Resident Policy Manual

 

 Anesthesia Residency Administrative Policy Manual

---

• POLICY 1.0 - PGY1 Anesthesia Rotations - Call
• POLICY 2.0 - Resident Grand Rounds Assignments
• POLICY 3.0 - Anesthesia Rotations Reduced Call Requirements For Vacation
• POLICY 3.1 - Adult Anesthesia Call Requirements– HSC
• POLICY 3.2 - Adult Anesthesia Call Requirements - SBGH
• POLICY 3.3 - Pediatric Call Requirements – Children’s Hospital
• POLICY 3.4 - Pain Rotation Call Requirements – HSC
• POLICY 3.5 - Neuro Anesthesia Call Requirements – HSC
• POLICY 3.6 - Scholarly Activity Call Requirements – HSC
• POLICY 3.7 - Obstetrical Anesthesia Call Requirements - HSC
• POLICY 3.8 - Obstetrical Anesthesia Call Requirements - SBGH
• POLICY 3.9 - PGY5 Anesthesia Residents Call Requirements
• POLICY 3.10 - Community Anesthesia Call Requirements
• POLICY 3.11 - SSCU Call Requirements - HSC
• POLICY 3.12 - Cardiac Anesthesia Call Requirements - SBGH
• POLICY 3.13 - Call Requirements prior to Compulsory Exams & Resident Retreat
• POLICY 4.0 - PGY5 Residents Written Exam Study Leave
• POLICY 5.0 - Christmas and New Years Holy Day Block
• POLICY 6.0 - Vacation Allotment
• POLICY 6.1 - Statutory Holidays
• POLICY 7.0 - Resident Education Leave
• POLICY 8.0 - Absence From Clinical Duties (Medical Leave, Personal Leave, etc.)
• POLICY 9.0 - Anesthesia Daily Evaluations
• POLICY 10.0 - Appeal Mechanism
• POLICY 11.0 - Call Requests
• POLICY 12.0 - Leave of Absence
• POLICY 12.1 - Maternity Leave
• POLICY 12.2 - Paternity Leave
• POLICY 13.0 - Moonlighting During the Anesthesia Residency
• POLICY 14.0 - Handling of Narcotics and Controlled Substances
• POLICY 15.0 - Attendance at Departmental Events
• POLICY 16.0 - Faculty Evaluations

 

 

---

POLICY 1.0 - PGY 1 ANESTHESIA ROTATIONS - CALL

In the first month at each hospital, PGY1 residents shall do two calls paired with a more senior resident and two weekend day shifts. There is no late call for PGY1 residents. This call shall be distributed as follows. In all subsequent rotations, call is the same as for any other resident. Call is distributed as follows:

• 2 Mon-Thursday nights
• 2 weekend day shifts
• 1 Saturday night call

At SBGH, the PGY1 resident is expected to report for call at 1600 and stay in hospital until 0800. Upon arrival, s/he should

• identify him/herself to the attending staff on the labour floor AND the OR
• ensure that the labour floor has his/her name and beeper number
• report to the primary call resident

At HSC the PGY1 resident is expected to report for call at 1530. Due to lack of call facilities, s/he shall stay in hospital until the OR is finished. After that time, s/he shall remain available by beeper until 0730 for interesting cases.

PGY1 residents at HSC will be slated into a low-risk room the day following call. Attendance will be expected according to following exceptions.

• If still in the hospital past 2100, the resident will remain on beeper availability until 0730, but will not be expected to report for elective cases until 1130 the next day.
• If still providing patient care in the hospital past 2400 hours, the resident will remain on beeper availability until 0730, but will not be expected to report for elective cases the next day.
• In the event that the s/he will not be attending a full day as per the above, the PGY1 resident MUST note on the OR slate at the OR desk “Post-call, in at 1130” or “Post-call, not in”
• The resident will be allowed to leave the hospital by 1600 the day after call, regardless of how late s/he worked during the night on call.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 2.0 - RESIDENT GRAND ROUNDS ASSIGNMENTS
Anesthesia Residents will present two city-wide Grand Rounds presentations between PGY3 and PGY5. Where possible at least one Grand Rounds presentation should be completed during a residents’ scholarly activity block.

PGY5 Residents should have their Grand Rounds requirements completed prior to January of their 5th year of training.

Faculty mentors will not be pre-assigned for Anesthesia Residents, the Residents have the option to decide if they want to have a Faculty mentor or not. If a Resident decides to have a Faculty mentor, it is the Resident’s responsibility to seek a mentor.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 3.0 - ANESTHESIA ROTATIONS REDUCED CALL REQUIREMENTS FOR VACATION

If a Resident chooses to take less than 28 days vacation in an Adult Anesthesia rotation call requirements will be adjusted accordingly. Residents will be expected to do up to the amounts in the following table.

