COVID-19 Updates and Resources for Faculty, Staff and Residents

Email sent April 3, 2020

Dear Residents,

We want to acknowledge and thank you for the outstanding work and commitment you have contributed during this difficult time in light of the COVID-19 pandemic.

We thought it would be great if we could all meet virtually via Zoom (details below) and talk about the changes, concerns and fears regarding your residency and COVID-19. With this said, we would like to invite you to the Resident “Town Hall”, scheduled for next Tuesday, April 7 from 7:30 a.m. to 8:30 a.m. EST. Time will also be provided for any questions or concerns you may have.

Your attendance is highly encouraged and we hope you can make it however, it is not mandatory.

Sincerely,

Dr. Stuart Murdoch

Dr. Batya Grundland

Dr. Fok-Han Leung

Zoom details:

Join from a PC, Mac, iPad, iPhone or Android device:

Please click this URL to join. https://zoom.us/j/492297051

Or join by phone:

Dial (for higher quality, dial a number based on your current location):

Canada: +1 778 907 2071 or +1 438 809 7799 or +1 587 328 1099 or +1 647 374 4685 or +1 647 558 0588

Webinar ID: 492 297 051

International numbers available: https://zoom.us/u/abI6GmG1o

Email sent March 21, 2020

Dear family medicine residents,

You may have heard that the University of Toronto has cancelled all convocation ceremonies in June. This was no doubt a difficult decision that had to be made by our President and University leadership.

In a message to you and our faculty on March 12th, the University of Toronto Department of Family and Community Medicine announced that we would be cancelling all events until the end of June to ensure that we keep our primary care workforce - who are so essential to the response to COVID-19 - safe and healthy. This included our planned Residency Graduation Ceremony on June 10th – a particularly hard decision to make.

This is not the end to your residency that you envisioned. Your time with us has been upended and many questions are still outstanding. This has not stopped you, however, from stepping up and providing what’s needed at this time of crisis. We are encouraging our postgraduate directors to share stories of your work and contributions so we can recognize them over the duration of your time with us, whether through our newsletter, social media or other channels.

We recognize that this is a difficult time right now and we want to thank all of you for your hard work to address this pandemic and your patience as we try to answer all of your questions.

Feel free to reach out to us with any questions, concerns and ideas.

Thank you and stay well,

David Tannenbaum and Stu Murdoch

Email sent March 24, 2020

Dear Residency and Fellowship Program Directors, and FM Site Directors,

I want to thank you all for your ongoing commitment and creativity in responding to the pandemic. We are doing well in terms of planning and working through issues together. Many more will come.

I wish to provide a summary update for our community to reiterate what we have done, where we are, and the items we are prioritizing this week. This will be incomplete the moment I send this out as issues arise rapidly. We will strive to address them in appropriate manner; some require lots of consultation. I welcome feedback about these items and whether we have focused on the right things at this time. We strive to be responsive to your needs and be helpful with appropriate direction at this tricky time.

What we have done

In a very short timeframe, we have…

1. Shifted the entirety of PGME operations online. Specifically, we have adapted our mission-critical activities: registration, payroll, wellness and learner support, to online models.
2. Developed and disseminated learner redeployment principles and procedures to all stakeholders.
3. Set up a centralized redeployment and absence tracking system to help match need to supply of the PGME learner workforce.
4. Established agreement of TAHSN hospitals around principles of portability of resident credentials across sites to eliminate redundant registration requirements.
5. Developed guidelines for medical accommodation and leaves specific to the pandemic, to be finalized shortly.
6. Lobbied the certifying Colleges to make definitive decisions about examinations to reduce uncertainty for trainees.
7. Worked with the licensing bodies to ensure graduating residents will have a pathway to temporary licensure regardless of examination completion this spring.
8. Clarified with the Ministry that we will have funding options for those residents who remain in training or are mandated to extend training due to disruptions.
9. Liaised with Federal officials to explore options for incoming residents and fellows on work permits to be exempt from the travel ban, should they still wish to come to Canada.
10. Worked with our undergraduate colleagues to establish a national working group on contingency planning for various outcomes pertaining to the ‘pause’ on medical student training and altered CaRMS schedules and elective patterns.
11. Worked with hospital partners to establish surge housing for PG learners who are either in isolation or choose to avoid being at home with family members.
12. Encouraged hospital partners to explore options for parking fee relief for PG learners, consistent with what they are doing for other hospital staff and physicians.
13. Developed and distributed resources to help programs shift to online delivery methods for core curricula and provide consultations on demand for these issues.

