Internal Medicine Program News Summary

Last updated May 27, 2020

IM Program News

*Updated
Academic Half Days*
ACLS expiry
Communication Strategy: IM Program
Competence By Design
PGCorEd
PGY1s and CBD*
PGY1s: Assessing your seniors on Qualtrics*
PGY2 Update*
PGY3 Update*
Procedures
Townhalls (PD)
Wellness Help/Tips*

COVID-19-related IM Program Information

Clinical COVID-19 Resources
Clinical Responsibilities
Concerns about Personal Exposure and/or symptoms (Getting COVID-19 Tested)
GIM Rotation COVID-19 Planning*
Goals of Care Resources
IM Program's Response to COVID document*
PARO COVID Information
Personal Health Concerns
Personal Protective Equipment

Resources:

IM Program News

Academic Half Days/Teaching

Teaching

Your chief residents have assembled a list of virtual teaching sessions happening across the city. Please check out The City-Wide Educational Schedule

We have also posted in Quercus in the "COVID" folder a transcription of Dr. Isaac Bogoch's AHD from April 1.

Last updated 2020-05-27

We are continuing AHDs online. Many programs are cancelling their AHDs. If residents are not watching our AHDs, we may be forced to cancel them, as they are time-intensive for the faculty and program administration to set up and run. You need to complete the survey so we know who is attending these remotely. We have fixed the recent link problem.

Last updated 2020-04-03

ACLS Status

If your ACLS credentials expire, as you are unable to get recertified now, the hospitals are honouring the expired credentials.

Last updated 2020-03-25

Communication Strategy: IM Program

The IM Program will now be sending regular updates summarizing all program, departmental and PGME news in one email, to reduce email fatigue. Please read all emails from your hospital and all emails from individual program admins and faculty directed to you.

A regularly updated summary document of important program information will be placed on the DOM website, with a direct link for your phone: this process is being set up. For now, it has been placed on Quercus, under “COVID”

The Monday morning “Weekly IM Resident Update” will still be sent regarding program activities.

Last updated 2020-03-25

Competence By Design

CBD is cancelled for the PGY2s: Given the stress on the PGY2s from the COVID outbreak, cancellations of away electives and the multiple obligations next year (CARMS and Royal College exam), the Residency Program Committee voted to cancel CBD for the PGY2s. This had the approval of the PGY2s who were surveyed by their PGY2 RPC representatives. The Royal College requires only our PGY1s to participate in CBD

Last updated 2020-04-03

PGCorEd

PGME is looking into getting the required completion date delayed, due to the COVID-19 pandemic.

Last updated 2020-03-30

PGY1s: Assessing your seniors on Qualtrics

PGY1 residents need to provide teaching feedback for their senior residents for this year. Here is the Qualtrics link again.

Password is wonderland

Last updated 2020-05-27

PGY1s and CBD

Due to the COVID Pandemic, the program has reduced the requirements for certain FOD EPAs:

  1. The number of required EPAs for FOD1 (Acute management of new patients), FOD 2A (Acute management of follow up patients) and FOD 5 (Management of unstable patients) remain unchanged.
  2. The requirement for all other EPAs has been reduced to 50% of the original targets, rounding up to the nearest integer (i.e, if prior target was 2, now it is 1; if prior target was 3, now it is 2)
    1. New Targets: FOD 1 -10, FOD 2A – 8, FOD 2B – 1, FOD 2C – 2, FOD 3 – 2, FOD 4 -2, FOD 5 – 7, FOD 6 – 2, FOD7 – 4.
  3. We have waived the requirements for 50% of EPAs to be completed by faculty.

Last updated 2020-05-27

PGY2s

CaRMs MSM Preparation:

Subspecialty CaRMS applications: At your request, we have added a paragraph to my Program Director reference letter, explaining the unique Toronto situation (describing that U of T has later electives than some other universities, and these electives have unfortunately been cancelled).

Fireside Chats with some of the subspecialty PDs on May 28 and June 4.

CaRMs prep and meet all the subspecialty PDs: AHD June 10, 2020

Putting your best foot forward: Prep for your application and interview: AHD July 7, 2020.

Last updated 2020-05-27

The Virtual PGY2 Practice Written Exam is happening on Wednesday, June 17, from 8:30-11:30 AM. The back-up date will be Wednesday, June 24 from 6:00-9:00 PM, in case you are post-call on June 17. Your results are formative, they will not be shared with your academic advisor or site director.

Last updated 2020-05-27

PGY3s

For Royal College documentation, you must upload onto your program sharefile:

  • An updated Procedures form (NOTE: COVID-pandemic reduced minimums of 3 for arterial lines, thoracentesis, paracentesis, LP, joint aspiration, airway management (ET), and 5 central lines)
  • Evidence for Research project completion / dissemination

Please let us know now if you anticipate any difficulty with completing either of these tasks. We will try to arrange for sim sessions for the missing procedures.

Last updated 2020-05-27

Procedures

All residents must log all procedures on Elentra.

