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LEADING THE CHANGE november 2019 | issue 41 15-16

“To Kill a An Interview with Mockingbird”... Dr. Alana Fleet & Dr. Resident Submission Nicholas Monfries

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Doctors of BC’s Enhanced Insurance Program


The purpose of Resident Doctors of BC is to support residents in fulfilling their education to become well-informed, prepared and professional physicians to enhance patient care. MISSION STATEMENT • • • • •

To To To To To

advocate for contractual matters support members’ education and encourage excellence in the teaching environment promote its members’ professional, personal and financial well-being foster collegiality among its members throughout British Columbia facilitate collaboration with the community and other professional groups

CONTACT US Phone 604-876-7636 | 1-888-877-2722 Email info@residentdoctorsbc.ca Facebook Resident Doctors of BC Twitter @ResidentDocsBC Instagram @ResidentDocsBC 350 - 1665 West Broadway Vancouver, BC V6J 1X1 CONTENTS 2 3 4 5 9 11 15 21 23

A Word From Our President Upcoming Events Board Dinner & Handover Recap Board of Directors 2019/2020 Resident Spotlight: Dr. David Kim “To Kill a Mockingbird” - What Did It Teach an Oncology Resident About Dying - Resident Submission An Interview with Dr. Alana Fleet & Dr. Nicholas Monfries Doctors of BC’s Enhanced Insurance Programs Heads-up about CPRSP: Don’t Leave Retirement Savings On the Table

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Distributed Site: Salt Spring Island


A WORD FROM OUR A WORD PRESIDENT FROM OUR PRESIDENT

Dearest colleagues and friends; I am writing to you for the first time as the President of RDBC. Let me take this opportunity to briefly introduce myself. Most people would describe me as a talker and I do love a good chat over coffee. I am in my third year of Physical Medicine and Rehabilitation training (aka. Physiatry aka. Rehab medicine). I am now based in Vancouver, but previously have lived across the country in Kingston, Halifax, and originally Toronto. I have been involved with Resident Doctors of BC since starting residency and represented BC last year on the Board and Executive of Resident Doctors of Canada. These experiences showed me the opportunities that can come with outside-the-box thinking and being open to change. There was also attention to governance – the theme to this issue. Now I know – you hear the word ‘governance’ and you think long policy documents and your eyes glaze over. But fear not! The topic is more exciting than you might think. Governance is what shapes an organization – it tells them how to function and structures all operations. It provides the foundation for our work. Last year, we were focused on important tasks around the negotiation of our Collective Agreement. RDBC has been growing and adapting to the changing needs of our membership. With that meant expanding many of our services and operations over the past few years. Moving forward, our focus has shifted inwards – looking to streamline our internal structures and refine our efforts. The goal is to ensure we are providing value to our Resident members and are effective in doing so. You can learn about the specifics of these changes in this issue or by visiting our website. The overall premise and vision is to better tap into our engaged members and allow improved workflow for our Resident representatives. If this piques your interest, please drop into the office, come to a Board meeting, or chat with your CoPR rep (who is someone in your program). I would love to chat at any time, so please feel free to shoot me an email at president@residentdoctorsbc.ca, stop me in the hospital, or find me at a local watering hole. Many thanks, Dr. Alana Fleet President of Resident Doctors of BC

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UPCOMING EVENTS Month-Long

Movember Contest & Fundraiser

November 13

Board of Directors Meeting

December TBA

Annual Christmas Social

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BOARD DINNER & HANDOVER RECAP On September 7, we held the first meeting of the 2019-2020 Board, after which was the Board Dinner & Handover at Bodega on Main. Dr. Nicholas Monfries officially welcomed the Board into their term and handed over Presidency to Dr. Alana Fleet. We are looking forward to working alongside the 2019-2020 Board in this coming year! For more photos of the event, visit our website, www.residentdoctorsbc.ca.

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BOARD OF DIRECTORS 2019/2020

Dr. Alana Fleet, President | R3, Physical Medicine & Rehabiliation This is Alana’s second year as a RDBC Board Director, previously serving as the Board Chair of Resident Doctors of Canada. Prior to her move to Vancouver, she split her time between Kingston and Halifax, attending Queen’s for undergraduate and medical degrees, and Dalhousie for her Master’s.

