Resident Safety Policy
Family Medicine Resident Safety Policy
Background
This document will clarify principles around resident safety while engaging in clinical/academic/research work as part of residency training and/or traveling required for the purpose of residency training.
The postgraduate program recognizes the importance of resident safety and is committed to ensure that the safest environment is available for residents during their training.
This document will discuss safety principles and issues in the following areas:
- Travel and Accommodations
- Family medicine clinic and on-call
- Off service and elective rotations
- Academic/Research activities
- Fatigue Management
If in the resident's opinion that his/her safety maybe jeopardized in a particular situation during training, the resident has the right to refuse to participate in that particular activity. In such a case, the resident must report the incident and issues ASAP to the appropriate personnel (e.g. preceptor/supervisor, rotation coordinator, family medicine office, program director).
*Supervisor - A supervisor may be a faculty member or allied health professional.
Travel and Accommodations
Residents are required to travel frequently for fulfillment of their academic/clinical/research training during residency.
If, in the opinion of the resident, that it would not be safe on a particular day to travel to their academic/clinical/research duties due to weather conditions, the resident may elect not to attend their academic/clinical/research session. The resident will be responsible for communicating their absence ASAP to the appropriate personnel (e.g. preceptor/supervisor, rotation coordinator, family medicine office, and program director).
Safety is also an important factor when choosing your accommodations during electives. Don’t hesitate to reach out to your preceptor/supervisor and rotation coordinator to find out more about the area and neighbourhoods where your hospital/placement is located. Some placement locations have vetted housing options available (e.g. Chatham, Sarnia, Stratford, Hanover, Listowel, Kitchener, Windsor) which can be arranged by our Distributed Education, Kitchener, and Windsor Offices. If a resident has safety concerns regarding accommodation or housing while on electives away from their home base, they should communicate with their preceptor/supervisor, rotation coordinator, family medicine office, and/or program director. It might be necessary to cancel a rotation when there are housing safety concerns and there are limited options to relocate.
Family medicine experience and on-call
Depending on the training site, residents may be required to work in different settings which include but are not limited to: emergency room, hospital ward, patients' home, long-term care institutions/group homes, and other ambulatory settings.
It is recognized that each training site will have its own safety protocol, but the safety protocol must abide by the following principles.
- In general during working hours of the office/ambulatory settings, there is always one or more clinic staff, resident, or supervisor* who is physically present in the same setting in which the resident is working.
- In general, it is recognized that there are always other staff present in the emergency room, hospital ward and long-term care institutions/group homes have other staff present while the resident is engaged in any clinical work.
- During housecalls or clinic work outside regular working hours, the safety risk must be determined beforehand. Under most circumstances, the resident should be accompanied by another person during these activities. If the resident is to attend a home visit or clinic alone, the patient and/or his/her home environment must be well known to the supervisor* and resident, the overall safety risk is either low or negligible, and both the resident and supervisor* must be comfortable with the arrangement. Should the resident feel unsafe at any time, they should contact their supervisor immediately and leave the premises. If a safety issue is suspected, then the patient’s chart should be flagged and consideration be made for residents not to be sent there again in the future. Additional safety measures may be instituted as necessary by the resident and his/her supervisor*.
Off service and elective rotations
The settings of these rotations vary significantly. If the experience is an ambulatory experience, the safety principles under Family Medicine experience and on-call above will apply. When on rotation away from a resident’s home base/university, residents are responsible for making appropriate arrangement for their academic assignments and follow rotation policies.
For international/global health electives, all residents must determine all prerequisites and insurance necessary to begin their rotations. Any concerns should be brought forward promptly to the preceptor/supervisor*, rotation coordinator, family medicine office, and program director.
Academic/Research activities
Residents are advised to discuss with their supervisors any safety risks that may be associated with these activities at the beginning of the experience.
Fatigue Management
Fatigue is common and expected in residency training and in medical practice. As such, strategies to identify, mitigate and prevent fatigue related adverse outcomes are important for everyone. Fatigue risk management for residents is crucial to maintain safe patient care, personal safety and wellbeing. Residents play a key role in assessing and monitoring their fatigue and the risk to patients and themselves.
Residents have a responsibility to manage their time before, during, and after clinical duties to prevent excessive fatigue. As such, residents are responsible for assessing and recognizing the signs of impairment due to fatigue in themselves.
Residents are responsible for managing their own fatigue during training. If a resident recognizes impairment due to excessive fatigue, they should immediately notify their supervisor.
Residents who experience fatigue which they think would impair their driving ability need to arrange for alternative transportation arrangements to ensure safe travel if required. Residents who commute must ensure they feel they can travel without increased risk to themselves or others as noted in the PGME Resident Safety Policy.
Rotations are responsible to have clinical duty and on-call schedules consistent with the PARO-CAHO Collective Agreement. Rotations have a duty to release residents post call in accordance with PARO’s Relief of Duties Post Call document.
If a program director or faculty member recognizes the effects of excessive fatigue adversely affecting the performance of a resident, the member must take steps to ensure the safety and wellbeing of the resident and their patients. Supervisors can use their discretion when assessing and addressing individual situations when this may arise.
The Family Medicine program will distribute an annual program evaluation survey each year which explores questions surrounding resident fatigue. Survey results are anonymous and are reviewed at the Postgraduate Education committee.
Residents are encouraged to review the Resident Doctors of Canada Fatigue Risk Management Toolkit, and the Schulich PGME Resident Safety policy for further information on Fatigue Risk management and Resident Safety concerns.
Other Resources
Schulich Postgraduate Medical Education Resident Safety Policy
Resident Doctors of Canada Fatigue Risk Management Toolkit
PARO Post Call relief of Duties
Last Reviewed: September 4, 2024
