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Orientation Manual
2016
PUBLIC HEALTH & PREVENTIVE MEDICINE RESIDENCY PROGRAM UNIVERSITY OF TORONTO
PHPM TORONTO | phpm.pgme.utoronto.ca | 155 College St. Toronto ON, Room 528
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Orientation Manual Contents WELCOME FROM THE PROGRAM DIRECTORS ............................................................................................................... 5
PROGRAM ADMINISTRATORS ........................................................................................................................................... 6
Public Health & Preventive Medicine Residency Program: Organizational Chart .................................................................. 7
TRAINING OVERVIEW ......................................................................................................................................................... 8
Family Medicine Rotations (Year 1-2): ................................................................................................................................. 8
Academic Training/Graduate Studies (Year 3-4) ................................................................................................................... 9
Field Rotations (Year 4-5) .................................................................................................................................................. 10
Field Rotation Sites: ....................................................................................................................................................... 12
General Electives, Research Electives & Medical Education Research Electives: ................................................................. 13
ACADEMIC HALF DAY ...................................................................................................................................................... 14
Topic of the Week .......................................................................................................................................................... 14
Rounds ........................................................................................................................................................................... 14
Field Notes ......................................................................................................................................................................15
RESIDENT EVENTS ............................................................................................................................................................. 16
Program Exams .............................................................................................................................................................. 16
Annual General Meeting (AGM) .................................................................................................................................... 16
Resident Research Day ................................................................................................................................................... 16
Media Day...................................................................................................................................................................... 16
Career Day ..................................................................................................................................................................... 16
Graduation and Awards Luncheon ................................................................................................................................... 17
RESIDENT LEADERSHIP & VOLUNTEER OPPORTUNITIES .......................................................................................... 18
Chief Resident .................................................................................................................................................................... 18
Treasurer ............................................................................................................................................................................ 18
Residency Program Committee (RPC) Resident Representative .......................................................................................... 18
Curriculum Sub-Committee ................................................................................................................................................ 18
Selection Sub-Committee ................................................................................................................................................... 19
CaRMS Selection Volunteers ............................................................................................................................................. 19
PARO Representative ......................................................................................................................................................... 19
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DLSPH Governing Council Representative ......................................................................................................................... 19
Public Health Physicians of Canada (PHPC) Representative ............................................................................................... 19
PROGRAM AWARDS .......................................................................................................................................................... 21
C.P. Shah Award ............................................................................................................................................................ 21
Resident Service Award .................................................................................................................................................. 21
Resident Teaching Award ............................................................................................................................................... 21
Faculty Educator Award ................................................................................................................................................. 22
COMMUNICATION ............................................................................................................................................................. 23
Blackboard portal ............................................................................................................................................................... 23
Dropbox ............................................................................................................................................................................. 23
Public Health and Preventive Medicine Listservs ................................................................................................................ 23
Program website ................................................................................................................................................................. 23
RESIDENT SAFETY AND WELLNESS ............................................................................................................................... 24
OTHER EDUCATIONAL OPPORTUNITIES ....................................................................................................................... 25
Resident Education Funding ............................................................................................................................................... 25
Extra Courses ..................................................................................................................................................................... 25
Canadian Field Epidemiology Program (CFEP) Epi In Action ......................................................................................... 25
Dr. Rachlis’ Policy Course.............................................................................................................................................. 25
Dr. Hodge’s Management Course ................................................................................................................................... 25
PHPM National Review Course ...................................................................................................................................... 25
Immunization Education Competencies Program (ICEP) ................................................................................................ 25
Conferences ....................................................................................................................................................................... 25
Memberships/Professional Affiliations ............................................................................................................................... 26
APPENDIX A: ROYAL COLLEGE CANMEDS OBJECTIVES FOR PHPM ........................................................................ 27
APPENDIX B: UNIVERSITY OF TORONTO PHPM PROGRAM POLICIES ....................................................................... 33
PHPM Residency Program UofT CanMEDS Goals and Objectives ...................................................................................... 33
Resident Assessment and Evaluation .................................................................................................................................. 35
RESIDENCY SAFETY POLICY ........................................................................................................................................ 37
Leave and Waiver Policy and Procedure ............................................................................................................................. 39
Terms of Reference: Chief Resident.................................................................................................................................... 41
APPENDIX C: PGME POLICIES .......................................................................................................................................... 43
Guidelines for Residency Leaves of Absence and Training Waivers .................................................................................... 43
Paid Leave...................................................................................................................................................................... 44
Unpaid leave .................................................................................................................................................................. 45
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Moonlighting Policy ........................................................................................................................................................... 48
Postgraduate Medicine Policy on Academic Appeals .......................................................................................................... 49
APPENDIX D: PROGRAM GRADUATES ............................................................................................................................51
APPENDIX E: Field Rotation Planning, Expectations, and Assessment ................................................................................... 57
Field Rotation Overview ...................................................................................................................................................... 57
Accredited Training Sites ................................................................................................................................................... 58
Rotation Planning and Development ................................................................................................................................... 58
Rotation Planning ........................................................................................................................................................... 58
Supervision .................................................................................................................................................................... 58
Personal Learning Objectives.......................................................................................................................................... 59
Rotation Expectations ......................................................................................................................................................... 59
Resident Expectations ..................................................................................................................................................... 59
Supervisor Expectations ................................................................................................................................................. 60
Assessment and Evaluation ................................................................................................................................................. 60
Assessment ..................................................................................................................................................................... 60
Evaluation ...................................................................................................................................................................... 60
APPENDIX F: Resident Portfolio Template ........................................................................................................................... 61
APPENDIX G: Objectives of Training in Public Health & Preventive Medicine (2014) .......................................................... 64
GOALS ........................................................................................................................................................................... 64
PUBLIC HEALTH AND PREVENTIVE MEDICINE COMPETENCIES ..................................................................................... 65
Medical Expert ............................................................................................................................................................... 65
Communicator ................................................................................................................................................................ 71
Collaborator ................................................................................................................................................................... 72
Manager ........................................................................................................................................................................ 74
Health Advocate ............................................................................................................................................................. 75
Scholar ............................................................................................................................................................................ 77
Professional ................................................................................................................................................................... 78
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WELCOME FROM THE PROGRAM DIRECTORS
Dear Residents,
Welcome to another exciting year in the Public Health and Preventive Medicine Residency Program at the
University of Toronto. As many of you know, we recently marked the 40th Anniversary of our program. Our
celebration event confirmed that our past and our future are bright!
Residency is the transformative penultimate chapter in every physician’s personal and professional life where
we finally complete the transition from student to specialist. For Public Health and Preventive Medicine
trainees, there are many additional challenges – the many role transitions within the program, the amorphous
nature of public health practice and the overwhelming breadth and scope of the knowledge required to be a
competent public health specialist. Being aware of these challenges, preparing for them, and sharing your
experiences with colleagues and faculty will ensure that you learn and grow throughout your training.
Postgraduate medical education is a unique educational environment, with its emphasis on work-based learning,
clinical/field supervision as a predominant method of training, performance-based assessment, and the
challenge of simultaneously delivering education, training and service. Residency education follows an adult
learning model, and as such, we are your partners in this process that is ultimately directed and driven by you –
the learner. Our primary role as program directors is to direct, facilitate, mentor and support you in becoming
competent public health physicians. Please help us help you by communicating with us regularly, preparing and
planning each stage of training well in advance, and providing us with positive and negative feedback. In many
ways, the program is what you make of it - as individuals and collectively. Please contribute to the program, the
school and the Faculty of Medicine by serving on committees, teaching and leading other initiatives.
Our program is dynamic, always adapting and improving in order to meet the educational needs of residents, the
service needs of our partner organizations and to fulfill our social responsibility to train the best public health
physicians in the world. This year, like most others, there new opportunities to become even better. We have
renewed our relationship with York Region, we have residents at new sites such as like Health Quality Ontario
and the Office of the Chief Coroner, and we have enhanced research opportunities for residents. The Clinical
Public Health division and the Dalla Lana School of Public Health also continue to grow and develop, led by
our faculty and residents, opening the way for new collaborations in indigenous health and additions, among
many others.
There are also challenges that we will face and overcome together. As program directors, our virtual doors are
always open.
This program orientation manual, like the residency program, is always a work-in-progress. Please ask us, or
your colleagues, if you have any questions about it, or anything else.
We looking forward to continuing to learn with you,
Dr.Barry Pakes, Program Director Dr. Onye Nnorom, Associate Program Director
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PROGRAM ADMINISTRATORS
Program Director: Dr. Barry Pakes
Summary of responsibilities:
Overall program direction
Program relationships
Curriculum
Resident assessment and promotion
Faculty assessment and evaluation
Associate Program Director: Dr. Onye Nnorom
Summary of responsibilities:
Resident recruitment and selection
Resident exam preparation and career support
Resident engagement and awards
Field site placement and NOSM liaison
Program Coordinator: Ezi Odozor
Summary of responsibilities (as most relevant to residents):
Supporting the program directors, the residency program, faculty and residents
Administrative support for rounds and other special Academic Half Days
Maintenance of program website and online repository of program documents,
including academic half-day material, policies and procedures, and rotation support
documents
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Public Health & Preventive Medicine Residency Program: Organizational Chart (Source: 2016 Internal Review Documents)
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TRAINING OVERVIEW
General Overview:
PGY1 Family medicine rotations
Quality Improvement (QI) project
PGY2 Family medicine rotations
Academic/research project
CCFP Exam/LMCC Step II
Apply for graduate training (if applicable)
PGY3 Graduate training
(UofT and other summer practicum(s) may be combined with public health rotation)
PGY4 Field rotations
Apply for Royal College exam
PGY5 Field rotations
Royal College exam
**Note** This generic timeline is for planning purposes only and does not take into account individual circumstances such as
waiving graduate training, part-time training or leaves of absence.
Family Medicine Rotations (Year 1-2): The Royal College requires 12 months of clinical training and accepts a second 12 months as credit towards the five year
training. The PHPM residency program at the University of Toronto requires that residents complete 24 months in family
medicine training to achieve this component.
“Family Medicine is a discipline ...utilizing prevalence based approach. In a given population, family physicians are
aware of common diseases in that population…. The skills that a family physician must possess include practicing preventive medicine”.
Program Goals:
▪ The program will graduate public health and preventive medicine specialists with competent clinical family medicine
knowledge and skills to assess and manage patient health issues within communities and populations. The program will
ensure that all graduates can make independent, evidence informed, community responsive, accountable clinical
decisions to maintain and improve health overall and reduce health inequities.
▪ The program will prepare all trainees to be able to serve as local medical officers of health. However, recognizing the
need for public health and preventive medicine specialists in many roles and the variety of career paths graduates may
choose, the program will support trainees to gain clinical certification in Family Medicine and to have opportunities to
enhance knowledge and skills including community oriented primary care in focus areas such as sexual health, TB,
travel medicine, and addictions.
▪ The program will ensure that residents are provided with sufficient learning and assessment opportunities to meet the
requirements to become certified by the College of Family Physicians. In addition, the program will provide support to
help residents tailor their family medicine training towards community oriented primary care through guidance on FM
site selection, electives, rural family medicine placement and second year research projects.
Resident Responsibilities:
• Ensure timely submission of family medicine POWER evaluations
• Complete PGCorEd modules
• Complete Quality Improvement project (during PGY-1 year)
• Complete research/academic project (during PGY-1 and PGY-2 years)
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• Attend PHPM program events when possible including academic half days, research day, annual general
meeting, media day, and others.
• Deliver one rounds presentation during each year of PGY-1 and PGY-2 at PHPM academic half day (may
be done as a junior resident co-presenter with a senior resident co-presenter)
Examples of public health focused electives:
In general, these could be sites such as STD/sexual health clinics, TB clinics, HIV clinics, travel clinics, etc. Some specific
examples include:
▪ Occupational Medicine Clinic at St Michael's Hospital
▪ TB clinics at TWH, SMH, HSC or West Park (the latter sees much of the MDRTB in the province)
▪ Hospital-based infection control (contact Allison McGeer, Michael Gardham or Mary Verncombe)
▪ Methadone clinics (including one at the Works at Toronto Public Health )
▪ Addiction Medicine St. Joseph’s Health Centre (Dr. Mel Kahan, PHPM)
▪ Aboriginal Health Services: Anishnawbe Health Centre
▪ Toronto General Hospital’s Tropical Medicine Clinic – Dr. Jay Keystone
▪ Evergreen Clinic (for street-involved youth)
▪ SHOUT clinic (street youth) – Dr. Karen Weyman from SMH
▪ Clinics for those experiencing homelessness – Seaton House, Salvation Army shelter, Inner City Health Associates
(ICHA)
▪ Hassle Free Clinic (STD Clinic)
▪ STD Clinics at Toronto Public Health
▪ HIV Clinic – SMH, TGH
▪ Community Health Centres
▪ Environmental Health Clinic at Women's College
▪ Refugee clinic at Women’s College (Dr. Meb Rashid)
▪ Research at ICES (Dr. Jeff Kwong, PHPM), PHO or CRICH (St. Michael’s Hospital – Dr. Andrew Pinto, PHPM)
▪ CAMH smoking cessation clinic (Dr. Karl Kabasele, PHPM)
Family Medicine Projects:
Family medicine training at UofT involves quality improvement and resident research projects. PHPM residents are encouraged
to engage in research and projects that relate to the goals and objectives of public health training and practice. Junior residents
should consult senior residents, program directors and faculty for support and examples of integrated FM-PHPM projects.
*New opportunities have become available in the 2016/17 academic year for PHPM residents completing their family medicine
training to engage in a research project in medical education, in partnership with DFCM. This project would be in lieu of the
standard ‘family medicine project.’ Interested PHPM residents will be given the opportunity to assess and evaluate the DFCM
curriculum, under the guidance of the DFCM Program Director and Associate Program Director (Dr. Karl Iglar and Dr. FokHan
Leung). Please contact the PHPM PD/APD if you are interested.
Academic Training/Graduate Studies (Year 3-4) The Royal College requires 12 months of training in the sciences of Public Health and Preventive Medicine. The majority of
Toronto residents complete an MPH or equivalent during this time frame. Residents interested in pursuing graduate
opportunities outside of the University of Toronto are required to meet the 12 months expectation and ensure that the core of
epidemiology, biostatistics, health system, policy, health promotion and research methods are included at an appropriate level of
depth and breadth.
Program Goals:
▪ The program will graduate public health and preventive medicine specialists with competent knowledge and skills to
assess and manage health issues within communities and populations through the successful completion of academic
courses in epidemiology, biostatistics, surveillance, research methods, as well as understanding the health system. The
program will ensure that all graduates can make evidence informed decisions to maintain and improve health overall
and reduce health inequities.
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▪ The program will prepare all trainees to be able to serve as local medical officers of health through the achievement of
graduate competencies. However, recognizing the need for public health and preventive medicine specialists in many
roles and the variety of career paths graduates may choose, the program will support trainees to have opportunities to
enhance knowledge and skills in graduate areas of research, education, environment and health, public health
administration and global health.
▪ The program will ensure that residents are provided with sufficient learning and assessment opportunities to meet
Royal College, program and personal objectives and support residents’ self-direction and self-assessment as well as
flexibility in the demonstration of achievement of competency through flexibility in choice of graduate program.
Resident Responsibilities:
• Discuss plans for graduate/academic training with program directors well in advance of graduate school
application deadlines.
• Ensure that graduate training (and course selections) meets Royal College and UofT PHPM program
requirements.
• Provide program director with graduate transcript by six months after completion of program
• Attend PHPM academic half days (if not conflicting with class schedule)
• Attend PHPM core event days (e.g. AGM, research day, media day, etc.)
• Deliver one rounds presentation during PGY-3 at PHPM academic half-day
Applying for Credit for Previously Obtained Masters in Public Health:
Residents who have already completed an MPH or equivalent may wish to apply for credit with the Royal College. This can be
done through the Credentials Unit of the Royal College of Physicians and Surgeons of Canada.
Email: [email protected]
Tel: 613-730-8191 ext 393
Toll free: 1-800-668-3740
Fax: 613-730-3707
In the past, the Royal College Credentials Unit has required residents to complete an application for assessment of Canadian
residency training, and submit a Letter of Recommendation from the Program Director with the support of the Associate Dean,
indicating the amount of credit to be received, along with the proposed end-of-training date. Once the Royal College
determines the final amount of credit to be granted, they send a Final Ruling Letter to the resident.
Field Rotations (Year 4-5) The Royal College requires 18 months of training in public health related field rotations. Many residents have 18-24 months or
more for field rotations depending on the length of their graduate training and previous experience.
Introduction to Public Health Practice (1 block)
Requirements may be modified by Program Director, depending on Public Health practice experience
Communicable Disease Control (3 blocks)
Must include local public health experience and on-call responsibilities
Environmental Health (3 blocks) Must include field inspections (unless completed elsewhere), environmental health assessment.
Health Policy, Systems and Planning (2-3 blocks) Must include policy analysis, policy development, and/or policy implementation.
Chronic Disease, Health Promotion and Injury Prevention (2-3 blocks)
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Before 2015, this was combined with the Health Policy, Systems and Planning rotation in a single 3-block rotation. In 2015,
there was a separation into two 2-3 block rotations.
Senior Management (6 blocks)
Can only be completed after at least 3 core rotations
Notes:
· One block is 4 weeks.
· All core rotations must be completed at accredited sites.
· Core rotations, other than Introduction to Public Health Practice, must be completed following graduate training.
· Residents are expected to have on-call responsibilities for at least 2 rotations (usually CD and EH or SM)
(Reference: Rotation Expectations document, approved by RPC June 19, 2015)
2016/17 Block Dates as established by PGME:
Block Start Date End Date
1 Friday, July 1, 2016 Sunday, July 24, 2016
2 Monday, July 25, 2016 Sunday, August 21, 2016
3 Monday, August 22, 2016 Sunday, September 18, 2016
4 Monday, September 19, 2016 Sunday, October 16, 2016
5 Monday, October 17, 2016 Sunday, November 13, 2016
6 Monday, November 14, 2016 Sunday, December 11, 2016
7 Monday, December 12, 2016 Sunday, January 8, 2017
8 Monday, January 09, 2017 Sunday, February 5, 2017
9 Monday, February 6, 2017 Sunday, March 5, 2017
10 Monday, March 6, 2017 Sunday, April 2, 2017
11 Monday, April 3, 2017 Sunday, April 30, 2017
12 Monday, May 1, 2017 Sunday, May 28, 2017
13 Monday, May 29, 2017 Thursday, June 30, 2017
For part-time
residents:
3 blocks = 12 wks
@ 0.6 FTE = 20 wks
@ 0.8 FTE = 15 wks
6 blocks = 24 wks
@ 0.6 FTE = 40 wks
@ 0.8 FTE = 30 wks
Logistical note:
If you aren’t on the block schedule above, please identify the last SUNDAY as your final day, not the FRIDAY as this suggests
you are taking “vacation” during your last weekend. Note: Residents taking parental leave have to enter their last day as
SATURDAY for Employment Insurance purposes.
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Core rotations must be completed at a University of Toronto affiliated site. Electives may be completed at any accredited site.
Residents may spend a maximum of 3 blocks at an unaccredited site. Core and elective rotation supervisors should have
Fellowship Certification in Public Health and Preventive Medicine and a faculty appointment with Dalla Lana School of Public
Health or UofT Faculty of Medicine. Exceptions to this rule may be made in discussion with program directors and with an
appropriate supervision and assessment plan in place.
Field rotations are guided by the PHPM program policy document “Field Rotation Expectations and Evaluation Form”.
Program Goals:
▪ The program will graduate public health and preventive medicine specialists with competent knowledge and skills to
assess and manage health issues within communities and populations through learning and application in core and
elective field rotations.
▪ The program will ensure that all graduates can make independent, evidence-informed, community responsive,
accountable decisions to maintain and improve health overall and reduce health inequities through learning and
assessment opportunities during core field rotations.
▪ The program will prepare all trainees to be able to serve as local medical officers of health through provision of some
or all core rotations in local public health agencies and the opportunity to network with local MOHs at meetings and on
the listserv. However, recognizing the need for public health and preventive medicine specialists in many roles and the
variety of career paths graduates may choose, the program will support trainees to gain field experience and to have
opportunities to enhance knowledge and skills in focus areas of research, education, environment health, public health
administration and global health through the provision of provincial, federal, and academic rotation opportunities.
▪ The program will ensure that residents are provided with sufficient learning and assessment opportunities to meet
Royal College, program and personal objectives and support residents’ self-direction and self-assessment as well as
flexibility in the demonstration of achievement of competency through the development and tracking of personal
objectives throughout the core and elective rotation opportunities.
Resident Responsibilities:
• Discuss field rotation interests, preferences, supervisors, and sites with program directors well in advance
of each field rotation block.
• Inform the Program Coordinator of rotation site, supervisor and dates in a timely manner.
- Vacations and Confirmed rotations should be submitted via the online form
- Planned rotations should be entered into the Resident Planning Table to assist with program
planning
• Develop rotation goals and objectives in collaboration with supervisor and/or program directors.
• Timely submission of ITERS (In-training evaluation reports), site and supervisor evaluations
• Attend PHPM academic half days (rounds and Topic of the Week) unless there are urgent service needs or
learning opportunities at the field rotation site.
• Lead Topic of the Week as part of academic half day when possible.