Where we are

We have made the following tactical decisions for the near future as we continue to work through issues arising:

1. All rotation changeovers will happen as planned, to the extent that they make sense from an education and service delivery perspective. Some rotations will need to be cancelled if there is no work or educational value, and some deferred because PG learners and/or staff are needed elsewhere. For now, PG learners are able to move between sites.
2. Accreditation and CBD planning and progress are happening in the background and we will minimize or eliminate any ‘asks’ of programs at this time. Those with capacity and will to move forward will receive full support from the PGME team.
3. Redeployment of PG learners is starting to happen to cover absences on certain services, and to match PG learners with both educational opportunities and clinical need. I thank you for your efforts in this regard. This is a collaborative effort between hospitals and university departments and I have insisted that both parties be involved and aware before any such action is taken. I will be the point of resolution for any issues that may arise. A strong spirit of collaboration and situational awareness will be paramount in helping us get through these tricky decisions.
4. We are committed to maintaining maximum flexibility in areas such as completion of training, counting altered educational experiences for credit, establishing a ‘minimum expectations’ approach to promotions and progress decisions, and attending to wellness for all in the face of clinical surge.

Priorities for this week

We are directing our energies to:

1. Supporting a comprehensive resident and faculty wellness response in collaboration with CAMH and the Faculty of Medicine.
2. Developing a basic education package of peer-reviewed resources for PG learners redeployed to care for sub-critical COVID patients at all levels, including PPE education.
3. Identifying parking and housing opportunities across the system to accommodate those who have alternative transportation and living needs.
4. Continuing to work with the certifying and licensing bodies to clarify processes for expedited licenses and/or modified examination options.

Reminders

1. Report trainees in self-isolation, self-quarantine or positive for COVID-19 to Maureen Morris Maureenf.morris@utoronto.ca
2. Report trainee redeployment plans to Lindsey Fechtig, lindsey@fechtig@utoronto.ca
3. Report any major changes, additions to call schedules to call.stipends@utoronto.ca
4. COVID-19 Updates for PGME can be viewed at https://pg.postmd.utoronto.ca/ and most recent updates from the Faculty of Medicine on COVID19.
5. Please continue to send any questions to postgrad.med@utoronto.ca

Sincerely,

Get the most recent updates from the Faculty of Medicine on COVID19

GLEN BANDIERA MD, MEd, FRCPC
Professor, Department of Medicine
Associate Dean, Postgraduate Medical Education

Email Sent March 19, 2020

Dear Colleagues,

We want to take a moment to thank you for your dedication and service to the postgraduate trainees, and the public at this very challenging time. We know it has been particularly difficult on many who have had to self-isolate, provide additional clinical service, support trainees through exam postponements, or figure out how to find childcare in the face of the school closings. We hope you are all doing okay under these circumstances.

We want to let you know that The Postgraduate Wellness Office remains open for remote support via phone or video appointments.

You or the trainees can reach us in the usual way, by emailingpgwellness@utoronto.ca or leaving a message at 416-946-3074. We will do our best to schedule an appointment, or an intake triage appointment (depending on the number of requests we have) for trainees as soon as possible; we are working hard to book trainees within a few days of contact with us.

If you need to reach us directly, myself and Heather Flett are most easily reachable by email:

Julie.maggi@utoronto.ca

Healther.flett@utoronto.ca

As a reminder, the following resources also remain open to the trainees for support:

PARO Helpline

The PARO 24 Hour Helpline is confidential support that is available to residents, their partners and family members, as well as medical students.

1-866-HELP-DOC (1.866.435.7362)

http://www.myparo.ca/helpline/

PHP – Physician Health Program

The Physician Health Program, through the OMA, offers confidential support for trainees and practicing physicians through live counselors available between 9am and 5pm.

1.800.851.6606

http://php.oma.org/what-we-do/

**As usual, if the trainee is experiencing a mental health emergency, please remember that Emergency departments are also a resource to them in these emergency situations.

At this time, in keeping with the general mandate to defer nonessential academic sessions, we are not providing Wellness workshops. We will re-evaluate this every few weeks. If your booked workshop is affected, our Office will contact you.

For any changes to our services, and for other information related to COVID 19 pandemic updates at the University, please check the Faculty of Medicine Website:https://medicine.utoronto.ca/news/coronavirus-your-safety-and-responsibility

Finally, we know that at times like these, our usual coping strategies can be quite taxed, and so we encourage you to take a few minutes (7 to be exact!) to watch this excellent video about coping by Drs. Robert Maunder and Jon Hunter, who are two of our Faculty of Medicine Psychiatrists from the Sinai Health System. Please share widely! https://www.youtube.com/watch?v=Rkz7vJOZ2HU

We are all in this together.