Dr. Nicholas Monfries, Immediate Past President | R4, Emergency Medicine Nick is based out of Vancouver General Hospital and is currently completing his Pediatric Emergency Medicine fellowship in Calgary. Nick has been involved with RDBC since his first year of residency, having served as Director of Finance, followed by President during the Negotiations year. Dr. Heather Cadenhead, Director | R2, Anesthesiology Heather’s program has the unique perspective of being one of the first CBD curriculum adopters, and she hopes that her presence on the Board will help for a smooth transition for other specialties. She is eager to work hard to be knowledgeable and current so that she filter and liaise valuable and time sensitive information to her peers throughout these transitional years. Dr. Casey Chan, Director | R4, General Internal Medicine Casey is is based in Vancouver but will be rotating across the province in the year. In medical school, he served as the Medical Student Senator on MUS, as well as Vice President of Leadership and Education as part of PARA during his time in Alberta. Dr. Geoff Frost, Director | R4, Physical Medicine & Rehabilitation Originally from Toronto, Geoff completed undergraduate and graduate degrees in engineering at the University of Toronto. Previously, Geoff served as the Director of Communications for two years.

Dr. Naima Kotadia, Director of Resident Affairs & Wellness | R2, Anesthesiology Naima hopes to bring fresh ideas, creativity and enthusiasm to the leadership this year. She has a passion for global health and resident wellness. To stay active, she enjoys playing softball and you can always call on her for an impromptu beach volleyball session or to be your climbing buddy.

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Dr. Meriem Latrous, Director | R3, Pediatrics Meriem has served on the Council of Program Representatives and is on her second year of being a Director. In her position as a Director, she hopes to continue being an advocate for residents in BC.

Dr. Daphne Lu, Director of External & Labour Relations | R2, General Surgery Daphne served as an Official Observer as well as the General Surgery Representative on the Committee of Program Representatives. She has also served for 4 years on a non-profit board and as the President of the UBC Medical Undergraduate Society where she had the chance to develop ber skills in grass-roots advocacy, policy development, and leadership. Dr. Patrick McDonald, Director of Operations & Finance | R4, Physical Medicine & Rehabilitation Patrick served on the RDBC Board of Directors and was a member of the Negotiations and Finance Committees during the 2018/2019 Academic Year. He looks forward to serving as Director of Operations and Finance, and working towards implementing RDBC’s Strategic Plan. Dr. Chantal McFetridge, Director | R3, Emergency Medicine Chantal has previously served as an Official Observer to the Board, as well as been on the RDBC Advocacy Committee and Ministry of Health Joint Task Force. She is passionate about quality of patient care, healthcare equity and Resident wellness. Dr. Sarah Silverberg, Director | R1, Pediatrics Sarah served as an Official Observer to the Board, as well as been a member of the Joint Task Force and the Strategic Planing team. She has also represented BC residents on the Resident Doctors of Canada Board, leading their portfolio on resident transfers and working on entry routes. Dr. Brandon Tang, Director | R2, Internal Medicine Brandon served as an Official Observer, and been a member of the Joint Task Force and the Communications Committee. He co-chaired the Resident Doctors of Canada Practice Committee, advocating for National Physician Licensure as well as resident wellness through the Resident Anthology.

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EX-OFFICIO

Mr. Harry Gray

Ms. Reem Raziz

Executive Director

Medical Undergraduate Society Representative

INTERNAL COMMITTEES & PROJECT TEAMS Committees play a major role in the association’s projects and initiatives. We encourage you to get involved, be heard, and join a committee. The following are open to the general membership; if you are interested in joining please visit our website for more information and to apply.

HEALTH AND WELLNESS COMMITTEE

RESIDENT SAFETY WORKING GROUP

Encourages resident heath and well-being by facilitating events and negotiating discounts of interest for the membership

This group reviews issues relating to resident health and safety with the employer

Applications for Project Teams are now open. These small groups focus on yearly projects. Currently projects include Accreditaion, Financial Literacy, and Pulse Podcast and Newsletter. To apply, please visit our website. 7


RESIDENT AWARENESS WEEK 2020 The dates for Resident Awareness Week 2020 have been announced by Resident Doctors of Canada, and BC will be joining the rest of the country in celebrating residents throughout February 10 to February 14, 2020! Here at Resident Doctors of BC, a team composed of staff and residents is already setting a plan in motion. A group of delegates is in the planning stages of arranging a breakfast with MLAs at the Legislature as part of our push to raise awareness of residents and residency in BC. Continuing our work from last year, residents will be leading a campaign to send out letters and meet with MLAs to raise awareness within the ridings. They are looking for volunteers interested in participating! If you have a passion for improving residency in BC and want to get involved, email info@residentdoctorsbc.ca and we’ll be happy to provide you with more information on this campaign. As always, we will be active on our social media accounts all throughout Resident Awareness Week. If you have a Facebook, Twitter or Instagram, be sure to follow us (if you haven’t yet!) to share the messages of Resident Awareness Week with your online circles.