Amount of Vacation	Mon - Thurs Night	# of W/E Shift*	Late Day (HSC only)
7 days	3	2	3
14 days	2	1	1
21 days	1	1	0

* W/E shift = (1) Saturday night (2) Friday/Sunday night (3) Saturday & Sunday day

When a rotation is longer than 28 days or shorter than 28 days calls will be adjusted accordingly.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.1 - CALL REQUIREMENTS FOR ADULT ANESTHESIA ROTATIONS – HSC

Anesthesia Residents are required to take calls in a 28-day rotation up to the amounts listed below:

• 2 - 5 Mon-Thurs Nights
• 5 Late days
• 2 weekends
  • Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

Night Calls
Monday to Friday overnights shifts begin at 1530 and end the next morning at 0700. Saturday and Sunday overnight shifts begin at 1500 and end the next morning at 0700.

Late days
Late days may be scheduled Mon-Fri. On a late day, the resident will work a regular OR day. From 1530-1930, the late resident will be available to run a second room in order to finish late rooms or start emergencies. The resident on late call will not stay past 1930. Any cases begun must either be finished by 1930, or the finished by the other on-call staff. If there is no need of a second room, the resident will be responsible for any outstanding consults. If neither is needed the resident is free to leave the hospital, remaining available by pager until 1830.

Sat/Sun Days
The weekend day shifts will begin at 0700 and end at 1500. Residents will be granted at least two entire weekends off.

When a rotation is longer than 28 days or shorter than 28 days calls will be adjusted accordingly.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.2 - CALL REQUIREMENTS FOR ADULT ANESTHESIA ROTATIONS – SBGH

Anesthesia Residents are required to take calls in a 28-day rotation up to the amounts listed below: (SBGH works on a 0800h - 0800h 24 hr call)

• 5 Mon-Thurs Nights
• 2 weekends
  • Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

Mon-Fri Night Calls
All overnight shifts begin at 1530 and end the next morning at 0730.

Sat/Sun Nights
Weekend night shifts begin at 1530 and end at 0730 the next morning

Sat/Sun Days
The weekend day shifts will begin at 0730 and end at 1530.

Residents will be granted at least two entire weekends off.

When a rotation is longer than 28 days or shorter than 28 days calls will be adjusted accordingly.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.3 - PEDIATRIC ANESTHESIA CALL REQUIREMENTS
CHILDREN’S HOSPITAL

An Anesthesia Resident on a Pediatric Anesthesia rotation will be required to take 6 calls in a 28-day rotation as follows. While on call, the resident will remain available by pager and be expected to attend for any cases in the call period.

• 4 weekdays (Monday – Friday) – No more than two Friday calls per rotation. On weekday call, residents will work a regular OR day and then take call until 0730 the next morning.
• 2 weekend days (Saturday, Sunday and Stat) Weekend call begins at 0730 and ends at 0730 the next morning.

Residents will be scheduled for a regular OR slate the next day. Attendance will be expected subject to the following exceptions:

• If still in the hospital past 2100, the resident will remain on beeper availability until 0730, but will not be expected to report for elective cases until 1130 the next day.
• If still providing patient care in the hospital past 2400 hours, the resident will remain on beeper availability until 0730, but will not be expected to report for elective cases the next day.
• In the event that the s/he will not be attending a full day as per the above, the resident MUST note on the OR slate at the OR desk “Post-call, in at 1130” or “Post-call, not in”
• The resident will be allowed to leave the hospital by 1600 the day after call, regardless of how late s/he worked during the night on call.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Residents will be granted at least two entire weekends off.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.4 - PAIN ROTATION CALL REQUIREMENTS - HSC

An Anesthesia Resident rotating in Pain (Regional Anesthesia, Acute Pain, and Chronic Pain) will takes general surgical calls per 28-day period up to the following:

• 2 weekday calls (Tues or Wed only)
• 0 late days
• 1 weekend call
  • Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday &
    Sunday day

In addition the resident will do APS home call according to the following:

3 month rotation – 2 Saturdays; 2 Sundays; 5 weekdays; and 2 weekday nights
2 month rotation – 2 Saturdays; 2 Sundays; and 4 weekdays
1 month rotation – 1 Saturday; 1 Sunday; 5 weekdays; and 2 weekday nights

APS Mon-Thurs evening shifts begin at 1600 and end at 0730 the next day. APS WE shifts will commence at 1600 on Friday and end at 0700 on Monday. The resident will carry the pain pager and be first call. The resident will participate in the daily assessment and planning rounds each day, see new consults, and attend as needed for problems on the wards. At a minimum, the staff person will be available by a second pager at all times as a resource to the resident, as well as attend in hospital when required.