Best,

Julie Maggi

Director, Postgraduate Wellness Office

Heather Flett

Associate Director, Postgraduate Wellness Office

Email sent March 19, 2020

Dear colleagues,

Thank you for your patience while we work to reschedule the spring 2020 Certification Examination in Family Medicine due to COVID-19. We understand the magnitude of the decision to postpone it and find an appropriate alternative date. Our priorities remain the health and safety of everyone involved: the exam candidates, the examiners, and those who support the exam administration. We must also maintain the quality and validity of the exam and address many complex logistical requirements. We are collaborating with other health care, academic, medical regulatory, and resident organizations to determine our new schedule as quickly and as smoothly as possible.

We have been assured that medical regulatory authorities across Canada are working to facilitate issuing provisional/restricted licences/registrations to candidates who will not have obtained their Certification in the College of Family Physicians of Canada (CCFP) when they start to practise. To implement this, each medical regulatory authority will require: 1. a statement verifying the resident’s completion of training, issued by their university; and 2. a statement that the resident is qualified to write the Certification Examination in Family Medicine. The CFPC will generate the documentation the medical regulatory authorities require indicating candidates’ eligibility for the examination.

We wish to share our proposed examination schedule, which assumes that health care settings will be stable and travel/group gatherings will once again be permitted.

The simulated office oral (SOO) component of the exam will be held October 16 to 18, 2020. Our plan is to hold the October SOOs at the 17 sites we had planned to use in April. Logistics related to holding the postponed spring exam in October, such as examiner recruitment, still need to be confirmed.

A decision regarding the written short-answer management problem (SAMP) component of the exam is still under consideration. We currently favour and are actively exploring with our vendor the possibility of holding the SAMP component in October 2020 prior to the SOO portion of the exam, and we will know more about this possibility over the next week. The biggest factor influencing this decision is that our vendor has confirmed that if we secure a June date and that this date ends up not being feasible, it cannot guarantee an October date. We basically need to firm up one final set of days for the SAMPs now.

Given the uncertainty of the current public health situation, the concerns some residents have about expectations regarding their service commitments, the likely need for them to self-isolate for two weeks prior to a June examination date, and the inability at this time to say whether this would be possible, we feel that, on balance, it is better for us to try to secure an October 2020 date now.

We are committed to ensuring our stakeholders know our 2020 examination schedule as far in advance as possible, and certainly no less than four weeks prior to the administration of an exam.

As you see, there are still many details to be confirmed and plans could change depending on public health priorities. We will share additional details with you as they become available. If you have immediate questions, please contact us at ccfpexam@cfpc.ca.

Sincerely,

Francine Lemire, MD CM, CCFP, FCFP, CAE, ICD.D Nancy Fowler, MD, CCFP, FCFP

Executive Director and CEO Executive Director, Academic Family Medicine

College of Family Physicians of Canada

Email sent March 18, 2020 

Dear Residents,

As the COVID-19 pandemic continues to evolve, the situation remains fluid with respect to expectations of residents and faculty.

We are writing to be sure that you are aware of the two emails that were sent to all residents from PGME yesterday afternoon. Please see both emails below.

Please note that in the second email at 530 pm yesterday, Dr. Glen Bandiera, Associate Dean Postgraduate Medical Education, clarified the revised PGME travel policy for asymptomatic learners and faculty returning from international travel.

“The clarification comes on the heels of the new provincial policy that the mandated isolation for all travellers applies only to non-healthcare workers.”

Moving forward, all residents returning from international travel with no symptoms must do the following:

1. Communicate with your site director about your recent travel.
2. Report to the Occupational Health Department in your hospital for guidance about returning to clinical duties and educational activities.

Please note that residents do not have to self-isolate for 2 weeks unless directed to do so by the occupational health department.

1. Submit a questionnaire to PGME

Your site director will inform us if you are required to self-isolate or self-quarantine (adpgme@utoronto.ca).

If you are currently in self-isolation secondary to international travel, please review this new policy with your Site Director and then report to your hospital occupational health department for screening and a return to work plan.

As this pandemic continues to evolve, our goal continues to be to keep you safe as you continue your education program and fulfill your clinical responsibilities. We will send regular updates as new information becomes available to us.