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RESIDENT SPOTLIGHT

SEPTEMBER, 2019 Dr. David Kim, PGY-4, Emergency Medicine

YOU HAVE SPENT time overseas at the European Space Agency in Germany and the Royal Air Force in the UK as an Aerospace Medicine MSc. Candidate. What inspired you towards this career path, and to apply to ESA? I’ve always been interested in human space travel ever since I was a little kid. Space was always fascinating for me and I would spend hours reading books, watching shows, and learning as much as I could about it growing up. When I found out I could merge my career in emergency/acute medicine with space, it was something I knew I had to pursue. Aerospace medicine is a small field that focuses on the health of pilots, aircrew, and passengers in the aviation industry. This includes doing pilot medical examinations and certifications as well as creating health related policy in the aviation industry such as a passenger’s fitness to fly if they have certain medical conditions. As well, it also involves the field of space medicine which looks at the care and protection of astronauts before, during, and after a mission to space.

learning about the various physiologic changes that happen during flight was eye opening. With increased altitude during flight, as atmospheric pressure decreases, the volume of gases inversely increases due DR. MEAGAN MCKEEN to Boyle’s law. This has various implications to normal physiology that changes how our bodies function. You add in temperature changes that approximately decrease by 2 degrees every 1000 ft in the troposphere and high-G maneuvers that pilots can be exposed to among various other factors, everything about your physiology changes. Gas exchange, breathing, cardiac output, neurologic functional, and pretty much everything else is now different. (Ok, I will stop nerding out about aerospace physiology!) So, through this experience I obtained my Diploma in Aviation Medicine through the UK Faculty of Occupational Medicine which means I can pursue various career paths in this field.

What did the Aerospace Medicine fellowship training entail? And what exactly is Aerospace Medicine? I was able to pursue a fellowship in Aerospace Medicine and got to spend some time with the Royal Air Force in the UK learning about military aviation medicine and commercial aviation medicine. Learning about how military pilots are selected, trained, and cared for was fascinating. Also

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I also got to spend some time in Germany at the European Space Agency with the Space Medicine Team to learn and research various areas in space medicine. They’re currently looking into planning for a deepspace


flight mission back to the moon and to other celestial bodies like Mars. This means designing countermeasures to space radiation and adapting to the changes that our bodies undergo in microgravity. ESA also operates current active missions on the International Space Stations with NASA, so I got to participate in some of that work too! What has your experience overall thus far been like? What have been some of the challenges or exciting events? It was an amazing experience. NASA, ESA, CSA, and various other space agencies have committed to returning to the moon by 2024 and further deep space missions in the future. In fact, I’m confident humans will be on Mars during my lifetime and that’s pretty exciting. My specific research project was investigating deep space radiation and the biological implications it has on our bodies. Without the protection of the earth’s electromagnetic field and atmosphere, the deep space radiation is quite hazardous and currently prohibitive to mission design for a roundtrip voyage to Mars. Thus, we must design some sort of biological or engineering countermeasure to overcome this and I was able to contribute a bit to this work. People often ask us why we invest so much into space travel. Well besides the obvious human nature of wanting to explore the unknown and pushing our boundaries, the applications of aerospace beyond its field is also limitless. What we learn from research and development from the aerospace industry has important implications on terrestrial health for example. The CT scan and MRI were adapted from technologies developed by NASA as well as countless other inventions such as prosthetic devices, pacemakers, and robotic surgery to name a few. We can also learn a lot about the health of our planet and gather data about how our climate is changing thanks to various technologies and satellites employed by the aerospace sector!

astronaut this year at the Mars Desert Research Station (MDRS) as the Crew Health Officer. MDRS is a research facility located in Utah meant to simulate a Mars habitat and a Martian environment to research how we might live on Mars one day. So that was pretty cool! Lastly: what do you miss most about Canada after being away for so long? I really missed my family! And you can’t beat a nice home cooked meal. And since I’m from the island, there is no place like home. The natural beauty of Canada and BC is truly amazing. I can’t wait to hit the mountain slopes again and hit some nice drives right down the middle of the fairway on the golf courses back at home!

