Waiver of Training after a Leave of Absence

The University of Saskatchewan Postgraduate Medical Education Office may grant 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).\

The Associate Dean, Postgraduate Medical Education (PGME) may approve a waiver of training following the recommendation of the resident’s Program Director in collaboration with the residency program committee (RPC) or Progress Committee, 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) provided the criteria outlined in this policy is met.

There are differences in the process for time-based programs and Royal College programs that have transitioned to Competence by Design (CBD). These are outlined in this policy.

Granting of a waiver of training after a leave of absence is the exception rather than the standard procedure.

Waiver of training after a leave of absence does not mean that a resident can shorten training because they have performed well and would like to start practicing earlier than their adjusted end of training. Waivers should only be considered if the resident is planning to pursue other training that would be compromised by their adjusted end of training date.

This policy applies to all Residents and faculty who assess residents in all residency training programs at the College of Medicine, University of Saskatchewan.

This policy is based on the RCPSC Policy and Procedures for Certification and Fellowship- Modification of Residency Training, and College of Family Physicians of Canada Requirements for Residency - Leaves of Absence.

Residents are required to complete their entire training program and demonstrate achievement of all learning objectives and competencies. A waiver of training may be appropriate for residents who have taken a leave of absence during their training and are undertaking further training that is set to begin on a date earlier than their current expected residency completion date.

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.

Residents who are granted a 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 consideration. Programs will arrange an RPC sub-committee or Progress Committee meeting to review waiver of training requests.

Residents are entitled to know, in advance, how their performance will be evaluated for them to qualify for a waiver. To make the decision objective and transparent all programs must make the criteria they will use in granting a waiver of training available.

Decisions regarding waivers must be standardized and consistent amongst the residents within the program.

Residents must discuss their eligibility to waive training requirements with their Program Director. The Competence Committee/Progress Committee, in collaboration with the RPC/RAS as appropriate, will determine if the resident has achieved the required competencies of training.

Residents may be approved for a waiver of training only once during residency training.

Residents in CBD training programs are not permitted to apply for accelerated training if a waiver of training is granted.

A decision not to grant a waiver of training cannot be appealed.

A waiver of training will be at the discretion of the Competence/Progress Committee (in collaboration with the RPC/RAS), using the principles outlined within this document, associated policy, and those established by the respective training program. Before recommending a waiver of training the Competence/Progress Committee must be satisfied that the resident will achieve a minimum level of competence by the end of the final year of training.  

When considering a waiver of training the Competence/Progress Committee is encouraged to consider:

1. Any unsatisfactory, borderline, or incomplete rotation evaluations. The resident must have clearly met the competencies outlined for each rotation. This includes assessments on ITERs in the range of “meets expectations” or “exceeds expectations”.
2. Inconsistent attendance at academic activities.
3. Training modifications which resulted in an overall dilution of the educational experience.
4. Any concerns about academic, professional, behavioral, and/or ethical performance.
5. Performance in objective evaluations.
6. Successfully completed all RCPSC and CFPC requirements AND program requirements including (as required): in-training examinations, research and/or quality improvement projects, case logs, and portfolios.
7. Verification that the resident has been accepted for further training. Verification must include a proposed start date earlier than their adjusted end of training date.
8. Each request for waiver of training will be reviewed on a case-by-case basis.

If it is determined that a waiver of training is appropriate, the program will submit a waiver of training application form to the PGME Office. Attached to the application form must be a summary of the information on which the program has based the waiver recommendation. The summary should describe the resident’s performance based on the relevant assessment criteria. The program may include copies of any relevant documents or information they feel makes the resident’s waiver application comply with competency requirements.

The recommendation from the program for the waiver of training must be approved by the Associate Dean, Postgraduate Medical Education (PGME).

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

i) It follows the waiver of training after a leave of absence sections from residency policies of the RCPSC and the CFPC.
ii) The resident is in the appropriate year to write their certification exams (pre-CBD & CFPC).
iii) The resident has not yet written their certification examinations (pre-CBD).
iv) The waiver requested does not exceed the maximum allowable duration.
v) The resident will have completed all mandatory components of training.
vi) The resident has been accepted to pursue additional training.

Requests for a waiver of training will be considered in accordance with the RCPSC and CFPC policies. If the respective policies change, the PGME Associate Dean will refer to the policies of the respective certifying College.

Pre-CBD Royal College Programs and CCFP Family Medicine Programs

Residents will apply for a waiver of training to their Program Director. Programs will arrange an RPC/RAS/ Progress Committee meeting to review waiver of training requests. The waiver of training request is typically submitted to PGME by the program at the beginning of the final year of a resident’s training and may also be submitted along with the program’s recommendation for exam readiness (i.e., when the program submits the Confirmation of Training (CCT) documents to PGME).

In Pre-CBD Royal College programs, a decision to waive training after an approved leave of absence can be made during the year the resident is scheduled to write their certification exam.  Waivers cannot be granted after the Resident has written the certification examinations.

 In Family Medicine Programs, requests for waivers can be submitted after the certification exam.

CBD Royal College Programs

Waivers of training for residents in CBD programs should be submitted to PGME during the last 12 months of training (and no later than 8 weeks prior to the revised recommended end-date) regardless of the resident’s stage of training.  Exam eligibility will be determined by the program during the third stage of training, Core of Discipline. Since exams are situated earlier in CBD programs, requests for waivers can be submitted after the certification exam.

College of Family Physicians of Canada (CFPC)
Family Medicine	4 weeks
Enhanced Skills	No waiver permitted
Royal College of Physicians and Surgeons of Canada (RSPSC)
1-Year Program	No waiver permitted
2 & 3-Year Program	6 Weeks
4, 5 & 6-Year Program	3 Months
Subspecialty	6 Weeks (in final year)

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

1. 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.
2. Only one waiver per training program may be granted. Should a resident take a 4^th year in Internal Medicine, the waiver will apply to the 4 years spent in the program.
3. In the subspecialty years, a decision to grant a waiver is recommended in the final year by the Competence Committee and approved by the Postgraduate Dean. A maximum 6-week waiver of training can only be taken in the final year of training.
4. If a 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 Internal Medicine training at the University of Toronto and switches to Cardiology at USask, the Postgraduate Dean from Toronto would approve the six-week waiver in Internal Medicine and the Postgraduate Dean from USask would approve the six-week waiver in Cardiology.

RCPSC Pre-CBD and CBD Programs:

The Royal College is not required to approve waiver of training requests, final approval is determined by the Associate Dean, PGME. If the Associate Dean, PGME approves the request, the PGME office will update the resident’s file to reflect the revised end date of the program.

CFPC Programs:

The Associate Dean, PGME will review and approve the waiver request submitted by the Program Director. If approved, the PGME office will provide a letter to the CFPC notifying the Board of Examinations and Certification that a waiver of training has been granted. The PGME office will also forward the response to the program and update the resident’s file to reflect the revised end date.

Once the final approval process is complete the PGME office will notify the program and it will be the program’s responsibility to update and inform the resident.

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

• PGME Waiver of Training Application Form
• RCPSC Policy and Procedures for Certification and Fellowship
• College of Family Physicians of Canada- Requirements for Residency - Leaves of Absence
• The RCPSC CBD Technical Guide for Exam Readiness
• Referenced with permission from McMaster University

Coordinator for Academic and Non-academic Processes, PGME Office

Phone: 306-966-6145