This must be approved by the Program Director.

Over the block of the Pain rotation the Resident will receive a balance of weekends off equivalent to two weekends off per 28 days.

Call schedules for Pain are prepared by the Medical Manager of the Acute Pain Service and general surgical calls are prepared by the Co-Chief Resident in consultation with the Medical Manager of APS and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.5 - NEURO ANESTHESIA CALL REQUIREMENTS - HSC

When an Anesthesia Resident is rotating in Neuro Anesthesia calls will consist of the following in a 28-day rotation:

• 2 weekday calls (Tues or Wed only)
• 0* Late Days
• 3 weekday Neuro Anesthesia home calls
• 2 weekends**
  • **Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

*There will be no Late Call Days as per the definition given in Policy 3.1. However, it is expected that the resident will stay to finish Neuro cases.

The Resident will be expected to return to the OR following academic day if requested by the Neuro Anesthesiologist.

Residents should be granted two entire weekends off.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010


POLICY 3.6 - SCHOLARLY ACTIVITY CALL REQUIREMENTS

Anesthesia Residents on Scholarly Activity rotations are required to do at least the following amounts of call.

If a Resident is on vacation during a Scholarly Activity rotation calls will be reduced as indicated in the table.

Amount of Vacation	Mon - Thurs Night	# of W/E Shift*	Late Day
0 days	2	2	0
7 days	1	2	0
14 days	0	2	0

* Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.7 - OBSTETRICAL ANESTHESIA CALL REQUIREMENTS - HSC

An Anesthesia Resident on an Obstetrical Anesthesia rotation at Health Sciences Centre will be scheduled for 5 calls during a 28-day rotation as follows:

• 2 weekday calls (Tues or Wed only)
• 2 weekends
  • Weekends = (1) Saturday night; (2) Saturday & Sunday day

An Anesthesia Resident may have up to one Monday-Thursday and/or one WE Obstetrical Anesthesia shift scheduled as general surgical calls in order to assist filling a general call schedule.

Residents will be granted at least two entire weekends off.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.8 - OBSTETRICAL ANESTHESIA CALL REQUIREMENTS - SBGH

An Anesthesia Resident who is rotating in Obstetrical Anesthesia at St. Boniface Hospital will be scheduled for up to the following calls within the general call schedule rotation.

However, the Resident in Obstetrical Anesthesia must ensure that their first priority is the Labour Floor not the General OR. If there are cases occurring simultaneously on the Labour Floor and the OR, the Labour Floor will take precedence. Attending staff should be made aware of this priority.

Call for a Resident on Obstetrical Anesthesia at St. Boniface Hospital during a 28 day will consist of calls as follows:

• 2 weekday calls (Tues or Wed only)
• 2 weekends
  • Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

Residents on Obstetrical Anesthesia will be granted at least two entire weekends off.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 3.9 - PGY5 ANESTHESIA RESIDENTS CALL REQUIREMENTS

Until 3 months preceding the Royal College of Physicians and Surgeons of Canada examinations PGY5 Anesthesia Residents take call as required in all call requirement policies with the exception of the following:

PGY5 Anesthesia Residents preparing for the Royal College of Physicians and Surgeons of Canada examinations in June are entitled to reduced call as follows.

12 - 4 weeks Preceding the date of the Oral Examination:

• 3 Mon-Thurs Night
• 3 late calls
• 2 weekends
  • Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

4 weeks preceding the date of the Oral Examination:

• 0 late
• 1 weekend
  • Weekends = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

• No Call two weeks prior to examination

Call post-oral examination:

The RCPS oral examination does not fall at a predictable point in any period. As a result, the proportion of a period that may remain after the oral exam can be anywhere from 2-7 days. All of the call and workload concessions established by the program are intended to improve the ability of the resident to focus on preparation for the exam. After the oral exam is over, the resident is expected to resume full responsibilities. The proportion of call assigned to the resident after the oral exam will be calculated as though the time up to the oral exam date plus one day for return travel were vacation.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010


POLICY 3.10 - COMMUNITY ANESTHESIA CALL REQUIREMENTS

In order to gain an appreciation of the nature of community anesthesia practice, Anesthesia residents rotating at the Community teaching sites will be responsible for call at the community site.

