the PGME Office.
b. Residency Program Director must notify the PGME Office of the resumption of training with as much notice as possible but at least one week prior to the date of return.
c. The PGME Office will notify:
i. CPSS to initiate reinstatement of the educational license
ii. Applicable regional health authority to reinstate credentialing/privileges
iii. University Registration to activate student status
iv. CMPA of return date
v. Human Resources/Payroll to reinstate salary where applicable and any other mandatory requirements.
d. A resident cannot resume training until CPSS licensure, health region credentialing/privileges and CMPA are reinstated.
Residents should not return from a leave of absence until they are ready.
i. Medical leave of absence: The Residency Program Director requires from the physician involved in the resident’s care, a written medical certificate or declaration of readiness to return as a condition of returning to work.
ii. The Residency Program Director, Residency Program Committee and/or the Associate Dean, PGME may request an additional independent medical opinion in order to ensure the resident’s medical fitness to return from the leave of absence.
iii. Residents returning after a prolonged non-parental leave of absence may require a modified educational program and may be assigned to a less advanced training level than that prior to the interruption of training. For specialty residents (RCPSC programs), no assurance can be given that all training taken prior to the interruption will still be acceptable, even though previously recognized by the Royal College.1
a) In order to determine the appropriate training level and program structure, a resident may be assigned a period of graduated return to residency. A Graduated Return to Residency (GRR) period is required for a resident returning after a Leave of Absence that is equal to or greater than one calendar year. The need for a GRR period for a resident returning after a Leave of Absence which is less than one year will be determined by the program. The Residency Program Director in consultation with the Residency Program Committee and educational programming resources will develop the GRR plan. A GRR period refused by a resident cannot be applied retroactively once training has been resumed.
b) All resident assessments during the GRR period will be reviewed by the Residency Program Director in consultation with the Residency Program Committee. A recommendation regarding the resident’s re-entry to training should be submitted to the Associate Dean, Postgraduate Medical Education (or designate) not later than two (2) weeks after the end of the GRR period. Possible outcomes of a GRR period include unconditional re- entry into the program or re-entry with a modified structure/training level. A GRR period may be credited towards residency training time, if recommended by the program.
In exceptional circumstances, the Residency Program Committee may determine that it is not appropriate for the resident on a leave of absence to return to the program. This decision must be submitted to and must be approved by the Associate Dean, PGME. The resident will be notified by the Associate Dean, PGME of a program’s decision against re-entry to the training program.
Appeals of this decision follow the College’s Postgraduate Medical Education policies/procedures for appeals.
References and Resources
- 1RCPSC Policy and Procedures for Certification and Fellowship – Section IV, 4.2.1
- RCPSC Policy and Procedures for Certification and Fellowship – Section IV, 4.3.2
- College of Family Physicians of Canada – Requirements for Residency - Leaves of Absence
- University of Alberta Faculty of Medicine & Dentistry, Postgraduate Medical Education Policy on Leave of Absence from Residency Training
- McMaster University Postgraduate Medical Education Leaves from the Program Policy
- University of Toronto, Faculty of Medicine, Postgraduate Medical Education Guidelines for Residency Leaves of Absence and Training Waivers
- University of Manitoba Faculty of Medicine Policy applied to all PGME Residency Programs Leaves of Absence & Waiver of Training Policy
Approved – Postgraduate Medical Education Committee – November 13, 2015