If you have any questions or concerns, please contact your site director or Dr. Stu Murdoch at stu.murdoch@utoronto.ca

Sincerely,

Dr. Stu Murdoch, Postgraduate Education Program Director

Dr. Risa Freeman, Vice -Chair Education

Dr. David Tannenbaum, Interim Chair

Email sent March 17, 2020 from Dr. Glen Bandiera, Associate Dean Postgraduate Medical Education

Dear colleagues,

On the heels of the update I just sent, I have now received the notice circulated from Dr. David Williams, Ontario Chief Medical Officer of Health last pm indicating that the mandated isolation for all travellers applies only to non-healthcare workers. Hence the directions of many of our hospitals to return to work for select members of their provider workforce is not contradictory to Public Health Directives. I am happy that communication is converging on this issue; PARO has made a similar statement.

Clarification re: Non U of T Electives:

All residents and fellows currently here for electives originally scheduled to start prior to March 16, 2020, either under the two-week quarantine or engaged in clinical activity, may complete their elective as planned. We understand that many schools are recalling their trainees; therefore, please check with your home PGME office to confirm your ability to continue your elective at U of T. Electives that have been scheduled to start between March 16 to June 30, 2020 have been cancelled. Acceptance and processing of elective requests from Non U of T trainees has been suspended. (See document CANCELLATION OF ALL VISITING ELECTIVES - all visiting electives from Canadian and international schools).

Kind Regards.

Get the most recent updates from the Faculty of Medicine on COVID19.

GLEN BANDIERA MD, MEd, FRCPC

Professor, Department of Medicine

Associate Dean, Postgraduate Medical Education

Email sent March 17, 2020 from Dr. Glen Bandiera, Associate Dean Postgraduate Medical Education

As the COVID-19 pandemic has evolved, numerous guidelines and directives have been put in place at the Faculty of Medicine to guide learner clinical placements and activities. The purpose of this note is to update you with regards to current guidelines and principles for PGME trainees and training programs.

U of T Trainees

1. Trainees with Recent travel: The Faculty’s communication dated March 4 (Subject: Procedure changes: International travel for medical learners) still stands. All UofT learners returning from international travel with no symptoms need to submit a questionnaire to PGME and consult with their local Occupational Health Department for guidance about returning to clinical duties and educational activities. Programs are asked to continue informing PGME of any of their trainees who self-isolate or self-quarantine (adpgme@utoronto.ca). We are aware that hospitals have subtle variations in how they respond and often provide advice that is contrary to that of public health agencies. We defer to hospitals.
2. Scheduled Electives outside U of T training sites: All electives by U of T trainees scheduled outside of U of T training sites have been suspended until further notice.
3. Scheduled Rotations within U of T training sites: All rotations (core and elective) scheduled within U of T training sites/affiliated hospitals should continue as planned. Trainees should direct any questions to their programs. A list of U of T Affiliated Hospitals can be found at https://medicine.utoronto.ca/about-faculty-medicine/university-affiliated-hospitals
4. Regarding Scheduled Vacation: We encourage residents to defer vacation and other leaves if possible and respect hospital’s rights to mandate rescheduling of vacation if there will be a demonstrable negative effect on patient care.
5. Modified work arrangements: We encourage programs to explore modified work hours or work from home arrangements if there are no clinical imperatives for residents to be in the hospital or other clinical settings. Residents who are pregnant or immunocompromised should follow advice of their treating physician. If your treating physician feels you should be deployed in a manner that minimizes your risk of exposure to COVID-19, please inform your Program Director to discuss possible solutions which may include moving you to a service with a low risk of exposure of placing you on paid leave of absence.
6. Redeployment: Residents may be redeployed from non-clinical work at any time based on hospital need. See document: Principles for Redeployment of Residents and Fellows in Times of Exceptional Health System Need, circulated March 16th from Associate Dean PGME (Dr. Glen Bandiera).
7. Extension of training program: Residents and fellows who undergo mandated isolation or are redeployed to non-core activities may need to extend a rotation to achieve or demonstrate required competencies only available on that rotation. Every effort will be made by programs to avoid any overall prolongation of training or delays to promotion or exam eligibility.
8. Childcare: UofT medical and nursing students have implemented a student run volunteer program to assist healthcare providers in GTA with childcare, pet care, grocery runs, errands etc. Interested healthcare providers, including residents, should contact: https://docs.google.com/forms/d/1AM3QGME29z5HBXnGzKxjETyNe-c37uCywPR0oLmL-ac/viewform?edit_requested=true

Non-UofT Elective Trainees

1. Electives for visiting residents and fellows are suspended until further notice. (See document CANCELLATION OF ALL VISITING ELECTIVES - all visiting electives from Canadian and international schools). Exception: Those visiting to do a CORE rotation from another school under an Inter-University Agreement (IUA) will be accommodated at the request of the sending Postgraduate Dean. Please ensure resident and program communicate this information to PGME for processing (postgrad.med@utoronto.ca).

