Principle

The Faculty of Medicine (FoM) recognizes that Postgraduate Learners have the right to a safe, positive and healthy training environment during their Postgraduate Training Program. The responsibility for promoting a culture of safety and well-being for Postgraduate Learners rests with the FoM, Affiliated Training Sites and hospitals, faculty, and the Postgraduate Learners themselves.

The concept of Postgraduate Learner safety and well-being includes minimizing the risk of injury and promoting a safe and healthy training environment. This includes the provision of physical, psychological, and professional security, safety, and well-being.

Purpose

To promote a safe and healthy training environment during Postgraduate Training by clarifying the concepts of safety in Postgraduate Training Programs, and Affiliated Training Sites and hospitals.

Scope

This policy applies to all Postgraduate Learners, Postgraduate Training Programs, and Affiliated Training Sites and hospitals of the Postgraduate Medical Education (PGME) program at Memorial University (Memorial) while Learners are undertaking activities related to the execution of Postgraduate Training duties.

Definitions

Learner — A trainee registered in a postgraduate training program accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC).

Memorial-Affiliated Learning Site — Teaching sites that have established Memorandums of Understanding (MOU's) with Memorial and provide Learners with medical education learning opportunities.

Postgraduate Training Program — A period of training in a specific discipline of medicine prescribed by the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC) leading to certification by one of these bodies.

Professional Association of Residents of Newfoundland and Labrador (PARNL) collective agreement — An agreement outlining the terms and employment conditions for residents, while maintaining a mutually beneficial relationship between the Employer (NL Health Services) and PARNL members.

Program Director — The faculty member assigned responsibility for the overall conduct of the  postgraduate training program in a given training program.

Required Training Experience — A pre-identified period of time in one (1) training program with a specified timeline that has a set of educational objectives and/or competencies to be successfully completed.

Residency Program Committee (RPC) / Residency Training Committee (RTC) — A committee established to assist the Program Director in the planning, organization, and supervision of the Postgraduate Training Program.

In Family Medicine the equivalent committee is the Residency Training Committee (RTC).

Social Media — Web-based and mobile technologies that allow people to monitor, create, share, or alter text, audio, photos, or videos with others.

State of Emergency —  As defined by the Government of Newfoundland and Labrador Adverse Weather Conditions and States of Emergency Policy

An abnormal situation that requires prompt action, beyond normal procedures to minimize damages to persons, property or the environment; a real or anticipated occurrence which endangers or is likely to endanger the safety, welfare, and well-being of some or all of the population, either in a municipality or the Province. A state of emergency may be declared by an incorporated municipality or by the Province

Supervisor — The individual responsible for documenting their observation of a Postgraduate Learner's performance. 

Weekend — A Weekend includes Saturday and Sunday.

Policy

1.0 Responsibilities

1.1. Postgraduate Learner

1.1.1. To comply with relevant safety policies, participate in required safety sessions, and be responsible for communicating safety and well-being concerns to their Postgraduate Training Program.

1.1.2. To manage their self-care and avail of resources and supports available through the FoM to support and address safety and well-being concerns.

1.2. Postgraduate Training Programs

1.2.1. To act promptly to address identified safety or well-being concerns and incidents and be proactive by providing a safe and healthy training environment.

1.2.2. To ensure appropriate educational safety sessions, and initial specialty and site-specific workplace safety orientations, are available to Postgraduate Learners.

1.2.3. To establish a written safety policy in accordance with the Canadian Excellence in Residency Accreditation (CanERA) General Standards, considering specific risks associated with the nature of the discipline and the organization of training.

1.2.4. To identify policies specifically related to patient transfers by ambulance including critical care and pediatric transport, as applicable.

1.2.5. To ensure Postgraduate Learners are aware of and able to access supports to address any well-being concerns as identified in the FoM Postgraduate Well-being Guidelines.

1.3. Affiliated Hospitals and Training Sites

1.3.1. Ensure that the supervision, safety, and security of Postgraduate Learners in their facilities are following employee safety and security policies, procedures, and PARNL Collective Agreement requirements.

1.3.1.1. All relevant parties will work together with the Affiliated Training Sites and hospitals to ensure the personal safety of all Postgraduate Learners, in compliance with applicable university regulations and contractual obligations.

2.0 Physical Safety

2.1. Training Environment

2.1.1. Site orientation should include a review of local safety procedures.

2.1.2. Call rooms and lounges provided for Postgraduate Learners must be clean, smoke free, located in safe locations, and have adequate lighting, a phone, fire alarms, and smoke detectors and any appliances supplied are to be in good working order. Call rooms and lounges must have adequate door locks.

2.1.3. Pregnant and breastfeeding/chestfeeding Postgraduate Learners should be aware of specific risks to themselves and their fetus or baby in the training environment and request accommodations, if needed. Postgraduate Learners should consult the Occupational Health and Safety Office of the health care facility for information. Accommodation requests, where indicated, should be made through the Program Director in consultation with the Associate Dean, PGME.

2.1.4. In addition to any requested accommodations, pregnant Postgraduate Learners are entitled to modified call obligations set out in the PARNL Collective Agreement.