• Deliver 2 rounds presentations in each year of PGY-4 and PGY-5 at PHPM academic half day
• Attend and help coordinate PHPM core event days (e.g. AGM, research day, media day, etc.)
Field Rotation Sites:
Accredited Training Sites
The Royal College allows training sites to be designated as either accredited or non-accredited. The practical implication of this
is that residents are limited to 3 blocks of field training at non-accredited sites. Accredited sites must undergo a review and sign
an agreement of affiliation to the program to be designated accredited. Accredited training sites currently include:
· Toronto Public Health
· Peel Public Health
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· Durham Region Health Department
· Halton Region Public Health Unit
· Simcoe Muskoka District Health Unit
· Middlesex London Health Unit
· Haliburton Kawartha Pineridge Health Unit
· Ontario Ministry of Health and Long Term Care's Public Health Division
· Canadian Partnership Against Cancer (updated Sept 2014)
· York Region Public Health Unit (updated June 2016)
· Public Health Ontario (PHO) formerly Ontario Agency for Health Protection and Promotion
· Public Health Agency of Canada (through the University of Ottawa only)
· Sites affiliated with Memorial University in St. John’s, Newfoundland and Capital Health Public Health Services in
Halifax, Nova Scotia
In addition, residents may complete training at any accredited training sites of the other Canadian Public Health and Preventive
Medicine Residency Programs (e.g. NOSM) with agreement of both programs.
(Source: Rotation Expectations document, approved by RPC June 19, 2015)
General Electives, Research Electives & Medical Education Research Electives:
General Electives
PHPM residents have many opportunities to meet personal and program objective by completing a rotation at various local,
provincial, national or international agencies. Electives should be discussed with the Program Director or APD at least 3 months
in advance.
Research Electives
During the 2015-16 academic year, residents conducted and environmental scan and needs assessment and made a number of
recommendations to facilitate research elective opportunities. This has led to a Research Elective ITER, and the development of
a database (presently a spreadsheet) of faculty in different universities who are willing to take on PHPM residents for public
health research electives. This document will be available in the Resident Resources Dropbox Folder.
Medical Education Research Electives
As of the 2016-17 academic year, new opportunities have become available to PHPM Residents to participate in curriculum
development and Medical Education research, in partnership with DFCM (Dr. FokHan Leung & Dr. Karl Iglar) and the CPPH
medical undergraduate education program (Dr. Allison Chris). There are opportunities to develop, implement, evaluate,
curricular approaches and tools used by DFCM to teach family medicine residents, or used by UGME to teach medical students
about public health.
Please inform the PD/APD if you are interested in any of these special elective opportunities.
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ACADEMIC HALF DAY
Academic Half Days (AHD) are the core formal curriculum of the PHPM program. They occur Friday mornings, usually
between 8:30 and noon in room 574 at Dalla Lana School of Public Health (DLSPH). The structure of our academic half days is
generally as follows:
8:30 – 9:20 Topic of the Week (ToW)
9:30 – 10:45 Rounds
11:00 – 12:00 Field Notes
Topic of the Week
ToW is an opportunity for more informal resident-to-resident teaching. The original concept was that it was to be similar to
internal medicine “morning report” in which residents interactively review a critical topic or framework without a formal
PowerPoint presentation. All residents are welcome to lead ToW, however, it is primarily an opportunity for senior residents to
teach junior residents. The topics covered complement and supplement those covered in formal rounds, and the format may be
case-based.
Examples:
Measles case management on call; PH investigation of water quality breach, framework for food safety (HAACP); Baltimore
classification of viruses.
Rounds
Rounds presentations are the more formal aspect of AHD. The topics are core public health topics, including hot topics in the
field of public health. Rounds are delivered in thematic areas over a two year cycle and have been assigned “Faculty Leads.”
Residents select a rounds topic within the assigned theme with an emphasis on meeting Royal College objectives in that topic
area. The topic may be chosen according to their interests, their field/clinical rotations, and their own learning needs as well as
the learning need of their colleagues. Rounds may take a variety of formats including resident presentations and interactive
workshops.
Residents are expected to present a certain number of times according to their post-graduate year.
PGY 1-2 1 presentation in conjunction with a senior resident
PGY 3 1 independent presentation
PGY 4-5 2 independent presentations
Chief residents are in charge of rounds scheduling and topics. To sign up to deliver rounds, speak to the chief residents and/or
visit live rounds schedule: https://docs.google.com/spreadsheets/d/1Ltesb5-
AQzmw8kskxV0HEvx3mIgbKIX4_c0x4L6UGyo/edit?usp=sharing
Resident Expectations:
• Consult with Faculty Lead on presentation topic, content and resources. Invite them to attend your rounds (as
appropriate)
• Submit a Cover Sheet (the template is on portal) with a summary, objectives, and readings to the Program Coordinator
on the Monday before the presentation.
• Submit the slides to the Program Coordinator by noon on Thursday, the day before the presentation
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Field Notes Field notes are the main forum for communication and experience sharing in the program. Field notes are structured as a weekly
committee meeting of the residents, chaired by the chief resident, during which issues that arise within the program are
resolved, events are communicated, and decisions made. It provides an opportunity to provide immediate feedback on the most
recent rounds and conduct a brief practice exam question. Program announcements and a summary of field notes is circulated
on the program listserv weekly.
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RESIDENT EVENTS
2016/2017 At-a-Glance – All dates tentative! Please refer to the Live Rounds Schedule for the most accurate dates
September 30 Program exams (written)
October 7 Program exams (oral)
October 14 Annual General Meeting (AGM)
November 25 Research Day
February (TBC) National program exams (written and oral)
March/April Media Day
May 26 (tentative) Spring Retreat or Field Trip
June 23 Career Day and Graduation
Program Exams
The program exams are held twice yearly on consecutive weeks in the fall and spring. They consist of a written exam (3hrs) as
well as an oral exam (4 12-minute questions) which are structured similarly to Royal College exams but the content assesses
resident progress within the program. Since February 2016, there will be one national program exam every February in lieu of
the program exam. Residents are required to successfully complete at least 2 written exams and 2 oral exams by the end of their
final year and demonstrate interval improvement. PGY4-5 are expected to participate in the exam. Depending on space and
availability of faculty (for oral exams), PGY1-3 are encouraged to sit the exams.
Annual General Meeting (AGM)
The annual general meeting is a formal opportunity for residents to discuss the overall functioning of the residency program in
the absence of any faculty members. This is an opportunity to engage in dialogue about program issues, concerns and strengths.
The meeting occurs instead of rounds on a Friday in the Fall. The Chief Resident will request agenda items prior to the meeting
and record minutes that will then be circulated among the residents and Program Directors. These minutes are discussed at a
residency program committee meeting held subsequent to the AGM.
Resident Research Day
The annual resident research day is an opportunity for residents to present research projects or activities with which they have
been engaged. The resident research day occurs instead of rounds on a Friday morning in the Fall. There is a separate resident
research day committee that organizes the day and has faculty advisors review the abstracts. The purpose of residents research
day is to share research ideas and results with colleagues, gain experience and receive feedback on presentation effectiveness,
and meet the scholar objectives of Royal College including those relating to research methods and evidence-based practice.
Media Day
The PHPM Media Day is held in collaboration with the Ryerson Journalism Program. The day is coordinated by 1-2 resident
volunteers and is meant to provide PHPM residents with an opportunity to practice their communication skills in a supportive
environment. The day typically includes the opportunity to participate in a practice television and/or radio interview on a pre-
determined topic. The day also provides residents with an opportunity to interact with Ryerson media students and develop an
appreciation for the training and perspectives of media students/professionals.
Career Day
The PHPM Career Day is held annually in June. It is coordinated by the Chief Resident(s) or his/her delegate. The day
involves a panel of public health physicians from a variety of backgrounds and that have incorporated different opportunities for
public health practice into their careers.
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Graduation and Awards Luncheon
The PHPM Graduation Ceremony is held annually in June, immediately following the Career Day. It is an opportunity to
celebrate resident achievements and help send off the graduating PGY5s. For details regarding the resident and faculty awards,
see the Program and Annual Awards section of this manual.
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RESIDENT LEADERSHIP & VOLUNTEER OPPORTUNITIES
Chief Resident The program has two co-chief residents at all times. The role of chief resident is a unique opportunity for residents to gain
experience and demonstrate leadership and management competencies. A Terms of Reference was created for the Chief
Resident in 2014 and was approved by the Residency Program Committee (RPC) in June 2014. Senior residents are nominated,
and vetted by the Program Director, elected by the resident group, and appointed by the RPC. The Chief Resident term is a
minimum of 6 consecutive months and is renewable for an additional 3-6 month term depending on program and resident
circumstances. Chief Residents receive a small additional pay stipend. The chiefs have one vote at the RPC.
Roles and responsibilities of the Chief Resident: support and guidance for junior residents, coordination of academic half
day content and schedule (including topic of the week, rounds, and journal club), chairing field notes and circulating
minutes, participating on program committees, participating in selection and orientation of residents, organizing an annual
general meeting and career day, and attending other program meetings as needed.
Treasurer The PHPM residents began to manage their own funds for academic and educational activities through resident treasurers as of
2009. There are two treasurers at any given time who each have two-year terms that overlap.
Roles and responsibilities of treasurer: To report to the residents on spending and lead the discussion on budget at the
resident annual general meeting; liaise with the program director and UT accountants regarding resident fund issues; and
administer the funds, including submitting resident educational claims to the DLSPH finance office. This is a relatively new, but
important role for residents who are interested in participating in the residency program with many opportunities for leadership
and advocacy.
Residency Program Committee (RPC) Resident Representative The Residency Program Committee is the Royal College mandated body that advises that oversees that residency program and
provides advice to the director. Representatives to the RPC include site faculty, the school of public health, and residents. In
addition to the Chief Resident membership on the RPC, one junior resident and one senior resident are elected for a one-year
term by the resident group to represent resident issues, interests and concerns in the residency program planning, supervision
and organization. The residency program committee is mandated by the RCPSC to assist the Program Director in the planning,
organization, and supervision of the program. Committee functions include accreditation, CaRMS selections and review of
resident placements. The resident rep has one vote at the RPC.
Roles and Responsibilities of resident representative: resident voice on RPC, attend regular (at least quarterly) RPC meetings,
solicit resident input for RPC decisions, report back to the program re: the activities of the committee on a regular basis (at least
after each quarterly meeting)
Curriculum Sub-Committee The curriculum sub-committee provides support to the RPC and the program in maintaining, developing and improving the
educational experience of trainees. In addition to the Chief Resident membership on the curriculum sub-committee, one to two
additional residents may volunteer to participate. This committee is tasked with ensuring general oversight for academic half
days, public health field rotations, resident resources, and other learning opportunities.
Roles and Responsibilities of resident volunteers: attend quarterly meetings, solicit resident input for committee decisions,
report back to the program re: the activities of the committee on a regular basis (at least after each quarterly meeting)
PHPM Orientation Manual - July 2016 | 19
Selection Sub-Committee The selection sub-committee supports the Associate Program Director in the recruitment and selection of residents for the
program. The Selection Subcommittee members develop and evaluate the selection processes, but do not necessarily participate
in the actual selection activities like file review or interviews (this is optional). Residents may volunteer to participate on the
selection sub-committee.
Roles and Responsibilities of resident volunteers: attend quarterly meetings, contribute to committee decisions, report back
to the program re: the activities of the committee on a regular basis (at least after each quarterly meeting)
Program Awards Sub-Committee The awards sub-committee supports the Associate Program Director in the selection of PHPM resident and faculty awards, as
well as developing and evaluating the award selection process. This committee meets twice a year (usually fall and spring).
Residents may volunteer to participate on the awards sub-committee.
Roles and Responsibilities of resident volunteers: attend meetings, contribute to committee decisions regarding the overall
award selection process. Review and select the winner of the Faculty Educator Award.
CaRMS Selection Volunteers Each year there is an opportunity for residents to participate in the CaRMS selection process. In the past, residents have been
involved with reviewing application packages, applicant interviews, attending an informal applicant luncheon and assisting
medical students interested in Public Health and Preventive Medicine to arrange electives. The chair of the selection sub-
committee will request volunteers for these roles during the fall.
PARO Representative The Provincial Association of Residents of Ontario (PARO) General Council consists of representation from each specialty in
Ontario. There is one position for Public Health and Preventive Medicine residents from Toronto on the PARO General
Council. PARO requests nomination of this position in the summer of each year. The first PARO General Council meeting
occurs in September. Most meetings occur in Toronto approximately every six weeks on a Friday afternoon/evening. In the
past, the Public Health and Preventive Medicine representatives have become further involved by seeking nomination and
election to the PARO executive council.
Roles and Responsibilities of the PARO representative: attending PARO general council meetings, inquiring about current
issues/concerns from the Public Health and Preventive medicine residents prior to each meeting, updating the general council
about Public Health and Preventive medicine issues, reporting back to Public Health and Preventive medicine residents about
PARO issues, participating in PARO working groups.
DLSPH Governing Council Representative The DLSPH governing council includes a resident representative from the PHPM/Occupational Medicine programs. The
governing council works to provide governance and oversight on faculty/school-wide issues and members of council represent
their respective departments at general meetings.
Roles and Responsibilities of the DLSPH representative: attending governing council meetings 3 times per year, regularly
informing residents of relevant decisions/discussions.
Public Health Physicians of Canada (PHPC) Representative PHPC is a professional organization specifically for Public Health and Preventive Medicine Specialists. The PHPC has a
Residents Council and each program across the country has 1 to 2 representatives in this group. There is also an
opportunity for a resident to act as the resident representative on the PHPC continuing professional development sub-
committee which runs the annual CPD day for PHPM practitioners as well as creating and delivering other educational
resources. All PHPM residents are invited to participate in the PHPC even if not a formal representative.
PHPM Orientation Manual - July 2016 | 20
Roles and responsibilities of the resident representative: The PHPC representative(s) are expected to participate in
monthly PHPC teleconferences, keep residents at the program informed about committee activities, and promote PHPC
membership. In addition to this, the representative can become involved with various PHPC Residents Council initiatives.
Some examples of these initiatives include advocacy on topical public health issues (e.g. writing op-eds, letters to
politicians, involvement in PHPC general council advocacy), resident mentorship (e.g. helping run the "Life After
Residency" webinar series), working on the Public Health Matters newsletter, and much more.
PHPM Orientation Manual - July 2016 | 21
PROGRAM AWARDS
In June of every year, three different program awards are presented to selected residents. In addition, a faculty member is
selected by the resident group to receive the Faculty Educator award. The nominations are reviewed and selected by the Awards
Committee, appointed by the Associate Program Director.
C.P. Shah Award Background: The C.P. Shah Award is named and endowed by Dr. Chan Shah the first Program Director at UoT. The
first award was given in 1988.
Inclusion Criteria: It is to be awarded annually to the resident enrolled in the Public Health and Preventive Medicine
Residency Program whose field or written research report has been judged as the best and of sufficient quality. The research
should be relevant to public health/preventive medicine, well-written with valid results and with appropriate
interpretation/recommendations.
The awardees will be encouraged to submit their report for publication in an appropriate peer-reviewed journal and to make an
oral presentation of their work at an appropriate academic forum.
Exclusion Criteria: Recipients will not be eligible in subsequent years.
Resident Service Award Background: The Resident Service Award was initially established to honor Dr. Harvey's distinguished service as University
of Toronto Public Health and Preventive Medicine Program Director from 1996 to 2006. The first award was issued in 2006 at
the Annual Program Luncheon.
Inclusion Criteria: It is open solely to Public Health and Preventive Medicine resident who has made a substantial
contribution to the social and intellectual life of the Residency Program, and who has demonstrated those qualities of
volunteerism, activism, leadership, humanism, integrity, professionalism, scholarship, and collegiality fostered and exemplified
by Dr. Harvey.
Exclusion Criteria: Recipients will not be eligible in subsequent years. The award will only be presented if an appropriate
candidate has been nominated and will not necessarily be awarded every year.
Resident Teaching Award Background: Public Health and preventive medicine residents are expected to be good teachers and often contribute
substantially to the education of medical students, graduate students in public health and their fellow residents at the University
of Toronto (U of T).
Inclusion Criteria: This award was created to recognize one resident each year who exhibits excellence in this area. Open to all
PHPM residents, the criteria for this award are demonstrated interest and efforts to teaching, engaging in curriculum design,
and / or evaluating education with respect to teaching PHPM/population health to undergraduate students, graduate students,
and residents at the University of Toronto. Preference will be given to the resident who has demonstrated consistent
engagement in teaching over a longer time.
Exclusion Criteria: Recipients will not be eligible in subsequent years. One award may be given each year.
PHPM Orientation Manual - July 2016 | 22
Info: If you have questions or are unsure about a nomination, please feel free to contact Ian Johnson at [email protected]
Faculty Educator Award The Faculty Educator Award is to honour the faculty members for their excellence in the education of Public Health and
Preventive medicine residents. The awardees are nominated and chosen by the Public Health and Preventive Medicine
residents.
PHPM Orientation Manual - July 2016 | 23
COMMUNICATION
E-mail is our main method of communication within the program. Rounds and other program announcements are made by
email, and rounds presentations, field notes, and program policies are posted on Blackboard Portal and Dropbox. You must
have a utoronto email account that is not forwarded in order to post to uToronto listserves (Instructions for setting up your
account can be found at: https://weblogin.utoronto.ca). Please read your e-mail regularly and keep your address up to date.
Please send any change in your email address to the Program Coordinator.
Blackboard portal http://portal.utoronto.ca
Log onto the portal with your utoronto username and password. The Public Health and Preventive Medicine page will be listed
under ‘My Courses - Public Health and Preventive Medicine Residency Program’. Blackboard Portal has served as a long-term
repository for Program Documents and is currently being reorganized to optimize ease of access.
Dropbox https://www.dropbox.com/sh/7eyzea2ydr9mmob/AAAGPt7a1YXqFD9lbvMZs8Jpa?dl=0
For ease of access, the Program Coordinator has begun to set up a file system under Dropbox, particularly for frequently
accessed documents such as resident forms, rounds slides and coversheets, and meeting file packages. Blackbord Portal
continues to be a long-term repository for Program Documents.
Public Health and Preventive Medicine Listservs Listservs are maintained by the Program Coordinator
This listserv includes all residents currently in the program, as well as the program director, associate program directors, and
recent graduates for one year after graduation. Only the Chief Residents, the Program Directors, and the Program Coordinator
have access to post to this listserv.
This listserv includes ONLY current residents. All residents should have access to post to this listserve via their utoronto email.
This listserv is a space where residents can communicate with each other on program and other public health-related issues.
Chief Resident Email Account [email protected]
Use this email account to get in touch with the current Chief Resident(s).
Suggestions for use: For rounds: Send all rounds cover sheets and presentations to the Program Coordinator, who will then distribute via weekly
Academic Half Day emails and post them to Dropbox and Portal. Large files (slides or photos) can take up space in UofT email
boxes and should be avoided when using the listservs.
Program website The current public program website (http://phpm.pgme.utoronto.ca) is maintained by the Program Coordinator. It contains
resident profiles, a description of the program, as well as resident resources, including rotation-specific resource documents.
PHPM Orientation Manual - July 2016 | 24
RESIDENT SAFETY AND WELLNESS Resident Wellness: http://www.pgme.utoronto.ca/content/resident-wellness
Residents are provided link to PGME Wellness and encouraged to seek assistance in confidence. The Program Director
routinely offers this excellent service to residents in confidence during one-on-one meetings.
The Office of Resident Wellness employs a full time Wellness Consultant who offers counselling and education services to all
residents, with particular focus on managing stress for optimal academic and workplace performance, adapting to the multiple
transitions of residency and the physician lifecycle, exam and performance anxiety and managing the stress associated with
academic difficulty. The Director, Resident Wellness is available for short term counselling as well as providing support for
disability and accommodation issues, academic difficulty, career uncertainty, and planning for maintenance of well-being
throughout the program. The Office maintains a list of family physicians for U of T residents as well as some consultant GP-
psychotherapists and psychiatrists. The Office maintains a website with resources available through PGME, the University and
the community, and literature, podcasts, and self-directed activities for stress management and physician well-being.
Residents have access to services, offered by the Physician Health Program of the Ontario Medical Association. This includes
access to mental health and substance abuse practitioners as well as monitoring.
Appointments with staff of the Office of Resident Wellness are available in person, by telephone or Skype. There are a limited
number of regular after-hours appointments offered with a Wellness consultant for counselling.
Workshops on managing stress for optimal well-being and performance and managing stress associated with transition and
change are available to individual programs through the Office of Resident Wellness.
Residents will be able to seek advice from the University Sexual Harassment Officer, the Ombudsperson or the University’s
Anti-Racism and Cultural Diversity Officer for issues related to intimidation and harassment or others.
The PARO Helpline (1-866-HELP-DOC) is a 24-hour confidential service provided by the Professional Association of
Residents of Ontario jointly with the Distress Centres of Toronto. This line offers crisis intervention as well as advice and
resources. PARO’s Residents Well-Being Committee keeps a log of family physicians and health professionals willing to see
Residents on a fairly urgent basis.
Resident Safety
In addition to our program safety policy, the Postgraduate Medical Education (PGME) Office developed Resident Health and
Safety Guidelines in March 2009. The Guidelines are available on the website at
http://www.pgme.utoronto.ca/sites/default/files/public/Policies_Guidelines/Health_Safety/Postgraduate%20Trainee%20Health
%20and%20Safety%20Guidelines.pdf.