PGY3s only: we are reducing the number of required procedures to the Royal College minimums: Central lines 5; then 3 of each of the rest (art lines, joint aspirate, thoracentesis, paracentesis, LP, intubation-airway management

If you haven’t logged some procedures, but have completed them, then you can provide the program with a list of procedures completed, the blocks completed, with your signature, at the end of your training.

Please email Dr. Goguen at jeannette.goguen@unityhealth.to if you still have gaps.

Last updated 2020-03-25

Townhalls (PD and residents)

Townhalls are now scheduled weekly, on Thursday evenings, PGY1s: 7:15, PGY2s: 8:00, PGY3s 8:45, and on Tuesdays at 7:15 for the PGY4s.

Last updated 2020-04-17

Wellness Help/Tips

Besides keeping our patients safe and alive, we need to look after our doctors too. If you have wellness issues, you can always reach out to your site directors, your CMR and/or Dr. Goguen.

  • Confidential resources are available:
    Our Wellness Leads, Dr. Rebecca Stovel and Dr. Tarek Abdelhalim
  • PGME Wellness
  • Hospital specific resources – as per informed by the leadership at your site's hospital
  • After Hours resident support Group (see Monday morning IM Team Email for scheduled times)
  • Pandemic Peer-2-Peer Support Group (see Monday morning IM Team Email for scheduled times)
    This is an online, video-conference, resident-only peer support group for residents from any specialty who want to talk about the pandemic, clinical practice, impacts on their lives, or anything else at all. Consider joining us to chat, listen, vent, and/or just generally support each other. We have the support of the Department of Psychiatry at Sunnybrook. Details on how to join are in the IM Team Email from Monday morning. 
  • 30 Days of Yoga with Adriene (free yoga on YouTube, highly recommended)
  • Wellness Bingo: Please check out the new Bingo card with activities for you to complete
    • Residents who complete 3 tasks in any row, column, or diagonal on the Bingo card will have their name entered once in the draw to win.
    • Residents who complete the entire Bingo card will be entered twice in the draw to win to increase your chance!

Last updated 2020-05-27

COVID-19-Related IM Program Information

Clinical COVID-19 Resources

Clinical resources:

Last updated 2020-04-03

Clinical Responsibilities

Our residents should expect to be caring for patients with COVID-19 disease (suspected and confirmed) at all of our sites, providing that they are able to comply with Infection Control guidelines on Personal Protective procedures, and that they do not have an accommodation for personal health reasons.

Concerns about personal exposure and/or symptoms (getting tested for COVID-19)

It is critical to stay home if you are having symptoms.

If you have had unprotected contact with a person with COVID-19, or if you have symptoms of COVID-19, you should contact Occupational Health at your site and not come into work until cleared.

Occupational health department contact information:

  • Mount Sinai Hospital: backtowork@sinaihealth.ca or 416-586-4800 x3907
  • Sunnybrook Health Sciences Centre: 416-480-6100 x7854
  • St. Michael's Hospital: (416) 864-5013
  • Toronto General Hospital: (416) 340-3463 Mon-Fri 7:30-3:30
  • Toronto Western Hospital: (416) 603-5101

If there is a delay reaching Occupational Health, you should proceed to get tested at an assessment centre, if you meet the city’s requirements for testing of health care workers. If you are very sick, go to Emergency.

Please contact your CMR to determine which assessment centre you should go to. If public transit would be required, you should go to the testing centre nearest to you instead.

When you are sent home by Occupational Health, and when you are cleared to return to work, you will need to notify all of the following people:

  • Rotation Faculty Coordinator/Supervisor
  • Site Director at your current site
  • Hospital Education Coordinator
  • Chief Medical Resident at your current site
  • Your attending physician (if relevant)

Last updated 2020-03-25

GIM COVID Planning

  • Variations on the GIM-Restructuring model will be used at all the sites for GIM. This process started in Block 10 at UHN/MSH and will start in Block 11 at SMH and SHSC.

  • Residents were redeployed to their base hospitals for Blocks 12 and 13, including those at community sites.

  • Residents will not be deployed from CCU/ICU rotations, otherwise, they may be deployed from rotations where they are not required (this decision is made at the level of the Physician-in-chief and Vice Chair Education)

  • There will be built-in days off, this may mean that vacations are moved and broken into smaller separated groups of days.

  • Residents will be sent home from quiet rotations, but must be ready to be redeployed to GIM or another urgent need rotation.

  • Each hospital’s Physician in Chief has a redeployment strategy across the Department of Medicine (core residents, subspecialty residents, fellows and faculty)

  • Each hospital’s VP of Education has a redeployment strategy across all departments. This level of redeployment has been required in Europe and in some US cities.

Last updated 2020-05-27

Goals of Care Resources

Goals of care module developed by Dr. Christine Soong

Goals of Care Communication Guide (one pager)

Last updated 2020-04-17

IM Program's Response to COVID

This document outlines how the IM Program leadership, the Department of Medicine, your Hospital and the University of Toronto has responded to the COVID-19 pandemic to support you.