Residents will be scheduled for a regular OR slate the next day. Attendance will be expected subject to the following exceptions:

• If still in the hospital past 2100, the resident will remain on beeper availability until 0730, but will not be expected to report for elective cases until 1130 the next day.
• If still providing patient care in the hospital past 2400 hours, the resident will remain on beeper availability until 0730, but will not be expected to report for elective cases the next day.
• In the event that the s/he will not be attending a full day as per the above, the resident MUST note on the OR slate at the OR desk “Post-call, in at 1130” or “Post-call, not in”
• The resident will be allowed to leave the hospital by 1600 the day after call, regardless of how late s/he worked during the night on call.

The community site calls for a four week rotation are as follows:

• 1 Monday- Thursday
• 1 weekend
  • Weekends = (1) Friday/Sunday night (2) Saturday & Sunday day

In addition to the community call, a resident may be scheduled for up to the following amounts of call in the tertiary sites schedules, as needed.

• 2 weekdays (Tues or Wed only)
• 0 Late Days
• 2 weekends
  • * = (1) Saturday night; (2) Friday/Sunday night (3) Saturday & Sunday day

Residents will be granted at least two entire weekends off.

Call schedules are prepared by the Co-Chief Resident and reviewed by the Program Office prior to distribution.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

An Anesthesia Resident on an SSCU rotation will be required to take 7 calls in a 28-day rotation as follows. While on call, the resident will remain available by pager and be expected to answer calls and attend patients when necessary after hours.  The call schedule shall be made by the medical director of the SSCU.

 

Residents will be expected to be in the SSCU days post-call. Attendance will be expected subject to the following exceptions:

• If working in the hospital consecutively until 2100, the resident will remain on beeper availability until 0730, but will not be expected to report to SSCU for clinical duties until 0900 the next day.
• If working in the hospital consecutively until 2400, the resident will remain on beeper availability until 0730 the next morning, but will not be expected to report to SSCU for clinical duties until 1200 the next day.
• If a resident works consecutively until later than 2400 – they shall not report for clinical duties the next day unless on call in which case they will report for call at 1700.
•  A resident may not under any circumstances work more than 26 consecutive hours.
• If a resident works 4 consecutive hours after 1900 and one of those hours is after 2400, for the purposes of payment this will be considered an in-house call as per the PARIM contract.  The resident may however, elect to work post-call if they wish.
• In the event that the s/he will not be attending a full day as per the above, the resident MUST inform the attending in the SSCU.

Approved By:  Anesthesia Postgraduate Education Committee April 9, 2013 

 

POLICY 5.0  - CHRISTMAS AND NEW YEARS HOLY DAY BLOCK

As per the PARIM agreement Residents are entitled to a 5-day holiday block at either Christmas or New Years in each academic year. This includes a Saturday and Sunday and does not reduce regular call requirements.

Anesthesia Residents must make their request for the block of time they wish off by the end of Period 5 of each academic year. Residents are not guaranteed their request will be met until the call schedule for that period of time is completed. Any Resident(s) who does not submit their request by the end of Period 5 will be assigned their block of time off by the Program Administrator in consultation with the Chief Resident and Program Director.

The Anesthesia Residency Program is only responsible for scheduling the Christmas and New Years holiday block for Residents rotating in Anesthesia rotations at that time of the holiday.

The 5 day holiday block for both Christmas and New Years will be determined by the Program Administrator in consultation with the Chief Resident and/or Program Director on or before September 1 of each calendar year.

Any Anesthesia Resident may make a written request to the Program Administrator requesting to use the 5-day holiday block at another time will be granted 3 days off as per the PARIM agreement. Any Resident who makes this request will be required to work regular shifts through the Christmas and New Years holiday (including December 24, 25, 26, 31, and January 1).

Residents are discouraged from rotating in Pediatric Anesthesia and Cardiac Anesthesia during the Christmas/New Years Holy Day Block to ensure that their educational exposure is maximized. In the event that a resident chooses either of these rotations he/she will be required to take their 5 days off on the days when the OR’s are recognizing stat holidays.

Any resident who wishes to observe holy days other than Christmas/New Year, may use three days for that purpose. Should s/he choose not to use these three days for that purpose, any leave requested for those Holy Days would have to be covered by stat or holiday time.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 6.0 - VACATION ALLOTMENT

Each Resident is granted 28 days vacation per academic year. Vacation cannot be taken in less than a 7-day block, which must include at least one weekend.

When vacation is not taken as a full period block (i.e. 28 days), vacation will be permitted only during the following types of rotations:

1. Adult Clinical Anesthesia rotations.
2. Scholarly Activity rotations.
3. Sub-specialty Anesthesia rotations (this last option only when the Resident has previously completed all required rotations in the same sub-specialty as per program requirements).