These Guidelines apply to all Residents.
The University, hospitals and affiliated teaching sites are accountable for the environmental, occupational, and personal health
and safety of their employees; in addition, all teaching sites must meet the requirements of the PARO-CAHO collective
agreement. Residents must adhere to the relevant health and safety policies of each rotation’s training site.
The PGME Guidelines set out reporting procedures where there has been or may be a personal safety or security breach, which
may include reports to the immediate supervisor at the training site, Program Director, and/or Director of Resident Wellness.
Urgent Resident safety issues will be brought to the attention of the Vice Dean, Postgraduate Medical Education, as well as, the
relevant field rotation site coordinators as appropriate
PHPM Orientation Manual - July 2016 | 25
OTHER EDUCATIONAL OPPORTUNITIES Resident Education Funding PHPM residents, not currently in their clinical/family medicine training, are entitled to funding support for educational expenses
(e.g. books, learning materials, conferences). The amount is determined by the resident group at the Annual General Meeting in
the fall of the same year. Original receipts and a signed reimbursement claim form should be submitted to the treasurer and
signed off by the Program Director before submitting to the DLSPH Business Manager. Fax copies of the reimbursement forms
will not be accepted. The reimbursement claim form is available on Blackboard.
Extra Courses
Canadian Field Epidemiology Program (CFEP) Epi In Action PHPM residents may apply to attend the CFEP Epi in Action training course which typically occurs in late September. This is a
three week course based in Ottawa that provides an overview on outbreak investigations and other aspects of practical
epidemiology. Applicants must have completed their core rotation in communicable disease prior to the course. Application
forms are typically circulated during the spring months via the Program Director. There are no course fees but spots are limited
and residents may apply for funding for travel and accommodation.
Dr. Rachlis’ Policy Course A mini policy course for PHPM residents has been offered by Dr. Michael Rachlis for the last several years. The course is
typically held on Friday afternoons in the winter. Interested residents should contact Dr. Rachlis directly if they are interested.
Dr. Hodge’s Management Course A one-week management course for PHPM residents across Canada has been offered in January for the past several years.
Since 2015, the cost of participation has been $750.
PHPM National Review Course A one-week review course for PHPM residents is been offered by Queens University annually – October 24-28, 2016. The
national review course is usually attended by PGY4’s and 5’s.
Immunization Education Competencies Program (ICEP) PHPM residents are typically offered free attendance to the ICEP, hosted by the Canadian Pediatric Society in May. Residents
from any year may apply. An announcement is circulated in the spring and interested residents asked to apply.
Conferences Follow the link to check out upcoming public health conferences! http://www.cpha.ca/en/conferences/all.aspx
Family Medicine Forum (FMF)
- Nov 9-12, 2016, Vancouver
- Attendees: family physicians, family medicine residents
- FMF website: http://fmf.cfpc.ca/
Association of Local Public Health Agencies (alPHa) Symposia
- Dates and locations TBA
- High yield: Council of Ontario Medical Officers of Health (COMOH) meeting
- Attendees: Board of Health members, public health unit staff, MOHs, AMOHs, PHPM residents
- alPHa website: http://www.alphaweb.org/
The Ontario Public Health Convention (TOPHC)
- Date and location TBA for Spring 2017
- TOPHC website: http://www.tophc.ca/Pages/home.aspx
Canadian Public Health Association (CPHA) Conference
- June 2017, Toronto
- High yield: the Public Health Physicians of Canada (PHPC) typically holds a day of Continuing Professional
Development talks on a pre-conference day, as well as the PHPC Annual General Meeting
PHPM Orientation Manual - July 2016 | 26
- Attendees: public health professionals, researchers, public health students, PHPM physicians, PHPM residents
- CPHA website: http://www.cpha.ca/en/default.aspx
- PHPC website: http://www.nsscm.ca/en/events/upcoming-phpc
Memberships/Professional Affiliations
Organization Cost for residents Comments and Link
Canadian Public
Health Association
(CPHA)
~ $100 per year Organization that includes public health nurses, inspectors, and
physicians among others. Many residents end up not joining this
however partly due to the cost. You can still attend the CPHA
conference if you are not a member.
http://www.cpha.ca/en/default.aspx
Public Health
Physicians of Canada
(PHPC)
None It seems that most residents join this group and it is recommended. It
originally began as the specialist society for public health and
preventive medicine specialists but is now also open to other
physicians who practice public health.
www.nsscm.ca/en/about
Ontario Medical
Association (OMA)
~$200 per year if
done together
Similar to medical school, not required but many residents do
maintain these two memberships. They also have sections / interest
groups you can be a part of, including public health and family
medicine.
www.oma.org
www.cma.ca
Canadian Medical
Association (CMA)
College of Family
Physicians of Canada
(CFPC)
$56 yearly as a
resident, more as a
family physician
May be required during your family medicine residency.
www.cfpc.ca
Royal College of
Physicians and
Surgeons of Canada
(RCPSC)
This organization has a resident affiliate role that is available.
http://www.royalcollege.ca
Canadian Medical
Protective Association
(CMPA)
Varies each year Required for medical practice
www.cmpa-apmc.org/index.htm
College of Physicians
and Surgeons of
Ontario (CPSO)
~$320 yearly as a
resident, more as a
family physician
Required for medical practice
http://www.cpso.on.ca/
PHPM Orientation Manual - July 2016 | 27
APPENDIX A: ROYAL COLLEGE CANMEDS OBJECTIVES
FOR PHPM
The Royal College of Physicians and Surgeons of Canada (RCPSC) has developed a set of objectives for public health and
preventive medicine specialty training which serve to define our specialty and provide a metric for the Royal College
Examination. These objectives are currently (and almost always) undergoing revision, but at a very slow pace not usually
relevant to current residents. Previous iterations of the objectives (2005) were more granular and provided residents with more
direction in their field rotations and exam preparation – these previous objectives can be found on the PHPM Portal. The most
current objectives (which apply to residents beginning the program in July 2014) are available on the Royal College website at
http://www.royalcollege.ca/cs/groups/public/documents/document/y2vk/mdaw/~edisp/tztest3rcpsced000887.pdf
In 2015, the broader CanMEDS physician competency framework was updated by the RCPSC. For the CanMEDS 2015
Physician Competency Framework, please see the following link:
http://www.royalcollege.ca/rcsite/documents/canmeds/canmeds-full-framework-e.pdf
DEFINITION
Public Health and Preventive Medicine is that branch of medicine concerned with the health of populations. The Public Health
and Preventive Medicine specialist uses population health knowledge and skills to play leading and collaborative roles in the
maintenance and improvement of the health and well-being of the community. Through inter-disciplinary and inter-sectoral
partnerships, the Public Health and Preventive Medicine specialist measures the health needs of populations and develops
strategies for improving health and wellbeing, through health promotion, disease prevention and health protection.
The Public Health and Preventive Medicine specialist demonstrates skills in leadership; development of public policy; design,
implementation and evaluation of health programs and applies them to a broad range of community health issues.
GOALS
The Public Health and Preventive Medicine specialist can engage in a number of careers, for example:
a. the practice of public health at a local, regional, national or international level;
b. the planning and administration of health services, whether in institutions or in government;
c. community-oriented clinical practice with an emphasis on health promotion and disease prevention;
d. the assessment and control of occupational and environmental health problems;
e. Teaching and research.
Residents in Public Health and Preventive Medicine must develop a comprehensive knowledge of the sciences of Public Health
and Preventive Medicine, and the skills to apply this knowledge to a broad range of community health issues in the socio-
political and cultural contexts in which they occur. They must demonstrate the knowledge, skills and attitudes relating to socio-
economic status, gender, culture and ethnicity of the populations with which they work. In addition, all residents must
demonstrate an ability to incorporate these factors in research methodology, data presentation and analysis.
During training, all residents will be expected to acquire a substantial knowledge of and necessary skills in: concepts of health
and illness and their determinants, methods in community health, health services organizations, trans-organization
collaboration, community health programs, communication and advocacy. In addition, candidates are encouraged to develop a
higher level of expertise in one of these fields, and to acquire knowledge in other academic subjects relevant to their own
interests.
In particular, residents who successfully complete the program will be able to:
a. assess the health needs, concerns and capacities of a population;
b. investigate potential or existing health issues occurring in a population
c. assess sociopolitical realities and be able to take and advocate appropriate action to improve health in the light of that
assessment;
d. plan, implement and evaluate health programs and/or other strategies to deal with these needs, concerns and issues;
e. contribute to the formulation of public policy and assess its impact on health;
f. communicate, consult, collaborate and build partnerships with the public, physicians and other health professionals,
volunteers, service provider agencies, elected and appointed officials and the media;
g. demonstrate ethical attitudes and behaviour and a critical approach to ethical issues in their work;
h. contribute to the body of knowledge of community health through scholarly activity and research; and
PHPM Orientation Manual - July 2016 | 28
i. Demonstrate leadership and management skills.
COMPETENCIES
At the completion of training, the resident will have acquired the competencies included in, but not limited to, the lists that
follow, and will function effectively as a:
Medical Expert/Clinical Decision-Maker
Specialists possess a defined body of knowledge and procedural skills which are used to collect and interpret data, make
appropriate clinical decisions, and carry out diagnostic and therapeutic procedures within the boundaries of their discipline and
expertise. Their practice is characterized by up-to-date, ethical, and cost-effective management and effective communication in
partnership with individuals (patients and clients), other health professionals, community leaders and the community at large.
The role of medical expert/clinical decision-maker is central to the function of specialist physicians, and draws on the
competencies included in the roles of scholar, communicator, health advocate, manager, collaborator, and professional.
General Requirements:
• Demonstrate diagnostic and therapeutic skills for ethical and effective interventions at the individual, group,
organization and population levels.
• Access and apply relevant information to the practice of Public Health and Preventive Medicine.
• Demonstrate effective consultation services with respect to assessment and interventions at the individual, group and
population levels.
Specific Requirements:
1. Diagnostic and Therapeutic Skills
(a) Assessment
● Assess and describe the health of a population.
● Identify those conditions or population characteristics that lend themselves to surveillance and be able to
select the most appropriate method.
● Use a variety of methods to collect information relevant to the clinical setting and situation at hand.
● Select and interpret relevant social, demographic and health indicators from a variety of data sources.
● Identify and interpret biological risk markers, e.g. age, sex, genetic makeup.
● Identify and demonstrate an understanding of social and economic environmental factors, such as
immigration policies and distribution of wealth.
● Identify and demonstrate an understanding of physical environmental factors, including noise, pollutants
and hazardous industrial processes, that are relevant to the given clinical context (individual, local,
regional, global).
● Identify and interpret the impact of health behaviours of individuals, groups and populations, particularly
with respect to nutrition, physical activity, use of tobacco and other substances, sexuality, risk taking,
vaccination and participation in recommended screening programs.
● Identify and demonstrate an understanding of factors that influence the potential for change in a given
context or population.
● Use computers or information technology in epidemiological investigations and data analysis.
● Interpret epidemiologic studies and assess their validity and applicability to a particular situation.
● Describe and apply guidelines for determination of causality (Koch, Hill)
● Understand the principles of infectious disease epidemiology and apply them in the investigation and
management of infectious disease.
● Conduct a communicable disease outbreak or disease cluster investigation
● Describe the major environmental health hazards and diseases, and the interaction of air, water and soil
characteristics with them.
● Carry out a health risk assessment of an environmental hazard.
● Use quantitative and qualitative methods including (but not limited to) participant observation, key informant surveys, nominal group, focus group and Delphi process, to explain differences in health and
health related behaviours.
●
(b) Interventions
● Manage a communicable disease outbreak.
PHPM Orientation Manual - July 2016 | 29
● Know the natural history, epidemiology, risk factors and health burden of the major communicable and
non-communicable (including injury) diseases of public health significance, and apply this knowledge in
the development, implementation and evaluation of appropriate surveillance and control programs.
● Describe the main methods of dealing with common environmental hazards, including (but not limited to)
water and sewage treatment, milk hygiene, and quality control of water, soil, air and food.
● Manage individually, or in a team, health risks from environmental or occupational exposures
● Understand and apply the principles of harm reduction, stages of change, health protection (including
legal, technical, economic and educational approaches) and health promotion.
● Develop, implement and evaluate approaches to community health issues that incorporate health
protection, disease prevention (primary, secondary and tertiary) or health promotion strategies as
appropriate.
● Identify those conditions that are amenable to population-based screening, and calculate and interpret
screening test characteristics. Understand, interpret and apply as appropriate, the methods and
recommendations of relevant practice guideline processes. Contribute to the development of a community
emergency preparedness plan, including measures to prevent and manage biological, chemical and
radiological agents
.
2. Information Access
● Identify access and critically appraise data from a variety of sources, including individuals, administrative
databases, the internet and health, epidemiological and social sciences literature.
3. Effective Consultation
● When called upon for advice, clarify the nature of the request and establish (negotiating where required)
the desired deliverables.
● Efficiently collect the information appropriate to the request.
● Formulate clear and realistic recommendations.
● Communicate the assessment and recommendations in a manner (oral and/or written) that is most suitable
to the client and given circumstances.
Communicator
To provide humane, high-quality care, specialists establish effective relationships with patients and a variety of clients (groups
and communities), other physicians, other health professionals, and service providers from non-health sectors. Communication
skills are essential for the specialist, and are necessary for obtaining information from and conveying information to, the
individuals and groups the specialist interacts with. Furthermore, these abilities are critical in eliciting clients’ beliefs, concerns
and expectations about their health and illnesses, and for assessing key factors impacting their health.
General Requirements:
● Establish relationships with patients and families, groups and communities, and other
physicians, health professionals and service providers, decision and policy makers and
the media, appropriate to the setting.
● Obtain and synthesize relevant information.
● Listen effectively.
● Convey information clearly in formats appropriate to the recipient (patient or other individual, family, group, other service
provider, community and media) that is relevant to the purpose at hand.
Specific Requirements:
● Interpret and present epidemiological data and risk information to affected individuals, the public, other professionals and
the media using a variety of modalities.
● Develop and implement a communication plan about a public health issue, including a media component.
● Respond effectively to public and media enquiries about specific health issues.
● Effectively communicate with members of an interdisciplinary team for the purpose of information exchange, conflict
resolution, and the provision and receipt of feedback.
● When called upon for advice, clarify the nature of the request and establish (negotiating where required) the desired
deliverables.
● Efficiently collect the information appropriate to the request.
● Formulate clear and realistic recommendations.
PHPM Orientation Manual - July 2016 | 30
● Communicate the assessment and recommendations in a manner (oral and/or written) that is most suitable to the client and
given circumstances.
Collaborator
Specialists work in partnership with others who are appropriately involved in the care of individuals, groups or communities. It
is therefore essential for specialists to be able to collaborate effectively with patients, clients, groups and communities, and a
multidisciplinary team of expert health and other professionals for provision of optimal care, education and research.
General Requirements:
● Consult effectively with other physicians, other health care professionals and service providers from other sectors.
● Contribute effectively to interdisciplinary team activities.
Specific Requirements:
● Identify individuals, groups and other service providers who can contribute meaningfully to the definition and solution of
an individual, group or community level public health issue, and education task or research question, including (but not
limited to) social services agencies, mental health organizations, the not-for-profit sector, and volunteers.
● Employ a variety of means to engage and enable the participation of identified key stakeholders.
● Clearly articulate the goals and objectives of a given collaborative process.
● Identify and describe the role, expected contribution and limitations of all members of an interdisciplinary team assembled
to address a health issue, educational task or research question, and work effectively within such a team.
● Describe the organization of community health and social services, including the not-for profit sector, volunteers and other
service agencies, in at least one province.
Manager
Specialists function as managers when they make everyday practice decisions involving resources, co-workers, tasks, policies,
and their personal lives. They do this in the settings of individual patient care, practice organizations, and in the broader context
of the health care system. Thus, specialists require the ability to prioritize and effectively execute tasks through teamwork with
colleagues, and make systematic decisions when allocating finite health care resources. As managers, specialists take on
positions of leadership within the context of professional organizations and the Canadian health care system.
General Requirements:
• Utilize resources effectively to balance professional demands, learning needs, and outside activities.
• Allocate finite health care resources wisely and ethically.
• Work effectively and efficiently in a health care organization.
• Utilize information technology to optimize patient care, life-long learning and other activities.
Specific Requirements:
● Use knowledge of the Canadian health system defining legislation, funding and organizations, to analyse community health
issues.
● Use an economic analysis in the assessment of a health issue and proposed intervention options.
● Describe the public health legislation in at least one province and how it relates to other relevant legislation at the
municipal, provincial and federal levels.
● Describe the organization of workplace health services.
● Design, implement, manage and evaluate a program.
● Design, implement and evaluate a change management process.
● Develop and implement a strategic plan.
● Participate in common human resource management functions, including (but not limited to) hiring, firing and performance
appraisal of staff.
● Develop and manage a budget.
● Understand the impact of various leadership styles and apply them appropriately in a variety of community and
organizational settings.
● Understand and use the techniques of conflict management, including negotiation and arbitration.
● Understand and use a variety of quality improvement techniques as appropriate to the organization and setting.
Health Advocate
PHPM Orientation Manual - July 2016 | 31
Specialists recognize the importance of advocacy activities in responding to the challenges represented by those socio-cultural,
environmental and biological factors that determine the health of individuals, groups, communities and society. They recognize
advocacy as an essential and fundamental component of health promotion that occurs at the level of the individuals, family,
community and society. Health advocacy is appropriately expressed both by individuals and the collective responses of
specialist physicians in influencing public health and policy.
General Requirements:
● Identify the important determinants of health affecting individuals and communities.
● Contribute effectively to improved health of individuals and communities.
● Recognize and respond to those issues where advocacy is appropriate.
Specific Requirements:
● Describe the distribution and determinants of health status of a specific population.
● Conduct a policy analysis.
● Describe mechanisms of policy development and methods of implementation, including legislation, regulation and
incentives.
● Recognize situations where advocacy is required and define strategies to effect the desired outcome.
Scholar
Specialists engage in a lifelong pursuit of mastery of their domain of professional expertise.
They recognize the need to be continually learning and model this for others. Through their scholarly activities, they contribute
to the appraisal, collection, and understanding of health care knowledge, and facilitate their own personal education as well as
that of their students, patients, community and others.
General Requirements:
• Develop, implement and monitor a personal continuing education strategy.
• Critically appraise sources of information relevant to the practice of Public Health and Preventive Medicine.
• Facilitate learning of patients and clients, residents, other health professionals and the community.
• Contribute to development of new knowledge.
Specific Requirements:
● Pose a research question and participate actively in the complete research process from grant preparation through to
dissemination of findings.
● Describe the elements of quantitative, qualitative and action research, including study purpose, design, conduct, analysis,
interpretation and reporting.
● Describe sampling methods as well as the estimation of appropriate sample sizes, including a consideration of type 1 and 2
errors.
● Select and apply descriptive and analytical methods appropriately,
● Recognize potential source of bias in research and describe methods to reduce the impact of such bias through design
and/or analysis
● Adapt educational and training strategies to the needs of the learner(s).
● Calculate and interpret measures of frequency (rate, ratio) and of risk (relative risk, attributable risk, odds ratio, etiologic
fraction, preventive fraction)
● Identify, access and critically appraise data from a variety of sources, including individuals, administrative
Professional
Specialists have a unique societal role as professionals with a distinct body of knowledge, skills, and attitudes dedicated to
improving the health and well-being of others. Specialists are committed to the highest standards of excellence in clinical care
and ethical conduct, and to continually perfecting mastery of their discipline.
General Requirements:
• Deliver highest quality care with integrity, honesty and compassion.
• Exhibit appropriate personal and interpersonal professional behaviours.
• Practise medicine ethically consistent with obligations of a physician
Specific Requirements:
PHPM Orientation Manual - July 2016 | 32
• Continually evaluate one’s abilities, knowledge and skills, and know one’s professional limitations, seeking advice and
assistance where appropriate.
• Identify ethical issues arising in the course of Public Health and Preventive Medicine practice, such as consent,
confidentiality, privacy, resource allocation, conflict of interest, public safety and individual choice, and apply appropriate
strategies to address them.
• Recognize, analyze and know how to deal with unprofessional behaviours in clinical practice, taking into account local and
provincial regulations.
• Adopt specific strategies to heighten personal and professional awareness and explore and resolve interpersonal difficulties
in professional relationships.
SPECIALTY TRAINING REQUIREMENTS
(These specialty training requirements apply to those who began training on or after 1 June 1995.)
Five years of approved residency training, which must be undertaken within or under the aegis of a residency program
accredited by the Royal College. Practical expertise will be developed in applied community settings in which the candidate
must assume responsibility appropriate to her/his developing expertise. Although these placements will often be outside the
confines of a University Health Sciences Centre, it is essential that they offer adequate supervision and regular evaluation from
the residency program.