Last updated 2020-05-28

PARO COVID Information

Residents and COVID-19 

Last updated 2020-04-03

Personal Health Concerns

Requesting accommodations or leave (PGME 2020-03-25)

  • All new requests for training accommodations are to be directed to the PGME Wellness Office now, instead of the program. You are not required to contact them if you have already self-identified to the program. (Accommodation for trainees March 25, 2020)

Personal Protective Equipment (PPE)

New video for donning and doffing PPE (note N-95 mask is only required for patients with or under investigation for COVID-19  during the performance of aerosol generating procedures such as intubation or CPR.

Additional resource: PHO lanyard card for donning and doffing

Update on Reuse & Reprocessing of PPE:

At some of the TAHSN hospitals, used masks are now being collected for "repurposing/reuse." This has further raised anxieties around the status of PPE supplies and safety at work.

At this time, there is NO plan to re-use PPE. However, as is prudent, the hospitals are planning for all potential situations, which may include a time when new PPE is no longer available. For this potentiality, research is ongoing to investigate the best methods by which to sanitize PPE for reuse, and to ensure that the equipment is safe for use post sanitization. Again, there is currently no plan to reuse PPE.

Last updated 2020-04-08

PGME’s document describes the use of PPE in hospitals, and residents’ rights and responsibilities.

PDF iconfaculty_learner_ppe_memo_april_2_2020.pdf (115.09 KB)Last updated 2020-04-09

At all sites, health care workers are wearing face masks when they are interacting with patients. There are variations across sites regarding PPE. There will be local teaching about keeping yourself safe. In addition, please view this CMaRS video.

Caveat: This video describes the use of an N95 respirator, which is no longer required for the routine care of patients under investigation or known to have COVID-19. Most patients with or suspected of having COVID-19 can be cared for with droplet-contact precautions, and a surgical mask can be substituted for the N95 respirator in the donning/doffing process. An N95 respirator is only required for patients with or under investigation for COVID-19 during the performance of aerosol generating procedures such as intubation or CPR.

Additional resource: PHO lanyard card for donning and doffing

Last updated 2020-03-22

Resources:

While normally physicians should not be accepting gifts from industry, these are extraordinary times. Given the additional burden of transportation and social distancing, and presence of free or subsidized parking available at or near the hospitals, you may want to take Hertz up on its offer of free car rentals to health care workers.

Please do not post anything on social media about accepting gifts, out of sensitivity to people in our community who are experiencing huge financial burdens now.

Health care workers (including all of us) should not be actively soliciting industries for handouts. Car rental Hertz is offering free car rentals to health care professionals

Car rental

Hertz is offering free car rentals to health care professionals.

Childcare Resource (City of Toronto)

The City of Toronto is offering childcare resources for essential and critical service workers: COVID-19: Child Care for Essential Workers

2020-03-28

Housing

StayWell

If you need to self-isolate away from your home and family, StayWell (www.staywell.charity) is a charity that will provide subsidized furnished accommodations for health care professionals. They normally provide this service for patients relocating to Toronto for specialized medical care. Given the current situation, they are pivoting temporarily in an effort to support front-line healthcare workers. The units are located in condominium buildings that are walking distance from the downtown hospitals. They are 1- or 2-bedroom and come fully equipped with furniture, a full kitchen and TV/Internet. They are being offered at subsidized rates as a more comfortable and affordable alternative to hotels, and located in the downtown core.

Here are the details:

  • Weekly rate is $600 for a one bedroom suite. There are some ancillary charges which will be provided once a request is made. FYI if the rental is greater than 30 days there's no HST.
  • 7 day minimum stay with a 3-day notice to vacate

If you need to access this option, please contact StayWell directly at info@staywell.charity with “Healthcare Worker” in the subject line.

PGME is working to identify alternative housing for this interim need that will be more cost-effective. In the interim, PGME has set aside some funding to offset the cost for residents. PGME will cost share and reimburse you up to half the cost of the accommodation if:

  • The housing was secured through StayWell
  • You have received a recommendation to self-isolate
  • You provide self-declaration that your current residence is not appropriate due to the presence of at risk individuals or you are co-habiting with other health care workers.

PGME email 2020-03-25

Free Apartment for Health Care Professionals: Casa Toronto

Casa Toronto is an organization which provides quality student living accommodations. To show their gratitude, they would like to offer temporary, free accommodation for frontline healthcare workers. They have several furnished apartments available, for free, for the month of April in the Yonge and St. Clair neighbourhood. All utilities, internet, cable TV are included.

This offer is open to any doctors or nurses working at Sunnybrook, Mount Sinai, Toronto General, or St. Mike’s, who might benefit from it.

Contact josematheus@casa-toronto.com or wendydemorest@casa-toronto.com with questions.

Last Updated 2020-03-30

Registration (Hospital)

The expiry date on all badges has automatically been extended to June 30, regardless of what it actually says on the badge. You can now access any Toronto hospital using your current badge. You will need to contact the medical education office to get computer access, retraining will not be necessary. You will need to contact security for card access to restricted areas in the hospital.

Parking

  • Reduced/free parking and TTC fees: check out your hospital’s policy