For more Resident Spotlight features, visit our website.

I even got to participate as an analogue

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RESIDENT SUBMISSIONS

“TO KILL A MOCKINGBIRD” - WHAT DID IT INTERVIEWAN WITH TEACH ONCOLOGY RESIDENT ABOUT IMMEDIATE PAST DYING PRESIDENT

Dr. Justin Oh, PGY-3, Radiation Oncology

“I WANTED TO see something about her—I wanted you to see what real courage is, instead of getting the idea that courage is a man with a gun in his hand… Mrs. Dubose won, all ninety-eight pounds of her. According to her views, she died beholden to nothing and nobody. She was the bravest person I ever knew.” – Atticus Finch, To Kill a Mockingbird I was 12 when I first read “To Kill a Mockingbird.” It was an eye-opening book, as it took me back to 1930s fictional rendering of a small county in southern US. Maycomb was a small, conservative, and serene county in Alabama. Beneath its surface however, racism was rampant, and the traditional precedence constantly clashed with progressive moral ideals. For the readers who are not familiar with the story, Ms. Dubose was an elderly woman suffering from a terminal illness, living just north of our young endearing protagonists, Scout and Jem Finch. Most of the time, Ms. Dubose was truculent and bed-ridden as she suffered through the excruciating pain from her disease. Whatever strength she had left, she would use it to verbally harass and cuss Scout and her brother Jem as they passed by the house; they were 9 and 11 years old. From Atticus, Scout’s compassionate and virtuous father, we learn that Ms. Dubose had been taking a large amount of opioids to calm her pain, but she gradually and painfully weaned herself off. In the process of opioid titration, she would suffer even more, often displaying fits of anger, confusion, and belligerence. At the end however, she died comfortably, not “beholden” to the opioids. The strangest

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and most striking part of the novel was the part when Atticus found the epitome of true courage in the stubborn, frail, and hostile Ms. Dubose. She was not a character that I could easily relate to as a young boy. I did not feel strong empathy for or admiration toward her. More importantly, I could not quite understand why someone would refuse opioids and go through the suffering and pain at the end of their life. Why did anything matter when she was already dying? Jem, when you’re sick as she [Mrs. Dubose] was, it’s all right to take anything to make it easier, but it wasn’t all right for her. She said she meant to break herself of it before she died, and that’s what she did. As a radiation oncology resident, the most rewarding part of the specialty for me is the interactions I have with palliative patients. Palliative care is a branch of medicine that deals with alleviation of symptoms rather than addressing the cure. While terminal illness is often associated with palliative care, the patients often have life expectancies of many months to years. In my specialty, which harnesses ionizing radiation to treat cancer, approximately 50% of radiation therapies are given for palliative purposes. Some people benefit from radiotherapy to bony metastasis to control pain, to bleeding tumors to stop the oozing, or to reduce discomfort from tumor burden compressing proximal structures. Just during my past 4 years as a resident, I have formed meaningful bonds with my patients, but I have also mourned their passing as well. Strangely, it occurred to me that some were more prepared for and


more comfortable with their death than the others. At this junction in my life as a resident doctor, I began to reflect on Ms. Dubose and to reconcile with the notion that how we die matters. Rationale for palliative care seems counterintuitive in the context of prevailing ethos of conventional medicine. Medieval reference to medicine often conjures up images of omnipotent figures performing miraculous interventions for patients spiraling toward death. However, death is inevitable. Increasingly, physicians are realizing that sometimes interventions that we do cause greater suffering, and even curtail the life expectancy. Aggressive end of life treatments have been routinely associated with worse quality of remaining life and high likelihood of caregiver burden and depression. We are recognizing that, more often than not, impetus toward death cannot be stopped. “She’s dead, son,” said Atticus. “She died a few minutes ago.” “Oh,” said Jem. “Well.” “Well is right,” said Atticus. “She’s not suffering any more. She was sick for a long time. Son, didn’t you know what her fits were?”