This period must include:
1. One year of basic clinical training.
2. a. Three years in a Royal College approved, university-sponsored program that includes course work in the sciences of
Public Health and Preventive Medicine and experience and responsibility in Public Health and Preventive
Medicine. This will include the equivalent of:
i. One academic year of course work in Public Health and Preventive Medicine;
ii. One year of field placements. Appropriate settings will include public health departments, health planning
authorities, government departments of health, environmental health settings, occupational health
departments in government and industry, and clinical departments with a commitment to practice and
research in preventive medicine. It is essential that candidates gain experience in a broad range of such
placements, although it is recognized that a single placement will often provide experience in more than
one subject area;
iii. One additional year, which may include:
● additional academic preparation or research experience
● additional field placements in applied Public Health and Preventive Medicine settings as in 2(a)ii,
above;
● additional field placements relevant to the candidate's training e.g., toxicology, aerospace
medicine, social services, nutrition, genetics;
b. One further year of training, in a Royal College approved, university-sponsored program which may include:
i. Residency in a clinical specialty relevant to the practice of Public Health and Preventive Medicine
(normally internal medicine, pediatrics, obstetrics or psychiatry); or with selective clinical experiences
related to disease prevention and health promotion for specific populations or groups.
ii. Additional training as in 2(a) iii, above.
NOTE: EXAMINATION Applicants who have completed residency training in Family Medicine, acceptable to the College of Family Physicians of
Canada for residency-eligibility for their examinations, may be deemed to have fulfilled the training requirements under
sections 1 and 2(b)i.
NOTE: PURPOSE OF THE TRAINING The purpose of the training required under Section 1 of the training requirements is to give the resident a degree of independent
responsibility for clinical decisions; an opportunity for further development of the skills required in making effective
relationships with patients; the consolidation of competence in primary clinical and technical skills across a broad range of
medical practice.
The purpose of the training required under Section 2 is to give residents an opportunity to develop the knowledge and skills to
function as a Public Health and Preventive medicine specialist. The scope of practice is broad. It requires knowledge of clinical
medicine and the basic sciences of community health; the ability to develop effective relationships with individuals and
communities; and knowledge of the health care system within its socio-economic and political environment.
PHPM Orientation Manual - July 2016 | 33
APPENDIX B: UNIVERSITY OF TORONTO PHPM
PROGRAM POLICIES
PHPM Residency Program UofT CanMEDS Goals and Objectives Approved by RPC June 18, 2010
The program will graduate community medicine specialists with competent knowledge and skills to assess and manage health
issues within communities and populations. The program will ensure that all graduates can make independent, evidence
informed, community responsive, accountable decisions to maintain and improve health overall and reduce health inequities.
The program will prepare all trainees to be able to serve as local medical officers of health. However, recognizing the need for
community medicine specialists in many roles and the variety of career paths graduates may choose, the program will support
trainees to gain clinical certification in Family Medicine if desired and to have opportunities to enhance knowledge and skills in
focus areas of research, education, environment health, public health administration and global health.
The program, like all of post-graduate medical education, relies on an adult learning model in which trainee education is a
shared responsibility. Residents will be responsible for their own learning path through the program with the assistance of a
personal learning plan, mentor and guidance from Program Directors and other faculty. The program will ensure that residents
are provided with sufficient learning and assessment opportunities to meet Royal College, program and personal objectives and
support residents’ self-direction and self-assessment as well as flexibility in the demonstration of achievement of competency.
Residents will be accountable to each other through participation in all aspects of program activities; in particular demonstration
of peer teaching and assessment and program leadership and management.
The resident Portfolio is the one of the tools that residents use to demonstrate competence in all CanMEDS domains. Residents
must maintain and update their Portfolio throughout their training and be able to present it to the RPC or program director upon
request. The portfolio will be reviewed by the program director as part of FITER preparation in the final year of training.
The program will prepare specialists who meet the seven CanMEDS roles as incorporated into the Royal College Objectives of
Training and Specialty Training Requirements in Public Health & Preventive Medicine (2014). These objectives are the basis
for the ITER and FITER evaluations of residents. Key objectives are summarized below.
Medical Expert: ● Communicable disease epidemiology;
● Biological risk markers;
● Impact of behaviours on the health of individuals, groups and populations;
● Natural history, epidemiology and risk factors for the major communicable and non-communicable diseases of public
health significance;
● Health protection and health promotion strategies for these diseases;
● Population based screening;
● Environmental factors that affect health;
● Health hazard identification, risk assessment and risk management;
● Disease surveillance;
● Population health status assessment.
Communicator ● Interpret and present epidemiological data and risk information;
● Develop and implement a communication plan;
● Effectively communicate with the media, public and other health professionals;
● Formulate clear and realistic recommendations.
Collaborator
● Function effectively as members of interdisciplinary teams;
● Understand the organization of community health services;
● Clearly articulate the goals of a given consultative process;
● Consult, collaborate and build partnerships with the public, physicians and other health professionals, volunteers,
service provider agencies, elected and appointed officials, and the media.
PHPM Orientation Manual - July 2016 | 34
Manager:
● Design, implement, and evaluate health programs to deal with public health issues;
● Develop a strategic plan;
● Develop and manage a budget;
● Understand and use quality improvement tools;
● Understand the impact of various leadership styles;
● Understand and use techniques of conflict resolution;
● Design, implement and evaluate a change management process;
● Participate in common human resource management functions;
● Manage a communicable disease outbreak;
● Manage an environmental health hazard;
● Contribute to the development of a community emergency preparedness plan.
Health Advocate:
● Describe the determinants of health and their distribution in a specific population;
● Conduct a policy analysis;
● Recognize situations where advocacy is required to effect a desired outcome;
● Assess sociopolitical realities and be able to take and advocate appropriate action to improve health in the light of that
assessment;
● Contribute to the formulation of public policy and assess its impact on health.
Scholar:
● Develop research questions and participate actively in the complete research process;
● Interpret research results;
● Understand epidemiological principles of causality;
● Identify, access and critically appraise available data;
● Calculate and interpret basic statistical measures in epidemiology;
● Describe the elements of quantitative, qualitative and action research;
● Contribute to the body of knowledge of community health through scholarly activity and research.
Professional:
● Knowledge of public health legislation and other relevant legislation at the municipal, provincial and federal levels;
● Self directed learning, self-knowledge and continuing education;
● Identify ethical issues in community medicine practice and apply appropriate strategies to address them;
● Recognize, and know how to deal with unprofessional behaviours;
● Ability to resolve interpersonal conflicts in professional relationships.
PHPM Orientation Manual - July 2016 | 35
Resident Assessment and Evaluation
Approved by RPC, June 2008, revised and approved 2011
Background The In Training Evaluation Report (ITER) exists to help standardize formative and summative resident evaluation.
The ITER is:
1) A template for possible structured mid rotation feedback
2) A final record of your performance in a rotation. This record of performance contributes to the Final In Training Evaluation
Report (FITER) that the Program Director submits to the Royal College when determining eligibility for fellowship
certification.
According to Postgraduate Medical Education, the purpose of the ITER is:
✓ To provide a framework for the assessment of the Trainee's knowledge, skills and attitudes by a Supervisor;
✓ To facilitate feedback to the Trainee by a Supervisor or the Program Director;
✓ To serve as a record of the strengths and weaknesses of the Trainee for the Program Director;
✓ To enable the Program Director to assist future Supervisors in ongoing supervision;
✓ To assist the Program Director in providing a final in-training evaluation of the Trainee for the RCPSC, [the CFPC, or
the CPSO;] and
✓ To establish the basis for progress and promotion.
A “1 Fails to Meet Expectations” on the overall assessment of performance at the bottom of the ITER will be interpreted by the
Program Director as a failed rotation.
If the overall assessment is a “2” or if there are several “1”s on the individual items in the ITER, then the Program Director will
initiate further discussion about items that need improvement. The context and previous performance of the resident will factor
into this discussion. The program director can interpret this as a failed rotation.
Residents need to consider whether they are longitudinally meeting objectives that are marked as “not applicable” in a particular
rotation. Recurrent “not applicable” in the same domain would be a cause for concern and inability to complete the FITER.
Suggestions for a Successful Rotation Assessment and Evaluation Process
Principles
Having a clear set of rotation objectives and activities are critically important to a successful rotation experience.
At least two week prior to commencing a rotation, the resident should prepare a rotation and objectives document. This
document may be based on rotation resource documents, prior resident objectives documents, Royal College objectives of
training and the program’s rotation specific objectives, as well as the ITER. All ITERs are available on the program Portal.
The resident should then initiate a (email) conversation with the prospective supervisor to ensure that the objectives and
activities are appropriate and achievable. During the first week of the rotation, the resident and supervisor should meet and
review the objectives and activities document. This document should then be sent to the program coordinator and program
director and will form the basis of resident assessment throughout the rotation. The resident and supervisor should set a
schedule for meeting to provide formal teaching, as well as to review interim objective milestones and activity completion.
Completion and submission of an ITER in a timely manner is a shared responsibility of the supervisor and the resident. During
the last week of the rotation the resident and supervisor should meet, in person, to review the draft completed ITER. Ideally the
ITER for a rotation should be completed at the end of the rotation. After two weeks of reasonable efforts following the rotation,
if a resident is having difficulty obtaining the ITER at the end of the rotation, the resident must ask the Program Director and
the Site coordinator for assistance.
Resident Task and Check list
● Send your draft objectives (includes BOTH program and personal objectives) to your supervisor prior to starting the
rotation.
● Schedule a meeting with your supervisor in the first week (or two) of the rotation to finalize your rotation objectives.
These objectives should be concrete and measurable and composed with the rotation-specific objectives in CanMEDS
format and the ITER in front of you during this meeting.
PHPM Orientation Manual - July 2016 | 36
● In the first week of your rotation, schedule an appointment with your supervisor during the last week to ten days of
your rotation for a final evaluation. You are more likely to have a completed ITER by the end of your rotation if you
schedule this appointment well in advance.
● Email a copy of your finalized rotation objectives to the Program Director within the first month of your rotation.
● Schedule a mid-rotation evaluation discussion with your supervisor. A written midterm evaluation is required for
rotations longer than 3 months. For three month rotations it may be beneficial but is not necessary if there are no
serious concerns articulated by your supervisor. The program director will likely communicate with your supervisor to
discuss your performance mid-rotation. If your supervisor indicates that they have serious concerns about your
performance, written documentation of these concerns is required and MUST be submitted to the Program Director.
You should also develop a written action plan to address your supervisor’s concerns. You may ask the Program
Director for assistance in developing the action plan. The midterm evaluation does not necessarily need to be part of
your rotation file if the action plan succeeds in improving your performance and you achieve expectations
● Keep a copy of your ITER (download a PDF from POWER). If the ITER is in paper, submit the original to the Program
Director and keep a copy.
● Complete an evaluation of your supervisor (via POWER) and/or submit a paper version to the Program Coordinator
● Complete an evaluation of your rotation site (via POWER) and/or submit it to the Chief Resident with a copy to the
Program Coordinator.
PHPM Orientation Manual - July 2016 | 37
RESIDENCY SAFETY POLICY Updated: December 4, 2015
1. BACKGROUND The Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada have
collaborated in developing national standards for Residency programs. Standard B 1.3.9 states that:
“3.9 The residency program committee must have a written policy governing resident safety related to travel, patient encounters,
including house calls, after-hours consultations in isolated departments and patient transfers (i.e. Medevac). The policy should allow
resident discretion and judgment regarding their personal safety and ensure residents are appropriately supervised during all clinical
encounters.
3.9.1 The policy must specifically include educational activities (e.g. identifying risk factors).
3.9.2 The program must have effective mechanisms in place to manage issues of perceived lack of resident safety.
3.9.3 Residents and faculty must be aware of the mechanisms to manage issues of perceived lack of resident safety.”
The document, “University of Toronto, Faculty of Medicine, Postgraduate Medical Education Resident Health and Safety
Guidelines” available at:
http://www.pgme.utoronto.ca/Assets/PGME+Digital+Assets/policies/Health+and+Safety+Guidelines.pdf?method=1
provides background to the relationship between the University and all clinical teaching sites with respect to resident
safety. Procedures for reporting and responding to specific circumstances are contained in that document. The PHPM
residency program formally acknowledges, endorses and agrees to adhere to these guidelines. The PHPM program
recognizes the unique application of this policy in public health field rotations.
2. PURPOSES OF THIS POLICY The purposes of this policy include:
PGME guidelines by identifying program-specific safety risks.
and conditions.
gment when deciding if, when, where, and how to engage
in clinical, public health practice and/or educational experiences that they perceive to involve safety risks.
3. SCOPE AND RESPONSIBILITY The University, teaching sites, the Dalla Lana School of Public Health and the Public Health and Preventive
Medicine Residency Program, and residents in the program share responsibility for resident safety.
and private
practice locales are accountable for the environmental, occupational, and personal health and safety of their employees.
eaching sites must meet the requirements of the PARO-CAHO collective agreement.
education carried out within the program, educating residents about risk minimization strategies, and for making
decisions about educational experiences that take into account, among other things, the educational benefit relative to
any safety risk.
-2 years who are engaged in clinical Family Medicine training are subject to the resident
safety policy of the Department of Family and Community Medicine.
This policy outlines the provisions to address safety concerns related to educational activities undertaken as part of
the PHPM residency program.
4. POLICY STATEMENT a) Reporting of, and response to, all manner of incidents related to Environmental Health, Occupational Health, and
Personal Health and Safety will be addressed as outlined in the document, “University of Toronto, Faculty of
Medicine, Postgraduate Medical Education Resident Health and Safety Guidelines.”
PHPM Orientation Manual - July 2016 | 38
b) The PHPM residency program requires residents to engage in the following specific situations that may pose a
safety risk:
nal public health agency
c) The program commits to providing residents with a full disclosure of foreseeable potential risks associated with
these activities. The program will ensure that residents receive education and preparation for these activities using
best available evidence and practices AND assess residents for appropriate understanding PRIOR TO involvement in
these activities.
d) Residents will not be required to see patients, community members, agency staff or other individuals alone in any
of the above situations if not appropriately supervised.
e) Residents must immediately notify their supervisor or program director or chief resident of perceived safety
concerns
f) It is recognized that, at times, a resident may be called upon to respond to an acute situation involving a patient or
public health emergency which poses a risk to the resident’s personal safety and wellbeing. Residents are expected to
consider the effect on themselves, the patient and others when deciding on a course of action. Every effort should be
made to consult more experienced health care providers, supervisors/faculty or staff and seek assistance, support or
alternative courses of action. Ultimately, residents should use their best judgment when deciding if, when, where,
and how to engage in clinical, public health and/or educational experiences. Should a resident fail to engage in such
an experience (or engage in a manner other than what has been requested or previously expected of them) due to
perceived safety concerns, the resident will report this to their field site supervisor immediately AND to the
residency program director at the earliest reasonable time.
g) Residents involved in safety-related events or who have safety concerns are encouraged to contact the office of
resident wellness, PGME.
h) A resident should not encounter negative repercussions for decisions they made in good faith related to personal
safety concerns.
i) The residency program committee will review all concerns brought forth and take steps to minimize future risk.
j) Should there be a situation in which a resident repeatedly fails to engage in an activity that can be reasonably
considered part of their specialty practice, that is a mandated component of the residency training, and for which all
means of risk reduction and education have been instituted by the program, the residency program committee will
review the circumstances in the context of the specialty-specific and general CanMEDS physician competency
frameworks. Disputes or appeals of decisions made by the residency program committee will be referred to the Vice
Dean or Associate Dean, PGME.
Drafted By: Dr. Barry Pakes; Approved By: RPC
Approval Date: December 4, 2015
Prior Revision: Dr. Fran Scott June 2012 Planned Revision Date: June 2018
PHPM Orientation Manual - July 2016 | 39
Leave and Waiver Policy and Procedure Approved by RPC June 18, 2010 [Following New UofT PGME Policies, this section will be updates in 2016/17]
The UofT PHPM Residency Program supports resident leaves from the program to meet resident personal and educational
objectives. Some residents value the opportunity to incorporate clinical medicine in their future careers with public health and
often use leaves of absence to consolidate their skills and knowledge. In addition to supporting all legislated leaves, this policy
provides support for re-entry following leave, timely program completion and effective program management. This policy is to
provide guidance to residents, program directors and the RPC on leave and waiver of training requests. Refer to the attached
April 2009 PGMEAC Policy.
Policy on Granting a Leave of Absence The Royal College and the Collège des médecins du Québec (CMQ) expects that all residents must have achieved the goals and
objectives of the training program and be competent to commence independent practice by the completion of their training
program. It is understood by the RCPSC and the CMQ that residents may require leaves of absence from training. The
university determines the circumstances that would qualify residents for leaves of absence. It is anticipated that any time lost
during a leave will be made up upon the resident’s return. [NB: UofT PGME passed a new Leave of Absence policy in June
2015. The UofT policy will be modified to comply with the new UofT policy.]
Policy on Granting a Waiver of Training:
● The postgraduate office may allow a waiver of training following a leave of absence, in accordance with university
policy and within the maximum time for a waiver determined by the RCPSC and the CMQ. A decision to grant a
waiver of training can only be taken in the final year of the program but cannot be granted after the resident has taken
the certification examinations.
● Each university will develop its own policy on whether or not it is willing to grant a waiver of training for time taken as
a leave of absence; however, in the case where waivers of training are acceptable to the university, they must be within
the acceptable times listed below. In addition, regardless of any waived blocks of training, the decision to grant a
waiver of training must be based on the assumptions that the resident will have achieved the required level of
competence by the end of the final year of training.
● A waiver of training can only be granted by the Postgraduate Dean on the recommendation of the resident’s Program
Director.
RCPSC and CMQ Maximum Allowable Times for Waivers:
● It is the responsibility of the Royal College of Physicians and Surgeons of Canada (RCPSC) and the Collège des
médecins du Québec (CMQ) to set maximum allowable times for waivers of training that would maintain eligibility for
certification.
● The following are the maximum allowable times for waivers:
Five year program – three months
Educational Leave
● Residents should begin to discuss any plans of a potential leave with the Program Director as soon as possible and
preferably within nine months of an anticipated leave so that the Program Director can seek the advice of the Residency
Program Committee (RPC).
● The Resident must submit a written request for leave to the Program Director (PD) with a clear explanation of how the
education activity fits with personal and program objectives (using the personal learning plan). The resident must
include details of how they will keep connected with the program during the leave at minimum every 6 months such as
through rounds attendance and assisting in the new resident selection process. The leave request must also outline
plans for how the resident will reintegrate into the program when they return from leave. Educational leave for further
clinical training such as Family Medicine PGY-3 fellowships or for additional graduate training (for example PhD) will
only be granted if the resident can demonstrate how that training will fit with the career path they envision for
themselves in Public Health and Preventive Medicine. Extensions to a 12-month educational leave are not possible
as per PGME policy.
● The PD will meet with the resident to discuss their leave request and submit the leave request to the RPC for their
advice with a recommended disposition of approval or disapproval.
● The PD will consider the timing of the request, the planning with respect to program completion on return from leave
and the commitment to stay connected to ensure smooth re-entry in making a decision re disposition. It is expected
requests that comply with this policy will be approved.
● The PD will submit the leave request to the Vice Dean of Postgraduate Medical Education (PGME) for approval. The
Program Director’s submission to the Vice Dean will include information about the advice of the RPC and the PD. The
PD will inform the resident of the decision of the Vice Dean.
PHPM Orientation Manual - July 2016 | 40
● The resident can appeal the decision of the Vice Dean through the University of Toronto appeal process.
Personal/Compassionate Leaves
Up to 3 months leave request ● Residents must request and gain approval from the PD who will inform the Residency Program Committee (RPC) six
months prior to the anticipated start of the leave. If circumstances requiring compassionate leave arise urgently, the
resident is not expected to meet the six-month timeline.
● For personal leaves residents must submit a written request to the PD with a clear explanation of how the activity fits
with personal and program objectives, how the resident will keep connected with the program during the leave and the
plans for the return to the program at the end of the leave. A leave request that is granted approval by the PD will be
communicated to the resident in writing. The PD will also inform the Postgraduate Education office and the RPC
through the planning table. If the PD chooses to deny the request, the determination will be communicated to the
resident in writing. The resident can appeal denied personal/compassionate leaves to the RPC, then the Vice Dean for
their consideration.
Request for more than 3 months up to 12 months ● Residents must request and gain approval from the PD six months prior to the anticipated start of the leave. If
circumstances requiring compassionate leave arise urgently, the resident is not expected to meet the six-month timeline.
● For personal leaves residents must submit a written request to the PD with a clear explanation of how the activity fits
with personal and program objectives, how the resident will keep connected with the program during the leave at
minimum every 6 months such as through rounds attendance and assisting in the new resident selection process, and
the plans for the return to the program at the end of the leave. A leave request that is granted approval by the PD will be
communicated to the resident in writing. The PD will also inform the Postgraduate Education office and the RPC
through the planning table. If the PD chooses to deny the request, the determination will be communicated to the
resident in writing. The resident can appeal denied personal/compassionate leaves to the RPC, then the Vice Dean for
their consideration.
Requests for additional leaves
● Effective July 2010, residents who have taken prior unpaid leave (within this policy approval) can request additional
leave such that the total leave time follows the above directions. For example, a resident who has taken a one-month
leave can request an additional 2 months under the 3-month leave section. A resident who has taken 3 months leave and
requests additional 9 months will follow the 3-12 month policy. The overall maximum unpaid leave time that can be
granted is 12 months except under extenuating personal circumstances.
● Requests for additional unpaid leave for personal reasons beyond the 12 month period will only be considered in
extenuating personal circumstances such as family illness, career uncertainty or significant personal debt with a written
request to the PD.