New UofT Fellowship & Resident Trainees

1. Residents & Fellows coming to UofT to join a residency or fellowship program are encouraged to come early as a 14-day self-quarantine will be in effect for all international trainees prior to starting their training.

PGME Office

In context of a global pandemic and strong public health social distancing advisories in effect, most Faculty of Medicine staff are working remotely, including PGME staff.

Please continue to direct questions to PGME at postgrad.med@utoronto.ca

Should you have any questions about any of the above or about other matters, do not hesitate to get in contact with us at:

Postgrad.med@utoronto.ca

adpgme@utoronto.ca

anne.matlow@utoronto.ca

Sincerely,

GLEN BANDIERA MD, MEd, FRCPC

Professor, Department of Medicine

Associate Dean, Postgraduate Medical Education

Email sent March 14, 2020 

Dear Residents, 

We hope that you are all safe and well. 

The impact of COVID-19 on our clinical and learning environment continues to bring many challenges and rapid changes.  

We are writing to thank you for your commitment to patient care and to let you know that we appreciate that you have questions about your education program and clinical responsibilities.   In consultation with Dr. Glen Bandiera, Associate Dean for Post Graduate Education, we would like to share the following information. 

1. Clinical rotations:  Residents will be permitted and required to work in clinical environments (hospital and outpatient offices) that have both of the following in place: 
   1. A rigorous screening protocol per current Public Health recommendations, AND 
   2. Full PPE protection is available if screen-positive patients will be provided with clinical care in that environment. 
   3. NOTE:  
      1. Residents will not be permitted to work in an environment that provides care to screen-positive patients without the availability of full PPE on site. 
      2. PPE requires surgical mask, disposable gown, gloves and eye protection.  
2. Electives:  
   1. All electives outside of the University of Toronto system are cancelled effective immediately.   
   2. NOTE: Teaching Practice placements will continue if they are able to provide a clinical environment as noted in #1 above. 
3. Self-isolation and quarantine:  If a resident is required to self-isolate or be in quarantine for reasons beyond their control, they will continue to receive pay for time away from clinical duties.  Residents may be required to make up for missed clinical time in order to complete their training program. 
4. Travel:  
   1. All residents returning from international travel will be required to self-isolate for 14 days before returning to any clinical activity. 
   2. Moving forward, any resident choosing to travel outside of Canada, including the United States, will not be paid for time off for clinical duties as a result of the need to self-isolate when they return.  Please note that your residency program will be extended as a result. 
5. Certification and licensing:  As you know, the certification exam has been postponed.  Dr. Bandiera and PGME are working closely with the CFPC and the CPSO.  Therefore, all scheduled study week preparations for the certification exams are suspended.  The program will endeavour to provide a study week, if possible, when we learn more about the timing of the exams.  At this time, a number of options for sitting the exam and licensure are being discussed and we will provide you with updates as soon as they become available to us. 
6. Core Day:  We are moving forward with plans to provide Core Day virtually.   

The situation is very fluid and the expectations of physicians will likely change frequently over the coming days and weeks.  Our collective goal will be to work together to create flexibility and capacity in the system and to keep you safe as you continue your education program and fulfill your clinical responsibilities.  We will revisit these issues and send regular updates as new information becomes available to us. 

We understand that these circumstances can be stressful.  If you have any questions or concerns, please reach out to your Site Director or Dr. Murdoch at stu.murdoch@utoronto.ca.  

The following options are also available to you: 

1. UofT Postgraduate Wellness Office: Please contact pgwellness@utoronto.ca or (416) 946-3074. 
2. PARO 24-hour Helpline:  1-866-HELP-DOC (1-866-435-7362) 
   1. A confidential support service for residents, medical students, their partners and families. The toll-free number is accessible anywhere in Ontario, 24 hours a day, 7 days a week.  
3. Physician Health Program Confidential help line: 1-800-851-6606 
   1. A confidential service providing assistance on issues, such as stress, burnout, mental health, and substance use issues, to both physicians and their families. They offer expedited referrals to third party providers with expertise in physician health. 

Sincerely, 

 Dr. Stu Murdoch, Postgraduate Education Program Director 

 Dr. Risa Freeman, Vice -Chair Education 

 Dr. David Tannenbaum, Interim Chair 

• Research at UofT FAQ
• Resources for Researchers During the COVID-19 Pandemic
• Research Rounds - March 19th, 2020  - Cancelled
• Research Rounds - May 21, 2020 - TBD

COVID-19 Research Links

World Health Organization: Global Research on Coronavirus Disease

New England Journal of Medicine: Responding to Covid-19 — A Once-in-a-Century Pandemic?

