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FACULTY OF HEALTH SCIENCES

Postgraduate Medical Education

COVID-19 FAQ’s

Learners can ask anonymous questions for PGME to post answers below

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Residents managing COVID-19 cases

  • The HHS hospitals and the St. Joseph’s hospitals each have an online screening tool that Learner’s are required to complete daily prior to every shift:
  • It is continuously recommended to follow physical distancing rules when out in public and when that is not possible, it is recommended you wear a mask.
  • When rotating outside of Hamilton or your home-base, learners must complete any mandatory screening procedures in place at those sites.

If you are experiencing symptoms and are unsure of what to do, contact Employee Health Services immediately.

 

PGME learners are permitted to provide care to patients with suspected and confirmed cases of COVID- 19, if the most responsible physicians are in agreement, and provided that residents and fellows are able to comply with Infection Control guidelines on Personal Protective procedures.

Please discuss with your program director as soon as possible, if for health-related issues or pregnancy, you are unable to care for patients with suspected or confirmed cases of COVID-19. There may also be other circumstances aside from personal health/ pregnancy that may affect your ability to care for these patients. We encourage you to speak with your program director and/or PGME regarding these concerns.

Please review the COVID Primer by Dr. Hosay Said, IM PGY2

All vaccine information can be found on the PGME Vaccination webpage

Please review the PGME PPE website. It provides you with the latest information from hospitals; donning and doffing videos, etc.

 

Updates

Travel

With the start of a new academic year during a pandemic, many considerations have taken place to ensure careful coordination between our Learner’s educational needs and the public health safety measures.

This information is to provide direction and clarity for Learners and their programs to help minimize the risks associated with training, such as travel and various training locations.

McMaster PGME continues to recommend avoiding all non-essential travel, as well as continuously checking for updates from Public Health. Recommendations may be updated in response to changing epidemiology.

As of July 5th, the hospitals will be following the public health guidelines of lifting the 14-day self-isolation for those who are FULLY VACCINATED.

All trainees who choose to travel to an international destination and are not fully vaccinated will be required to quarantine for a period of 14 days upon their return to Canada; 24 hours for 14 full days. If you don’t have COVID-19 symptoms, you must quarantine for 14 days while you’re still at risk of developing symptoms and infecting others. If you have COVID-19 symptoms, you must isolate for 14 days.

Learners should plan accordingly as the self isolation period is considered to be time away from training and vacation days may be applied to this period. It is essential that you plan accordingly and discuss any international travel with your program director.

  • McMaster University is committed to ensuring that all incoming international medical Learners self-quarantine for a mandatory 14 days upon arrival to Canada; 24 hours for 14 full days
  • In order to begin your training on time, it is highly recommended that you arrive to your host city more than 14 days before your training start date.
  • PGME is requesting the following information from each international Learner to assist us in monitoring their self-isolation period: arrival date, self isolation plan, plan for transport from the airport to their accommodations, the location of their accommodations during self-isolation, and an outline of their plan once settled (e.g. groceries, food delivery, self-care items, etc.).
  • To assist you with housing if your permanent housing is not available 14-days prior to your start date, PGME has compiled the resources below:

Government of Canada – https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/latest-travel-health-advice.html?topic=tilelink

Learner Q&A

PGME recognizes that Learners have a lot of questions about the constantly changing situation with COVID-19 and the workplace. Learners can submit an anonymous question to PGME by completing this form and the responses will be posted here for your reference.

Q. Has PGME heard anything regarding the pandemic pay that we are supposed to be getting? This was announced by PARO on June 14th and we haven’t heard anything from them, from PGME, or from the HHS pay centres about this since then.

A. Unfortunately at this time we have not heard anything further from PARO or the Ministry regarding the payout. Once we have more information we will email all of the learners directly.

Q. We need PGME to advocate for cancelling the Royal College OSCE for medicine residents this year. We are drowning under the current workload and anticipate this will only worsen. It is bad for the health of our patients and ourselves to expect us to continue to prepare for this invalidated exam in these extenuating circumstances.