● PD will submit the leave request to the RPC for advice with a recommended disposition of approval or disapproval.
The PD will also submit the leave request to the Vice Dean for approval with information about the advice of the RPC
and the PD. The PD will inform the resident of the decision of the Vice Dean. The resident can appeal the decision of
the Vice Dean through the PGME appeal process.
Waivers of training ● Residents are required to complete the full five years of training. Residents who have not completed the full five years
of training by June of their final year must be offered and sign back a contract for the outstanding time. NB Residents
can apply to sit the Fellowship exams in their final year provided they would have completed the five years by
December 31 of that year.
● Decisions to waive up to 3 months of training will be considered after the FITER is signed and submitted to the Royal
College and prior to writing of the Fellowship exams.
● The Resident must submit a written request for a waiver of training to the PD immediately after the FITER is signed
and NO LATER than the end of April of the final year. Using the CMRP personal learning plan, the waiver request
must include a clear explanation of how the resident will have completed the Royal College, program and personal
objectives without need for the waived time. PD will submit the waiver request to the RPC for advice with a
recommendation on whether the waiver should be approved.
● The PD will submit to the Vice Dean for approval with information about the recommendation of the RPC and the PD. The PD will inform the resident of the decision of the Vice Dean. The resident can appeal the decision of the Vice
Dean through the appeal process.
NB: Leave requests can be submitted and considered by current residents only. The program will not consider requests from
applicants or new accepted residents without signed contracts.
PHPM Orientation Manual - July 2016 | 41
Terms of Reference: Chief Resident Original passed by RPC June 20, 2014.
Amendments passed by RPC June 19, 2015.
1. Introduction
The position of Chief Resident is mandated by the Royal College of Physicians and Surgeons of Canada for residency programs
in Canada. Within the Public Health and Preventive Medicine (PHPM) residency program at the University of Toronto, the
position of Chief Resident is governed by the Professional Association of Residents of Ontario collective agreement as well as
applicable policies passed by the Residency Program Committee. The Chief Resident represents the interests of the program as
a whole and works primarily as a liaison between the program and the residents.
For PHPM residents, the position of Chief Resident it is an opportunity to participate in the leadership and management of the
PHPM residency program and fulfill CanMEDS requirements in leadership, management, communication, and advocacy, as
outlined by the Royal College.
The purpose of this terms of reference is to outline the selection, reporting and term of the Chief Resident and to
clarify/articulate roles and responsibilities associated with this position.
2. Selection, Reporting Relationships and Term
2.1 The PHPM program will have one or two Chief Resident(s) concurrently. The decision to have either one or two Chiefs
will be dependent on the number of residents available and interested to take on the position.
2.2 Residents may nominate themselves or be nominated by others when a Chief position becomes available. The candidates
will be approved by the Program Director to ensure that they are in good standing with the program. A vote will be held by the
resident group to select among multiple candidates. The selected resident(s) are recommended by the Program Director and
appointed by the Residency Program Committee.
2.3 The Chief Resident(s) will be in PGY3 or greater.
2.4 The Chief Resident(s) will report to the Program Director and his/her associate Program Directors.
2.5 The term of the Chief Resident(s) will be 6 consecutive months, renewable for up to one additional 6-month term.
3. Roles and Responsibilities
3.1 Leadership Responsibilities:
- Serve as liaison between the Program Director(s) and residents
- Meet with PHPM residents and/or Program Director(s) as required
- Serve as a mentor/teacher and resource for junior residents
- Participate as a full member of the Residency Program Committee
- Participate as a full member of the Curriculum Sub-committee
- Coordinate and facilitate the PHPM Resident Annual General Meeting
- Bring resident-generated issues to the Residency Program Committee and/or Program Director as necessary and assist
with their resolution
- Represent the program to external parties (as required)
- Participate in other committees as required by the program (or delegate to other residents)
PHPM Orientation Manual - July 2016 | 42
3.2 Teaching Responsibilities:
- Organize and facilitate Topic of the Week (ToW) during Academic Half Day
- Coordinate facilitation of Journal Club during ToW
- Assist in organizing other educational sessions (e.g., Field Trips, Media Day) or delegate this task to other residents, as
appropriate
3.3 Administrative Responsibilities:
- Facilitate Field Notes at weekly Academic Half Day including circulation of program updates to residents and Program
Director(s)
- Assist in the scheduling and coordination of Rounds at Academic Half Day
- Assist the Program Director(s) in providing orientation for new residents
- Facilitate updating and distribution of the annual program Orientation Manual
- Prior to completing his/her/their term(s) as Chief Resident(s), meet with the incoming Chief Resident(s) to review the
roles and responsibilities of the Chief Resident and provide handover on current issues
4. Program Support
4.1 The PHPM residency program facilitates the Chief Resident(s) to have one half day per week to assist with Chief Resident
activities. The PHPM Program Director will notify the rotation supervisor(s) of this prior to the resident rotation.
4.2 The Chief Resident(s) will be supported to attend the annual PGME chief resident orientation session as well as facilitate
other leadership learning opportunities.
4.3 The Program Director or his/her associates will provide the Chief Resident(s) with a letter of recognition at the completion
of his/her term
5. Terms of Reference Renewal
These terms of reference will be reviewed and evaluated following 1 year of implementation.
PHPM Orientation Manual - July 2016 | 43
APPENDIX C: PGME POLICIES
Guidelines for Residency Leaves of Absence and Training Waivers University of Toronto
Faculty of Medicine, Postgraduate Medical Education
1. BACKGROUND
The training requirements of residency programs define specific time requirements. While these requirements are generally
completed in sequence, it is recognized that a resident may need to interrupt training for a number of reasons. Such
interruptions are referred to as leaves of absence. This guideline is intended to provide guidance to program directors on a
range of issues relating to leaves of absence taken during residency training including the granting of leaves, salary level
implications, and impact on certification exam eligibility.
Related documents:
A number of important documents govern leaves and their impact on certification exam eligibility. This guideline is not
intended to supersede these documents, but will serve to assist Program Directors in their interpretation and application.
• PARO-CAHO Collective Agreement. The PARO-CAHO agreement outlines the employment relationship between
residents and the Ontario teaching hospitals. This agreement establishes entitlements relating to pregnancy and parental
leaves, sick leave, vacation, and professional leave. This agreement can be obtained at http://www.myparo.ca
• Council of Ontario Faculties of Medicine (COFM) Leaves from Ontario Postgraduate Residency Programs, October
2009. The COFM leaves policy provides direction on a number of issues including return to the program after training
and granting of unpaid leaves. This policy can be obtained at
http://www.pgme.utoronto.ca/content/policies-guidelines
• Royal College of Physicians and Surgeons of Canada (RCPSC) and the College des medecins du Quebec (CMQ)
Joint Policy on Waiver of Training After a Leave of Absence from Residency. The RCPSC policy on waivers
following a leave of absence states that:
The postgraduate office may allow a waiver of training following a leave of absence, in
accordance with university policy and within the maximum time for a waiver
determined by the Royal College and the CMQ. A decision to grant a waiver of training
can only be taken in the final year of the program but cannot be granted after the
resident has taken the certification examinations. Each university will develop its own
policy on whether or not it is willing to grant a waiver of training for time taken as a
leave of absence; however, in the case where waivers of training are acceptable to the
university, they must be within the acceptable times listed below. In addition, regardless
of any waived blocks of training, the decision to grant a waiver of training must be
based on the assumptions that the resident will have achieved the required level of
competence by the end of the final year of training.
This policy can be reviewed at Section 4.3.2 at the following weblink: RCPSC Policies and Procedures for
Certification and Fellowship, August 2014
PHPM Orientation Manual - July 2016 | 44
• The College of Family Physicians of Canada (CFPC) states that Family Medicine residents must complete 24
months of training to be eligible for the Family Medicine certification exam. Waivers of training of a maximum of 4
weeks may be granted at the discretion of the Program Director. This policy can be reviewed at
http://www.cfpc.ca/LeavesAbsenceWaivers/
2. DEFINITIONS:
A leave of absence is defined as an approved interruption of training for any reason. Leaves may be taken for a
variety of reasons, but are generally categorized into leaves with pay and leaves without pay.
In all cases, the Program Director, in discussion with the returning resident, should determine:
• the training level to which the resident will return following the leave; and
• the necessary educational experiences required for the resident to complete the residency requirements and goals and
objectives of the training program.
Unless required by the Program Director or for purposes of the Record of Employment, leaves of one week or less are not
required to be submitted to the central Postgraduate Medical Education Office.
Paid Leave
a) Pregnancy and Parental Leave:
Entitlement to pregnancy and parental leave is addressed in Section 15 of the PARO-CAHO Agreement.
b) Medical/Sick Leave:
Residents are entitled to 6 months of paid sick leave. Further details on Long Term Disability and other entitlements
regarding illness or injury are addressed in Section 14 of the PARO-CAHO Agreement.
c) Professional Leave:
The PARO-CAHO Agreement describes Professional Leave as 7 days per year in Section 12, as well as time to take
Canadian or American certification examinations. This time will not be considered to be a leave for the purposes of this
guideline or reporting to the College of Physicians and Surgeons of Ontario (CPSO), or granting of waivers of training.
d) Vacation:
Residents are entitled to 4 weeks of paid vacation per year. Vacation entitlement accrues while on maternity/parental
leave such that a resident returning from a one-year maternity/parental leave is entitled to 4 weeks of paid vacation in
addition to the regular 4-week allotment.
The 4 weeks vacation time must be taken within the academic session and cannot be rolled over or “stockpiled” to the
next year, or counted towards waived training time. In addition, vacation time should not be carried over when the
resident enters a sub-specialty program.
Hospitals may not restrict the amount of vacation a resident can take in a rotation, but do have the right to delay a
vacation request with regard to professional and patient care responsibilities.
PHPM Orientation Manual - July 2016 | 45
e) Emergency, Family, Bereavement Leave
A resident may request a leave due to a death in the immediate family or a person with whom the resident had a close
relationship. A leave may also be requested due to family illness, injury, medical emergency, or other urgent family
matters to which the resident must attend. Five consecutive working days may be granted by the Program Director for
this paid leave. This guideline should be interpreted with proper sensitivity.1
Unpaid leave
a) Educational Leave:
A resident may request an unpaid educational leave on the basis that the time away from the residency program
is relevant to his/her current program. This must have the support of the resident’s Program Director, and the approval
of the Postgraduate Dean or designate.
The maximum educational leave period is usually one year. Leaves beyond one year will be assessed by the Residency
Program Committee, Program Director and the Postgraduate Dean or designate.
b) Personal/Compassionate Leave
A resident may request a unpaid leave of absence due to a personal situation or career uncertainty. These leaves
will be considered on an individual basis by the Program Director in consultation with the Postgraduate Dean or
designate. The maximum leave period in this category is normally 6 months.2
3. SALARY CLASSIFICATION:
Residents will normally advance to the next pay level at the successful completion of 12 months of training. Residents who
have taken a leave of absence of more than one month during the training year, will proceed to the next level only at the
discretion of the Program Director.
Factors to be considered in promotion to the next level will include the resident’s full completion of the goals and objectives
of the training year as measured by ITERs, and all other evaluation tools such as in-training exams, case logs, and
completion of academic projects.
Program Directors may also decide to re-appoint residents to the next pay level at the beginning of an academic session to
allow them to stay with their cohort, and require them to make up the leave in their final year of training.
4. RETURN TO TRAINING:
Residents returning to training after a prolonged non-parental absence may need to return to an earlier level of training
and/or require a modified educational program. For specialty residents, no assurance can be given that all training taken prior
to the interruption will still be acceptable, even though previously recognized by the
RCPSC.3
In order to decide on the appropriate training level and program structure, residents may be assigned a 4-12 week period of
assessment, similar to the Assessment Verification Program (AVP), structured and organized by the Program Director in
consultation with the Residency Program Committee and educational programming resources.
PHPM Orientation Manual - July 2016 | 46
The Program Director, in consultation with the Residency Program Committee, will review the results of the assessment
program and submit a recommendation to the Vice Dean or designate regarding the resident’s re-entry to training. If
approved, the Program Director will discuss with the resident the modified program structure, training level, the evaluation
process, and expected outcomes.
Residents returning after medical leave will provide a written medical certificate from their treating physician indicating the
resident’s capability and fitness to return to the program. The Program Director or the Vice Dean or designate may request
an additional independent medical opinion to ensure the resident’s capability to resume his/her residency program. The Vice
Dean or designate will communicate with the resident when a Residency Program Committee decides against a resident’s re-
entry to the training program. The case may be referred to the Faculty of Medicine’s Board of Examiners-PG or the Board
of Medical Assessors. Any appeals would follow the normal Faculty and University Appeals process.
5. WAIVER OF TRAINING
Both the RCPSC and CFPC state that residents must complete all of a program’s training requirements including duration
and competence. However, the University is free to set policies regarding granting leaves of absence and the criteria by
which waivers of training time (if any) may be granted.
To meet the CFPC certification exam eligibility requirements, Family Medicine residents must make up any leaves of
absence to ensure the full duration of 24 months training is completed. Waivers of training of 4 weeks may be granted at the
discretion of the Program Director. Only by exception and under unusual circumstances will the University’s Department of
Family and Community Medicine agree to review or grant a shortened program. The CFPC must be notified of the waiver
prior to submission of the completion of training notice to the College.
Where a resident in a RCPSC program will have achieved the required level of competence by the end of the final year of
training, a waiver of 4-12 weeks may be granted at the Program Director’s discretion, referring to the maximum allowable
time for waivers outlined in section 4.3.2 in the RCPSC Policies and Procedures for Certification and Fellowship, August
2014
In Internal Medicine and Pediatrics, where residents are undertaking 3 core years and 2 subspecialty years, a maximum of 6
weeks may be waived in the first three core years and a maximum of 6 weeks in the final two subspecialty years. The first 3
core years are to be treated separately for the purpose of considering a training waiver. All core requirements are to be
completed before a resident will be released to pursue his/her subspecialty training program.
Completion of training includes not only meeting all specialty training requirements of the RCPSC, but also all of the
program’s required rotations and items such as intraining examinations, research and/or quality improvement projects, case
logs, portfolios and other assessments.
Each program is expected to establish the criteria by which they will allow waivers. Such criteria should be made available
to residents, preferably on the program’s portal or website.
PHPM Orientation Manual - July 2016 | 47
To reconcile the need for residents who must make up leave time and the annual exam schedule, the RCPSC allows residents
to write the Spring exam and complete their residency training requirements by December 31 of that year, or February 28th
for the Fall exams.
6. REPORTING:
The Postgraduate Medical Education Office will notify the College of Physicians and Surgeons of Ontario (CPSO) of all
interruptions in training greater than one week, as reported by the Program Director.
Residents must be aware of their professional obligations to report leaves to the CPSO when applying for or renewing
licenses. Failure to disclose leaves from the training program may result in delays in license renewal as a result of
investigation and/or disciplinary action.
1 see Employment Standards Act, 2000. Section XIV refers to unpaid leaves of absence entitlement at http://www.e-
laws.gov.on.ca/html/statutes/english/elaws_statutes_00e41_e.htm#BK68 .
Also, see Canadian Labour Code, Section 200, reference to 3 consecutive days of paid bereavement leave for federal employees
http://laws.justice.gc.ca/en/L-2/
2 from the Council of Ontario Faculties of Medicine (COFM) document, Leaves from Ontario Postgraduate Residency Programs, October 2009.
See section on Compassionate Leave.
3 RCPSC Policy and Procedures for Certification and Fellowship, August 2014. See Section 4.2.1.
Approved: PGMEAC, HUEC - April 2009 rev. Approved PGMEAC
February 27, 2015
PHPM Orientation Manual - July 2016 | 48
Moonlighting Policy [The UofT Moonlighting policy is currently under review following changes in the UofT PGME Policy]
Tip: Previous PHPM residents who have practiced clinically recommend that, based on the advice of the CPSO, the clinical
practice address be listed as the primary address on the public CPSO doctor register. This is to ensure that potential patient
information (e.g. lab reports) is directed to the clinical setting, and not to an academic address such as the Dalla Lana School.
The Dalla Lana School of Public Health can be listed as a primary practice address for those who are not practicing clinically,
and be listed as a secondary address for those who practice clinically.
Two Moonlighting Policies are listed at PGME website site (http://www.pgme.utoronto.ca/content/policies-guidelines)
One was issued by the Royal College of Physicians and Surgeons of Canada, and the second was issued by the Council of
Ontario Faculties of Medicine (COFM). Both policies are listed below :
The Council of Ontario Faculties of Medicine Policy on Resident Moonlighting
November 2004
Moonlighting is defined as: Residents registered in postgraduate medical education programs leading to certification with the
Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada who provide clinical
services for remuneration outside of the residency program. Moonlighting has been more recently called “restricted registration
for residents”.
The Ontario Faculties of Medicine do not support resident moonlighting. Moonlighting compromises postgraduate programs
and undermines the educational environment.
The Royal College of Physicians and Surgeons of Canada Moonlighting Policy
The Royal College of Physicians and Surgeons of Canada defines moonlighting as the independent practice of medicine during
residency training in situations that are not part of required training in the residency program.
The RCPSC neither condemns nor condones the practice of moonlighting during residency training.
However, if moonlighting does occur, the following principles should be considered:
1. Moonlighting must not be coercive. Residents must not be required by their residency program to engage in moonlighting.
2. The moonlighting workload must not interfere with the ability of the resident to achieve the educational goals and objectives
of the residency program. All program directors have an obligation to monitor resident performance to assure that factors such
as resident fatigue from any cause are not contributing to diminished learning or performance or detracting from patient safety.
Program directors should bring to the attention of all residents any factors which appear to detrimentally affect the performance
of the resident. To facilitate this, it is advisable that the program director be informed when a resident chooses to moonlight.
3. If residents do moonlight, it should not occur on the same unit or service to which they are currently assigned as a resident.
For example, a resident on an ICU rotation and taking call should not also cover the same ICU as a moonlighting physician on
other days of the same rotation. This has been seen to lead to difficulties in lines of responsibility and resident evaluation.
Confirmation of licensing, credentialing and appropriate liability coverage is the responsibility of the employer.
Approved by Accreditation Committee - 10 January 2002
PHPM Orientation Manual - July 2016 | 49
Postgraduate Medicine Policy on Academic Appeals
University of Toronto Governing Council
http://www.governingcouncil.utoronto.ca/policies/appeal.htm
1. Guiding Principles
The implementation of all academic appeals within the University across all divisions should be informed by the following
principles:
i. Diversity, Equity, and Accommodation: Consistent with the University’s commitment to diversity, equity and
accommodation, and its accompanying institutional policies, every division should be sensitive to issues of diversity,
equity, and accommodation in the academic appeals process.
ii. Consistency: The purpose of the Policy on Academic Appeals within Divisions is to formalize University wide
principles to ensure effective procedures for the academic appeals process are in place within divisions. The Policy
is designed to set minimum standards and consistent procedures across the University.
iii. Flexibility: While the Policy is intended to establish certain essential features of a division’s academic appeal
system, it recognizes that divisional size and complexity of issues have a bearing on divisional needs in this regard.
iv. Transparency and Timeliness: The University ensures that information on procedures for academic appeals are well
publicized, accurate, clearly presented, and readily accessible to students, instructors, and staff. Student academic
appeals should be addressed in a timely manner, using appropriate, fair and transparent procedures.
v. Fairness and Confidentiality: Throughout the process, students should have the opportunity to raise matters of proper
concern to them without fear of disadvantage and in the knowledge that privacy and confidentiality will be
appropriately respected. Both formal and informal resolutions for academic appeals should be available to the
student.
vi. Academic Standards and Regulations: The academic appeals process and principles should be applied in a manner
that maintains academic standards and contributes to the University goal of academic excellence. Detailed
information about the University of Toronto’s Academic Regulations and Requirements can be found in relevant
University Policies regarding academic regulations and requirements such as the Grading Practices Policy, as
amended from time to time.
2. The Academic Appeal
i. An academic appeal is an appeal by a student of the University:
1. Against a University decision as to his or her success or failure in meeting an academic standard or other
academic requirement of the University; or,
2. As to the applicability to his or her case of any academic regulation of the University; however,
3. No appeal lies from any admissions decision.
ii. The standard of review of an academic appeal is reasonableness.
3. Guidelines for Divisional Processes for Academic Appeals
i. Divisions should decide how best to implement this policy and what additional principles, structures and procedures,
not inconsistent with the spirit of this policy, may be required.
ii. Divisional processes should be broadly communicated and available in print form and electronic form.
iii. Divisional processes should offer opportunities for early resolutions and should provide informal lines of
communication throughout the process. Students should be encouraged to resort to these alternatives before
launching formal appeals.
iv. Divisional processes should recommend informal mediation throughout the process and parties should be
encouraged to consider the possibility of resolution throughout the process
v. Divisional processes should encourage a student’s confidential disclosure of appropriate information at the earliest possible stage particularly with respect to diversity, accommodation and other personal issues that may be relevant
to the disposition of the appeal.
vi. Divisional processes should set timelines for administrative decision making and student response throughout the
process. Timelines should include sufficient flexibility and discretion to accommodate the particular circumstances
of the appeal and to avoid inappropriate prejudice to the student or to the University.