of treatment including chest compressions and intubations? Do we want to be at home? Hospice? What kind of music would we like to listen to and who should accompany us? Or, it can be general: What are our fears and wishes? What do we value in our life? What would we like to be able to do until the very end? Jem opened the box [left by Mrs. Dubose]. Inside, surrounded by wads of damp cotton, was a white, waxy perfect camellia…We went by Mrs. Dubose’s house, standing empty and shuttered, her camellias grown up in weeds and Johnson grass. So, what can or should we do in anticipation of our death? Even at my young age of 29, I have come to terms with my mortality. I am comfortable discussing and planning my own death if and when I become ill. “To Kill a Mockingbird” suggests that perhaps the process of dying is when we make the most important and enduring testimony of our life. Dying matters because it is a natural extension of life, and it should reflect the values and beliefs that we have cherished in our lifetime. It also provides an opportunity for us to make a statement that will live on beyond us, just like how Ms. Dubose had indirectly instilled meaning of courage to our impressionable protagonists. Accordingly, we should carefully plan how we want our final chapter to close with our loved ones and health care providers. After all, things still matter in the end.

Should we plan our death? It may sound morbid. It is not a celebration. But death is also an important event in our life. Many people may find it surprising that early advanced planning can reduce unnecessary aggressive treatments, provide more effective pain relief, and improve the quality of life at the end. In addition, “Did she die free?” asked Jem. “As the mountain advanced planning reduces the financial air,” said Atticus. burden on the healthcare system. It can be specific: Do we want the most aggressive forms

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PLAN YOUR OWN SOCIAL Have a party... on us! Resident Doctors of BC wants to help you and your residency program plan a social event. We will sponsor up to $750 (up to $1,700 if two programs collaborate) towards your program social event. Interested? Visit our website and look under 'Contact'!

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ANNUAL CHRISTMAS SOCIAL

COMING SOON DECEMBER, 2019 14


FEATURE

AN INTERVIEW WITH DR. ALANA FLEET & DR. NICHOLAS MONFRIES DR. ALANA FLEET is the new President of RDBC, and Dr. Nicholas Monfries serves as the current Immediate Past President. Both have led the initiative to adopt a new governance model at RDBC, and create a Strategic Plan that reflects the changing interests of our members. This year, RDBC has adopted a new governance model. Amongst the changes, we have shifted the Board committees towards a Project Team Model, and have made changes to the executive titles, duties and portfolios. Could you speak more about the changes to the governance model, and the context behind the decision? As Residents, time is a limited commodity. We made changes to focus our efforts and to reflect how the organization has grown over time. This includes creating portfolios that map to our activities. It also meant moving away from static annual committees to more dynamic project-based teams. By moving to a project team model, the goal is to make better use of of Resident representatives’ time and skills. Based on set priorities for RDBC, these projects are composed of Board members or Residents from the general membership. Further, by focusing the efforts of our representatives to particular projects, we can better align our initiatives to our newly developed strategic plan. Each project team will be expected to have action-oriented goals that can be achieved within a term (or

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two) that align with our strategic priorities. How was feedback gathered in regards to what aspects of our previous governance model could be improved on? During the last Board term, we developed a Governance Review Working Group that consisted of a number of current Board members and representatives from the general membership, in addition to staff. We utilized resident member feedback collected during the negotiations process, experiences from past Board members, and a formal legal review of our previous governance structure to guide the changes. We were also able to collaborate and learn from other provincial Resident organizations and Resident Doctors of Canada. How do you see these changes impacting the current board and future years? We hope that the current Board and membership will move forward with these changes, but most importantly, provide feedback as the year goes on. As with any significant organizational change, it is important to reflect and re-evaluate the changes at regular intervals. We also hope this model will increase active engagement as we are now able to include more representatives from the general membership and provide more leadership opportunities for our Board directors. Amongst the changes introduced for this year and the future ones, what are you most excited to see happen in action?


