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Purpose

To display the commitment of the Postgraduate Medical Education Office (PGME) to the health, protection, and safety of its postgraduate medical trainees.

To promote a safe and healthy environment and minimize the risk of injury on the University campus and teaching sites.

To deliver a mechanism to report unsafe/hazardous training environments along with a procedure to take corrective action.

This policy is being written in accordance with the CanRAC accreditation requirements. In addition to this policy, each program must establish a written policy in accordance with the General Standards for Accreditation of Residency Programs, taking into account specific risks associated with the nature of the discipline and the organization of training. This policy must be made available to Residents.

Principles:

n/a

Definitions:

Affiliated teaching sites refers to teaching locations across Saskatchewan in conjunction with the University of Saskatchewan and Saskatchewan Health Authority that support Resident learners’ clinical experiences and training.


Associate Dean, Postgraduate Medical Education (PGME) the senior Faculty officer responsible for overall conduct and supervision of Postgraduate Medical Education within the Faculty in the College of Medicine. The Associate Dean, PGME reports to the Vice-Dean, Medical Education.


Blood Borne Pathogens (BBPs) refers to Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS).


PGME Community refers to all employees, faculty, or other staff as well as agents, contractors, persons, or organizations acting for or on behalf of the Postgraduate Medical Education Office.


Program Director is the faculty member most responsible for the overall conduct of the residency program in each discipline and responsible to the Head of the Department and to the Associate Dean, PGME in accordance with the criteria of the RCPSC/CFPC. Responsibilities of the Program Director can also apply to the responsibilities of the Site Director in CFPC programs, where appropriately delegated to the Site Director by the Program Director.


Postgraduate Medical Education (PGME) Office refers to the Associate Dean, PGME and the administrative personnel who are responsible for coordination and administration related to the oversight of the residency training programs.


Residency Program Committee (RPC; synonym Residency Training Committee) oversees the planning for the residency training program and overall operation of the program to ensure that all requirements as defined by the national certifying college are met; this includes selection of Residents, assessment and promotion of Residents, assessment of the rotational components/learning experiences of the program and individual clinical supervisors, program evaluation and curriculum development, and other tasks defined in the General Standards of Accreditation Applicable to All Residency Programs.  


Resident refers to postgraduate medical trainee enrolled in the RCPSC or the CFPC program.


Residency Training Program or Program is the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC) accredited residency training program at the College of Medicine.


Saskatchewan Health Authority (SHA) refers to the single health region of the province of Saskatchewan. It is a health authority providing direct and contracted health services including primary, secondary, tertiary, and quaternary care, home and community care, mental health services, population and preventive health and addictions services to the people of Saskatchewan.


Supervisor refers to the licensed physician who is ultimately responsible for the supervision of a Resident or group of Residents in a particular practice or service.
University (USASK) refers to the University of Saskatchewan.

Scope of this Policy

This policy applies to Residents, faculty, and staff in all residency training programs in the College of Medicine at the University of Saskatchewan (USASK).

The University of Saskatchewan, Saskatchewan Health Authority (SHA), and affiliated teaching sites are accountable for the environmental, occupational, and personal health and safety of their employees and have the right to make implementation decisions within their respective policies and resource allocations.

Policy

The General Standards of Accreditation for Institutions with Residency Programs standard #4.1.3 states:

 

4.1.3: Residency education occurs in a safe learning environment.

4.1.3.1: Safety is actively promoted throughout the learning environment for all those involved in residency education.

4.1.3.2: Effective central policies and processes are in place addressing Residents’ physical, psychological, and professional safety, including but not limited to:

  • After-hours consultation
  • Complaints and allegations of malpractice
  • Fatigue risk management
  • Hazardous materials
  • Infectious agents
  • Ionizing radiation
  • Patient encounters (including house calls)
  • Patient transfers (e.g., Medevac)
  • Safe disclosure of patient safety incidents
  • Travel
  • Violence, including sexual and gender-based

Residents should be aware of the various USASK policies on health, safety and environment: Animal Control, Biosafety, Compliance Enforcement Pertaining to Hazardous Agents, Contractor Hot Work, Discrimination and Harassment Prevention, Employee Assistance Program, Fieldwork and Associated Travel Safety, Furniture, Long Term Storage of Nuclear Substances, Radiation Safety, Smoking, Violence, Working Alone, Workplace Safety and Environmental Protection (WSEP), which can be found on policies.usask.ca.

