Clinical Immunology & Allergy Residency Program

Resident Occupational Health and Safety Policy 

  1. Introduction

Resident education must occur in a physically safe environment (Royal College of Physicians and Surgeons of Canada, standard A.2.5; College of Family Physicians of Canada). The university also recognizes that safe working environment for trainees is beneficial to resident education and patient care, and that there are ethical and moral reasons for maintaining such a working environment.

The purpose of this document is to provide a policy regarding workplace safety for postgraduate trainees in Clinical Immunology and Allergy at McMaster University and to demonstrate the commitment of the residency training program in providing and maintaining healthy and safe working and learning environment for all postgraduate trainees. This is achieved by observing best practices which meet or exceed the standards to comply with legislative requirements as contained in the Ontario Occupational Health and Safety Act, Environmental Protection Act, their regulations, and the policy and procedures established by the University.

It is expected that the postgraduate trainee, the residency training program, the Postgraduate Medical Education (PGME) Office will work together with the affiliated teaching hospitals and community training sites to ensure the personal safety of all postgraduate trainees.

This policy complies with the Royal College accreditation standards A2.5 and B1.3.9 and does not supersede any University wide or PGME Policy that is already established. In this policy, “Safety” relates to the residents’ physical, emotional and professional wellbeing. See: //fhs.mcmaster.ca/postgrad/policies.html

  1. Scope

This policy covers resident safety in the areas of travel, patient encounters, including house calls, after-hours consultations in isolated departments (Royal College Standard B1.3.9). This policy should allow resident discretion and judgment regarding their personal safety and ensure residents are appropriately supervised during all clinical encounters.

These policies apply only during residents’ activities that are related to the execution of residency duties.

  1. Program Specific Policies

3.1 The Resident Safety Policy needs input and acceptance from the residents through the residency education committee.

3.2 Residents need to provide rotation and faculty evaluations to help direct or establish concerns of resident safety.

3.3 The residency program administration and the Program Director need to act promptly to verify safety issues and take due action to rectify the problem.

3.4 Critical incidents involving residents must be recorded, and appropriate debriefing should occur in a timely fashion.

  1. Responsibility of the Resident

Travel

4.1 Residents traveling for clinical or other academic duties by private vehicle should maintain their vehicle adequately and travel with appropriate supplies and contact information. Residents should not use cell phone use or text messaging while driving.

4.2 If the resident has determined that it is unsafe to travel (i.e. due to extreme weather concerns), the resident may elect not to attend clinic, see a consult, or academic half day. However, they must inform their clinical supervisors as soon as possible in a professional manner.

4.3 Residents should ensure adequate rest after call duties before traveling home from the site of clinical duties. Call rooms are available at each training site to accommodate residents for rest before travel. Residents should discuss such arrangements with the on-call supervisor or program director.

4.4 Residents who are called in for clinical duties after 6 pm and before 6 am, and feel unsafe to drive post call should opt to take a taxi for transportation. Reimbursement for taxi charges will be provided upon presentation of appropriate receipts.

4.5 Residents are not required to attend academic half day if they are greater than 50 km away from the academic half day location nor are they required to attend on post call days. Should residents feel well rested despite being post call, they are encouraged and welcome to attend academic sessions. If not attending due to post call, residents must inform the Program Assistant (Ann-Marie) of this reason for absence.

Physical Safety

4.6 Residents must participate in required safety sessions including Workplace Hazardous Materials Information and Safety (WHMIS), Fire safety, and abide by the Safety codes of the designated area where s/he is training.

4.7 Residents must observe universal precautions and isolation procedures. If necessary, a refresher or literature will be provided on universal precaution procedures.

4.8 Residents should familiarize themselves with the occupational and safety office. This includes familiarity with policies and procedures in reporting contact with contaminated fluids, needles, TB exposure or risk, etc.

4.9 Residents should keep their immunizations and TB skin testing up to date. Overseas travel immunizations and advice should be organized well in advance when traveling abroad for electives or meetings. Since the residency training program does not mandate overseas electives, the resident is expected to coordinate and finance these services.

4.10 Residents should not assess violent or psychotic patients without the backup of security or a supervisor and also an awareness of accessible exits.

4.11 Residents should not work alone at after-hours clinics, make unaccompanied home visits, perform air transport, or arrange to meet patients after hours without on-site support. This does not apply if a patient is being seen in the emergency room or on a hospital ward. A supervisor must always be present if the resident is assessing a patient in an ambulatory setting after hours.