Announcing the CRIS Research Roundup sent March 31, 2020

The Centre for Research & Innovation Support (CRIS) has published its first Research Roundup, a weekly digest of key research and innovation-related communications.

To access the digest for the week of March 23-29, visit our website here:

Issue 1 – Research Roundup March 31, 2020 .

The digest will include a recap of research alerts, communiques from information technology services and Libraries, and other newsletters and notices relevant to the research & innovation community. This digest was created in response to requests from the community to keep them informed by streamlining communications.

The Research Roundup will be published on Tuesday and include information communicated in the week preceding. A research alert will announce the weekly publication.

Submission requests can be sent to cris@utoronto.ca, with a deadline of 12pm on Friday, for publication on Tuesday. Requests should include a copy of the original communication and the URL.

To join the CRIS mailing list click here.

Eligibility Update - Toronto COVID-19 Action Initiative sent March 25, 2020

Further to the Research Alert posted on Monday, this is to advise the U of T research community that the Toronto COVID-19 Action Initiative is now open to all full-time faculty at the University of Toronto and affiliated hospitals who are independently eligible to hold tri-agency funding.

The University of Toronto, with its affiliated hospitals, has created a Toronto COVID-19 Action Fund of $6,000,000. University Advancement is seeking contributions to increase the size of this fund. The goal of this Fund is to support research that renders near-term results (from one month to 12 months depending on the nature of the impact) with strong potential to positively impact individuals, communities and public health systems.

Awards of up to $500K will be awarded through an expedited peer review process to successful applications according to the following timelines:

Application Deadline: Wednesday, April 1, 2020 at 11:59 p.m. EDT

Adjudication: by April 10, 2020

Notification of Results & Release of Funds: April 17, 2020

For program details and access to the guidelines and application form, please see:

https://research.utoronto.ca/funding-opportunities/db/toronto-covid-19-action-initiative

Questions regarding this funding opportunity should be addressed to strat.initiatives@utoronto.ca

Message from the Centre for Research & Innovation Support sent March 25, 2020

CRIS Spotlight: Resources for Researchers during the COVID-19 Pandemic

In response to the COVID-19 pandemic, the Centre for Research & Innovation Support (CRIS) has curated a set of resources for researchers. This new Spotlight page highlights specific resources to support researchers during this exceptional period. The Spotlight page currently features technology and training on working remotely; highlights online professional development opportunities; and provides links to COVID-19 information for faculty from various sources at the University. This page will be updated regularly to respond to the needs of our community.

To sign up to receive future email communications from CRIS, including new Spotlight resources, please click here.

Email sent from CIHR on March 17, 2020.

CIHR, NSERC and SSHRC are closely monitoring the evolution and impact of the novel coronavirus (COVID-19), and are taking action to support our grants, scholarships and awards recipients, as well applicants, peer reviewers and employees. We are also contributing to the efforts to slow the spread of COVID-19 and, like other organizations in Canada, are putting in place appropriate social distancing measures and other modifications to our business operations. The situation continues to evolve rapidly, and we will make further adjustments as needed.

The granting agencies recognize that the COVID-19 pandemic may affect your work, your ability to conduct and to review research, and your ability to prepare and submit publications or grant and scholarship applications. We understand that some research could be jeopardized or slowed down; the preparation of research and financial reports may be delayed; and meetings, events, and travel plans might also be affected. The granting agencies will continue to support the research community as we adapt to these challenges.

As previously communicated, if you must cancel or postpone travel or events paid through agency funds, we will consider the costs associated with the changes as allowable project expenses, provided they align with agency policies. The Agencies are also canceling or postponing non-essential events and travel at least until early April (more details to come).

Over the coming days and weeks, the Tri-agency will provide agency-specific information (program by program), as we continue to monitor and evaluate adjustments to program application deadlines and reporting due dates, as needed. These will be communicated by each agency, for each program, as we make those adjustments. Please consult the CIHR, NSERC, and SSHRC websites regularly for updates.

We will continue to make adjustments and put in place additional measures. If you have already submitted a grant application, we will strive to provide you with a timely response; however we do anticipate that the coronavirus will have an impact on the ability of reviewers to participate in planned peer review activities. We will advise you if significant delays are foreseen. Grant and grant application extensions are part of the measures being considered due to the exceptional circumstances. The details for each program will be shared in the coming days.