Residents can access the PGME Online Reporting Tool to report instances of personal injury, near miss incidents, workplace hazards, safety concerns, mistreatment, discrimination and harassment, alleged malpractice, suspicious activity, and sexual violence. Information collected from the reporting tool is confidential.

PERSONAL, PSYCHOLOGICAL & PROFESSIONAL SAFETY:

PERSONAL SAFETY:

Residents must report all situations where personal safety is threatened.

If a Resident identifies a personal safety or security breach, they must report it to their immediate supervisor and Program Director to ensure resolution of the situation.

If a Resident feels that they are in a situation where their safety is threatened, the Resident should seek immediate assistance and remove themselves from the situation in a professional manner. The Resident should notify their immediate supervisor and Program Director. Should the Program Director be unavailable or additional consultation is required, the Postgraduate Medical Education Office is available for consultation.  

INJURY REPORTING:

The Saskatchewan Worker’s Compensation Board (WCB) requires all Saskatchewan employers to report injuries to the WCB within five days of being aware of an injury as per The Worker’s Compensation Act 2013. As such, when a Resident is involved in an incident that results in injury while at work or is involved in any event that could have injured someone, but did not (dangerous occurrence, near miss, near accident), it needs to be reported.

Residents must report any occurrence or event that causes or has the potential to cause injury, illness or damage to people, property and the environment that happen while engaged in activities at the USASK or SHA training sites.

Residents are both USASK employees and students working within SHA training sites, therefore, personal injury incidents or near-miss incidents must be reported to both USASK Safety Resources and the SHA.  USASK Safety Resources provides an online safety reporting tool, which acts as the notification system for the SHA. 

All Residents receive a new Resident safety orientation from USASK Safety Resources as well as an introduction to SHA safety reporting from the SHA safety team at the annual SHA orientation for new Residents.

Residents should familiarize themselves with the PGME Reporting work related injuries and incidents document.

TRAVEL:

It is the Resident’s responsibility to exercise judgment during travel to and from the workplace (i.e. be aware of alternate options to prevent driving a personal vehicle when fatigued; ensure they drive while fully alert; determine, if in their estimation, that it would not be safe to travel because of weather, in which case they must notify the appropriate person as soon as possible in a professional manner of absences due to inclement weather).  

When Residents are travelling for clinical or other academic assignments by private vehicle, they are expected to maintain their vehicle adequately, and travel with appropriate supplies and contact information.

Residents are encouraged to access the taxi reimbursement program provided under section 9.17 of the RDoS collective agreement should they feel unsafe to operate a motor vehicle after work.

WORKING ALONE/AFTER HOURS CONSULTATIONS:

Residents should be aware of the security contact information of their rotation sites should there be a safety issue after regular working hours.

Residents should not work alone after hours in health care or academic facilities without adequate support from University Campus Protective Services or SHA site Security.

Programs must ensure procedures are established for Residents who may work alone. A supervisor/co-worker must be present in the following situations:

  • When the Resident is seeing a patient after hours in a clinic setting (This does not apply if in an emergency room/hospital based/ facility based urgent care setting).
  • Home visits by the Resident.
  • After office hours if the Resident is still seeing patients.

Residents should not walk alone for any major or unsafe distances at night. Residents are encouraged to access Safewalk or security services at their training site where available.

Safewalk

USASK and the SHA provide a Safewalk program. Safewalk volunteers and/or security services provide escorts for Residents to their vehicle or destination (within a reasonable distance).  See Appendix A for contact information.

USASK Virtual Safewalk

Using the USAFE app, sends a Resident’s location in real-time to a friend so they can watch them walk to their destination. If necessary, they can trigger a call to campus emergency services.