Dr. Alana Fleet

Dr. Nicholas Monfries

Dr. Nicholas Monfries (left) and Dr. Alana Fleet (right) at the 2019-2020 Board Dinner & Handover. We are very excited about the creation of Board portfolios and changes in the executive roles. We completely redesigned the executive positions to include positions under the portfolios of Operations & Finance, Resident Affairs & Wellness, and External & Labour Relations. This change aligns our executive positions to specific areas of focus that was identified as strategic priorities by our members and staff. In addition, it allows for greater accountability and a clearer line of communication and leadership for our Board directors, CoPR and other involved Resident members. Alongside the new governance model, we have also introduced the new Strategic Plan for RDBC. The Board priority areas are Resident Wellness, Labour Relations, External Relations, and Operations & Finance. Could you speak more to the selection of these specific themes, and the strategy you plan to set in motion and follow to meet the Plan goals? Through the negotiation process this past year, we reflected on areas of organizational strength and opportunities for growth. As such, it was a great time to review our strategic plan and consider what Residents want out of the organization over the next 5 years. A major role of RDBC is labour relations

and we will continue to advocate strongly on behalf of our members on their labour rights and professional wellness. In addition, we will continue to build and enhance strategic relationships with our stakeholders to support our member’s interests. In this regard, we have shifted our focus and strategy to have more discrete short and long-term plans and goals in place. The work for the next round of negotiations has already started. We also heard from our members that they wanted to see RDBC take on a larger role beyond labour relations, including advocating for and supporting Residents’ personal wellness, supporting residents with financial literacy, leadership development, and transition to practice (to name a few). The Strategic Plan reflects the changing interests of our members and advances the ultimate mandate of our organization; improving and supporting the lives of Resident Doctors in BC.

To view the new Board portfolios, visit our website.

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Awards o f Excelle nce 2019 Three awards are given each year to outstanding individuals in the field of medicine. recipients receive:

Commemoration on a plaque at the Resident Doctors of BC office A personal commemorative award $1000 donation to the charity/charities of their choice AWARD OF MERIT The purpose of this award is to recognize a Resident whose outstanding achievements and/or leadership reflect the aims and objectives of Resident Doctors of BC. The award will be presented annually to a Resident who has shown outstanding initiative in any of the following areas: • Resident health and well-being • Promotion of the role of residents in the healthcare system • Advocacy and representation of Residents leading to improved work or learning environments AWARD OF MERIT The purpose of this award is to recognize an individual who displays significant interest in issues of importance to Residents. The award will be presented annually to a person who advocates for the personal. professional or educational advancement of Residents.

DR. PATRICIA CLUGSTON MEMORIAL AWARD FOR EXCELLENCE IN TEACHING The purpose of this award is to recognize a physician clinical educator for his or her contributions to Residents’ medical education. The recipient will have created a safe learning environment that encourages self-inquiry, supports adult learning, and fosters within learners a desire to achieve their highest potential.

All nominations require a nominator, a letter of support, and contact information for two references.

ns begin in Nominatio 020! January, 2

media to on social s u w o ll o F o-date keep up-t ocsBC ResidentD Twitter: @ ocsBC ResidentD @ : m ra g ta rs of BC Ins ent Docto id s e R : k o Facebo

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SHOW YOUR ‘STACHE. WE’LL DONATE THE CASH.

Resident Doctors of BC will donate $5.00 to the Movember Foundation for every participant in this year’s Movember campaign. Submit a photo of your ‘stache (real or fake) by email and you will receive a $5 Starbucks gift card! After November 30, members will vote for the best ‘stache, and the winner will receive their choice between a hot shave (for the Mos) and a spa of their choosing (for the Mos and MoSistas alike)! All Mos and MoSistas are encouraged to participate. Visit mosista.co/rdbc to join the RDBC Team or donate to the cause!

BE THE DIFFERENCE. GRO A MO, SAVE A BRO.

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INSURANCE

DOCTORS OF BC’S ENHANCED INSURANCE PROGRAMS HIGHER COVERAGE AMOUNTS. More Features. Easier portability. Doctors of BC is excited to announce new enhancements to its insurance plans that will benefit those who are currently enrolled in its plans, and those who enroll in the future. Doctors of BC is a not-for-profit voluntary member organization supporting over 15,000 physicians, students and residents. It has been offering members insurance programs since 1950 and now manages over 35,000 plans for its members and their families. After 25 years with its previous insurer, effective October 1, 2019, Doctors of BC changed its Resident Disability insurance carrier from Sun Life to Manulife. This change allows Residents to receive enhanced benefits like the Top Up Feature at no extra cost. This feature allows Residents to receive more coverage when they need it most (if their employer plan stops paying), without having to purchase more coverage unnecessarily. Both the Doctors of BC and your employer long-term disability plan will pay in the event you’re unable to work due to a disability. Let’s take Hannah, an R1 Family Medicine, as an example. Hannah has $3,000 Doctors of BC Resident Disability coverage and she also receives 66.67% of her R1 income through her employer long-term disability plan. If Hannah were unable to work due to an illness or accident, she could receive $6,047.30/ month tax-free ($3,000 from Doctors of BC and $3,047.30 from HEABC HBT employer plan). The employer disability plan changes its definition of disability after 2 years to “Any

