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Fédération des médecins résidents du Québec

FMRQ Express Vol. 7, No. 12 June 2011

FMRQ Express is a publication of the Fédération des médecins résidents du Québec which reports on developments with regard to the main issues to which special attention is paid and on decisions made by Federation bodies, notably the Executive Committee, Board of Directors and Delegates’ Assembly.

CURRENT NEGOTIATIONS SUSPENSION OF TEACHING ACTIVITIES – FROM JUNE 6 TO 10, IT’S PRIORITY TO PATIENTS DEVELOPMENTS IN THE NEGOTIATIONS RESIDENT DAY 2011 – FRIDAY, MAY 27, 2011 PILOT PROJECT FOR THE INTERNAL MEDICINE AND PEDIATRICS EXAM CANCELLED QUEBEC UNIVERSITY NETWORK FOR THE HEALTH OF MEDICAL RESIDENTS AND STUDENTS (RUQSREM) PROFESSION SANTÉ L’ACTUALITÉ MÉDICALE: A PUBLICATION AIMED AT YOU IN SEVERAL FORMATS COLLÈGE SURVEY OF CURRENT AND FORMER HOLDERS OF RESTRICTIVE PERMITS–RESIDENT — HAVE YOU RESPONDED? HOW WELL DO YOU KNOW YOUR COLLECTIVE AGREEMENT? BCLS, ACLS, ATLS . . . WELLNESS CAPSULE PRESENTEEISM AMONG MEDICAL RESIDENTS DEATH NOTICES FOR PATIENTS STAYING IN AN ESTABLISHMENT – IMPORTANT RECOMMENDATIONS PERSONALITY TYPES FAVOURED IN MEDICINE CHANGES OVER TIME ALDO-QUEBEC – CALENDAR FOR 2011 RESTRICTIVE PERMIT–RESIDENT/MOONLIGHTING


CURRENT NEGOTIATIONS SUSPENSION OF TEACHING ACTIVITIES FROM JUNE 6 TO 10, IT’S PRIORITY TO PATIENTS    

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Those of you who follow us on www.releveensante.ca already know that bargaining sessions with the government are currently taking place weekly. But we still have a long way to go to obtain our demands. So far, the government is still refusing to acknowledge the ever-widening salary gap between Quebec's medical residents and their colleagues in the other provinces. In fact, with the recent conclusion of negotiations by medical residents in Saskatchewan and Newfoundland & Labrador, we have now moved from 25% to 37% below the Canadian average! Early in the month, you were notified of the initiation of the first province-wide pressure tactic: a suspension of teaching activities. Throughout the week, medical residents were invited to do no teaching, in any form whatsoever. A week without teaching was for us the best way of getting the government to understand the scope of our involvement in that regard during our residency and to convince it to pay medical residents for this teaching, just as it does practising physicians. We will be reporting on this operation in upcoming emails and on www.releveensante.ca in the coming days.

DEVELOPMENTS IN THE NEGOTIATIONS  We need your support and co-operation to remind the government that medical residents are currently working in suboptimal conditions, in terms both of call duty schedules and of their overall compensation.  THE NEGOTIATING TEAM is working for you. The team consists of the four association presidents, the three Executive Committee members, the chairperson of the Union Affairs Committee, the FMRQ executive director, administrative director and legal counsel, as well as the union affairs co-ordinator and the communications advisor.  For more information on the negotiations, get in touch with Marie-Anik Laplante, the FMRQ's union affairs co-ordinator, by calling 514-282-0256 or 1-800-465-0215 or emailing malaplante@fmrq.qc.ca.

Drop by www.releveensante.ca regularly and Register!

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RESIDENT DAY 2011 – FRIDAY, MAY 27, 2011

This year, Resident Day 2011 returned to health care establishments with a vengeance, on Friday, May 27. Information booths The members of the Resident Wellness Committee and some of their colleagues gave generously of their time to ensure a presence at information booths near the cafeterias of 10 or so university hospitals. They met medical residents, staff members and patients in the course of this activity to raise awareness of the work performed by medical residents.