VACATION REQUESTS MUST BE SUBMITTED IN RESIDENT MANAGER PRO (RMP) BY MARCH 1ST. ANY VACATION DAYS NOT SCHEDULED BY SEPTEMBER 15TH    OF EACH ACADEMIC YEAR (AS PER THE PARIM AGREEMENT) WILL BE ASSIGNED BY THE PROGRAM ADMINISTRATOR IN CONSULTATION WITH THE PROGRAM DIRECTOR.

Vacation cannot be carried over to the next academic year without extenuating circumstances that must be approved by the Program Administrator.

If a Resident chooses to take less than 28 days vacation in an Adult Anesthesia rotation call requirements will be adjusted as per Policy 3.0.

A Vacation Request must be completed for each block of vacation requested and submitted in Resident Manager Pro (RMP). A Resident should not assume that their vacation request is approved until they have received approval in RMP.

The decision regarding whether a particular request can be granted will be contingent upon the availability of staffing for the time in question. In the event that the granting of all outstanding requests would result in a shortfall in staffing, then some requests will be denied. In the case of such a conflict, the requests will be granted according to the following in descending order of priority:

1. the date on which in the request was submitted in RMP
2. seniority of the resident(s)- favouring the more senior, if #1 is non-discriminatory
3. time submitted if the first two are non-discriminatory

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 6.1 - STATUTORY HOLIDAYS
If an Anesthesia Resident is on call on a statutory holiday they will receive a day in lieu of the statutory holiday, if post call from an in-house Anesthesia call on a statutory holiday the Resident will receive a day in lieu of the statutory holiday. Post call days on statutory holidays from home call will be dealt with on an individual basis by the Program Administrator, Chief Resident, and Program Director.

Off Service Stats:

If an Anesthesia Resident is on an off service and works a statutory holiday they should receive a day in lieu of during that rotation on the service they worked the stat day. A stat day near the end of rotation should be dealt with by making arrangements to take the day in lieu of stat during an earlier period of same rotation. Stat days earned in an off service rotation cannot be accumulated and used in an Anesthesia rotation.

Anesthesia Residents who work a stat day in an Anesthesia rotation must reclaim the stat day within 3 months of receipt. Residents are not permitted to reclaim a stat day prior to working the stat day.

Stat days are recorded in APMSS and must be requested in Resident Manager PRO (RMP) noting the date the stat is being reclaimed from (eg. thanksgiving). If a resident does not submit the request through RMP it will not be considered for review.    The reclaimed stat day will be approved in RMP by the Program Administrator and recorded in APMSS. It is the Resident’s responsibility to inform the Senior Resident and Site Coordinator in writing if they are taking a day in lieu of a stat day.

Site Coordinators and/or Senior Residents are not to approve a stat day off request without approval from the Program Administrator and/or Program Director.

Requests for day off in lieu of stat day that impacts a final call schedule or staffing may not be approved.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 7.0 - RESIDENT EDUCATION LEAVE

In order to ensure continued and appropriate functioning of educational and clinical activities, the following guidelines will apply to all residents regarding educational leave:

1. All residents are eligible to attend one (1) meeting per year. Leave time for this meeting is in addition to vacation. Resident will apply in Resident Manager PRO (RMP) for educational leave for their meeting with the annual rotation and vacation request in advance of the academic year, or at least three months prior to the requested meeting.    A travel day before/after the meeting may be approved by the Program Director. If the meeting occurs at a time when the resident is on a non-anesthesia service, written approval of the Off-Service Program Director or coordinator is required.
2. Funding to support resident travel and attendance at one meeting per year is provided by the department as available. A list of meetings which are approved for application for resident travel support have been generated by the Postgraduate Education Committee and are available to residents.
3. A resident will be allowed to attend a second meeting if it is an appropriate national or international meeting at which the resident is presenting.    Application for funding to attend a second meeting, at which the resident is a presenter, must be made directly to the Associate Head of Research and Academic Affairs and the Program Director.
4. A Resident may attend additional meetings on their vacation time (funding not provided).

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 8.0 - ABSENCE FROM CLINICAL DUTIES (Medical Leave, Personal Leave, etc.)

If an Anesthesia Resident is unable to report for clinical duties due to illness or personal reasons they must inform the Program Administrator and/or Program Director as soon as possible that they are unable to report for duties.

It is also the Resident’s responsibility to inform the Senior Resident, Site Coordinator, or another Anesthesiologist by 7:30 a.m. that they are unable to report for duties.

If on an off service, the Resident must inform his/her immediate supervisor and/or Chief Resident of that service.

If a Resident is away during Scholarly Activity they are to inform their SA supervisor.