PATIENT ENCOUNTERS/AGGRESSIVE PATIENTS:

Residents should not be required to see potentially violent patients unless appropriate steps have been taken to optimize their safety.

The physical space requirements for management of violent patients must be provided where appropriate.

Special training should be provided to Residents who are enrolled in programs where there is a reasonable expectation of an encounter with aggressive patients.

INFECTION CONTROL:

Residents must be familiar with the PGME Blood Borne Pathogens Policy.

Residents are required to self-disclose blood borne pathogens or infections directly to the College of Physicians and Surgeons of Saskatchewan. Should the Resident not disclose their condition, the Program Director has an ethical responsibility to report the condition to the College of Physicians and Surgeons of Saskatchewan (CPSS).

New Resident orientation provided by USASK, and SHA must include a review of local onsite safety protocol and procedures regarding infection control.

Residents should familiarize themselves with the location and services offered by the SHA Occupational Health and Safety Office.

Residents must be familiar with policies and procedures for infection control and protocols following exposure to contaminated fluids, needle stick injuries, and reportable infectious diseases.

Residents must be familiar with SHA policy and guidelines during Large Scale Communicable Disease Outbreak i.e., Saskatchewan Health Authority COVID-19 Outbreak Guidance.

Residents must maintain up to date N95 respirator fittings.

Residents must observe universal precautions and isolation procedures when indicated.

IONIZING RADIATION:

Radiation doses received by Residents within a SHA workplace shall be kept below the statutory limit regardless of practice.

Residents will receive appropriate training from the SHA for the use of the X-ray equipment and will not operate equipment for which they have not be appropriately trained or qualified to operate.

FATIGUE RISK MANAGEMENT:

Fatigue Risk Management is a shared responsibility between Programs, Faculty, Residents, the Resident Resource Office, and PGME.

Residents are responsible for recognizing signs of impairment in themselves and their peers, including that which is due to fatigue. If a Resident themselves is experiencing any difficulties that they feel could impact their ability to perform their duties due to fatigue, they are encouraged to seek assistance as soon as possible.

Residents who recognize impairment due to fatigue in their peers should notify their supervisor immediately. Residents can seek help through the Resident Resource Office, Program Director, Program Coordinator, PGME office, RDoS office, Saskatchewan Medical Association (SMA) Physician Health Programs, USASK Employee and Family Assistance Program (EFAP), or faculty member as appropriate.

Residents should familiarize themselves with the PGME Fatigue Risk Management Policy.

HAZARDOUS MATERIALS:

Programs that include exposure to or handing of hazardous materials must ensure that Residents are appropriately trained and familiar with safety protocols and procedures.

Residents must be familiar with USASK and SHA guidelines on Hazardous Materials & personal protective equipment. 

New Resident orientation provided by USASK, and SHA must include a review of local onsite safety protocol and procedures regarding hazardous materials.

PATIENT TRANSFERS:

Programs must maintain policies governing Resident participation in patient transfers by ambulance including critical care and infant transport where applicable that reflect the unique risks in each discipline. Resident well-being should be considered in all transports.

Participation in patient transport in many programs is a valuable learning experience for Residents. At the program level, there must be clear educational objectives underlying the Resident’s participation in patient transport.

Residents must have appropriate training with demonstrated competency in the circumstances relevant to the transport experience.

Communication and supervision between the Resident and his/her designated supervising physician must be always available.

If travel extends outside of the home-based training site a University Authority to Travel form must be completed by the Resident and approved by the Program Director and kept in the Program’s files for future reference if/as required.

RESIDENTS WHO ARE PREGNANT:

Residents who are pregnant should be aware of specific risks to themselves and their fetus(es) in the training environment and request accommodations where indicated. 

As per section 13.3.1 of the RDoS collective agreement, “if the condition of a pregnant Resident so justifies, that Resident shall, upon submission of a medical certificate signed by a medical doctor have duties amended to meet the medical requirements. On call and night shifts will cease at 28 weeks of gestation unless the employee provides a medical note allowing them to continue with those duties. The inability to do call shall not be used to justify a demand that the employee cease work.”