Establishments and teaching directors got involved, and staff physicians too!  Posters were visible in most establishments in the health care system.  Some establishments offered staff physician-medical resident breakfasts or lunches, and marked the day in their respective publications.  Some faculties sent their medical residents messages.  And some staff physicians showed medical residents their support all day long.  Also, the medical resident associations held or will be holding social activities to underscore their members' contribution. Pager contest  The pager contest rewarded medical residents once again this year. Resident Day at the Quebec National Assembly  Quebec’s Minister of Health and Social Services, Dr Yves Bolduc, tabled a motion underscoring Medical Resident Day and medical residents' contribution to access to care during the proceedings of the National Assembly on the morning of May 26. Medical Resident Day 2011 in the media  In addition to coverage in the in-house newsletters of establishments and universities, Medical Resident Day garnered special attention in the print and electronic media.  Interviews were given by medical residents responsible for information booths.  L’Actualité médicale should be publishing a report on the subject shortly.  On RDI Santé, a former Academic Affairs Committee–Family Medicine (CAP-MF) member, Dr Johanne Blais, delivered a highly realistic, while flattering report of medical residents and their contribution to access to health care services in Quebec. Take a look at it on Radio-Canada, in the 12th minute of the report, after the section on bicycle helmets. Thanks to all who contributed directly or indirectly tothe success of Medical Resident Day 2011, and see you next year!

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PILOT PROJECT FOR THE INTERNAL MEDICINE AND PEDIATRICS EXAM CANCELLED   

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Over the past year, the Federation on several occasions lobbied the Royal College of Physicians and Surgeons of Canada seeking the postponement of the pilot project to change the process for the certification exam in internal medicine and pediatrics. The RCPSC wanted to make a pass in the written component of the exam mandatory for a candidate to be able to take the oral component. The chairperson of the Academic Affairs Committee–Specialties (CAP–S) and the president of the Federation—following several interventions by members of the CAP–S, the Executive Committee and the Board of Directors of the FMRQ—sent a letter on May 9, 2011 to the president and the CEO of the RCPSC, urging them to place the project on the backburner until the various stakeholders, in particular medical residents, were given a hearing concerning the disastrous impact of this change. Letters were also sent to chief examiners, deans and associate deans of faculties, and program directors in those disciplines, as well as to medical residents, inviting them to sign and send in a petition demanding the postponement of the pilot project. On May 27, 2011, the FMRQ received correspondence from Dr Kenneth A. Harris, director of the Royal College's Office of Education, confirming that the project had been cancelled for 2012 and that the cohort concerned would follow the same rules as previously for the certification exam. Furthermore, a committee bringing together all stakeholders concerned by this issue is to be set up to review the overall pilot project, with a view to identifying the most appropriate model for all the parties concerned.

QUEBEC UNIVERSITY NETWORK FOR THE HEALTH OF MEDICAL RESIDENTS AND STUDENTS (RUQSREM) Presentation on call duty schedules at the meeting of April 18, 2011  Last April 18, the members of the Resident Wellness Committee took part in the second meeting of the year held by the Quebec university network for the health of medical residents and students (RUQSREM).  At this meeting, Dr Frédéric Dallaire, chairperson of the Federation's Union Affairs Committee, made a presentation on the scientific evidence underlying the rearrangement of call duty schedules from 24 hours to a maximum of 16 consecutive hours; the presentation was very well received by participants.  Note that the members of RUQSREM are directors and other consulting physicians in the medical faculties' aid offices, representatives of the Quebec Physicians’ Health Program (QPHP), the chairperson and four members of the FMRQ's Resident Wellness Committee and a student representative named by the Fédération médicale étudiante du Québec (FMEQ).  The purpose of RUQSREM is to enable the different authorities involved to exchange ideas on the difficulties encountered by medical students and residents on various fronts and to identify solutions that are brought to the attention of the authorities concerned, in particular the associate deans.

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RUQSREM (cont’d) FMRQ to receive RUQSREM members on November 25, 2011  Some good news for next year: following an invitation from Dr Étienne Désilets, chairperson of the FMRQ's Resident Wellness Committee, the Federation will be receiving RUQSREM members in its offices for the next RUQSREM meeting, on Friday, November 25, 2011.  RWC members have already begun identifying the themes to be looked at during that meeting, which will of course be focussed on concerns more specifically associated with residency, with respect to distress and harassment in the workplace, but also with respect to various academic aspects.