2.1.5. Postgraduate Learners should be provided with an appropriate environment for breastfeeding/chestfeeding and lactation.

2.2. Security

2.2.1. Postgraduate Learners should not work alone, after-hours (in clinical or academic facilities) without adequate support from security services, on-site support or supervision.

2.2.2. Postgraduate Learners should not be expected to walk for unsafe distances at night and should use security services where available.

2.2.3. Postgraduate Learners should not disclose their personal and/or private information to patients including home or cell phone numbers, personal email addresses, social media contacts, or home addresses. Particular attention should be paid to the Postgraduate Learner’s social media presence, in line with the Guidelines for the Appropriate Use of Social Media.

2.3. Patient Encounters

2.3.1. Consideration should be given to having Postgraduate Learners accompanied for home visits.

2.3.1.1. A Postgraduate Learner may only be permitted to do a home visit alone when they (or their preceptor) know the patient and/or have been to the patient’s home on a previous visit and they feel comfortable executing the visit alone. If these conditions are met, the Postgraduate Learner may visit the patient in their home by themselves and contact the back-up faculty during their visit to discuss management.

2.3.2. Postgraduate Learners should consider contacting patients from a clinic or hospital telephone line. If calls must be made with a personal or mobile phone, this should be done using call blocking.

2.3.3. Specialty training must be provided to Postgraduate Learners who are expected to encounter hazards such as exposure to violence from patients or others.

2.3.4. Postgraduate Learners should have the backup of security and an awareness of accessible exits when assessing violent or potentially violent patients.

2.3.5. Postgraduate Learners who feel their personal safety or security is threatened must remove themselves immediately, in a professional manner, and seek urgent assistance from their immediate Supervisor or from security services.

2.4 Sexual Harassment and Sexual Assault

2.4.1. Postgraduate Learners are entitled to a training environment free from all forms of sexual violence including sexual assault and sexual harassment. The Sexual Harassment Office supports all members of the university community and administers the following policy and procedures: Sexual Harassment and Sexual Assault Policy and University-Wide Procedures for Sexual Harassment and Sexual Assault Concerns and Complaints

2.5. Travel

2.5.1. Postgraduate Learners are not to be expected to travel long distances during inclement weather for clinical or other academic assignments. Postgraduate Learners are encouraged to use common sense and practical considerations when making travel decisions.

2.5.1.1. If inclement weather prevents travel, the Postgraduate Learner is expected to contact their Supervisor/program office promptly. Assignment of an alternate activity may be required. In such extraordinary circumstances, annual leave may be extended if alternate and timely travel arrangements cannot be made.

2.5.2. When Postgraduate Learners are travelling for clinical or other academic assignments by private vehicle, it is expected that they adequately maintain their vehicle (e.g., winter tires, sufficient gas) and travel with appropriate supplies (e.g., emergency car kit and contact information).

2.5.3. If long distance travel is required for clinical or other academic assignments, Postgraduate Learners should ensure that the program office is aware of their itinerary.

2.5.4. Postgraduate Learners should not be on-call the day before driving long distances, for clinical or academic assignments. When long distance travel is required, the Postgraduate Learner should request that they not be on-call the Weekend preceding the start of a new Required Training Experience.

2.5.5. More detailed information regarding Postgraduate Learner Travel Safety can be found in the Travel Safety Guidelines for Postgraduate Learners.

2.5.6. If a State of Emergency has been declared which impacts Memorial University or an Affiliated Teaching Site, Postgraduate Learners should refer to the Faculty of Medicine’s State of Emergency Policy.

2.6. Elective Training

2.6.1. To ensure compliance with safety standards and best practices, Postgraduate Learners undertaking electives in low-resourced and under-resourced Canadian and/or International communities must complete the Electives/Selective Proposal and Authorization Form. Once approved, Learners should contact the Global Health and Health Equity Coordinator for pre-departure preparation and training.

2.6.2. For all international electives, Learners will register with the Memorial Go Abroad Office. If the proposed elective is in a low-resource location outside Canada, or in an under-resourced community within Canada, Postgraduate Learners are also required to register with the Global Health and Health Equity Program.

2.6.3. For electives in any country outside of Canada, Postgraduate Learners are responsible for communicating with the institution where the elective is based, to determine how to obtain recognized and sufficient liability coverage.

2.7. Workplace, Environmental and Occupational Health and Safety

2.7.1. Postgraduate Learners must be made aware of site-specific safety risks. Postgraduate Training Programs and Affiliated Training Sites and hospitals must ensure Postgraduate Learners are appropriately oriented to current workplace safety guidelines.

2.7.2. Postgraduate Learners should familiarize themselves with the location and services offered by the Occupational Health and Safety Office of the health care facility in which they are training. This includes familiarity with policies and procedures for infection control and protocols following exposure to contaminated fluids, needle stick injuries, and reportable infectious diseases.

2.7.2.1. All entry-level Postgraduate Learners must undergo training in infection control precautions provided by Newfoundland and Labrador Health Services at the start of their Postgraduate Training Programs.