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Occupation,” making it more difficult to continue a claim. However, Doctors of BC has a “True Own Occupation” definition of disability throughout the entire policy duration. If Hannah’s employer plan stops paying after 2 years, Doctors of BC can increase its payment by $2,000 so that Hannah receives $5,000/month tax-free from Doctors of BC, helping ensure a more comfortable financial situation. If residents with at least $2,000 of Doctors of BC Resident Disability coverage for at least 12 months prior to practice, they will be eligible to enroll in the BC government paid physicians’ disability insurance (a negotiated benefit) without proof of health. In Hannah’s example, because she was enrolled in Doctors of BC Resident Disability plan as an R1, when she completes family medicine training in 2 years, she will be eligible for the BC government disability, no medical questions asked. It’s important to have your own disability coverage so that you’re guaranteed a plan that will cover any health conditions or lifestyle activities that occurred in the past or may occur during your residency and fellowship. Your employer disability plan stops covering you as soon as residency ends. Ninety-five percent of physicians don’t have any employer disability coverage in practice and are required to protect their own income. Doctors of BC’s practicing disability insurance can continue to protect you worldwide.


Deadline

Know The Difference!

January 15, 2020 is the deadline to enroll in the enhanced Doctors of BC Resident Disability program without proof of health. If you were previously enrolled in the plan, your coverage has automatically been enhanced and information has been sent to you by email.

All residents have the Resident Doctors of BC’s employer mandatory basic disability that ends upon residency completion. Doctors of BC’s Resident Disability plan is an optional, enhanced career-long coverage that can cover you in practice anywhere in the world.

To learn more about the newly enhanced plan, please visit https://www.doctorsofbc. ca/member-area/insurance/life-disabilityaccident-illness/residents.

2020

HOSTED BY

For more info, visit rccbc.ca

HIGHLIGHTS • Interactive rurally relevant CME/CPD

SAVE THE DATE!

MAY 29-31 PENTICTON

group sessions and hands-on skills workshops • Add-on courses: HOUSE-OB, CASTED, The CARE Course and more • Complimentary childcare during conference hours • Provider wellness opportunities: massage chair, complimentary yoga, and more • Opportunities to socialize + network with colleagues

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RETIREMENT

HEADS UP ABOUT CPRSP: DON’T LEAVE RETIREMENT SAVINGS ON THE TABLE MD Financial Management DID YOU KNOW that you could get money to boost your retirement savings? In British Columbia, there is a benefit called the Contributory Professional Retirement Savings Plan (CPRSP). Practising physicians are eligible for this benefit if they’re paid under the fee-for-service model, or paid sessional or service contract income by one of the six health authorities in the province. The CPRSP is definitely something to keep in mind after you finish your residency!

The benefit has two components: a basic benefit available to all eligible physicians based on eligible income; and a length of service (LOS) benefit based on how long you’ve been practising medicine in B.C. — the minimum being nine months of work earning eligible income while covered by the Canadian Medical Protective Association. For 2019, the maximum basic benefit is $4,100 and the maximum LOS benefit is $3,480 for a combined maximum of $7,580. To get the maximum, you would need a net eligible income of at least $120,000 in the prior calendar year and 20 LOS years in B.C. Great news for new-in-practice physicians If you’re in your first to fifth year of practice, you will be able to receive this benefit without having to make a matching RRSP contribution.

How the CPRSP works The CPRSP is a benefit negotiated between Doctors of BC, the Medical Service Commission and the Government of British Columbia. Each year, eligible doctors in B.C. receive contributions to their retirement savings, if they contribute to their RRSP.

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This change was introduced only in 2018, so be sure to apply once you’re in practice. The deadline is typically in the latter part of January. To receive the CPRSP, you need to complete the benefit application form. If you don’t apply and claim it, your basic benefit will expire in three years. Each September, eligible physicians receive an email notification from Doctors of BC with details of their CPRSP benefit.