L’ACTUALITÉ MÉDICALE: A PUBLICATION AIMED AT YOU IN SEVERAL FORMATS

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L’Actualité médicale is a free publication aimed at all health professionals. When you apply for your training card, you can ask to receive it by checking ―YES‖ to receive Collège publications. But L’Actualité médicale is also available in electronic format. Subscribing could not be simpler. Consult the promotional poster attached or visit http://www.professionsante.ca/

COLLÈGE SURVEY OF CURRENT AND FORMER HOLDERS OF RESTRICTIVE PERMITS–RESIDENT — HAVE YOU RESPONDED?   

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Last May 19, you received an invitation from the Collège des médecins du Québec to complete a survey on restrictive permits for medical residents. If you responded to the survey, we thank you very much indeed. Your answers and the numerous comments received are highly appreciated. On the other hand, if you have not yet responded to the survey, we would ask you once again please to take part in the study. Responding to it will take just a few minutes. Your opinion as a resident who has practised during residency is very important and will be very helpful, to us and to future cohorts. To ensure the broadest possible participation, the Collège has postponed the deadline for responding to June 20, 2011. Thank you in advance for your co-operation and for taking part in the study! If you need to, or for information on accessing the questionnaire, feel free to contact Caroline Brassard at 514-933-4441 or 1-800-633-3246, ext. 5238.

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HOW WELL DO YOU KNOW YOUR COLLECTIVE AGREEMENT? BCLS, ACLS, ATLS . . . 

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Article 13.04 of the collective agreement provides for the possibility for any medical resident to be released to attend the following courses: BCLS/ACLS/ATLS/APLS/NPLS (NRP)/ALSO.  To do so, you must have authorization from the competent authority (program director, department head or any other person in authority).  Some programs have drawn up lists of courses which are automatically authorized. But, even if such a list of authorized courses exists in your program, nothing prevents a medical resident from asking for authorization for a course that is not listed, if it is important for his choice of future practice. Note that days used to attend courses must NOT be taken from the bank of days set aside for participation in a conference. Also, you can receive reimbursement for the course taken, if it was authorized by the competent authority. To do so, please apply to the director of teaching in your establishment.

WELLNESS CAPSULE PRESENTEEISM AMONG MEDICAL RESIDENTS

Last fall, the Journal of the American Medical Association (JAMA) published an article on presenteeism at work, based on research conducted on medical residents. 

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The article deals with the fact that many medical residents work even though they are sick, for two reasons: because of pressure in their training sites, or because they don't have time to see a doctor—always assuming they can find one. They also talk of fear of letting down teammates. According to the authors, regardless of the reason, there is a risk of transmitting health problems to patients or of committing errors, and program directors should discourage medical residents from reporting to work in such circumstances. To find out more, read Presenteeism Among Resident Physicians (Anupam B. Jena; DeWitt C. Baldwin Jr; Steven R. Daugherty; et al, JAMA, 2010).

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DEATH NOTICES FOR PATIENTS STAYING IN AN ESTABLISHMENT IMPORTANT RECOMMENDATIONS 