A. Please believe that as your PG dean, I am actively taking all concerns of the residents to the Royal College and they are aware of the impact of this third wave. Decisions regarding certification exams are made by the Colleges in consultation with the regulatory bodies and universities and need to consider the needs and concerns of all residents who are taking the exam this year. I have had emails from residents who are worried about cancellation and what that would mean for licensing in July 2021. I have communicated with the other PG deans and the Royal College directly and will continue to bring forth these concerns.

Q. What has the RC planned if a provincial lockdown is undertaken? Residents have reached out to ask, with no response.

A. On April 7th the RC circulated a message that PGME shared with all Learners, explaining that as of the current moment spring exams will proceed. Please see the message that was sent to all Learners, posted on the COVID-19 Licensure & Exam update page

Q. The residents writing the Royal College haven’t heard anything from PGME re: exams. Most of us have a written + OSCE in the next two months. When the third wave hits, and Jr residents may need to be redeployed, the senior residents will be called on to help cover service. Inevitably, this will make studying even more challenging than it has been over the last few months. Has PGME been advocating for us with the Royal College?

A. The postgraduate deans are in regular communication with the RC as they continue to review options and plans for exams. All updates from the RC are shared with our Learners quickly and we will continue to support you in any way possible as we recognize the stress you all face during this time.

Q. Is PGME advocating for residents to receive timely vaccinations, including in the cases of delayed second doses up to 4 months in place by the provincial government? There are many priority 1 sequenced residents who have still yet to receive first or second doses.

A. It is our understanding that the priority sequencing is functioning accordingly and, any and all updates PGME receives are circulated to Learners and posted in the vaccination hub of the COVID-19 website. If you feel you should have been contact by now based on when you registered and your priority sequence, please email covidvaccination@hhsc.ca or call (905) 381-7055

Q. Will there be opportunities for residents to work at COVID vaccination clinics?

A. For Learners interested in working at a COVID vaccination clinic during your regularly scheduled clinical activities, approval by your supervisor is required.

Q. Many Learners, due to self-isolation with some inter-provincial or international travel, have not been able to visit their loved ones for over a year. This is a huge strain on learner wellness. Are there any initiatives from PGME or amongst PD’s to grant time off that could accommodate for period of isolation associated with such travel.

A. PGME has encouraged Program Directors to work with their learners who want to return to their home province and or country. In some instances the Program Directors can assist the learner, upon return, by creating a virtual 2 week period that would allow them to self isolate and work in tandem. However, this is not possible for all programs and may not be possible for every learner in a program, therefore the Program Director must exercise fairness and equity amongst their learners. In these cases learners have been asked to take 2 weeks of their allocated vacation or an unpaid leave, to accommodate for the required self isolation period upon return back to Canada.

Q. Based on my home program, I would be in stage 1 of the vaccination roll out. I’m off until block 10 on leave; where do I place myself in the vaccination sequence?

A. You would fall in line with the general populace during your time off as you are not currently practicing and technically don’t align with a sequence during this time. Upon your return, you would become a priority 1.

Q. Does the new provincial lockdown mandate that Learners isolate upon return to Ontario from out of province travel?

A. There are currently no specific restrictions for interprovincial travel for Ontario, though the situation is evolving rapidly.

Q. Hello, I was wondering why learners interacting with patients (with and without COVID swabs pending) are provided level 1 face masks, when other hospitals/communities are providing level 2 or even level 3 masks?

A. The regional Subject Matter Expert Commitee (eg. JBH, NGH, HHS, SJH) has agreed that a Level 1 mask is adequate for COVID Care.  Many GTA hospitals do not actually delineate which masks are to be used for what clinical area.  No larger organization has stated (eg. PIDAC, PHAC) that any level of mask is necessary for COVID Care, if it is a hospital grade mask.

The main difference between ASTM level 1 and 2 masks is increased fluid resistance.  And even this difference is not major, and a face shield is also recommended when face splash risk to provide a more fulsome barrier in addition to eye protection. ER, ICUs were given level 2 masks due to the urgent procedural nature of their work.

The recommendation is a level 1 mask is adequate for COVID care.  The filtration efficiency is essentially equivalent between the level 1 and 2.  Level 3s are still in short supply and not in use at HHS in any areas.