If a Resident is required to be absent from clinical duties longer than 3 working days

• they must provide a medical certificate verifying their illness to the Program Administrator upon his/her return to clinical duties.
• This shall be considered a leave of absence and governed by Policy 12.0
• The missed time may have to be recovered at a later date if it is a subspecialty

It is extremely important that if you are calling in absent that you do so in a timely manner, i.e. well before the OR is preparing for cases to begin or the ward is commencing rounds. Any calls received after 7:30 a.m. regarding an absence will need to be addressed directly to the Postgraduate Program Director or Department of Anesthesia Administrator in his/her absence.

If a Resident is unable to do an Anesthesia call due to an absence they are required to make arrangements for another Resident to switch calls. If a Resident is unable to make arrangements for coverage he/she is to contact the Chief Resident and/or Department of Anesthesia Administrator.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 9.0 - ANESTHESIA DAILY EVALUATIONS

Anesthesia Residents on an Anesthesia Service must request daily evaluations from their supervising staff person each day.

Daily evaluations will be collected by the Site Coordinator and used for the basis of discussion and completion of the rotation ITER at the site based resident evaluation meeting by faculty.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 10.0 - APPEAL MECHANISM

1. Residents may appeal individual program component evaluations, rotation evaluations (ITERS), or Final In-Training Evaluations through the site or rotation coordinator, or through the Program Director.
2. Residents may also appeal through the Department Head.
3. Residents may bring concerns forward to either the Program Director or the Education Committee through the Chief Resident or the Residents’ Central Committee (a Residents only committee).

At the levels delineated above ((items 1 – 3), the appeal may be made verbally or in writing.

1. If a Resident’s appeal is not addressed to that Resident’s satisfaction through the preceding mechanisms, a departmental Residents Appeals Committee will meet to address a written appeal. There is an identified Chair of this committee (a Department Faculty Member) who will call a meeting of the committee. The membership of the Departmental Appeals Committee consists of the designated Chair, two other Anesthesia Faculty Members, an Anesthesia Resident not involved in the appeal, and a Faculty Member from outside the department.
2. If the Resident wishes to pursue subsequent appeals, these can be made in writing to Faculty of Medicine Committee on Postgraduate Medical Education (FCPGME).
3. If there is no remedy at the FCPGME level, the next level would be the Appeals Committee of the Faculty Council Executive.
4. If there is no remedy at that level, the Resident can appeal to an Appeals Committee of the University of Manitoba Senate.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 11.0 - CALL REQUESTS
It is important for residents to be able to plan their lives and to be able to have some latitude in a busy schedule for scheduling personal activities. Thus, it is reasonable to allow residents to make requests for call. However, such requests place a significant burden upon the co-chief resident, who must make up the call schedules. In addition, as numbers of requests increase, the likelihood of conflict and resultant denied requests increases.

Thus, it is necessary for the efficient and amicable operation of the program that there be a policy to govern call requests, so that every resident has reasonable and equal consideration.

All call requests must be submitted in APMSS no later than 4 weeks prior to the start of the rotation for which the request is being made. Call requests that are not logged in this manner by this deadline will not be considered. Each resident may make a maximum of two requests per period, subject to a total maximum of 11 requests per year.

The decision regarding whether a particular request can be granted will be contingent upon the availability of staffing for the time in question. In the event that the granting of all outstanding requests would result in a shortfall in staffing, then some requests will be denied. In the case of such a conflict, the requests will be granted according to the following in descending order of priority

1. the number of granted requests in the preceding 12 months
2. seniority of the resident(s)- favouring the more senior, if #1 and 2 are non-discriminatory
3. time submitted if the above are non-discriminatory
4. reason for request will be considered, but must be submitted in writing to the Program Administrator in addition to be entered into APMSS

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 12.0 - LEAVE OF ABSENCE

A resident shall be permitted to take a leave of absence from the training program, and return to training thereafter, subject to the following principles. The reason for this policy is to ensure equitable application of the LOA, so that time is available to those in need at the time of their need, without eroding the quality of the training program.

