Resident Safety Policy
PGME Committee approval 1 February 2018
Faculty Council approval 6 March 2018
Effective 6 March 2018
The Dalhousie Faculty of Medicine recognizes that postgraduate trainees have the right to a safe learning environment during their residency training. The responsibility for promoting a culture and environment of safety, which includes physical, emotional, and professional safety, for postgraduate trainees rests with the Faculty of Medicine, district health authorities, clinical departments, training sites, individual postgraduate training programs and postgraduate trainees themselves.
Given the shared responsibility for postgraduate trainee safety, this Policy must be read in conjunction with:
· the safety policy developed by the applicable postgraduate training program, which takes into account the specific risks associated with the nature of the discipline and the organization of training;
· the workplace health and safety policy of any applicable health authority; and
· the collective agreement between Maritime Resident Doctors and the Nova Scotia Health Authority, Izaak Walton Killam Health Centre for Children, Women and Families, New Brunswick Regional Health Authorities, Prince Edward Island Health and any other hospital/medical centre/community centre involved in the Dalhousie University Postgraduate Medical Education Program (“Collective Agreement”).
· The Dalhousie University Environmental Health and Safety Policy
· For Postgraduate trainees
To provide information and communicate safety concerns to the program and training site, as well as to comply with all applicable safety policies.
· For Postgraduate training programs
To develop and regularly review the program-specific safety policy, to act promptly to address identified safety concerns and incidents, and to be proactive in providing a safe learning environment by ensuring postgraduate trainees are made aware of applicable safety policies.
1. Physical safety
1.1. Postgraduate Trainee Travel
1.1.1. Postgraduate trainees must be compliant with all provincial laws, pertaining to the safe operation and maintenance of motor vehicles including the prohibition on cell phone use and text messaging.
1.1.2. For long distance travel for clinical or other academic assignments, postgraduate trainees should ensure that a colleague or the home residency office is aware of their itinerary.
1.1.3. Postgraduate trainees will be provided with appropriate time to travel for clinical or other academic assignments by car. When long distance travel is required by a Postgraduate trainee as part of their training program, the call restrictions specified in the Collective Agreement will be followed.
1.1.4. In situations where postgraduate trainees are concerned about personal safety related to travel during inclement weather, they should communicate promptly with the program office. Assignment of an alternate activity is at the discretion of the Program Director.
1.2. Personal Security
1.2.1. Postgraduate trainees should not work alone after hours in health care or academic facilities without adequate support from the applicable health authority’s security services or Dalhousie’s Security Services, respectively.
1.2.2. Postgraduate trainees are not expected to work alone at after-hours clinics.
1.2.3. Postgraduate trainees are not expected to make unaccompanied home visits.
1.2.4. Postgraduate trainees are entitled to a safe and secure environment when using health care facilities or Dalhousie premises, including parking lots and parkades. Postgraduate trainees are strongly encouraged to notify and utilize available security services when walking outdoors at night.
1.2.5.Postgraduate trainees should only telephone patients from an institutional phone line or while using caller blocking if calling from a personal phone line.
1.2.6. Postgraduate trainees should not provide patients with their personal or private information, including home or cell phone numbers, personal email addresses, social media contact information, and home addresses.
1.2.7. Postgraduate trainees should avoid driving home after call if they have not had adequate rest and should make alternate arrangements according to the provisions of the collective agreement.
1.2.8. Postgraduate trainees should not assess violent or agitated and potentially violent patients without having received appropriate training on how to deal with such patients.
1.2.9.Site orientations should include a review of local safety procedures and policies.
1.2.10. Call rooms and lounges provided for postgraduate trainees must adhere to the provisions of the Collective Agreement.
2. Infection Control and Occupational Health
2.1. Postgraduate trainees have a duty to familiarize themselves with the location of and services offered by the Occupational Health Office at each training site to which they are assigned, as well as with site-specific policies and procedures for infection control and protocols following exposure to contaminated fluids, needle stick injuries, and reportable infectious diseases.
2.2. Postgraduate trainees must observe universal precautions and isolation procedures when indicated.
2.3. Postgraduate trainees should keep their immunizations up to date. Overseas travel immunizations and advice should be sought well in advance when traveling abroad for electives or meetings.
2.4. Postgraduate trainees are professionally and ethically obligated to follow the provisions of the Infectious Diseases and Immunization Policy. Accommodation or modification of their program will be determined in accordance with the Postgraduate Medical Trainee Accommodation Policy.
3. Radiation Safety
3.1. Postgraduate trainees are not expected to work in areas of high and long-term radiation exposure to radiation without receiving prior appropriate education on radiation safety.