Once again, we encourage you to regularly consult the relevant agency webpages for further updates. Please do not hesitate to contact your university administration or the Agencies if you have any questions.

• DFCM 50th Thank You Event - March 25th, 2020 - Cancelled
• DFCM Conference - April 24th, 2020 - Postponed, new date TBA
• Climate Change Symposium - March 25th, 2020 - Cancelled
• DFCM Faculty Awards - June 24th, 2020 - Cancelled
• Toronto International Program – Cancelled 
• Refugee Health Primer – Cancelled 
• Leadership Basics - April 2nd, 2020 - Cancelled
• EBMLive - July 6 - 8, 2020 - Cancelled
• QI Program Retreat - June 2nd - cancelled

• Keep up to date on the latest messages from the Provost via the Provost's Weekly Digest
• Faculty of Medicine COVID-19 Updates for Faculty, Staff and Students 
• Research & Innovation Coronavirus (COVID-19) FAQ 
• March 18: Message from the University regarding the Coronavirus (COVID-19)
• March 17: [COVID-19] Public Health Process at the University of Toronto (PDAD&C #53)
• March 16: Message from the University regarding the Coronavirus (COVID-19) 

• COVID-19 Information and Resources 
• Exam Information

Email sent March 19, 2020

Dear colleagues,

Thank you for your patience while we work to reschedule the spring 2020 Certification Examination in Family Medicine due to COVID-19. We understand the magnitude of the decision to postpone it and find an appropriate alternative date. Our priorities remain the health and safety of everyone involved: the exam candidates, the examiners, and those who support the exam administration. We must also maintain the quality and validity of the exam and address many complex logistical requirements. We are collaborating with other health care, academic, medical regulatory, and resident organizations to determine our new schedule as quickly and as smoothly as possible.

We have been assured that medical regulatory authorities across Canada are working to facilitate issuing provisional/restricted licences/registrations to candidates who will not have obtained their Certification in the College of Family Physicians of Canada (CCFP) when they start to practise. To implement this, each medical regulatory authority will require: 1. a statement verifying the resident’s completion of training, issued by their university; and 2. a statement that the resident is qualified to write the Certification Examination in Family Medicine. The CFPC will generate the documentation the medical regulatory authorities require indicating candidates’ eligibility for the examination.

We wish to share our proposed examination schedule, which assumes that health care settings will be stable and travel/group gatherings will once again be permitted.

The simulated office oral (SOO) component of the exam will be held October 16 to 18, 2020. Our plan is to hold the October SOOs at the 17 sites we had planned to use in April. Logistics related to holding the postponed spring exam in October, such as examiner recruitment, still need to be confirmed.

A decision regarding the written short-answer management problem (SAMP) component of the exam is still under consideration. We currently favour and are actively exploring with our vendor the possibility of holding the SAMP component in October 2020 prior to the SOO portion of the exam, and we will know more about this possibility over the next week. The biggest factor influencing this decision is that our vendor has confirmed that if we secure a June date and that this date ends up not being feasible, it cannot guarantee an October date. We basically need to firm up one final set of days for the SAMPs now.

Given the uncertainty of the current public health situation, the concerns some residents have about expectations regarding their service commitments, the likely need for them to self-isolate for two weeks prior to a June examination date, and the inability at this time to say whether this would be possible, we feel that, on balance, it is better for us to try to secure an October 2020 date now.

We are committed to ensuring our stakeholders know our 2020 examination schedule as far in advance as possible, and certainly no less than four weeks prior to the administration of an exam.

As you see, there are still many details to be confirmed and plans could change depending on public health priorities. We will share additional details with you as they become available. If you have immediate questions, please contact us at ccfpexam@cfpc.ca.

Sincerely,

Francine Lemire, MD CM, CCFP, FCFP, CAE, ICD.D 
Executive Director and CEO 
College of Family Physicians of Canada College of Family Physicians of Canada

Nancy Fowler, MD, CCFP, FCFP
Executive Director, Academic Family Medicine
College of Family Physicians of Canada College of Family Physicians of Canada

Message sent March 24 to CMA members

Dear members,

Please find below an update on our latest work on COVID-19.

Supplies of personal protective equipment

We’re hearing members loud and clear about the need to secure and distribute additional personal protective equipment (PPE). We’re hearing first-hand from physicians running low on supplies in their clinics, having to send stock to local hospitals, or considering using expired items. We’ve also been receiving suggestions to tap into existing stock from other sectors and professionals who may not currently require these supplies.