The email will contain a link to your customized CPRSP letter/application form, outlining your benefit entitlement. If you started practising anywhere in the world from 2014 onwards, you would be eligible. It’s retroactive so you can claim the CPRSP basic benefit from 2017, 2018 and 2019 if you haven’t done so already. Where can I learn more? You can find out more on the Doctors of BC website, by emailing benefits@doctorsofbc. ca or by calling Doctors of BC at 604 6382926. MD Financial Management’s close relationship with Doctors of BC means we can also provide information and assistance in understanding and applying for the CPRSP benefit.

The information contained in this document is not intended to offer foreign or domestic taxation, legal, accounting or similar professional advice, nor is it intended to replace the advice of independent tax, accounting or legal professionals. Incorporation guidance is limited to asset allocation and integrating corporate entities into financial plans and wealth strategies. Any tax-related information is applicable to

Canadian residents only and is in accordance with current Canadian tax law including judicial and administrative interpretation. The information and strategies presented here may not be suitable for U.S. persons (citizens, residents or green card holders) or nonresidents of Canada, or for situations involving such individuals. Employees of the MD Group of Companies are not authorized to make any determination of a client’s U.S. status or tax filing obligations, whether foreign or domestic. The MD ExO® service provides financial products and guidance to clients, delivered through the MD Group of Companies (MD Financial Management Inc., MD Management Limited, MD Private Trust Company, MD Life Insurance Company and MD Insurance Agency Limited). For a detailed list of these companies, visit md.ca. MD Financial Management provides financial products and services, the MD Family of Funds and investment counselling services through the MD Group of Companies.

Are you interested in submitting a feature for a future edition of the PULSE? Contact RDBC at info@residentdoctorsbc.ca.

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DISTRIBUTED SITE: SALT SPRING ISLAND

Salt Spring Island DESTINATION BC

SALT SPRING ISLAND, nestled up against the east side of Vancouver Island, is considered to be the jewel of the Southern Gulf Islands. Three official villages reside on Salt Spring: Fulford in the south, Ganges about mid-island, and Vesuvius toward the northwest. Each community is unique and worth visiting during your time on the island. THINGS TO DO Fun Escapes Salt Spring Island has a unique a Mediterranean climate, allowing its citizens and visitors to experience more sunshine and less rain than the surrounding areas. Be sure to enjoy events both outdoors and indoors to get the full range of what the Island has to offer! • Ruckle Provincial Park is a popular park on the Island with a 7km shoreline. Sea lions and killer whales can be spotted out in the waters.

Events • Farmers Market - the market runs from April to late October, and is known for its organic produce with home cooked meals, embroideries, art pieces and live music! • Wintercraft - Escape the cold air and come in to the historic Mahon Hall in November for some pottery, artisan soap, painting and so much more to offer. • Christmas Fair - Beaver Point and Fulford Hall offer fairs running from December 6th to 8th with food, Christmas lights, and of course, Christmas cheer. • Polar Bear Plunge - a crowd favourite New Year’s tradition to dive into the waters at Vesuvius Beach. Wash away the old year and hopefully catch sight of the marine wildlife! Food and Drink

• Scuba diving is a popular activity, as the location is known to be one of the best coldwater diving destinations in the world.

• Head to Mateada, “born by the community for the community”, which offers a relaxing environment with an organic menu and some live music!

• The Island has a moderately challenging 9-hole golf course with an indoor tennis court and a lounge for you to enjoy.

• Salt Spring Salads is a vegetarian food truck with organic ingredients whose proceeds go to help the food sustainability of the Island.

• Art Spring Theatre is a cultural must-stop. It offers dancing, drama, classical performances as well as jazz for your taste of local culture!

• Ever had coffee and dined under a plum tree? Treehouse Cafe offers a comfortable ambiance and hot drinks to welcome you.

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Available on Podbean & Apple Podcasts

PULSE PODCAST Residency • Finances  •  Parenting 26


PU SE The Pulse newsletter is always looking for submissions from residents like you! If you have article ideas, announcements, or other interesting insights about life as a resident doctor, please contact us at: info@residentdoctorsbc.ca

IMPORTANT PHONE NUMBERS

HSSBC Benefits & Payroll 1-866-875-5306

Physician Health Program 1-800-663-6729

Employee Wellness 1-800-505-4929

Profile for Resident Doctors of BC

November 2019 Pulse: Leading the Change  

November 2019 Pulse: Leading the Change  

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