2.7.3. Postgraduate Learners working in areas of high and long-term exposure to radiation must follow radiation safety policies and minimize their exposure according to current guidelines.

2.7.3.1. Radiation protective garments (i.e., aprons, gloves, neck shields) must be used by all Postgraduate Learners using fluoroscopic techniques.

2.7.4. It is recommended that all Postgraduate Learners keep their immunizations up-to-date. Overseas travel immunizations and advice should be sought well in advance when traveling abroad for electives or meetings.

2.7.5. Postgraduate Learners must abide by the FoM BloodBorne Viruses Policy.

2.7.6. Injury Reporting

If an injury occurs while performing Postgraduate Training, the Postgraduate Learner must:

a. Seek the appropriate level of medical attention necessary, go to the nearest Emergency Room if necessary, and identify themselves as a Postgraduate Learner;

b. Complete an Injury/Incident Report Form within 24 hours (forms available in the local Emergency Room or the Occupational Health and Safety office (or equivalent) of the hospital/training site where the injury took place); and

c. Submit the Injury/Incident Report Form to the hospital/training site where the injury took place. That hospital/training site will be responsible for administering the claim.

3.0 Psychological Safety

3.1. Training environments must be free from intimidation, harassment, and discrimination as outlined in the Prevention and Resolution of Medical Learner Mistreatment in the Faculty of Medicine Policy, Student Code of Conduct and Sexual Harassment and Sexual Assault Policy.

3.2. Postgraduate Learners are entitled to freedom from discrimination including personal harassment and harassment based on the Prohibited Grounds of Discrimination under the Newfoundland and Labrador Human Rights Act, 2010.

3.3. Postgraduate Learners should contact the Office of Learner Well-Being and Success to avail of immediate and long-term help, resources and support for psychological issues, substance abuse, harassment, mistreatment, and inequities.

3.4. Mistreatment complaints are handled in accordance with the Policy for the Prevention and Resolution of Learner Mistreatment in the Faculty of Medicine.

4.0 Professional Safety

4.1. Postgraduate Learners must be members of the Canadian Medical Protective Association (CMPA) and follow CMPA recommendations in the case of real, threatened, or anticipated legal action. CMPA coverage is applicable only in Canada.

4.2. Postgraduate Training Programs must promote a culture of safety and well-being in which Postgraduate Learners are encouraged and supported to report and discuss critical incidents and adverse events without fear of reprisal.

5.0 Learner Well-Being

5.1 Postgraduate Learners are responsible for managing their self-care to ensure their own well-being, and are encouraged to access the supports and resources offered by the Office of Learner Well-Being and Success (LWS).

5.2 The LWS Office provides a confidential space where Learners can feel safe discussing personal matters. The LWS Office supports Postgraduate Learner’s well-being including supports to engage in healthy habits, and making lifestyle and mindset changes.

5.3 Postgraduate Learners with accommodation needs are supported by Accessibility Services (the Blundon Centre) as outlined in the Memorial University Accessibility for Students with Disabilities Policy.

6.0 Safety or Security Breach Process

6.1. If a Postgraduate Learner feels that their own personal safety or security is threatened, they should seek immediate assistance and remove themselves from the situation in a professional manner.

6.1.1. The Postgraduate Learner should ensure that their immediate Supervisor and/or Program Director has been notified, as appropriate. If a personal safety or security issue involves their Supervisor and/or Program Director, the Postgraduate Learner should notify an appropriate superior (i.e., Discipline Chair).

6.2. The PGME office is available for consultation during regular work hours, particularly if the Program Director is not available. If an issue arises after regular office hours when the immediate Supervisor and/or Program Director may not be available, the Postgraduate Learner can contact security of the health care facility where they are based.

6.3. Postgraduate Learners in community-based practices or other non-institutional settings should discuss issues or concerns with the staff physician or the community-based coordinator, or bring any safety concerns to the attention of their Program Director and/or the Distributed Medical Education (DME) Office or Stream Lead, as applicable.

6.4. The Program Director has the authority to remove Postgraduate Learners from clinical placements if a risk is seen to be unacceptable.

6.4.1. If a decision is made to remove a Postgraduate Learner, this must be communicated promptly to the RPC and the Associate Dean, PGME.

6.4.2. If a Postgraduate Learner’s removal is due to a perceived or real threat from a faculty member, the Office of Faculty Affairs must be notified promptly, along with the RPC and the Associate Dean, PGME.

Related Documents

Bloodborne Viruses Policy

Environmental Health and Safety Training Offerings Memorial

Environmental Health and Safety- Report a safety Concern or Hazard

Fatigue Risk Management

Guidelines for the Appropriate Use of Social Media

Housing Policy (FoM)

Information Management Policy

PARNL Collective Agreement

Policy for the Prevention and Resolution of Learner Mistreatment

Sexual Harassment and Sexual Assault Policy

State of Emergency Policy 

Travel Safety Guidelines for Postgraduate Learners

Travel Outside of Canada Policy

Procedures:

There are no procedures associated with this policy.