Q. Why does HHS refuse to provide appropriate PPE? Having worked at several regional hospitals over the last few months, are all giving us adequate level 2/3 masks to wear while operating. HHS claims all we need is a level 1 mask (which is not liquid-proof) and provides us with “level 1” masks (which are in packages labelling them as non-medical masks).

A. Hello and thank- you for the email. The IPAC team is reviewing their current PPE guidelines. They have told us in the past that any recommendation has followed public health guidelines. But this is actively being reviewed by the IPAC teams at SJH and HHS. As soon as we hear of any changes, we will forward to all the residents.

Q. If we travel to the United States, do we still have to undergo a full 14 day quarantine if we get tested upon our return to Canada and are negative without symptoms?

A. Currently yes, a 14 day quarantine period is required when traveling home to Canada even with a negative COVID-19 test result. We are currently in review with our legal team about policies specific for physicians and international travel. We are doing this in collaboration with the policies set by our main hospital sites who require 14 day isolation. HHS has travel information posted on their website.

Q. Are electives PGME trainees from within the province able to visit for electives. If not, when is this expected to change?

A. McMaster is accepting visiting electives from within Canada, at this time. The only exception is core Internal Medicine electives. These are currently cancelled from block 1-4.

Q. Are there restrictions for residents visiting family and friends that are out of province during their time off? Or is this prohibited as non-essential travel?

A. Travel outside of Ontario to other Canadian Provinces is not prohibited as per the Provincial guidelines, but it continues to be discouraged if it is non-essential. It is advised to check Public Health guidelines before travelling to other provinces.

Q. Can Learners prophylactically get tested for COVID-19 prior to planned travel to a low-risk province? 

A. No, at this time Learners cannot get a prophylactic test for COVID-19 prior to travel. It is advised to check Public Health guidelines before travelling to other provinces.

Q. Any restriction on general surgery electives to McMaster from other Ontario schools, UofT for example?

A. Currently there are no restrictions on general surgery electives to McMaster from other Ontario schools, however, keep in mind that things do continue to change frequently at this time.

Q. I am a clinical research fellow. Due to the lockdown and temporary cessation of non-urgent medical visits in Ontario, I was given permission to return to my home province during the peak months of the pandemic and work remotely on research from there (I did not have patient contact while out of the province). I was wondering if I should self quarantine for 14 days upon my return to Hamilton before seeing patients/physically returning to the hospital again? The most recent official Ontario guidelines does not require self-quarantine following civilian inter-provincial travel.

A. No, as per the Province of Ontario guidelines, self-isolation is not mandated in Ontario when traveling within Canada. You also discuss with your Program Director as well. It is advised to check Public Health guidelines before travelling to other provinces.

Q. Is self-isolation mandated for residents who return from travel to another province at the level of HHS and St. Joseph’s Healthcare? At the time of writing (June 23), Ontario does not mandate self-isolation upon return from out of province.

A. No, as per the Province of Ontario guidelines, self-isolation is not mandated in Ontario when traveling within Canada. It is advised to check Public Health guidelines before travelling to other provinces.

Q. I am a trainee who holds an independent license in internal medicine. If I get redeployed to CTU, can I bill for the services I provide? I very strongly feel that I should be allowed to do so considering that I am fully licensed, and redeployment will take away time that I could spend doing locums at a community hospital (for which I would be getting appropriately compensated). Thanks!

A. All Learners will be paid their regular salary (the same) for their redeployment efforts (if they are MOH funded or Gulf sponsored) should they be involved in redeployment. If you are not paid through one of these channels, you are welcome to discuss further with Dr. Wasi directly –  wasip@mcmaster.ca

Q. Dear Dr. Wasi, This email is on behalf of the Plastic Surgery Residents concerning a recent change in our program which was delivered by email to residents in the last few days. Essentially, we were emailed with the decision that staff were making a unilateral change to increase the amount of back-up call that is required by senior residents for Block 12 and potentially onward. We are already short residents in many years due to maternity leave/CIP, etc. and this has resulted in both junior and senior residents working the PARO maximum….
As there was no resident consultation – being a unilateral staff decision – we wanted to respectfully bring this to the attention of PGME for an external perspective. Thank you, Plastic Surgery Residents 