3.2. Postgraduate trainees working in areas of high and long term exposure to radiation must follow radiation safety policies and minimize their exposure according to current guidelines.
3.3. Radiation protective garments (aprons, gloves, neck shields) must be used by all postgraduate trainees participating in x-ray guided procedures – for example fluoroscopic procedures or CT guided procedures.
4. Safety during Pregnancy
4.1. Postgraduate trainees are never expected to compromise their personal safety or the safety of their fetus in the course of their clinical or academic duties.
4.2. Pregnant postgraduate trainees should be aware of specific risks to themselves and their fetus in the training environment and request accommodations where indicated through the Postgraduate Medical Trainee Accommodation Policy. Postgraduate trainees should consult their Program Director and/or the Assistant Dean of Resident Affairs for information.
4.3. In addition to any accommodations granted pursuant to the Postgraduate Medical Trainee Accommodation Policy, pregnant postgraduate trainees are entitled to any modified call obligations set out in the Collective Agreement.
5. Psychological safety
5.1. Learning environments must be free from intimidation, harassment, and discrimination as defined in Appendix A of the PGME Intimidation and Harassment policy.
5.2. When a postgraduate trainee’s performance is affected or threatened by poor health or psychological conditions, the postgraduate trainee should request sick leave according to the collective agreement or seek an accommodation in accordance with Postgraduate Medical Trainee Accommodation Policy.
5.3. All programs should appoint or provide access to an ombudsperson and ensure that all postgraduate trainees in the program are informed as to the program-specific policies regarding the ombudsperson role and contact information.
5.4. Postgraduate trainees should be aware of and have easy access to the available sources of immediate and long-term help for psychological problems, substance abuse problems, harassment, and inequity issues. Resources include the Resident Affairs Office, the Dalhousie University Health and Wellness Centre, Human Rights and Equity Services, and the MarDOCS Employee Assistance Program.
6. Professional safety
6.1. Some physicians may experience conflicts between their ethical or religious beliefs and the training requirements and professional obligations of physicians. Postgraduate trainees should contact the office of the Assistant Dean of Resident Affairs for resources to help deal with these conflicts.
6.2. Postgraduate trainees should have adequate support from their program and/or the office of the Assistant Dean of Resident Affairs following an adverse event or critical incident.
6.3. Programs must promote a culture in which postgraduate trainees are able to report and discuss adverse events, critical incidents, ‘near misses’, and patient safety concerns without fear of punishment or retaliation, while also recognizing the need for accountability.
6.4. Residency program committee members and faculty must not divulge information regarding postgraduate trainees. It is the responsibility of the residency Program Directors to make the decision and to disclose information regarding postgraduate trainees (e.g. personal information and evaluations) outside of the residency program committee and to do so only when there is reasonable cause, or they are required to do so by law.
6.5. With regard to postgraduate trainee files, programs must be aware of and comply with the Freedom of Information and Privacy (FOIPOP) Act. Programs must follow the PGME Postgraduate Records & FOIPOP Policy on Access to Resident Files. Programs can obtain guidance about FOIPOP issues from the Dalhousie University FOIPOP Coordinator.
6.6. Feedback and complaints made by postgraduate trainees must be handled in a manner in accordance with the PGME Intimidation and Harassment policy. However, in the case of a complaint that must be dealt with due to its severity or threat to other postgraduate trainees, a Program Director may be obliged to proceed, against the complainant’s wishes. In that case the Associate Dean of Postgraduate Medical Education and the Assistant Dean of Resident Affairs should be consulted immediately. Depending on the nature of the complaint, the regional health authority and/or the College of Physicians and Surgeons of the province where the program is located, may need to be informed and involved. In general, the Program Director should serve as a resource and advocate for the postgraduate trainee in the complaints process.
6.7. In addition to CMPA coverage for patient actions, postgraduate trainees are indemnified for actions or lawsuits arising from the actions or decisions made by committees (e.g. tenure, appeals, residency training) they may serve on, under the university insurance for lawsuits related to academic issues.
Physicians Support Program, DoctorsNS
Director, Medical Education
Room 222 Bethune Building
1276 South Park Street
Halifax, NS B3H 2Y9
5955 Veterans’ Memorial Lane
Halifax, Nona Scotia B3H 2E1
Phone: (902) 473-4773
Fax: (902) 473-2451
Room B31, Bethune Building
1278 Tower Road, Halifax
Nova Scotia B3H 2Y9
Phone: (902) 473-8416
Fax: (902) 473-2963