Hints for Managing a Happy Program

Many of the organizational issues that occupy a Program Director's time involve non-RCPSC guidelines such as labour agreements, funding, and departmental policies.  It is worth articulating your program's guidelines for those generally predictable issues ahead of time or ensuring that they are posted on your website.

Guidelines should be fair to the residents and the department, recorded, and fairly applied.  Try to determine from the former PD what the old guidelines were, and decide if they need revision.  Record the reasons for your decisions regarding individual residents.

A resident handbook given out at the start of the year is an effective way to provide residents with your guidelines, as well as their rotational goals and objectives, information about their in-training evaluation system, and availability of resources.  This is a lot of work to write the first time but is easy to edit and saves a great deal of time and misunderstanding.  An example created by Anesthesiology can be found here.

The following are management issues that all Program Directors must eventually address, along with some suggestions for dealing with them.

Abuse and intimidation of residents

This can still happen at and between every PGY level.  Your personal availability and receptiveness will determine how much you hear about it.  Identify immediately how willing the resident is to proceed with a complaint. Seek the advice of a wise colleague and the PG Dean.  Confidentiality is critical and you’ll need to know the avenues and resources available to deal with these issues.

Academic Activities

Decide which are mandatory for your residents to attend, and how the service needs are going to be meet during those hours.  If there isn’t a provision for service coverage, residents won’t attend.  

Call

Know the contractual agreement between PARO and the hospital.  Set guidelines for requesting specific days off and respect the guidelines in the PARO agreement.  Functional guidelines regarding post-call days and total hours of work are a difficult challenge and need to be negotiated respecting provincial regulations.  Statutory holidays and rotation schedules are available on the PGME website.

Complaints

Complaints regarding interactions between residents and hospital staff must be handled promptly and carefully in conjunction with the appropriate hospital management.  The PG Dean and Department Head should normally be involved.  A written description of the complaint can help clarify the event and issues.  Depending on the situation, a mediator acceptable to both parties may be able to facilitate a helpful discussion and resolution.

Conference Leave

Each Program Director must be able to address the length, type of conference, and funding available for residents wishing to attend conferences.  Many departments have clear guidelines posted on their on their website.  Usually, residents presenting material are funded.

Holidays

Program Directors need to have a clear process in place for approving holidays.  It's important to be aware of the requirements of the PARO agreement and if there are questions, check with the PGME office or PARO directly.  Statutory holidays are posted on the PGME Website.

Pregnancy and Parental Leave

Residents who are going to become parents are entitled to a leave defined by the PARO agreement.  The dates need to be provided to the PGME office so that a change can be made to the registration status of the resident.

Moonlighting

Residents are not encouraged to moonlight but if they do so, it should not occur at the same hospital or on the same service in which they are engaged in educational programs.  The Ontario Faculties of Medicine does not support resident moonlighting as it compromises postgraduate programs and undermines the educational environment.  More information on moonlighting is available on the PG website.

Rotational Assignments

Every Program Director needs a standard resident rotational template and schedule.  It will be changed many times and a Program Director should start planning in March-May for the July 1 start.  A copy of the schedule should be sent to the PG Office and to PARO.  You should also establish guidelines for the following:

  • Dates of notification
    • When residents and other Program Directors need to make requests for specific rotations for the following year
  • Criteria for choosing between residents competing for favourite rotations, both those from your program and from others.
  • Criteria for deciding which services are not assigned residents and how often this occurs.
Remember that rotations to/from other centres and provinces may require applications for licensure or hospital privileges that must be arranged long in advance.  Residents may need help in getting accommodations, and the funding issues around that need to be clarified especially if a rotation to another centre is mandatory.  Be sure to contact the Regional Education Office at Queen’s for help.

Interaction with other programs can be difficult if their residents expect different experiences than your rotations normally provide to your own residents.  A discussion with their Program Director of the rotational goals and objectives may prevent mid-year controversies.

When residents are doing rotations on services in other programs, it is important to identify which academic sessions they are expected to attend back in their home program and how/if this can be accommodated.