• The application for and approval of any leave of absence (LOA) shall be forwarded to the Postgraduate Office, and the Royal College as per their respective policies.
• The decision as to whether to grant an LOA request will be predicated upon the reason for the request. Reasons for which LOA shall be granted include
  • parental leave, as per the PARIM contract
  • illness
  • bereavement
  • any other reason approved by the Assessment Committee, the Postgraduate Dean, and the Royal College

• Whether the LOA shall be paid or unpaid shall be determined by the provisions of the PARIM contract, and is not subject to the judgment of the Program.
• The Royal College Policy on LOA requires that any LOA time in excess of three months cumulatively over the course of the five year program be made up by extending the period of training by that amount.
• The decision as to whether a resident shall be required to make up any or all of an LOA period within the three month allowance rests with the Program Assessment Committee. That decision shall be predicated upon consideration of the resident’s performance. At the midpoint of the final year, in preparation for the submission to the Royal College of the final assessment of training, the committee shall review the resident’s performance. Should that assessment conclude that the resident is performing at a level below that of his/her peers, the period of training shall be extended by whatever proportion of the original LOA is felt to be necessary in order to reach the expected level of performance. It is important to note that the decision is not predicated upon the attainment of a minimum level of competency, but average. This is intended to ensure that residents taking LOA’s commit themselves sufficiently diligently in the remainder of the training to make up the deficit. It is only appropriate to allow a resident with less training than
• his/her peers to acquire the same credentials if s/he can show that it has not adversely affected his/her education.
• The decision as to whether to issue a FITER is a separate one, predicated upon attainment of a minimum acceptable proficiency. The issuance of a FITER does NOT preclude a requirement to make up the LOA time. A requirement to make up LOA time does not preclude the issuance of a FITER. In the event that an extension is required, but the issuance of a FITER is felt to be justified, the timing of the FITER and associated exam shall be determined by the final date of training as per the Royal College limits.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010


POLICY 12.1 - MATERNITY LEAVE

The scheduling of maternity leave involves consideration of issues relative to the PARIM contract, Royal College Policy, and the exigencies of scheduling within the department. The following policy outlines the principles that are necessary to meet all of these sets of demands.

• The PARIM contract dictates a minimum period during which the resident shall be freed from all responsibilities related to the program. A resident may elect to take less than the minimum period. Leave periods longer than the minimum and up to one year may be granted at the mutual discretion of the resident and the program administration.
• The resident may be required by the program, the PGME office or the Royal College to make up all or part of the LOA. This decision shall be made in accordance with POLICY 12.0.
• Residents must notify the Program Director in writing of the expected date of confinement as soon as it is known or at 20 weeks, whichever is later.
• Should the resident wish to exercise the option of refraining from overnight call as per the PARIM contract, it is her responsibility to notify the program director in writing four weeks prior to the cessation of night call. If the Chief Resident solicits call requests for the period where overnight call will cease more then 4 weeks before the cessation of night call, the resident must indicate her intent to cease night call with the call request. In the absence of such notification, the period of exemption from call shall begin four weeks from the date of notification.
• Female residents shall not be scheduled for overnight call within four weeks of the expected date of confinement.
• Residents shall not be scheduled for subspecialty or off-service rotations in the last two periods prior to the expected date of confinement.
• Should the delivery occur during a subspecialty rotation, the leave time shall be credited as adult anesthesia, and the subspecialty time made up in a subsequent rotation.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010



POLICY 12.2 - PATERNITY LEAVE

Residents are entitled to paternity leave as governed by the PARIM agreement. The inherent unpredictability of the time of delivery presents a serious challenge to scheduling. In order to allow for a minimum of disruption without unduly limiting residents’ freedom, the following restrictions will apply:

• Any resident planning to take paternity leave shall notify the department of his intended start date at least four weeks prior to the start of the leave period. If the Chief Resident solicits call requests for the planned period of leave more then 4 weeks before the start of the leave the resident must submit his request for leave with the call request. In the event that a resident wishes to begin a leave period without four weeks notice, or after the deadline for submitting call requests for the planned period of leave, this request shall be granted. However, the resident shall be responsible for working or arranging replacement(s) for any outstanding call shifts falling within the four-week notification period.
• The PARIM contract dictates a minimum period during which the resident shall be freed from all responsibilities related to the program. A resident may elect to take less than the minimum period. Leave periods longer than the minimum and up to one year may be granted at the mutual discretion of the resident and the program administration.
• The resident may be required by the program, the PGME office or the Royal College to make up all or part of the LOA. This decision shall be made in accordance with POLICY 12.0
• Residents will be assigned to normal duties, including call, up to the planned start date for the leave period.
• The resident may opt to begin the paternity leave prior to the expected date of confinement, in order to ensure complete freedom from responsibilities at the time of delivery.
• The leave period must begin within 52 weeks of the day upon which the baby was discharged from hospital.
• Residents shall not be scheduled for subspecialty or off-service rotations in the last two periods prior to the expected date of confinement.
• Should the delivery occur during a subspecialty rotation, the leave time shall be credited as adult anesthesia, and the subspecialty time made up in a subsequent rotation.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 13.0 - MOONLIGHTING DURING ANESTHESIA RESIDENCY

Moonlighting refers to working outside of the auspices of the residency program. It is allowed under certain circumstances, subject to the following constraints.