A. Dear Residents: Thank-you for your email and appreciate the concerns. Would appreciate to speaking to a representative from the group to discuss this situation. Please contact me at wasip@mcmaster.ca and will arrange a time. Parveen

Q. Hi Dr. Wasi, Thank you for keeping us updated. I and my husband are both residents and we have a 5-year-old daughter who is sitting with us now as a consequence of school closure. Since the march break, we have applied for the emergency child care and we have not received any match for our request. Is there any way that we sort this? We don’t have family support here and it’s very stressful thinking of what we are going to do day-to-day with her care. We have very supportive programs and PDs but I’m wondering if the PGME put this situation into account. This whole thing is very stressful and we are really concerned. Thank you

A. Hello, Thank you for your email. We will follow up with our undergraduate colleagues to see if medical students are offering child care services; and with McMaster university team about any central resources that may be available. We will update you via our website once we hear back.
For now- things to consider:
– Would a Leave of Absence help either of you? We are pretty lenient with LOAs; the only issues being loss of training time if core experiences will be missed (but if not, would be considered as part of waiver). It may we worth speaking to your respective Program Director to see if this is feasible for either of you. If that is not what you want nor an option for either of you, perhaps consider the following:
– staggering any redeployment to make sure both of you are on not on at the same time but that may not help if the other one still has clinical responsibilities at the same time.
– we will also add this to both your names so consider it when we are selecting residents for redeployment- if you would like this option please email sophiab@mcmaster.ca and apprise her of your situation.
I am happy to talk on the phone as well if you want to give me your number – completely confidentially. Please email me directly wasip@mcmaster.ca

Q. Now that the CDC and WHO have started to consider and recommend cloth face masks for the general public for areas of high risk of community transmission how will this translate to need for in hospital PPE for residents?

A. Right now PPE is recommended for all health care workers in certain sites (ER; ICU; Labour and Delivery). HHS and SJH have not instituted masks for all HCW in any clinical setting. This is an active discussion but will depend on availability of PPE- to ensure that there are sufficient supplies for patients who require PPE for care. Hopefully once supplies increase, HHS and SJH will institute masks for all HCW involved in patient care in any setting.

Q. I received an email from staff, which I would like clarification on as I have attempted to reconcile some of the information provided with available information on the HHS hub. Is the HHS ED under the assumption that everyone is infected with COVID? Are the stated dress code requirements being implemented in the HHS ED? Personally, I have not experienced any ED nurses denying PPE, however there may be misunderstandings/confusion regarding circumstances of when to use certain PPE, in which case it may be helpful to have the policies posted in high needs area for all individuals to review.

A. I am not aware of these guidelines for HHS ER. Definitely all health care workers based in the ER must wear masks (now up two per shift). But not aware of clothing restrictions; will follow up with the ED Chief to see if these recommendations are personal opinions. Each patient will have specific PPE requirements posted if appropriate. I will look into the issue of scrubs, etc. We have also added a PPE section to the PGME COVID-19 website to highlight any communications regarding PPE from the hospitals so that they don’t get lost in the hospital daily updates.

Q. Do we have to specifically mention what comorbidities (personal health information) we have, to the program/program director? With this new process through ability@hhs.ca would the program be informed of ‘what’ chronic health condition/s that one has or will it remain anonymous? We understand safety is of utmost importance during this time of uncertainty but also feel somewhat uncomfortable divulging personal health information to the program and colleagues that we will be working with in the years to come.

A. You do not have to disclose any personal health information to your program. If any questions or concerns, you can contact me directly or talk with the resident wellness office.

Q. For the COVID-19 screening we do every day, how will it change for those of us with seasonal allergies? We will basically have a runny nose every day for a month or so.

A. EHS states that allergies have been considered in the screening process. They indicate that they are looking for new or unexplained symptoms. If a runny nose or sneezing is “normal” for you during allergy season, that would not fall into the “new or unexplained” category of symptoms.

