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The University of Saskatchewan Postgraduate Medical Education Office wishes to retain the possibility of granting a waiver of training after an approved leave of absence for residents, in accordance with the policies of the Royal College of Physicians and Surgeons of Canada (RCPSC) and the College of Family Physicians of Canada (CFPC).

Leave of absence approvals are at the discretion of the Program Director and the Postgraduate Dean.

Granting of a waiver of training after a leave of absence is considered to be the exception rather than the standard procedure. Therefore programs and residents must not assume that a waiver will be approved and should plan the final year of training and graduation date accordingly. A decision not to grant a waiver of training cannot be appealed.

The duration of training may be reduced following an approved leave of absence on a recommendation by the Program Director with final approval by the Postgraduate Dean and College of Family Physicians of Canada (CFPC) or the Royal College of Physicians and Surgeons of Canada (FRCPSC)

A decision to waive training after an approved leave of absence can only be made in the final year of training and it cannot be granted after the resident has taken the certification examinations.

College of Family Physicians of Canada Allowable Times for Waivers

The maximum length of a waiver of training for residents in family medicine residency training programs will be four weeks.

Family medicine residents registered in enhanced skills programs of one year or less in duration must complete the entire duration of training.

Royal College Maximum Allowable Times for Waivers

1. One year program – no waiver allowed

2. Less than one year for remediation or enhanced skills – no waiver allowed

3. Two year program – six weeks

4. Three year program – six weeks

5. Four year program – three months

6. Five year program – three months

7. Six year program – three months

8. In Internal Medicine and Pediatrics, where residents are undertaking three years of training with an Internal Medicine or Pediatrics Program Director, a maximum of six weeks may be waived for these three years of training. Subsequently, a maximum of six weeks of training may be waived in the following 2 years of training under the subspecialty Program Director. The process for these programs is as follows:

i. Three years of training completed with an Internal Medicine or Pediatrics

ii. Program Director followed by 2 or 3 years of subspecialty training with a different program director are treated separately for the purpose of the waiver of training.

iii. A waiver must be recommended by the Internal Medicine or Pediatrics Program Director and approved by the Postgraduate Dean on the Core in-Training Evaluation Report (CITER). A decision to grant a waiver is made in the PGY3 for a maximum duration of 6 weeks.

iv. In the subspecialty years, a decision to grant a waiver is recommended in the final year by the Subspecialty Program Director and approved by the Postgraduate Dean. A maximum 6 week waiver of training can only be taken in the final year of training.

v. If the resident undertakes three years of Internal Medicine or Pediatrics training with an Internal Medicine or Pediatrics Program Director at one university and switches to another university for subspecialty training, it is the responsibility of the Postgraduate Dean at the corresponding institution to approve the waiver of training. For example, if a resident does pediatric training at the University of Toronto and switches to pediatric nephrology at McGill, the Postgraduate Dean from Toronto would approve the six week waiver in pediatrics and the Postgraduate Dean from McGill would approve the six week waiver in pediatric nephrology.

Residents are entitled to know, in advance, how their performance will be evaluated in order for them to qualify for a waiver of training. It must not be assumed that the resident is entitled to a waiver of training. A waiver of training will be at the discretion of the program director using the principles outlined within this document and those established by the respective training program.

All mandatory rotations must be satisfactorily completed.

Residents who fail rotations or undergo remedial training for any reason are not entitled to claim a waiver of training.

Before recommending a waiver of training the Program Director must be satisfied that the resident will achieve a minimum level of competence by the end of the final year of training. In order to make the decision objective and transparent all programs must make public the criteria they will use in granting a waiver of training.

When considering a waiver of training the Program Director is encouraged to consider:

a) Any unsatisfactory, borderline or incomplete rotation evaluations.

b) Inconsistent attendance at academic activities.

c) Training modifications which resulted in an overall dilution of the educational experience.

d) Any concerns about the academic, professional, behavioral and ethical performance of the resident.

e) Performance in objective evaluations including OSCE, mini CEX, multiple choice examinations, oral examinations, short answer questions and in evaluating examinations.

f) That all training objectives outlined by the respective College will be met by the end of training (including all mandatory rotations).

Waiver of training does not mean that a resident can shorten training because s/he has performed well and would like to start practicing earlier than the planned end of the residency. Residents must be aware that commitments regarding any new employment can only be timed for when their residency officially ends.

Residents who are granted waiver of training and then go on to fail their certification examinations are not entitled to additional funding to extend their residency.

Residents must apply in writing to their program director for waiver of training.

Programs are encouraged to set up a RPC sub-committee to review waiver of training requests.

A waiver of training will be considered by the Associate Dean PGME only under the following circumstances:

1. Compliance with the Waiver of Training after a Leave of Absence from Residency policies of The Royal College of Physicians and Surgeons of Canada and The College of Family Physicians of Canada;

2. The resident is in the final year of training, but has not yet taken certification examinations;

3. The waiver requested does not exceed the maximum allowable;

4. The resident will have completed all mandatory components of training;

5. Programs will be required to submit an application form to the PGME office when requesting a waiver of training. Attached to the form must be a brief summary of the information on which programs have based the waiver recommendation (e.g. ITERs, national in-training examinations, OSCE’s, peer assessments, abstracts, publications etc.). The summary should describe the resident’s performance based on the CanMEDS/Four Principles of Family Medicine criteria. Programs may include copies of any relevant documents. Programs csn provide any other information that they feel makes the resident’s application for waiver of training satisfy the requirement of competency.

References

References

RCPSC Policy and Procedures for Certification and Fellowship – Section IV, 4.3.2 http://www.royalcollege.ca/portal/page/portal/rc/common/documents/credentials/policy_procedures_e.p df

College of Family Physicians of Canada – Requirements for Residency - Leaves of Absence - http://www.cfpc.ca/LeavesAbsenceWaivers/

 

Resources

Adapted from:

University of Alberta Faculty of Medicine & Dentistry, Postgraduate Medical Education Policy on Waiver of Training After a Leave of Absence http://www.med.ualberta.ca/-/media/medicine/pme/policy/waiveroftraining.pdf

University of Calgary Faculty of Medicine, Postgraduate Medical Education Leave of Absence Policy http://cumming.ucalgary.ca/pgme/files/pgme/uofcpgmeloaapprovedapril-2008revisionmay2009.pdf

Dalhousie University Faculty of Medicine, Postgraduate Medical Education Policy on Waiver of Training Following a Leave of Absence http://medicine.dal.ca/departments/core-units/postgraduate/calendar/academic-guidelines- policies/waiver-of-training.html

Dalhousie University Faculty of Medicine, Postgraduate Medical Education Application for Waiver of Training Following a Leave of Absence from Residency http://medicine.dal.ca/content/dam/dalhousie/pdf/faculty/medicine/departments/core- units/postgrad/Application_Waiver_Training.pdf

 

Approved by PGME Committee – November 13, 2015