PHPM Orientation Manual - July 2016 | 50
vii. Divisional processes should provide a mechanism for periodic internal review and a reporting mechanism for an
annual report to the division’s governing body.
viii. Divisional processes should refer to the fact that throughout the process, students should have the opportunity to
raise matters of proper concern to them without fear of disadvantage.
ix. Divisional processes should provide a clear mechanism for responding to academic appeals. Guidelines for
divisional processes should delegate the authority to determine divisional appeals to a standing committee of
reasonable size (“the divisional appeals committee”). This committee should report to the division’s governing body
for information. This committee should include members of the teaching staff and student body. The selection
process for student members should be done with a view toward diversity and transparency.
x. Divisional processes should provide that students commencing a divisional appeal do so by a written notice that
states the nature and grounds of the appeal, and which includes copies of any documents relied upon in support of
the appeal.
xi. Divisional processes should ensure that the student has the right to a hearing before the divisional appeals committee
in person, with or without counsel or other advisor, and to call evidence and present argument in person or by
counsel.
4. Right of Appeal to the Academic Appeals Committee of the Academic Board of Governing Council
i. Divisional processes should require that any student whose appeal has been denied must be advised of a further right
of appeal of the decision of the divisional appeals committee to the Academic Appeals Committee of the Academic
Board of Governing Council. The existence of this right of appeal should be clearly communicated, in writing, to
students for whom the appeal was denied at the divisional level.
ii. The procedures for appeals to the Academic Appeals Committee are set out in the Committee’s Terms of Reference.
5. Implementation and Monitoring
i. So as to provide for the fair and effective disposition of academic appeals, every division of the University is
required to maintain processes for academic appeals that are consistent with this Policy.
ii. The Office of the Provost will establish a framework for the divisional academic appeal processes which reflects
best practices and incorporates the principles and minimum standards set out in this policy.
iii. The Office of the Provost is responsible for monitoring the implementation of divisional appeals processes that are
in compliance with this Policy. The Office of the Provost is also responsible for facilitating a periodic review of
divisional processes for consistency to the Policy, for facilitating effective communication of the Policy and
divisional processes, and for conveying information to the divisions about suggested best practices.
iv. The Office of the Provost will undertake to ensure that information about divisional processes is communicated in
technologically relevant, up-to-date and easily accessible ways.
Approved: December 2005
To request an official copy of this policy, contact:
The Office of the Governing Council
Room 106, Simcoe Hall
27 King’s College Circle
University of Toronto
Toronto, Ontario
M5S 1A1
Phone: 416-978-6576
Fax: 416-978-8182
E-mail: [email protected]
Website: http://www.governingcouncil.utoronto.ca
PHPM Orientation Manual - July 2016 | 51
APPENDIX D: PROGRAM GRADUATES
Nick Brandon – 2016 Graduate
Clinical Southlake Family Health Team (Newmarket)
Graduate MPH/MSc at University of Waterloo; MA in Criticism and Theory at
University of Exeter (pre-med school)
Field CD (TPH), EH (PHO), CDPPPHP (CPAC), SM (TPH, Peel)
Electives Project (Peel)
Interests Communicable disease control, environmental health, chronic disease
prevention, health promotion, medical education, risk communication, culture
and public health, health communication, health education, global health,
research methodology, scientific evidence
Contact information [email protected]
Alanna Fitzgerald-Husek – 2016 Graduate
Clinical St Michael’s Hospital (clinic at St James Town Health Centre)
Graduate Johns Hopkins Bloomberg School of Public Health
Field CD (TPH, Vinita Dubey), EH (PHO, Ray Copes), HPCDIP/Policy (CPAC,
Heather Bryant), SM (Peel, Eileen de Villa)
Electives Immunization Policy (SAGE Committee, WHO, Philip Duclos), Medical
Education (University of Namibia School of Medicine, Christian Hunter),
Management and Leadership (Peel, Eileen de Villa)
Interests disease prevention and control (CD and NCD), marginalized/vulnerable
populations, global public health, public health and medical education,
program planning and evaluation, interface of public health and primary
preventive care, health equity and determinants of health
Contact information [email protected]
Winnie Siu – 2015 Graduate
Clinical Markham Stouffville Hospital
Graduate MSc in Health Policy, Planning and Financing at the London School of
Hygiene and Tropical Medicine (2012/2013)
Field CD (TPH, Elizabeth Rae), EH (PHO, Ray Copes), PPCD (Michael Rachlis)
Electives
Interests Global health, health policy, writing (narrative medicine, medical editing)
Contact information [email protected]
Natalie Bocking – 2015 Graduate
Clinical Credit Valley Hospital
Graduate MIPH, University of Sydney, 2004
Field CD (TPH, Michael Finkelstein), EH (PHO, Ray Copes), PPCD (Michael
Rachlis), SMR (Peel Public Health, David Mowat)
Electives Epi and Surveillance (PHO, Ian Johnson), Aboriginal Health (SLFNHA), Child
Health (PHO, Heather Manson)
Interests Aboriginal health, global health, primary health care Contact information [email protected]
Pamela Leece – 2015 Graduate
PHPM Orientation Manual - July 2016 | 52
Clinical St. Joseph's Health Centre
Graduate MSc - Health Research Methodology, McMaster University (2003-05)
Field CD - TPH, Dr. Herveen Sachdeva; EH - PHO, Dr. Ray Copes; Policy -
University of Toronto, Dr. Michael Rachlis
Electives Program Evaluation - TPH, Dr. Rita Shahin; Addictions (Clinical) – multiple
sites
Interests addictions, inner city health, research
Contact information [email protected]
Parisa Airia – 2014 Graduate
Clinical CVH
Graduate PhD, UofT
Field Halton, Peel
Electives Research
Interests Cancer epi
Contact information [email protected]
Christine Navarro – 2014 Graduate
Clinical St. Michael's Hospital
Graduate MSc Epidemiology, University of Ottawa, 2001
Field Communicable Diseases (TPH, Vinita Dubey), Environmental Health (TPH,
Howard Shapiro), Chronic Diseases & Health Promotion (PHO, Heather
Manson), Elective in Environmental Health (PHO, Ray Copes), Senior
Management (Peel Region)
Electives
Interests
Contact information [email protected]
Aaron Orkin – 2014 Graduate
Clinical NOSM - Thunder Bay, Sioux Lookout, Marathon Ontario
Graduate MSc, History of Medicine, Science and Technology, University of Oxford,
2010. MPH, Epidemiology, University of Toronto, 2013.
Field HPAPCD: Dalla Lana School of Public Health, Supervisor Dr. Donald Cole.
CD: Toronto Public Health, Supervisor Dr. Lisa Berger. Enviro Health: Public
Health Ontario, Supervisor Dr. Ray Copes. Senior Management: Toronto
Public Health, Supervisor Dr. Barbara Yaffe
Electives
Interests Medical and public health epistemology, rural and remote health, health equity,
disease mongering, emergency medicine/family medicine/public health
interfaces, advocacy, cooking, bicycles, golden doodles.
Contact information [email protected]
Nikhil Rajaram – 2014 Graduate
Clinical St. Joseph's Health Centre
Graduate MPH (Epidemiology), University of Toronto, 2011-2012
Field Intro to Public Health ( EH - public health ontario, Ray Copes), EH (Toronto
Public Health, Howard Shapiro), CDC (Toronto Public Health, Vinita Dubey),
PPCD (Public Health Agency of Canada, Karen Grimsrud), SMR (Simcoe
Muskoka DHU, Charles Gardner)
PHPM Orientation Manual - July 2016 | 53
Electives
Interests environmental health, other stuff perhaps
Contact information [email protected]
JinHee Kim – 2013 Graduate
Clinical St. Joseph's Health Centre
Graduate Toronto
Field Peel (CDC, SM), PHO (EH), Dr. Michael Rachlis (PPCD)
Electives PHO (EH), PHAC (Canadian Field Epi Affiliate), ICES (research)
Interests Environmental health, urban form and health, CDC
Contact information [email protected]
Shovita Padhi – 2013 Graduate
Clinical St. Michael's Hospital
Graduate MPH - University of Toronto, 2011
Field Toronto Public Health - Environmental Health, Communicable Disease,
Chronic Disease, Policy and Planning and Senior Management
Electives Public Health Ontario - Emergency Management, Vaccine Preventable
Diseases, Environmental Health; Gov't of the Northwest Territories - Elective;
Saskatoon Health Region - Senior Management Elective; National
Collaborating Centre for Methods and Tools - Knowledge Translation Elective
Interests Early Childhood Development, Built Environment, Chronic Disease
Prevention, Aboriginal Health, Newcomer Health
Contact information [email protected]
Michael Schwandt – 2013 Graduate
Clinical Women's College Hospital
Graduate MPH, Harvard School of Public Health
Field Public Health Ontario (Environmental Health, Chronic Disease, Senior
Management), Toronto Public Health (Communicable Disease)
Electives Dignitas International (Malawi), Clinton Health Access Initiative (Rwanda),
various research projects
Interests Global health, social determinants of health, health equity, HIV prevention,
sexual and reproductive health, epidemiology, research methodology
Contact information [email protected]
Ryan Sommers – 2012 Graduate
Clinical Dalhousie Medical School, Family Medicine, Northumberland Family
Medicine Training Unit (2006 – 2008)
Graduate Community Health, Dalhousie University
Field CD – Capital District Health Authority, Halifax, NS, Health Policy & Chronic
Disease - Capital District Health Authority, Halifax, NS, Environmental Health
– Simcoe Muskoka District Health Unit, Barrie, Ontario
Electives National Collaborating Centre for the Determinants of Health (NCCDH) –
Antigonish, NS, Canadian Centre for Vaccinology – Halifax, NS
Interests Chronic Disease Prevention, Integration of Primary Care and Public Health,
Health Education / Health Promotion, Policy Analysis
Contact information [email protected]
Liane Macdonald - 2012 Graduate
Clinical Core: Hamilton Health Sciences Centre, St Joseph's Hospital (Hamilton),
Hamilton General Hospital; Elective: Toronto Western Hospital (TB Clinic),
PHPM Orientation Manual - July 2016 | 54
Lawrence Heights CHC, Centre Francophone CHC, Mount Sinai Hospital
Medical Microbiology
Graduate London School of Hygiene and Tropical Medicine
Field CDC (Toronto Public Health), Environmental Health (TPH), Policy, Planning
and Chronic Diseases (Cancer Care Ontario), Senior Management and
Administration (TPH)
Electives First Nations and Inuit Health (First Nations and Inuit Health - Ontario Region
/ University of Toronto); Academic (LSHTM); Surveillance/VPD (Upcoming
at OAHPP); Canadian Field Epidemiology Program Community Medicine
Affiliate position (Upcoming)
Interests Lots!!, including but certainly not limited to public health policy, vaccine-
preventable diseases, globalization and public health
Contact information [email protected]
Clarence Clottey – 2012 Graduate
Clinical CCFP (Family Medicine) St. Michael’s Hospital
Graduate MPH (International Health), Harvard School of Public Health
Field CD -- Halton Health Region; EH - Halton Health Region, Planning and Policy
– OAHPP; Senior Management –MOHLTC
Electives Occupational Medicine (St. Michael's Hospital- Dr. Ron House)
Interests Chronic disease policy, global health, evidence-based public health, health
promotion, smoking control
Contact information [email protected]
Lawrence Loh – 2012 Graduate
Clinical St. Michael's Hospital (2006 – 2008)
Graduate MPH, Johns Hopkins Bloomberg SPH (2009 – 2010)
Field Environmental Health (Ray Copes, OAHPP), Communicable Disease (Irene
Armstrong, TPH), Policy, Planning and Chronic Disease (Rachel Rodin,
PHAC), Senior Management (David Mowat, Peel Region), Research (Eileen
de Villa, Peel and Bart Harvey, UoT)
Scheduled: Senior Management (David Mowat, Peel)
Electives China (PGY-1, FM) and Costa Rica (PGY-1, FM/PH)
Pan-American Health Organisation, Health System Strengthening unit (May
2009)
World Health Organisation Human Resources for Health Unit (Mar-May 2011)
Foundation for the Advancement of Medical Education and Research
(FAIMER, Jun 2011), New York City Department of Health and Mental
Hygiene, Built Environment Unit
Interests Professional: global health, particularly human resources for health
(training/education, global health careers, and health care worker retention and
migration), coordination of care abroad, emergency preparedness, urban
health, clinical medicine Personal: music (guitar and piano), drama, writing,
running, history, geography, religions/philosophy, travelling and world affairs,
politics, networking
Contact information [email protected]
Hamidah Meghani – 2012 Graduate
Clinical CCFP (Family Medicine) St. Michael’s Hospital
Graduate Columbia University Mailman School of Public Health (NYC)
Field CD/EH - Halton Public Health, CDPP/EH - NYC Department of Health
Electives
Interests Sexual and Reproductive Health, HPV vaccine acceptability
Contact information [email protected]
PHPM Orientation Manual - July 2016 | 55
Michelle Murti - 2012 Graduate
Clinical Women's College Hospital
Graduate MPH U Toronto
Field EH - TPH with Dr. Shapiro; CD - TPH with Dr., PnP = Public Health Ontario,
Senior Management – Toronto Public Health, Sachdeva (both of these done as
a practicum placement during the MPH);
Electives NWT with their CMOH; alPHa with Linda Steward/Dr. Sutcliffe; EH at the
OAHPP
Interests Environmental health, integration of PH and primary care, Going to CDC for
EIS fellowship in Environmental Health
Contact information [email protected]
Donatus Mutasingwa – 2012 Graduate
Clinical Family Medicine at Sunnybrook Hospital 2008-2010
Graduate Masters of Philosophy (Health Promotion) -University of Bergen, Norway
PHD-UNIVERSITY OF CALGARY (EPIDEMIOLOGY)
Field ENVIRONMENTAL HEALTH (PUBLIC HEALTH ONTARIO), COMMUNICABLE
DISEASE (TPH), POLICY, PLANNING AND CHRONIC DISEASE (PUBLIC HEALTH
ONTARIO), STARTING SENIOR MANAGEMENT (DURHAM REGION)
Electives ICES
Interests RIGINAL HEALTH, GLOBAL HEALTH, USING LARGE ADMINISTRATIVE
DATABASES FOR VARIOUS PUBLIC HEALTH PURPOSES, DEVELOPMENT OF
BUSINESS INTELLIGENCE TOOLS FOR HEALTH ASSESSMENT AND SURVEILLANCE
Other: Worked as an Epidemiologist with Health Canada (First Nations and
Inuit Health, Alberta Region), 2006-2008 , Also worked as Medical Incharge
in Refugee Camps in Kigoma, Tanzania, Born in Tanzania, Married, has two
lovely girls
Contact information [email protected]
Peter Tanuspetro – 2012 Graduate
Clinical St. Michael’s Hospital
Graduate MHSc Community Health and Epidemiology, University of Toronto
Field CD - Simcoe Muskoka District Health Unit, EH – OAHPP, Senior,
Management – SMDHU, Policy - OAHPP
Electives
Interests Health services research, health of refugees and immigrants, mental health
research
Contact information [email protected]
Fiona Kouyoumdjian – 2011 Graduate
Clinical Family Medicine, Toronto Western Hospital
Graduate John Hopkins for MPH during medical school from 2002 – 2003, then Dalla
Lana School for Public Health for PhD in Epidemiology starting in 2007
Field Halton Public Health for Intro to Public Health Unit, Peel Public Health for
CD, Baltimore Health Department for Policy, First Nations Inuit Health for
Environmental Health, Hamilton Public Health for Senior Management
Electives OAHPP= Michael Gardam with a focus on TB
Interests Communicable diseases in marginalized populations, incarcerated persons,
violence, global health
Contact information [email protected]
Hong Ge – 2011 Graduate
PHPM Orientation Manual - July 2016 | 56
Clinical Training: Sunnybrook 2008-2010
Graduate Training: MHSc of Community Health and Epidemiology, UofT, 2000-2002
Field Based Rotations: CDC, Toronto Public Health, Dr. Irene Armstrong
Healthy Environment, Toronto Public Health, Dr. Howard Shapiro
Planning and Policy, Toronto Public Health, Dr. Rosana Pellizzari
Senior management: Durham Region Health Department, Dr. Robert Kyle
Electives: Research, ICES, Dr. Jeff Kwong, Durham Region Health Department, Dr. Robert Kyle
Family medicine, Davenport Perth Community Health Care Centre
Interests: Professional: epidemiology, international health, information technology, public health
practice in local public health units
Personal: spending time with twin children and family
Contact: [email protected]
Monica Hau – 2011 Graduate
Clinical Training: St. Michael’s Hospital
Graduate Training: MSc Public Health, London School of Hygiene and Tropical Medicine
Field Based Rotations: Environmental Health, Toronto Public Health; Chronic Disease, Planning and Policy,
Cancer Care Ontario; CDC, Peel Public Health
Electives: (Medical Student), Public Health Agency of Canada-Centre for Chronic Diseases and
Prevention Control- Dr. Gregory Taylor, MSc summer project in Gulu, northern Uganda
on gender-based violence
Interests: public health education, medical student recruitment into Community Medicine, Global
health, homelessness, Aboriginal and Inuit health, gender-based violence
Contact: [email protected]
Andrew Pinto – 2011 Graduate
Clinical Training: St. Michael’s Hospital
Graduate Training: MSc (Health Policy, Planning & Financing) at London School of Hygiene and Tropical
Medicine and London School of Economics
Field Based Rotations: CDC (TPH), HP/CD (OAHPP), Environmental health (OAHPP), Senior Management
(Peel Public Health)
Electives: Research on gun violence (El Salvador); Policy/Planning (Zomba, Malawi)
Interests: global health, health equity, Aboriginal health, peace activism, political
economy, ethics, food security
Interests: Research on gun violence (El Salvador); Policy/Planning (Zomba, Malawi)
Interests: global health, health equity, Aboriginal health, peace activism, political
economy, ethics, food security
Contact: [email protected]
Lynda Earle – 2011 Graduate
Clinical Training: FAMILY MEDICINE NORTH: NWO (THUNDER BAY), MCMASTER UNIVERSITY
Graduate Training: MPH, UNIVERSITY OF WATERLOO
Field Based Rotations: Policy: Capital Public Health, Nova Scotia, Dr. Watson-Creed
Environmental Health: Sudbury & District Health Unit, Dr. Sutcliffe
CDC: Capital Public Health, Nova Scotia, Dr. Watson-Creed
MANAGEMENT & ADMINISTRATION: PUBLIC HEALTH SERVICES:SOUTH SHORE,
ANNAPOLIS VALLEY AND SOUTHWEST DISTRICT HEALTH AUTHORITIES, NOVA SCOTIA,
DR. GOULD
Electives: NATIONAL COLLABORATING CENTRE FOR DETERMINANTS OF HEALTH, CHRONIC
DISEASE & INJURY: (ALCOHOL INDICATORS): DR. WATSON-CREED, CAPITAL DHA, NS
Interests: Professional: health disparities and social justice
PERSONAL: MY CHILDREN AND FAMILY, READING, SAILING, COOKING AND SPENDING
TIME WITH FRIENDS
Contact: [email protected]
PHPM Orientation Manual - July 2016 | 57
APPENDIX E: Field Rotation Planning, Expectations, and
Assessment
Field Rotation Overview
Core Field Rotations: (18 blocks)
Introduction to Public Health Practice (1 block)
● Requirements may be modified by Program Director, depending on Public Health practice experience
Communicable Disease Control (3 blocks)
● Must include local public health experience and on-call responsibilities
Environmental Health (3 blocks)
● Must include field inspections (unless completed elsewhere), environmental health assessment.
Health Policy, Systems and Planning (2-3 blocks)*
● Must include policy analysis, policy development, and policy implementation.
Chronic Disease, Health Promotion and Injury Prevention (2-3 blocks)*
● May be combined with planning and policy rotation if appropriate.
Senior Management (6 blocks)
● Can only be completed after at least 3 core rotations
Notes:
● One block is 4 weeks.
● * A minimum of 2 blocks is required for the chronic disease and policy rotations, but a resident can opt to extend
either one to 3 months, upon discussion with the Program Director
● All core rotations must be completed at accredited sites.
● Core rotations, other than Introduction to Public Health Practice, must be completed following graduate training.
● Residents are expected to have on-call responsibilities for at least 2 rotations (usually CD and EH or SM)
Elective Rotations: (6-8 blocks)
A resident may choose to pursue an elective of their choice or may pursue a structured elective, which may include but are not
limited to:
- Occupational Health - Clinical Public Health - Infection Prevention & Control
- Aboriginal Health - Population Health Research
- Global Health - Immigrant/Refugee Health
Notes:
● Elective rotations may be done at any accredited site
● A maximum of 3 blocks may be done in an unaccredited site
PHPM Orientation Manual - July 2016 | 58
Accredited Training Sites
The Royal College allows training sites to be designated as either accredited or non-accredited. The practical implication of this
is that residents are limited to 3 blocks of field training at non-accredited sites. Accredited sites must undergo a review and sign
an agreement of affiliation to the program to be designated accredited. Accredited training sites currently include:
● Toronto Public Health
● Peel Public Health
● Durham Region Health Department
● Halton Region Public Health Unit
● Simcoe Muskoka District Health Unit
● Middlesex London Health Unit
● Haliburton Kawartha Pineridge Health Unit
● Ontario Ministry of Health and Long Term Care's Public Health Division
● Canadian Partnership Against Cancer (updated Sept 2014)
● York Region Public Health Unit (updated June 2016)
● Public Health Ontario (PHO) formerly Ontario Agency for Health Protection and Promotion
● Public Health Agency of Canada (through the University of Ottawa only)
● Sites affiliated with Memorial University in St. John’s, Newfoundland and Capital Health Public Health Services in
Halifax, Nova Scotia
In addition, residents may complete training at any accredited training sites of the other Canadian Public Health and Preventive
Medicine Residency Programs (e.g. NOSM) with agreement of both programs.