Q. How will COVID-19 impact the incoming summer of 2020 Class?

A. At this time, the plan is to proceed as normal. As we receive more information this may change. We are currently looking at potentially moving orientation to an online format in the event we are not able to host an in person orientation for PGME.

Q. I am a fellow in a sub specialized clinic. Given that clinics are closed and doing less procedures now, seeing urgent cases if any and follow patients virtually, if this will take long can I ask for extension of my training after that if my program agrees to do so?

A. All programs are trying as much as possible to count every experience as part of the training. However we recognize that there may be critical experiences and certain required competencies may not be met due to cancellation of clinical services. It certainly will be possible to extend training on the recommendation of the program director for those Learners who need to complete core components.

Q. What happens if a resident has been exposed to a patient who is COVID+?

A. If you are exposed to a patient or staff member/physician who has tested positive:

  • Employee health will call you and ask for details of your interaction with the infected patient or staff member/physician.
  • Details of interest are duration of contact, proximity, whether PPE was in place.
  • You will then be advised to either self-monitor for symptoms or to self-isolate at home.
  • If you are instructed to self-isolate at home, you may be recalled to work if you are deemed essential, i.e. not able to be replaced due to staff shortages where unique knowledge and skills are required.
  • If you develop symptoms consistent with COVID-19, follow the instructions for contacting Employee Health Services listed above.

Q. What can be done for parents of newborns or spouses of pregnant women as we are concerned about spreading the infection to them?

A. We do understand that there are many social situations that are causing a lot of anxiety for the people we love. We are currently looking into the possibility of subsidized housing for residents and fellows who are on self-isolation. We should have more information by the end of this week.

Q. If we are in our final year and vacation is cancelled, will we be reimbursed for this time?

A. Unfortunately, we do not have a way to payout vacation if it is not utilized. If it is possible to take the vacation at this time, we would highly encourage it.

Q. We have heard only rumblings from our program around redeployment. Are we able to volunteer for this should the need become excessive? It may be better on a voluntary basis as residents even within programs will have varying levels of comfort to cover other services.

A. The PGME-COVID-19 Taskforce, in collaboration with Program Directors, has created redeployment principles (refer to Friday, March 27 email to Learners). Program Directors in consultation with their learners will play a vital role in providing information about their learners to the PG Taskforce to help inform redeployment. Decisions and most appropriate service(s) should need be required. We will do our best to notify residents and fellows in ample time regarding any redeployment efforts. We hope to have more for Learners regarding redeployment by early next week. All redeployment activities will take into account skills of the learners based on prior clinical experiences, and will ensure appropriate orientation and supervision.

Q. Are safety glasses safe substitutes for visors/face shield/goggles?

A. Please refer to the approved PPE on the website

Q. If a resident has a chronic medical condition i.e. Bronchial asthma, type 1 or 2 diabetes, renal disease, hypertension, on CPAP for OSA etc. would that be considered a situation where they should not take part in the care of a confirmed or suspected COVID patient?

A. We encourage all residents who have comorbid conditions that places them at higher risk of serious illness if COVID19 is contracted to discuss with their program director. All PDs have taken this into account when assigning clinical activity. If there are still concerns, please contact me directly at wasip@mcmaster.ca

Q. Any chance there will be subsidies or assistance for residents who test positive for COVID-19 but unable to stay home to quarantine with fear of infecting others/family members in the home? Although still COVID-19 negative after a test this week, I’m looking at renting an air bnb for an extended period as our apartment in Hamilton is too small to physically isolate myself away from my wife, toddler, and infant. 

A. We are currently looking into the possibility of designated subsidized housing for residents and fellows who are on self-isolation. We should have more information by the end of this week.

Q. My partner is also a resident and I am the main care giver for our children. If I am redeployed, what support can I expect for childcare given daycare closures and restrictions on using grandparents for childcare given the high risk posed to them? Is there any precedent to NOT redeploy residents who are the sole care provider for their young children.

A. If there are circumstances such as child care that precludes people from clinical activity, we suggest that this be discussed with your Program Director; we will also be developing a budget from PGME to subsidize potential costs to residents.