Recently, the Quebec Minister of Health and Social Services informed the Federation of a series of recommendations from the provincial human rights and youth rights commission (Commission des droits de la personne et des droits de la jeunesse) in connection with a Notice on the application of the Act respecting the determination of the causes and circumstances of death in establishments, resources and residences for the elderly. These recommendations were addressed to the Collège des médecins du Québec and the medical federations, and reiterated that the role of doctors, when they certify a death, is important since they are in a position to detect elements which could mean a coroner's inquest should be held. The Commission recommends: o That the medical faculties, the Collège des médecins du Québec and the medical federations respectively ensure that the initial or ongoing training of doctors specifically includes their professional and legal responsibilities with respect to the coroner's notice; o That the Collège des médecins du Québec periodically remind its members of their obligations with respect to the coroner's notice; o That the Coroner's Office and the Ministry of Health and Social Services set up a multidisciplinary committee whose mandate would be to examine the deaths of elderly individuals staying in such facilities; o That the Act respecting the determination of the causes and circumstances of death be amended expressly to include negligence in the list of circumstances contemplated by the mandatory notice; o That the Act respecting the determination of the causes and circumstances of death be amended to extend to long-term residential care facilities (CHSLDs), intermediate resources and residences for the elderly the obligation to notify the coroner, while giving the coroner the power to determine whether it is appropriate to conduct an inquest in that case. The document also refers the reader to the resolution recently adopted by the United Nations General Assembly in order to ensure follow-up on the Madrid International Plan of Action on Ageing, particularly with regard to governments' responsibility for creating conditions enabling families and communities to deliver care and protection to aging individuals and, in particular, to reduce mortality, as well as drawing up more effective prevention strategies and more energetic statutes and policies to deal with problems of abuse of or violence against the elderly. If you would like a copy of the Commission's notice, just get in touch with the FMRQ by calling 514-282-0256 or 1-800-465-0215 or emailing fmrq@fmrq.qc.ca.

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PERSONALITY TYPES FAVOURED IN MEDICINE! CHANGES OVER TIME

Variety is the spice of life Credit: THE WELLCOME LIBRARY

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The different personality types found in life are also seen in medicine. These differences can cause friction, but they can also be beneficial. Recently, we came across an article on the different personality types, originally published in February 2005 and reissued in 2010. The article describes the personality types and behaviours which were favoured in establishments and the health care system in general in 2005, and which seem still to apply today, in a perspective of change within the profession.

Traditional preferences and behaviours encouraged in today's health service

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So here is a suggestion for some slightly lighter reading for early summer: Understanding Personality Type: The importance of having all types in a workforce, by Anita Houghton, published in the British Medical Journal in February 2005. We remind you that if your state of health requires attention, you should feel free to consult your doctor or get in touch with the Quebec Physicians’ Health Program (QPHP) at 514-397-0888 or 1-800-387-4166.

DON’T FORGET . . . WELLNESS IS IN YOUR HANDS!

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ALDO-QUEBEC – CALENDAR FOR 2011 (registration required one month prior to training session) N.B. We invite you to consult the Collège site to check that certain sessions have not been postponed.

DATE

CITY

LOCATION

July 5

Montreal

August 23 August 30 September 13 September 27 October 11 October 25 November 8 November 29 December 6 December 13

Montreal Quebec City Montreal Sherbrooke Montreal Montreal Sherbrooke Montreal Montreal Quebec City

McGill University (ENG) McIntyre Building Meakins Room 521 University of Montreal (FRE) Laval University (FRE) University of Montreal (FRE) University of Sherbrooke (FRE) McGill University (ENG) University of Montreal (FRE) University of Sherbrooke (FRE) University of Montreal (FRE) McGill University (ENG) Laval University (FRE)

ALDO-Quebec training sessions run from 1 pm to 4 pm, unless indicated otherwise. The registration form is available on the Collège site, and must reach the department responsible at least one month prior to the training session in which you wish to participate. You may register after the deadline, but additional fees could be charged. For further information, consult the Collège des médecins du Québec site at www.cmq.org, under Students, Residents and Fellows/Examinations and ALDO.

RESTRICTIVE PERMIT–RESIDENT/MOONLIGHTING Deadline for sending in documents

Collège meeting

July 6 August 31 October 12 November 7 December 7

July 14 September 8 October 20 November 15 December 15

Permits are issued a few days after the meetings. Enjoy the newsletter! Charles Dussault, MD President For further information, please contact the FMRQ by phoning 514-282-0256 or 1-800-465-0215 or emailing fmrq@fmrq.qc.ca, or visit our Web site at www.fmrq.qc.ca.

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P ROFESSION SANTÉ L’A CTUALITÉ MÉDICALE : A PUBLICATION AIMED AT YOU IN SEVERAL FORMATS H OW WELL DO YOU KNOW YOUR COLLECTIVE AGREEMENT ? BC...

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