PSYCHOLOGICAL SAFETY:

DISCRIMINATION/HARASSMENT/MISTREATMENT/VIOLENCE:

PGME is committed to providing and maintaining safe and positive learning environments in which any form of discrimination, harassment, mistreatment, violence (sexual or gender based), is unacceptable.

All members of the PGME community share the responsibility for creating and promoting a safe environment and are expected to conduct themselves in an appropriate and responsible manner.

Programs should support an environment in which Residents are able to report and discuss adverse events, critical incidents, ‘near misses’, and patient safety concerns without fear of punishment. PGME provides an online reporting tool that allows Residents to feel comfortable reporting their experiences anonymously should they choose.  Residents may report issues of general, sexual racial/ethnic, sexual orientation/gender identity, patient, and/or peer-to-peer mistreatment.

Any Resident who believes she or he has been subject or witness to a harmful incident or mistreatment is urged to bring their concerns forward. Before reporting a formal complaint, the Resident is advised to consult in confidence with their Chief Resident, Supervisor, Program Director, hospital authority, PGME Resident Resource Coordinator, Resident Doctors of Saskatchewan, or the University’s Discrimination and Harassment Prevention Services (DHPS) office.

Residents should be familiar with the PGME Wellness Policy, PGME Online Reporting Tool, USASK Violence Prevention Policy, and PGME Discrimination and Harassment Policy.

PROFESSIONAL SAFETY:

Residents may experience conflict between personal ethical/religious beliefs and professional duties as determined by the Program. In such instances the Resident may consult one or more of the following resources for direction:

Programs must act in accordance with the provisions of the Resident Doctors of Saskatchewan Collective Bargaining Agreement.

Information disclosed during meetings of either a Residency Program Committee or Competence Committee meeting may be disclosed to the Associate Dean PGME but is otherwise considered confidential.

Residents are required to secure and maintain Canadian Medical Protective Association (CMPA) professional liability and malpractice coverage through CMPA. Residents must be members of the CMPA and follow CMPA recommendations in the case of real, threatened or anticipated legal action.

Programs must comply with all PGME and University policies and procedures and are subject to and shall adhere to the provisions of The Local Authority Freedom of Information and Protection of Privacy Act unless otherwise expressly permitted by law.  Residents should familiarize themselves with the PGME Privacy Policy.

COMPLAINTS PROCESS:

Resident feedback, complaints, or allegations of malpractice must be handled in a manner that ensures Resident anonymity unless the Resident explicitly consents otherwise.  Depending on the nature of the complaint, SHA/USASK and/or CPSS may be informed and involved. Residents may report complaints or allegations of malpractice through the PGME Online Reporting Tool. Information collected from the reporting tool is confidential.

CONFIDENTIALITY & ACCESS TO INFORMATION:

All Resident files are considered confidential.  Those with a role in the Resident’s education such as Program Directors, Assistant Program Directors, Site Directors, Program Administrators, Residency Program Committee/Competence Committee/Progress Committee and/or Academic Advisors may have access to information within a Resident’s academic file as required to ensure the proper management of the Resident’s training. Program faculty and staff are bound by the confidentiality agreements put in place upon commencement of employment by the University of Saskatchewan or Saskatchewan Health Authority.

Programs and Residents should be aware of the PGME Resident Records and Access to Information Policy.

PATIENT SAFETY:

Patient safety and incident reporting is managed through the SHA. Residents should inform the most responsible practitioner and most appropriate operational leader as soon as possible when a safety incident has occurred to plan for disclosure and ongoing patient care. Residents can reference the SHA Disclosure of Patient Safety Incidents Policy for further details.

Programs must ensure that Residents are aware of confidential procedures to report patient safety concerns.

Residents may disclose concerns regarding patient safety to any of the following:

  • Program Director/Supervisor/Faculty member
  • PGME Resident Ombudsperson
  • PGME Resident Resource Office
  • PGME Online Reporting Tool
  • SHA

Responsibilities

All members of the PGME community share the responsibility for creating, ensuring, and promoting a safe learning environment and are expected to conduct themselves in an appropriate, respectful, and responsible manner.