Rotation Planning and Development
Rotation Planning As part of ongoing discussions with PD/APD regarding overall residency planning, the resident will identify preference for
site/supervisor for core rotations at least 3 months prior to commencement of each rotation. The resident should consult with the
PD/APD, faculty and other residents to identify site/supervisor options. The resident will contact the supervisor or site
coordinator to discuss the possibility of the rotation and keep the PD and program assistant informed of these discussions. The
supervisor and site coordinator will keep each other informed as to other requests, back up supervision and capacity issues.
The resident will review the program objectives for the rotation and begin to develop and document their personal objectives
well before each field rotation begins. These objectives will be based on the revised (2014) PHPM CanMEDs objectives of
training and the program’s general and rotation specific objectives. Each resident’s objectives document and should be tailored
to help each resident achieve their personal learning goals.
Supervision
Core rotation supervisors should have Royal College Fellowship Certification in Public Health and Preventive Medicine or
equivalent and a faculty appointment with Dalla Lana School of Public Health. If this is not feasible then linkages must be made
with the site coordinator who does have certification and a faculty appointment. Elective supervisors should have the equivalent
of fellowship certification, and a faculty appointment.
The resident will ensure, prior to confirmation of the rotation, that the supervisor can accommodate program and personal
activities such as part-time status, academic half days, special call requests, program roles such as chief or resident
representative as well as vacation and personal situations.
The resident and supervisor will discuss on-call expectations prior to commencing the rotation, if possible or in the orientation.
Residents are expected to be on call for the CD rotation and wherever possible, it is recommended residents be on call for the EH or senior management rotation as well.
The supervisor will make arrangements for adequate space and equipment required to ensure that the resident can function
optimally during the placement. The supervisor should make arrangements for an orientation to the rotation and the host
PHPM Orientation Manual - July 2016 | 59
organization/agency during the first week of the rotation. The supervisor and resident should discuss the frequency of planned
structured teaching, mentorship, informal and formal feedback.
Personal Learning Objectives Once the resident and supervisor have agreed to the placement, the resident will send the supervisor:
● Draft personal learning objectives
● Program objectives for the rotation, in CanMEDS format.
o Examples of rotation specific objectives will be available on Portal and residents are encouraged to consult
more senior residents or chief residents for guidance.
● Rotation specific assessment/evaluation forms (i.e. ITERs) OR REVIEW THESE PRIOR TO THE ROTATION
● For faculty who do not regularly supervise residents, the resident should also send a link to CPSO Supervision
guidelines: Professional Responsibilities in Postgraduate Medical Education
http://cpso.on.ca/policies/policies/default.aspx?id=1846&terms=postgraduate
The resident and supervisor will discuss and sign off on the personal and program objectives prior to the start of the rotation.
The resident will send a copy of the rotation objectives to the Program Director and program assistant for the resident’s file. The
resident must also inform the program assistant to update POWER regarding the rotation type, dates and supervisor.
Note that all PHPM residents at the University of Toronto have an educational or general license and are covered under CMPA.
This is a requirement of registration with the Post-Graduate Medical Education office.
Rotation Expectations
Resident Expectations During the rotation, the resident shall:
● Attend and participate in appropriate agency meetings.
● Interact with appropriate senior staff employed by or working with the agency/organization
● Participate in field activities with front line staff employed by or working with the agency/organization
● Respond to and manage questions and issues from the agency/organization staff and/or the community (e.g. community
physicians, teachers, school principals, the public, etc.), with supervision that is appropriate for the resident’s level of
training.
● Communicate re: any absences, whether planned or unintended with relevant stakeholders (e.g. AMOH, Manager, and
other staff closely involved in resident’s day to day work)
● Accept and manage INCREASING RESPONSIBILITY AND AUTHORITY THROUGHOUT THE ROTATION.
On-Call:
● The resident is expected to be on call for the CD rotation and wherever possible, it is recommended residents be on
call for the EH or senior management rotation as well.
● Residents may cover call for other core and elective rotations.
● Residents receive the call stipend for this.
● The rotation cycle in health units are for 7 days of home call, an average of once per 4-week block. Deviation from
this cycle will require permission from the Program Director.
● Clinical work during on-call hours is not permitted
Absence from Rotations Due to Program Activities:
● The resident is expected to attend the academic half-day on Friday mornings (8:30am-12pm), in person or by
teleconference.
● The resident is expected to return back to their rotation site in the afternoon.
● Residents may be required to participate in occasional full day program activities such as program exams, Media Day,
etc… Residents must discuss these absences with their supervisor in advance.
● Chief residents and other residents may have other program-related meetings and duties on Friday afternoons. These should be discussed in advance with supervisors.
● In exceptional circumstances the supervisor and resident may agree that the time and distance required to return to the
site would be onerous. In such cases, rotation duties can be fulfilled by distance on Friday afternoons.
PHPM Orientation Manual - July 2016 | 60
Supervisor Expectations The supervisor shall:
● Assist the resident in developing placement-specific educational objectives, which will form the basis of the mid- and
end-of-rotation in-training evaluations (ITERs).
● Ensure that the resident receives an orientation to the rotation and the agency/organization.
● Negotiate with the resident a "work plan" which will enable the resident to meet her/his proposed educational
objectives within site context. Note: the work-plan is usually based on the objectives document.
● Supervise and provide feedback on a mutually agreed upon project during the rotation (policy/procedure, in-training,
article, rounds etc…), if appropriate.
o Projects at the local public health level should not be more than 30% of resident time, particularly for CD, EH,
and SMR.
o Projects at provincial, federal or academic sites should not be more than 50% of resident time (this does not
include electives/selectives with a research focus).
o The scope and duration of the project should not require a resident to continue the project beyond the time of
their rotation. Projects must be limited to the duration of the rotation.
● Provide adequate supervision of the resident with regards to meeting the placement-specific educational objectives,
especially responding to and managing community medicine questions from agency/organization staff and the
community (e.g. community physicians, teachers, school principals, the public, etc.)
● Provide the resident with INCREASING responsibility and authority throughout the rotation.
● Meet regularly (at least weekly) with the resident and undertake the following:
o Provide formal teaching.
o Informal (or formal) discussion of resident performance, progress and plans for the upcoming week.
o Discuss resident concerns regarding the meeting of program and personal objectives.
● Conduct mid- and end-of-rotation in-training evaluations of the resident, (As per the Royal College of Physicians and
Surgeons of Canada Guidelines). See below.
Assessment and Evaluation
Assessment ● The resident shall be assessed using the personal and program objectives agreed to at the outset of the rotation.
● The formal resident assessment must use the Royal College of Physicians and Surgeons of Canada Guidelines and the
rotation specific In-Training Evaluation Report (ITER) Form on POWER.
● For 3-block rotations, the mid term evaluation may be verbal but in the near future there will be a brief mid-term ITER
to be submitted via POWER.
● For longer rotations a formal written ITER should be completed at the mid-point and end-point of the rotation.
● Significant concerns identified at mid-term assessment must be communicated in writing to the Program Director.
● End-of-rotation evaluations will include a full discussion of the evaluation with the resident before being submitted on
POWER. The end-of-rotation evaluations should be submitted by the last day of the rotation.
● Once completed on POWER, the resident must send/give the assessment/evaluation record to the Program Assistant to
be reviewed by the Program Director prior to filing.
Evaluation
The resident must evaluate the placement and supervisor using the "Resident Placement Evaluation Form" and the “Supervisor
Evaluation form.”
PHPM Orientation Manual - July 2016 | 61
APPENDIX F: Resident Portfolio Template
University of Toronto
Public Health and Preventive Medicine Residency Program
Resident Portfolio Template
Resident Name:
Duration of Training:
Date of Entry into Program:
Date of RC Exam:
Expected Date of Exit of Program:
Leaves of Absence
Part time Training
Family Medicine Training:
FM Training Dates
FM Training Site
FM Training Supervisor
Quality Improvement Project
DFCM Academic Project
Other DFCM Training/Accomplishments
Graduate Training:
Dates Degree Institution Area of Specialization/Emphasis
Prior Graduate
Training
PHPM Graduate
Training
Other Graduate
Training
Other
Coursework/
Training
PHPM Orientation Manual - July 2016 | 62
Field Training:
Rotation
Site
Supervisor
Duration
[Fulltime] Activities/Deliverables
Communicable
Disease eg: outbreaks investigated.
Environmental
Health eg:HIA performed.
Chronic
Disease, Policy
& Planning
eg: policy analysed
Senior
Management eg: budgets reviewed, meeting chaired,
change managed.
[Elective 1]
[Elective 2]
[Elective 3]
[Elective 4]
Academic Half Day Contributions
Event Date Topic
[Media/Research Day
organization]
[Rounds]
[Rounds]
[Topic of the Week]
Other Achievements
Research/Publications
Title Content Area Journal/Conference/Institution Citation
Media
Title Date Media Outlet Content Area
PHPM Orientation Manual - July 2016 | 63
Education/Teaching
Educational Role Topic/Course/Presentation Institution/Audience
Leadership
Leadership Role Dates Specific Achievements
Chief Resident
[Other]
[Other]
Other Co-Curricular Activities
Role/Event Date Achievements Learning Objectives Met
NB: This is a template for your portfolio, but is not the portfolio itself. This template will be used as your Final
In-Training Evaluation Report (FITER) Summary. It is in your interested to keep it updated
PHPM Orientation Manual - July 2016 | 64
APPENDIX G: Objectives of Training in Public Health &
Preventive Medicine (2014)
Public Health and Preventive Medicine is the medical specialty primarily concerned with the health of
populations. The discipline’s focus is disease and injury prevention and control, which is achieved through
health protection and health promotion activities. A Public Health and Preventive Medicine specialist monitors
and assesses the health needs of a population and develops, implements, and evaluates strategies for improving
health and well-being through interdisciplinary and intersectoral partnerships.
Building on foundational competencies in clinical medicine and the determinants of health, the Public Health
and Preventive Medicine specialist demonstrates competencies in public health sciences, including but not
limited to epidemiology, biostatistics, and surveillance, planning, implementation and evaluation of programs
and policies, leadership, collaboration, advocacy, and communication. These competencies are applied to a
broad range of acute and chronic health issues affecting a population, including those that may be related to
environmental exposures.
The Public Health and Preventive Medicine specialist may pursue and engage in a number of different types of
careers in a variety of settings including but not limited to:
• a municipal, regional, provincial, or federal government
• an international inter-governmental organization
• a non-profit or private sector health or social services organization
• a community-oriented clinical practice with an emphasis on health promotion, disease prevention, and
primary health care
• in an academic environment as a researcher, scholar, or educator
Within these diverse settings, a Public Health and Preventive Medicine specialist may be a consultant, advisor,
medical health officer, executive, manager, researcher, scholar, or educator.
GOALS
Public Health and Preventive Medicine residents must demonstrate comprehensive knowledge of the science and art of Public
Health and Preventive Medicine, and the skills to apply this knowledge to a broad range of population health
issues in the socioeconomic, political, and environmental contexts in which they occur. Residents must
demonstrate the knowledge, skills, and attitudes related to assessing the determinants of health, including but
not limited to income, environment, gender, education, social support systems, health behaviours, and access to
health care, of the populations with which they work. Further, residents must demonstrate competence in
incorporating these determinants of health into research methodology, data presentation and analyses as well as
in strategies that will improve the health of these populations.
Upon completion of training, a resident is expected to be a competent specialist in Public Health and Preventive
Medicine capable of assuming a public health leadership and management role in a health-related organization,
including as a consultant in the specialty. The resident must demonstrate a working knowledge of the theoretical
basis of the specialty, including its foundations in the clinical sciences, public health sciences, and humanities.
Residents must demonstrate the requisite knowledge, skills and attitudes to effectively provide community-
focused care to diverse populations. In all aspects of specialist practice, the resident must be able to address
issues relating to the determinants of health in a professional, ethical manner. In addition, residents are
encouraged to have developed a higher level of expertise in one of the core fields, including but not limited to
communicable disease, environmental health, chronic disease, and to acquire competency in an area of practice
PHPM Orientation Manual - July 2016 | 65
relevant to their own professional and personal development objectives, including but not limited to education;
global health; leadership, management and administration; and occupational health.
PUBLIC HEALTH AND PREVENTIVE MEDICINE COMPETENCIES At the completion of training, the resident will have acquired the following competencies and will function
effectively as a:
Medical Expert Definition:
As Medical Experts, Public Health and Preventive Medicine specialists integrate all of the CanMEDS Roles,
applying medical knowledge, clinical and public health skills, and professional attitudes in their provision of
care at the individual, family, group, organization, community, and population levels. Medical Expert is the
central physician role in the CanMEDS framework.
Key and Enabling Competencies: Public Health and Preventive Medicine Specialists are able to...
1. Function effectively as consultants, integrating all of the CanMEDS Roles to provide optimal, ethical
care at the individual, family, group, organization, community and population levels
1.1. Perform a consultation effectively, including the presentation of well-documented assessments and
recommendations in written and/or oral form, in response to a request from a variety of sources
1.1.1. Clarify the nature of the request and establish, negotiating where required, the desired deliverables
when called upon for advice
1.1.2. Collect and interpret information efficiently and appropriate to the request
1.1.3. Formulate clear and realistic recommendations
1.1.4. Communicate the assessment and recommendations in a manner (oral, written or both) that is
most suitable to the given circumstances
1.1.5. Assess the implementation or impact of recommendations
1.2. Demonstrate use of all CanMEDS competencies relevant to Public Health and Preventive Medicine
1.3. Identify and appropriately respond to relevant ethical issues arising in the care of individuals, families,
groups, organizations, communities and populations
1.4. Demonstrate the ability to prioritize professional duties effectively and appropriately when faced with
multiple issues and problems
1.5. Demonstrate compassionate care at the individual, family, group, organization, community and population
levels
1.6. Recognize and respond to the ethical dimensions in public health and relevant clinical decision-making
1.7. Demonstrate medical expertise in situations other than patient care, such as providing expert legal
testimony and advising governments
2. Establish and maintain medical knowledge, skills and behaviour appropriate to Public Health and
Preventive Medicine
2.1. Apply knowledge of the fundamental biomedical, clinical, and public health sciences relevant to Public
PHPM Orientation Manual - July 2016 | 66
Health and Preventive Medicine practice
2.1.1. Describe the natural history, epidemiology, risk factors and health burden of the major
communicable and non-communicable diseases, including injury, of public health significance
2.1.2. Apply knowledge of the principles of:
2.1.2.1. Disease and injury prevention and control
2.1.2.2. Health and disease surveillance
2.1.2.3. Health protection 2.1.2.4. Health promotion
2.1.2.5. Population health assessment
2.1.3. Describe the principles of infection control and their application to effective and appropriate
procedures and policies to reduce risk
2.1.4. Describe the general principles of emergency planning and incident management
2.1.5. Discuss knowledge translation and social marketing strategies as relevant to the promotion of
health
2.1.6. Describe the analytic tests and methods used to explain differences in health and health related
behaviours including but not limited to:
2.1.6.1. Analysis of variance (ANOVA)
2.1.6.2. Chi- square
2.1.6.3. Forecasting
2.1.6.4. Geospatial analysis
2.1.6.5. Kappa correlation
2.1.6.6. Life tables
2.1.6.7. Logistic regression
2.1.6.8. Modeling
2.1.6.9. Survival analysis
2.1.6.10. T-test
2.1.7. Describe the methods used to explore knowledge, attitudes, beliefs and behaviours and public health
interventions including but not limited to:
2.1.7.1. Delphi process
2.1.7.2. Focus group
2.1.7.3. Key informant surveys
2.1.7.4. Nominal group
2.1.7.5. Participant observation
2.1.7.6. Social network analysis
2.2. Describe the CanMEDS framework of competencies relevant to Public Health and Preventive Medicine
2.3. Apply lifelong learning skills of the Scholar Role to implement a personal program to keep up-to-date,
enhance areas of professional competence, and maintain specialty certification
2.4. Integrate the available best evidence and best practices to enhance the quality of care and patient and
program safety in Public Health and Preventive Medicine
PHPM Orientation Manual - July 2016 | 67
3. Perform a complete and appropriate assessment at the individual, family, group, organization,
community, and population levels
3.1. Perform a health needs assessment for a defined population for a specific purpose using appropriate
methods (qualitative, quantitative or both) that are relevant, concise and reflective of context and preferences,
describe the results of such an assessment, and make recommendations for action
3.1.1. Analyze population level data in order to assess health status, health inequalities, determinants,
and different needs to support prioritization of action
3.1.2. Use and interpret information from a range of sources, including but not limited to, mortality,
hospital admission, census, primary care, communicable diseases, cancer registries, reproductive and
sexual health data, and health surveys, to support public health activities in an evidence informed,
resource-effective and ethical manner
3.1.3. Use a range of methods to assess morbidity and burden of disease within and between
populations
3.2. Identify and explore health issues effectively, including context, preferences, and values
3.2.1. Define, develop, select and interpret relevant social, demographic, and health indicators from a
variety of data sources including but not limited to vital statistics, administrative databases, registries,
and surveys.
3.2.1.1. Discuss and take into account the limitations in these data sets and their use
3.2.2. Identify and interpret the impact of health behaviours of individuals, groups and
populations, particularly with respect to nutrition, physical activity, use of tobacco and other
substances, sexuality, risk taking, immunization, and participation in recommended prevention
and screening programs
3.3. Conduct an assessment that is relevant, concise and reflective of context and preferences for the purposes of
Public Health and Preventive Medicine.