• Moonlighting during clinical anesthesia rotations, including subspecialty rotations shall be tolerated subject to the following conditions:
  • The resident must obtain written approval from the Anesthesia Postgraduate Program Director prior to commencing moonlighting
  • The resident maintains good academic performance
  • There is NO interference with performance of clinical duties. This includes scheduling of moonlighting call shifts, such that residency clinical or academic activities fall in a post-call period
  • Attendance at academic activities (grand rounds, talk rounds) is maintained
  • In the event of scheduling conflicts with the residency program, the program needs shall take precedence

• Moonlighting on off-service rotations is discouraged, but ultimately is subject to the rules of the particular off-service rotation. In the event that a resident does moonlight while off-service and receives a significant negative comment on that rotation evaluation, that shall serve as grounds for remedial action.
• Moonlighting while on Scholarly activity, while discouraged, shall be tolerated providing that:
  • It does not interfere in any way with the completion of the scholarly activity
  • Does not conflict in any way with the clinical responsibilities of the Scholarly period
  • The resident is in good standing in the program, and having no academic difficulty

• Residents choosing to moonlight on Scholarly Activity time, and subsequently receiving significantly negative comments on their scholarly evaluations shall be grounds for remedial action.
• Any resident on remediation is prohibited from moonlighting during any rotation
• Residents are free to use their own holiday time as they see fit, and may moonlight without restriction.

The remedial action indicated in the instance of moonlighting in contravention of the above guideline, shall be determined by the Assessment Committee, and may include failure of a rotation, negative evaluations on the ITER and/or FITER or any other action deemed appropriate and consistent with the university policy on remediation.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

 

---

POLICY 14.0 - HANDLING OF NARCOTICS AND CONTROLLED SUBSTANCES

Narcotic handling policies have been created to mitigate the risks to society of diversion, and to the individual caregivers of substance abuse. It is therefore mandatory for all care- givers in the OR environment to be familiar with the departmental policies and legislation governing narcotics. It is equally important that all caregivers support each other in observing and intervening to correct inappropriate handling, whether by themselves or others.

Each department will have specific policies and procedures for the handling and recording of narcotics. Each caregiver must acquaint him/herself with the local policies while working in a site. Each site will have:

• a secure area in which controlled substances are stored
• a protocol for accessing that secure area
• a locally produced NCDUR (Narcotic Control Drug Utilization Record), which is a document upon which is recorded the amount and type of drugs signed out and to whom, the amount given to each patient, the amount wasted and the amount returned.

The general rules that should guide behaviour are as follows:

• All controlled substances must be signed out under one person and all use, waste and residual returned accounted for by that person on the NCDUR (Narcotic Control Drug Utilization Record) such that all drugs initially signed out have been accounted for
• All use of controlled drugs must also be recorded in the patient record
• Drugs should be kept secure
  • not be removed from the care environment
  • All drug use should be resolved at the end of the shift
  • They should NOT be passed on to subsequent caregivers when care is signed over
  • Drugs left over and intact should be returned to pharmacy through the secure mechanism provided by that site
  • Drugs left over in open vials or syringes MUST BE DISCARDED in a manner that prevents their subsequent salvage or diversion

Further Resources:
Controlled Drugs and Substances Act

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 15.0 - ATTENDANCE AT DEPARTMENTAL EVENTS

Attendance is mandatory at all Departmental Educational Events such as:

• Talk Rounds
• Journal Club
• Visiting Professor
• Research Symposium
• Manitoba Provincial Conference
• Grand Rounds

Residents on Anesthesia rotations are excused from call responsibilities during the event but must return for call immediately following the event.

Residents on off service rotations are expected to inform their rotation supervisor(s) of the educational event and request to be excused from clinical duties. There is no obligation for off service rotations to provide residents the time away.

Although attendance is mandatory it is expectation that all residents will RSVP as required by the circulated notice.
Exceptions to mandatory attendance are vacation and leave of absence.

Approved: Anesthesia Postgraduate Education Committee, October 27, 2010

---

POLICY 16.0 - FACULTY EVALUATIONS

Residents are required to complete an evaluation on each faculty member that they have had a teaching encounter with prior to the completion of each academic rotation (this includes on call and daytime work). 

 

Residents who fail to complete all required faculty evaluations prior to the last day of the academic rotation will be deemed to have an incomplete rotation until all evaluations are completed.

 

Residents will be provided with a reminder to complete evaluations 14 days prior to the end of the academic rotation. 

 

Approved By:  Anesthesia Postgraduate Education Committee, May 24, 2011