We’ve been raising these critical concerns in our discussions with federal officials, as well as working with the PTMAs to do the same at the provincial/territorial level – highlighting that this issue must be resolved immediately.

Here are the most recent updates:

• On Friday, March 20, the federal government announced an action plan to work with businesses and manufacturers to retool their operations to produce medical equipment, including ventilators, masks and other protective gear.
• The federal government is leading the bulk purchasing and working with provinces/territories to distribute supplies where they’re needed most.
• Together, the provinces/territories have been advocating for increased supplies for health care workers, and in many instances, conducting stock inventory to better inform distribution.
• On March 18, Health Canada temporarily modified its regulations to allow expedited access to disinfectants, hand sanitizers and personal protective equipment, as well as swabs for testing.

Practice management resources

• We recognize that many patients may be contacting you with questions about their regularly scheduled visits. The CMA has put together some template information you can share with them about potential changes to your office procedures and how they can stay healthy.
• On that same page, you’ll also find new information on the general infection prevention and control measures primary care providers should be following, and who should or shouldn’t be tested for COVID-19, according to current guidelines.

Health and wellness resources

• BC clinical psychologist Dr. Catherine Costigan shares her suggestions for how health care providers can talk to their children about COVID-19.
• As a reminder, if you are feeling distressed or need personal assistance, please reach out to your provincial physician health program.

Phishing and scams on the rise

• The Canadian Centre for Cyber Security has seen an increase in the number of phishing attempts and scams related to COVID-19. They have put together a list of how to spot malicious emails and websites, and protect your device from cyber attacks.

Again, if you have suggestions for how we can best support you during this incredibly challenging and stressful time, please contact our Member Service Centre at memberservicecentre@cma.ca or toll-free at 1-888-855-2555 (weekdays from 8 am to 8 pm EDT).

Thank you and be well,
Dr. Sandy Buchman

• Public Health Agency of Canada: KNOW THE DIFFERENCE: SELF-MONITORING, SELF-ISOLATION, AND ISOLATION FOR COVID-19
• Public Services Health & Safety Association: Doffing Guideline
• Public Services Health & Safety Association: Donning Guideline
• Ministry of Health COVID-19 Guidance: Primary Care Providers in a Community Setting
• COVID-19 Toronto Resources App
• COVID-19 printable handouts in multiple languages to address language barriers
• Empower Health - website to provide timely clinic and pharmacy information
• COVID-19 Resources & Available Services in GTA
• Ontario Works handbook
• COVID-19: Updates on the law and legal services
• Interim schedule for pregnant women and children during the COVID-19 pandemic
• Quick Guide - Resources for Physicians (March 2020)
• Individual Physician Skill Set Inventory
• Principles of Care for Physicians During a Pandemic (2020)
• Ministry of Health: Public health management of cases and contacts of COVID-19 in Ontario
• COVID-19 Goals of  Care Communication Guide for Clinicians
• COVID-19 and Serious Illness Communication Skills by Dr. Warren Lewin at Toronto Western Hospital

Important Open Access Resources for Clinicians

1. Free access to UpToDate: From now until April 30 (and subject to extension) access to the UpToDate clinical decision support online resource is free for members of the UofT community. My thanks to the university's Chief Librarian, Larry Alford, for his assistance in securing this access. In order to receive free access, any new subscriber simply needs to follow this link: UpToDate Guest Pass. If a clinician had a license in the past and it is no longer valid, they can simply reach out to our customer support team. Customer Support can extend access for lapsed individual subscribers through April 30, 2020. These lapsed subscribers will need to contact Customer Support directly:
   • Online at www.uptodate.com/home/contact-us - users can choose to open a web case, chat, call or email from that page:
   • By email at customerservice@uptodate.com
   • By phone at 1-800-998-6374 or +1 781-392-2000
2. Online ICU Training Resources: Members of the Critical Care Education Pandemic Preparedness (CCEPP) project have developed an online resource for non-intensive care clinicians -- doctors, nurses, RTs, and others -- who may find themselves working in critical care during the pandemic. www.QuickICUTraining.com is a study guide and quick reference resource for those upskilling, renewing, or reviewing their critical care capabilities in response to COVID-19. It is meant to supplement simulation- and/or on-the-job learning and more formal training programs.
   • QuickICUTraining.com is comprised of short "pocket card" summaries, evidence-focused lectures, procedural demonstration videos, and links. Content on this website is a result of both collation of existing materials and novel creation. The website also houses triage guidelines and recommendations. Please note that this resource continues to be developed and improved as we are receiving and generating more materials and refining current materials.