Residency Program:

Residency Training Programs are responsible to:

  1. Ensure Residents receive appropriate educational safety sessions including USASK safety orientation and WHMIS training.
  2. Ensure Hospitals and associated teaching sites have appropriate health and safety measures in place for Residents.
  3. Ensure Residents are aware that they are subject to all USASK and PGME policies, procedures, and regulations as well as to all relevant policies, procedures and regulations of the hospitals and associated teaching sites.
  4. Ensure Residents are adequately oriented to policies and procedures prior to initiating clinical services.
  5. Not partake in discrimination, harassment or mistreatment of Residents, patients, coworkers, or staff.
  6. Act in accordance with the provisions of the Resident Doctors of Saskatchewan Collective Agreement.

SHA Hospitals and Affiliated Teaching Sites:

SHA hospitals and affiliated teaching sites are responsible to:

  1. Ensure Residents are appropriately supervised during their work and learning.
  2. Provide orientation information regarding all relevant policies, procedures, regulations, and occupational health and safety requirements.
  3. Identify and communicate potential health and safety hazards and risks to Residents.
  4. Implement appropriate health and safety measures, procedures, and processes to protect Residents.
  5. Ensure Residents receive appropriate health and safety training including for emergency situations – site specific WHMIS training, instructions for dealing with serious or critical incidents and reporting procedures.
  6. Ensure procedures are established for Residents who may work alone.
  7. Ensure Residents are not subject to discrimination and harassment.
  8. Establish processes for Residents to communicate health and safety concerns/issues, and to report incidents.
  9. Maintain relevant health and safety records including for Resident training and reported incidents.
  10. Not partake in discrimination, harassment or mistreatment of Residents, patients, coworkers, or staff.

PGME Office:

The Postgraduate Medical Education Office is responsible to:
a)      Work conjointly with residency training programs and the Saskatchewan Health Authority to ensure that each program and training site is in compliance with health and safety requirements.
b)      Provide current policies and procedures to programs and Residents.
  1. Not partake in discrimination, harassment or mistreatment of Residents, faculty, coworkers, or staff.

Residents

Residents are responsible to:

  1. Participate in appropriate health and safety training required by USASK, and host hospitals and affiliated teaching sites.
  2. Adhere to USASK health and safety requirements, and applicable occupational health and safety regulations.
  3. Be aware of and adhere to all USASK/PGME/SHA policies relevant to residency training.
  4. Not partake in discrimination, harassment, or mistreatment of patients, coworkers, or staff.
  5. Report health and safety concerns to their local supervisor(s) and Program Director.
  6. Become familiar with emergency response procedures of the host training site.
  7. Immediately report incidents to their host institution local supervisor, and Program Director, and/or PGME.

Non-compliance

Instances or concerns of non-compliance with this policy should be brought to the attention of the Associate Dean, PGME.

References, Resources & Relevant Documents:

PGME:

PGME Policies: includes Resident Accommodation, Wellness, Fatigue Risk Management, Blood Borne Pathogens, Health & Safety and other PGME policies.

PGME Resident Resource Office

PGME Online Reporting Tool

Reporting Work Related Injuries and Incidents


University of Saskatchewan:

USASK Policies: includes Biosafety, Discrimination & Harassment, Health & Safety, Radiation Safety, Violence Prevention, Working Alone and other USASK policies.

Emergency Management Policy

Safety Resources: 306-966-4675

Wellness Resources: 306-966-4580

EFAP: 1-855-575-1740

Discrimination & Harassment Prevention Services: 306-966-4936

Protective Services: 306-966-5555

Access and Equity Services: 306-966-7273

Other:

Resident Doctors of Saskatchewan

The Saskatchewan Employment Act

College of Physicians and Surgeons of Saskatchewan

Saskatchewan Health Authority

This policy has been adapted with permission from the University of Calgary and the University of British Columbia.

Contact

Coordinator, Academic and Non-academic Processes, PGME Office

Phone: 306-966-6145