4.12 If the resident feels that his/her own personal safety is threatened, s/he should seek immediate assistance and remove themselves from the situation in a professional manner. The resident should be aware of the contact for security at participating training sites. The resident should ensure that their immediate supervisor and/or Program Director, has been notified, as appropriate. The resident can also bring their safety concerns to the attention of the PGME office (905 525 9140 Ext. 22118) during regular work hours, particularly if the Program Director is not available. If an issue arises after regular office hours, where the clinical supervisor and/or Program Director may not be available, contact Security of the institution where the trainee is based.

4.13 Residents doing home call and arriving after hours should be aware of their environment before leaving their car and have a cellphone available to contact security if it is deemed an escort is required. If residents feel potential threat to their safety, residents should not exit their cars and leave accordingly. In the rare event this occurs, residents should notify the clinical supervisors on call.

4.14 Residents must get approval from the program director when planning to do an elective outside of North America to ensure compliance with standards and best practices for the safety of all trainees. International electives must occur in a stable political environment with a qualified preceptor to provide appropriate supervision. Additionally, there must be a Canadian Consulate in that country.

4.15 Residents must use caution with respect to confidential personal and patient information, and exercise good judgment and professional behavior when using social media.

4.16 If an injury occurs while working, the injury must be reported as follows:

  • During daytime hours, while working at one of the Hamilton teaching hospitals, the trainee should go to the Employee Health Office at any of the teaching hospitals. An incident form will be provided by the Employee Health Office to the trainee. Trainees are encouraged to submit a copy of the incident form to the Program Director and the PGME Office for records.
  • During after hours, while working at one of the Hamilton teaching hospitals or if working at a training site outside of the Hamilton area, the trainee should go to the nearest emergency room and identify themselves as a resident and request to be seen on an urgent basis. The trainee must complete, within 24 hours, an Injury / Incident Report available in the local emergency room. The form should be submitted to the hospital where the injury took place, the Program Director and the PGME office for records

Psychological Safety

4.17 Residents are encouraged to report incidents of intimidation, harassment and discrimination to the Program Director. Any incidents or issues brought forth to the Program Director will remain confidential and residents have the right to confidential psychological and counseling services.

4.18 Residents are encouraged to comment on the rotation evaluations professional issues encountered by staff and residents.

Professional Safety

4.19 Residents must not be expected to participate in any situation that would go against their professional responsibilities, ethics, or moral beliefs.

4.20 Residents must have adequate contact with their clinical supervisors for help during critical incidents.

4.21 CMPA provides legal advice and insurance for residents who have acquired coverage.

  1. Responsibility of the Program

5.1 It is the responsibility of the residency training program and the PGME to ensure that appropriate safety sessions are available to all trainees. In addition to WHMIS, the residency training program must ensure that there is an initial, specialty, site-specific orientation available to the trainee.

5.2 It is the responsibility of the residency training program to ensure that individual clinics or practice settings develop a site specific protocol in the event that personal safety is breached. The protocol should include the following:

  • Identify potential risks to the trainee
  • Include how the trainee would alert the supervisor if they felt at risk during an encounter, identification of potentially problematic patients at the beginning of the encounter, so they could be monitored.
  • A supervisor or co-worker must be present:
    • While the trainee is seeing a patient after hours in clinic. This would not apply if the patient is being seen in an emergency room.
    • At the end of office hours if the trainee is still with patients.

5.3 It is the responsibility of the residency training program to that each training site remains compliant with the program policy.

5.4 It is the responsibility of the residency training program to ensure a safe learning environment that is free from intimidation, harassment and discrimination. The residency training program will not tolerate such behaviors.

Resources available

Postgraduate Medical Education Office
Phone 905-525-9140 X22118
Fax 905-527-2707

Faculty of Health Sciences Safety Office
Health Sciences Centre, Room 3N1C
1200 Main Street West, Hamilton ON L8N 3Z5
Phone 905-525-9140 X24956
Fax 905-528-8539

Hamilton Health Sciences
Human Resources – Employee Health
Telus Sourcing Solutions
120 King Street West, Suite 200
Hamilton, ON
Phone 905-387-9495 X63900

St. Joseph’s Healthcare
Occupational Health and Safety Services
50 Charlton Avenue East
Hamilton ON L8N 4A6
Phone 905 522 1155 X33344