3.3.1. Organize and analyze data, meta-data, information and knowledge using information technology
as appropriate
3.3.2. Appraise the validity and relevance of data and data systems in order to assess their quality and
appropriateness for purpose
3.3.3. Use data with consideration of the legal and ethical aspects of data collection, manipulation,
retention, and release in order to balance societal benefit with individual privacy
3.3.4. Integrate different types of data, using complex data sets or data from a variety of sources, to
draw appropriate conclusions
3.3.5. Discuss and apply guidelines for assessing causality, using Koch’s postulates and Bradford-Hill
criteria
3.4. Select appropriate investigative methods which are evidence informed, resource- effective and ethical
3.4.1. Identify, select and interpret biological risk markers including but not limited to age, sex, race,
genetic makeup
3.4.2. Select, discuss and demonstrate an understanding of the socio-economic, political, and
environmental factors, relevant to investigate a given context, including but not limited to:
3.4.2.1. Distribution of wealth and power
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3.4.2.2. Urbanization
3.4.2.3. Industrialization
3.4.2.4. Social attitudes and values
3.4.2.5. Immigration policies
3.4.3. Select, discuss and demonstrate an understanding of physical environmental factors, including but
not limited to:
3.4.3.1. Hazardous emission and spills
3.4.3.2. Noise
3.4.3.3. Air and water pollutants
3.4.3.4. Natural disasters
3.4.3.5. Effects of climate change that are relevant to investigate a given health context
(individual, local, regional, provincial, national, global)
3.4.4. Apply and interpret appropriate quantitative methods and analytic tests to explain differences in
health and health related behaviours, including but not limited to:
3.4.4.1. Life tables
3.4.4.2. Survival analysis
3.4.4.3. T-test
3.4.4.4. ANOVA (Analysis of Variance)
3.4.4.5. Chi- square
3.4.4.6. Logistic regression
3.4.4.7. Kappa
3.4.4.8. Correlation
3.4.5. Interpret appropriate quantitative methods and analytic tests to explain differences in health and
health related behaviours, including but not limited to:
3.4.5.1. Modelling
3.4.5.2. Forecasting
3.4.5.3. Geospatial analysis
3.4.6. Apply and interpret qualitative methods to explore knowledge, attitudes, beliefs and behaviours
and public health interventions, including but not limited to:
3.4.6.1. Participant observation
3.4.6.2. Key informant surveys
3.4.6.3. Nominal group
3.4.6.4. Focus group
3.4.6.5. Delphi process
3.4.6.6. Social network analysis and applicable approaches
3.5. Demonstrate effective problem-solving and judgment in addressing health problems, including interpreting
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available data and integrating information to develop and implement management plans
3.5.1. Perform an assessment of the health impact of a policy or project for a defined population and
make recommendations
3.5.2. Use evidence from health and non-health sources, including qualitative and quantitative studies,
to answer a defined question, taking into account relative strengths and weaknesses of evidence used
3.5.3. Use an appropriate framework to critically appraise evidence, including but not limited to
ecological, qualitative, etiological, interventional, and economic studies
3.5.4. Use an economic analysis including but not limited to cost-benefit, cost- effectiveness and cost-
utility in the assessment of a health issue and proposed intervention options
3.5.5. Formulate a balanced, evidence-informed recommendation explaining key public health concepts
using appropriate reasoning, judgement and analytic skills for a public health setting
3.5.6. Ascertain, in a timely fashion, key public health information from a range of documents,
including but not limited to briefings, policies, and news reports, and use it appropriately and in relation
to wider public health knowledge
3.5.7. Incorporate relevant legal and ethical frameworks into assessment of evidence
4. Design and effectively implement and evaluate primary, secondary, and tertiary interventions relevant
to Public Health and Preventive Medicine
4.1. Plan and design an intervention management plan in collaboration with individuals, families, groups,
organizations, communities, or populations
4.1.1. Debate the relative importance of individual and societal decisions for health and ethical issues
related to public health practice
4.1.2. Discuss the theories of community development
4.1.3. Discuss the strengths and weaknesses of health promotion interventions directed at populations
including but not limited to social marketing, healthy public policy and harm reduction
4.1.4. Communicate the need for health promotion strategies in a defined community, presenting a case
for action/inaction in response to the presenting health problem
4.1.5. Develop a plan to address a health need in a defined community making clear the theoretical base
for a proposal and developing a business case for an activity with consideration to the strengths and
weaknesses of health promotion interventions
4.1.6. Apply the theoretical models of behaviour change to the general population, high risk and hard to
reach groups
4.1.6.1. Identify and demonstrate an understanding of factors that influence the potential for
change in a given context and population
4.1.7. Apply knowledge translation and social marketing to encourage the application of best
practices
4.2. Demonstrate effective, appropriate, and timely performance of interventions relevant to Public Health and
Preventive Medicine
4.2.1. Advise on and co-ordinate public health action in the light of existing local, provincial, and
national policies and guidelines
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4.2.2. Describe the general principles of emergency planning and incident management
4.2.3. Contribute to the development and utilization of a community, provincial, or federal emergency
preparedness plan, including but not limited to measures to prevent and manage exposure to biological
and chemical agents, and radiation-emitting agents and devices
4.2.4. Lead or take a major role in the investigation and management of a significant incident, including
but not limited to a communicable disease outbreak, non-infectious disease incident, or a look back
4.2.5. Contribute to the formulation of healthy public policy or legislation at local, provincial or federal
level
4.2.6. Lead or make a significant contribution to a major public health campaign demonstrating an
understanding of appropriate theory and applications of social marketing and mass communication
4.2.7. Implement and evaluate a health promotion intervention, including assessment of outcomes,
methods, and costs; identifying strengths and limitations of intervention, communicating findings and
makingr e c o mme n d a t i o n s
4.2.8. Develop, implement and evaluate health protection programs applying knowledge of common
environmental hazards, including but not limited to water and sewage treatment and quality control of
water, soil, air and food
4.3. Ensure appropriate informed consent is obtained for therapeutic and preventive interventions
5. Demonstrate proficient and appropriate use of procedural skills for diagnosis and intervention
5.1. Demonstrate effective, appropriate, and timely performance of diagnostic procedures relevant to Public
Health and Preventive Medicine
5.1.1. Identify known or potential health effects associated with a particular hazard relevant to
health protection in a population, drawing on expertise as appropriate
5.1.1.1. Characterize the hazard identified, both quantitatively and qualitatively
5.1.1.2. Assess the degree of risk associated with exposure to a hazard found in a
population
5.1.2. Integrate hazard identification, characterization, and assessment into an estimate of the
adverse events likely to occurin a population, based on a hazard found in that population
5.1.3. Design, implement and evaluate surveillance systems that inform public health programs
5.1.4. Apply the principles of infectious disease epidemiology to the investigation and
management of communicable disease outbreaks in individuals, families, groups, organizations,
communities and populations
5.2. Ensure appropriate informed consent is obtained for interventions consistent with the public health
legal and regulatory framework
5.3. Document and disseminate information related to interventions performed and their outcomes
5.4. Ensure adequate followup and evaluation after interventions
6. Seek appropriate consultation from other health professionals, recognizing the limits of one's own
expertise
6.1. Demonstrate insight into one's own limits of expertise
6.2. Demonstrate effective, appropriate, and timely consultation of another health professional as
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needed for optimal practice
6.3. Arrange appropriate followup care and services for individuals, families, groups, communities, or
populations
Communicator Definition:
As Communicators, Public Health and Preventive Medicine specialists facilitate effective relationships with
individuals, families, groups, organizations, communities, and populations.
Key and Enabling Competencies: Public Health and Preventive Medicine Specialists are able to...
1. Develop rapport, trust, and ethical relationships with individuals, families, groups, organizations,
communities, and populations
1.1. Recognize that being a good communicator is a core skill for physicians, and that effective
communication can foster improved outcomes
1.2. Establish constructive relationships with individuals, families, groups, organizations,
communities, and populations that are characterized by understanding, trust, respect, honesty,
and empathy
1.3. Respect confidentiality, privacy, and autonomy
1.4. Listen effectively
1.5. Be aware of and responsive to nonverbal cues
1.6. Facilitate all encounters effectively
2. Elicit and synthesize accurately relevant information and perspectives of individuals, families, groups,
organizations, communities, and populations, including colleagues and other professionals
2.1. Gather information about a health situation, including the beliefs, concerns, expectations,
and experiences of all those involved
2.2. Seek out and synthesize relevant information from other sources and stakeholders
3. Convey relevant information and explanations accurately to individuals, families, groups,
organizations, communities, and populations, including colleagues and other professionals
. 3.1. Deliver information in a humane manner and in such a way that it is understandable, and
encourages discussion and participation in decision-making
4. Develop a common understanding on issues, problems, and plans with individuals, families,
groups, organizations, communities, and populations, including colleagues and other
professionals, to develop a shared plan
4.1. Identify and explore problems to be addressed, including stakeholders' context, responses,
concerns, and preferences
4.2. Respect diversity and differences, including but not limited to the impact of gender, religion
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and cultural beliefs on decision-making
4.3. Encourage discussion, questions, and interaction in the encounter
4.4. Engage all stakeholders in shared decision-making to develop a plan
4.5. Address challenging communication issues effectively, such as obtaining informed consent,
delivering bad news, and addressing anger, confusion, misunderstanding, and conflicting
priorities
5. Convey effective oral and written information
5.1. Maintain clear, concise, accurate, and appropriate records of encounters and plans
5.2. Present reports of encounters and plans
5.3. Convey medical information appropriately to ensure safe transfer of care
5.4. Present health information effectively to the public or media about a health issue
5.4.1. Present epidemiological data and risk information to affected individuals, the public, other
professionals, and the media using a variety of modalities
5.4.2. Apply risk communication theory, and communication styles
5.4.3. Develop and implement a communication plan about a public health issue, including a
media component
5.4.4. Respond effectively to public and media enquiries about specific health issues using
various media channels, as indicated
5.4.5. Evaluate the effectiveness of different types of media, including but not limited to print,
broadcast and web-based, for reaching the intended audience
Collaborator Definition:
As Collaborators, Public Health and Preventive Medicine specialists work effectively with others to achieve
optimal health outcomes.
Key and Enabling Competencies: Public Health and Preventive Medicine Specialists are able to...
1. Participate effectively and appropriately in an interprofessional and interdisciplinary team and with
other partners, including but not limited to community partners and populations served as well as sectors
outside the health field
1.1. Describe the roles and responsibilities of the Public Health and Preventive Medicine specialist to
other professionals, especially in circumstances involving legislative authority or emergency situations
1.2. Describe the roles and responsibilities of other professionals within the health team
1.2.1. Identify and describe the role, expected contribution and limitations of all members of an
interdisciplinary team assembled to address a health issue, educational task or research question
1.2.2. Identify individuals, groups, and other service providers who can contribute meaningfully
to the definition and solution of an individual, group, or community level public health issue, and
education task or research question, including but not limited to social services agencies, mental
health organizations, the not-for-profit sector, and volunteers
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1.3. Recognize and respect the diversity of roles, responsibilities, competencies and, as applicable,
authority of other professionals in relation to their own
1.3.1. Describe the organization, structure, function, and effectiveness of community health and
social services in at least one province, including but not limited to maternal and child health;
dental health; child abuse; income maintenance, including the not-for-profit sector; volunteers
and; other service agencies
1.4. Work with others to assess, plan, provide, and integrate services for individuals, families, groups,
organizations, communities, and populations
1.5. Work with others to assess, plan, provide, and review other tasks, such as research, education,
program review, or administrative responsibilities
1.5.1. Employ a variety of means to engage and enable the participation of identified key
stakeholders
1.5.2. Articulate the goals and objectives of a given collaborative process clearly
1.5.3. Foster collaboration among other individuals and groups
1.6. Participate effectively in interprofessional and interdisciplinary interactions, including but not
limited to team meetings
1.7. Enter into relationships with other professions for the provision of quality care or health programs
1.8. Demonstrate effective team participation, including but not limited to team leadership, utilizing the
principles of team dynamics, including but not limited to the dyad model of physician-manager
integration
1.9. Respect team ethics, including confidentiality, resource allocation, and professionalism
1.10. Demonstrate leadership in a health team, where appropriate
2. Work with health professionals and other stakeholders effectively, including community partners and
population served, to prevent, negotiate, and resolve interprofessional and other conflicts
2.1. Demonstrate a respectful attitude towards other colleagues and members of an interprofessional
team
2.2. Work with other professionals to prevent conflicts
2.3. Employ collaborative negotiation to resolve conflicts
2.4. Respect differences and address misunderstandings and limits of scope of practice in other
professions
2.5. Recognize one's own differences, misunderstandings, and limitations that may contribute to
interprofessional and interdisciplinary tension
2.6. Reflect on interprofessional and interdisciplinary team function
2.7. Demonstrate the ability to work on initiatives with non health sector organizations and
staff/volunteers
2.7.1. Enter into interdependent relationships with stakeholders/experts in other sectors for the
assessment and application of responses to issues impacting the determinants of health or other
services outside of health care including but not limited to school boards, water services,
municipal planners, and ministries or other government departments outside of health
2.7.2. Demonstrate an ability to meaningfully engage with the public/clients/community
members in the identification of issues and solutions that impact them
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Manager Definition:
As Managers, Public Health and Preventive Medicine specialists are integral participants in organizations,
organizing sustainable practices, making decisions about allocating resources, and contributing to the
effectiveness of health care and other systems.
Unique among the medical specialties, upon certification Public Health and Preventive Medicine specialists are
expected to be competent to function in administration, management and leadership roles within public health
service delivery organizations. These competencies are at the core of the Public Health and Preventive Medicine
specialty practice.
Key and Enabling Competencies: Public Health and Preventive Medicine Specialists are able to...
1. Participate in activities that contribute to the effectiveness of their health care organizations and
systems
1.1. Work collaboratively with others in their organizations
1.2. Participate in quality improvement initiatives to enhance the quality of care and patient safety in Public
Health and Preventive Medicine, integrating the available best evidence and best practices
1.2.1. Design and implement data collection for a defined service question and integrate with other
routinely available and relevant data
1.2.2. Assess the evidence for proposed or existing screening programs, using established criteria and
the performance of screening tests including but not limited to sensitivity, specificity, predictive value,
and number needed to screen
1.2.3. Monitor and appraise the impact of screening and other disease detection and prevention
programs
1.2.4. Describe the principles of infection control and their application to effective and appropriate
procedures and policies to reduce risk of infection
1.2.5. Develop, implement and critically appraise relevant practice guidelines
1.2.6. Investigate and intervene when a potential health hazard is identified in a clinical setting
1.2.7. Manage a project or program including human, financial and material resources
1.2.7.1. Hire, support and guide staff, monitor performance, receive and give constructive
feedback
1.2.7.2. Develop and manage a budget including but not limited to alignment of activities and
accountabilities with resources, assessment of results against objectives, and flexible budgeting
1.2.7.3. Develop and implement a plan to secure necessary material resources
1.2.7.4. Use information technology effectively in the management of a project or program
1.2.8. Implement quality improvement techniques as appropriate to the organization and setting
1.3. Describe the structure and function of the health care system as it relates to Public Health and Preventive
Medicine, including the roles of physicians
1.3.1. Compare and contrast the different models of public health structures in Canada
1.3.2. Discuss the organization of workplace health services in at least one part of Canada
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1.3.3. Describe principles of health care financing, including physician remuneration, budgeting and
organizational funding
2. Manage their practice and career effectively
2.1. Set priorities and manage time to balance professional responsibilities, outside activities, and
personal life
2.2. Manage a practice, including finances and human resources
2.3. Implement processes to ensure personal practice improvement
3. Allocate finite public health resources appropriately and participate in service planning, resource
allocation and evaluation at the community, regional or provincial level
3.1. Recognize the importance of just allocation of health care resources, balancing effectiveness, efficiency and
access with optimal patient care
3.1.1. Allocate finite health resources using evidence informed and ethical concepts
3.2. Apply evidence and management processes for cost-appropriate care
3.2.1. Apply a determinants of health analysis to a policy or program question to assess the equity
implications of policy or program options
4. Serve in administration and leadership roles
4.1. Chair and participate effectively in committees and meetings 4.2. Lead or implement change in health
systems
4.2.1. Develop a vision, implement a strategic plan, and communicate that effectively to other key
stakeholders
4.2.2. Negotiate and influence in a multi-agency arena
4.3. Demonstrate critical self-appraisal and reflective practice with regards to administration and leadership
roles
4.3.1. Demonstrate insight into one’s own leadership style, personality style, and preferences in
different circumstances
4.3.2. Discuss and apply different approaches to leadership development
4.3.3. Use effective and appropriate leadership styles in different settings and organizational cultures
taking account of the differences between elected and appointed roles
4.3.4. Discuss and use the techniques of conflict management, including negotiation and arbitration
Health Advocate Definition:
As Health Advocates, Public Health and Preventive Medicine specialists responsibly use their expertise and
influence to advance the health and well-being of individuals, families, groups, organizations, communities, and
populations. Public Health and Preventive Medicine specialists advocate for the health of individuals or groups
and need to use judgment in balancing efforts to achieve health for all.
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Competencies required to achieve this role include full understanding of tools of population health assessment,
community engagement, and working in partnership with a wide range of interested parties. Public Health and
Preventive Medicine specialists apply strategies to influence and build healthy public policy, as well as public
health policy, and recognize the role of political factors and the political context, to make use of formal and
informal systems to influence decision-makers and policy decisions.
Key and Enabling Competencies: Public Health and Preventive Medicine Specialists are able to...
1. Respond to individual, family, community and population health needs and issues
1.1. Identify the health needs, concerns, and assets of individuals, families, communities, and
populations served
1.2. Identify opportunities for advocacy, health promotion and disease prevention with
individuals, families, communities and populations served
1.3. Demonstrate an appreciation of the possibility of competing interests and implement
processes for decision making to resolve competing interests incorporating an ethical approach
2. Identify the determinants of health for the populations that they serve
2.1. Recognize situations where advocacy is required and define strategies to effect the desired
outcome
2.2. Identify vulnerable or marginalized sub-populations within those communities and
populations served and respond appropriately
2.2.1. Engage and involve vulnerable or marginalized sub-populations, including but not
limited to Indigenous Peoples, new immigrants and refugees, and socio-economically
disadvantaged persons and groups, to address health inequities
3. Promote the health of individuals, families, communities, and populations to improve health equity
3.1. Describe an approach to addressing a determinant of health of the population they serve, including
identifying the roles of public health players
3.2. Discuss and analyze health law and common law relevant to public health policy and healthy public
policy
3.3. Describe how public policy impacts on the health of the populations served
3.3.1. Integrate public health and preventive medicine, and social science evidence into
strategies for healthy public policy
3.3.2. Discuss the processes for health impact assessment and analyze the health impact of
public policy
3.3.3. Discuss mechanisms of policy development and methods of implementation, including
legislation, regulation, and incentives
3.3.4. Demonstrate an understanding of how competing values affect policy decision making
including but not limited to, liberty of the individual, equality, common good of the community
and prosperity
3.3.5. Conduct a policy analysis and policy evaluation
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3.4. Identify points of influence in the health care system and its structure that impact population health
3.5. Describe the ethical and professional issues inherent in health advocacy, including altruism, social justice,
autonomy, integrity, reciprocity and idealism
3.6. Demonstrate an appreciation of the possibility of conflict inherent in their role as a health advocate for a
patient or community with that of manager or gatekeeper
3.6.1. Demonstrate an appreciation of the potential for, and implement strategies to address this conflict
balancing multiple accountabilities including but not limited to individuals, employers, the public, and
within the health profession
3.7. Describe the role of the medical profession in advocating collectively for healthy individuals, systems and
populations
3.7.1. Discuss strategies for advocating for quality improvement and patient safety from a population
health perspective that includes addressing health inequities
Scholar Definition:
As Scholars, Public Health and Preventive Medicine specialists demonstrate a lifelong commitment to reflective
learning, as well as the creation, dissemination, application and translation of relevant knowledge.
Key and Enabling Competencies: Public Health and Preventive Medicine Specialists are able to...
1. Maintain and enhance professional activities through ongoing learning
1.1. Describe the principles of maintenance of competence
1.2. Describe the principles and strategies for implementing a personal knowledge management system
1.3. Recognize and reflect on learning issues in practice
1.4. Continually evaluate one's abilities, knowledge, and skills, and know one's professional limitations,
seeking advice, feedback and assistance where appropriate
1.5. Pose an appropriate learning question
1.6. Access and interpret the relevant evidence to a learning question
1.7. Integrate new learning into practice
1.8. Evaluate the impact of any change in practice
1.9. Document the learning process
2. Critically evaluate health and other information and its sources, and apply this appropriately to
practice decisions
2.1. Describe the principles of critical appraisal
2.2. Identify, access and critically appraise data from a variety of sources, including individuals,
administrative databases, the Internet and health, epidemiological and social sciences literature
2.3. Integrate critical appraisal conclusions into professional practice
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3. Facilitate the learning of individuals, families, students, residents, other health professionals, the public
and others, as appropriate
3.1. Describe principles of learning relevant to medical education
3.2. Identify collaboratively the learning needs and desired learning outcomes of others
3.3. Select effective teaching strategies and content to facilitate others' learning
3.3.1. Adapt educational and training strategies to the needs of the learner(s)
3.4. Deliver effective lectures or presentations
3.5. Assess and reflect on teaching encounters
3.6. Provide effective feedback
3.7. Describe the principles of ethics with respect to teaching
4. Contribute to the development, dissemination, and translation of new knowledge and practices
4.1. Describe the principles of research and scholarly inquiry
4.1.1. Discuss and apply the principles of quantitative, qualitative, and action research/scholarly
inquiry, including but not limited to study question/objective, design, conduct, analysis,
interpretation, and reporting
4.1.2. Discuss and apply sampling methods as well as the estimation of appropriate sample
sizes, including study power, alpha and beta levels, and a consideration of type I and II error
4.1.3. Calculate and interpret measures of frequency including but not limited to counts, rates,
ratios, and, as applicable, their standardization
4.1.4. Calculate and interpret measures of risk including but not limited to relative risk, risk
difference, attributable risk, odds ratio, etiologic fraction and preventive fraction
4.2. Describe the principles of research ethics
4.3. Pose a scholarly question and participate in the research process
4.4. Conduct a systematic search for and review of relevant evidence including but not limited to
systematic review, meta-analysis
4.4.1. Recognize potential sources of bias and confounding in research and discuss methods to
reduce the impact of these through study design or analysis
4.4.2. Discuss interaction, including but not limited to additive, multiplicative, synergism and
antagonism, and effect modification in research and discuss methods for their identification and
interpretation
4.5. Select and apply appropriate methods to address the question
4.6. Disseminate and mobilize the findings of a study appropriately
4.7. Complete a scholarly research, quality assurance, or educational project relevant to Public Health
and Preventive Medicine that is suitable for peer-reviewed publication or presentation at an academic
meeting
Professional Definition:
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As Professionals, Public Health and Preventive Medicine specialists are committed to the health and well-being
of individuals and society through ethical practice, profession-led regulation, and high personal standards of
behaviour.
Key and Enabling Competencies: Public Health and Preventive Medicine Specialists are able to...
1. Demonstrate a commitment to individuals, families, groups, organizations, communities and
populations served, their profession, and society through ethical practice
1.1. Exhibit appropriate professional behaviours in practice, including accountability, honesty, integrity,
commitment, compassion, respect, and altruism
1.2. Demonstrate a commitment to delivering the highest quality practice and maintenance of
competence
1.3. Recognize and appropriately respond to ethical issues encountered in practice
1.4. Recognize and manage real or perceived conflicts of interest
1.5. Recognize, discuss, and apply the principles and limits of confidentiality, privacy and access to
information as defined by professional practice standards and applicable laws
1.6. Maintain appropriate relations with individuals, families, groups, organizations, communities, and
populations
2. Demonstrate a commitment to individuals, families, groups, organizations, and populations served,
profession, and society through participation in profession- led regulation
2.1. Demonstrate knowledge and an understanding of the professional, legal and ethical codes of
practice
2.2. Fulfil the regulatory and legal obligations required of current practice in public health and
preventive medicine
2.3. Demonstrate accountability to professional regulatory bodies
2.3.1. Distinguish among the roles of provincial and national licensing bodies, medical
associations, and specialty societies
2.4. Recognize and respond appropriately to others' unprofessional behaviours in practice
2.5. Participate in peer review
3. Demonstrate a commitment to physician health and sustainable practice
3.1. Balance personal and professional priorities to ensure personal health and a sustainable practice
3.2. Strive to heighten personal and professional awareness and insight
3.3. Recognize other professionals in need and respond appropriately
REVISED – Specialty Standards Review Committee – April 2014
