RESIDENTS

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O.A.G.S. Resident Representative, Dr. Karen Devon, PGY4, UofT

Photo Not Available As of May 12, 2007, Dr. Karen Devon of Toronto, Ontario succeeded Dr. Shiva Jayaraman as O.A.G.S. Resident Representative...

Hi! I am a PGY-4 at the University of Toronto. I am pleased to be the Resident Representative to the Ontario Association of General Surgeons (OAGS).

My role is to represent residents to the board and express our opinions to our soon to be colleagues as well as disseminate important information from Ontario's general surgery community to the residents.

In my first "Resident Rostrum" of The Cutting Edge newsletter, I will be discussing the new limited licensure pilot project…. Stay tuned.

OAGS is an important voice representing all of us at the Ontario Medical Association and lobbying for important issues (such as OR time!). I hope my fellow residents will take advantage of the low cost of membership to get involved and meet your future colleagues. Looking forward to meeting everyone soon at the Annual Meeting in Toronto, but in the meantime, feel free to contact me anytime with questions, comments or concerns.

Cheers,
Karen

Karen Devon
karen.devon@utoronto.ca

RESIDENT ROSTRUM (Spring/Summer, 2008; Issue #27)

To those of you who don’t yet know me, I am the new Resident Representative to the OAGS. My role is to represent residents to the board and express our opinions to our soon-to-be colleagues as well as disseminate important information from Ontario’s general surgery community to the residents. I hope that the dialogue will be in both directions. Thus far, attending board meetings has been an interesting and educational experience, and it is clear to me that this is an excellent forum for discussion and debate and has highlighted the important work that the organization does to protect the interests of patients and surgeons in Ontario.

One of the hot topics in resident life these days is that of the limited licensure pilot project which has been a goal of the resident’s association for many years. Such restricted practice is approved and widely used in eight of the nine other provinces with residents. There appears to be many advantages of such a program intended to assist communities and patients in need due to physician shortages. For the residents, the numerous benefits include: exposure to community practice and variety of cases, generalist training, aiding in the transition to independent practice, improving financial well-being, and fulfilling CANMEDS competencies.

Currently in Ontario in order to be eligible, residents must have completed the MCCQE 1 and 2 exams in good standing, pay a yearly fee of $515 and submit a separate application to each of the potential work units (even if both are in the same hospital). This has been described as a lengthy process of up to 16 weeks per application as it goes through numerous committees for approval.

Furthermore, there will be several restrictions as follows. Work hours are limited to those already stipulated in the PAIRO collective agreement. This is a controversial issue, as the PAIRO agreement exists to restrict the hours residents are required to work for their employers, and none of the other provinces where limited licensure exists imposes this. In addition, one will not be able to take any shift within 12 hours prior to a residency shift. Deans and program directors will also have the right to veto the project for individual or all residents at any time. In terms of remuneration, currently it appears that residents will be paid through the hospitals and amounts have not yet been stipulated and therefore will be negotiated on an individual basis. In most surgical programs, residents will be allowed to work in the ICU, emergency department and by taking surgery call including assisting in the OR. Some program directors have placed additional restrictions where the resident is only permitted to work in locations where they’ve previously done service.

The feedback from residents have been mixed. One colleague has said, “Nobody in the General Surgery program during a clinical rotation will be able to take calls. It’s ridiculous that the programs have the right to regulate what a resident will do with his or her free time. The way it should work is that you can take as many calls as you think is adequate and if the program thinks your performance is being affected, then they take the appropriate measures. This is not going to fulfil the goals of improving resident’s income and ameliorate the shortage of the province.” Another has commented on the significant amount of paperwork that appears to be involved and adds, “In principle, it’s nice to know that we can freelance, but I can’t see myself wanting to add anything extra to the time I already spend as a resident.  The only aspect that might change my mind is a substantial increase in salary.” PAIRO recognizes some of the difficulties and states, “Ontario residents definitely share concerns that this process is cumbersome at present and needs to be streamlined in the future. We are hoping that the educational centres and CPSO can soon follow the examples of other provinces in creating a more efficient process, especially in the current time of physician shortages”. However, there are some positive outlooks as well and the project is particularly attractive to residents on research rotations. One resident has applied purely in order to support the project as it has been suggested that once deemed successful, money to pay the residents will actually come from the government. Furthermore at some sites, the moonlighting that is already occurring under the table will be legitimized. I would love to hear more of your thoughts as this project gets underway.

In closing, I’d like to encourage residents to become involved as members and attend future annual meetings. It is evident to me that OAGS is an important voice representing all of us at the Ontario Medical Association and lobbying for important issues such as OR access and on call coverage. The organization also helps to implement guidelines and continuing education programs and keeps us all up to date on current events and controversial issues affecting general surgeons such as wait times, regionalization, most responsible physician position statement, anaesthesia for endoscopy, and province-wide colorectal screening initiatives.

In 2007, we had a good turnout at the 13th OAGS Annual Meeting with ten percent of the attendees being residents. The talks were both educational and riveting and included progressive issues such as bariatric surgery in Ontario by Dr. Laz Klein and an incredible talk on a surgeon’s experience in Iraq by the keynote speaker Dr. Carlos Brown. This year, the meeting is on November 1, 2008 and we are organizing a resident break-out session which may include topics such as finding a job and starting a practice as well as what to expect once you’re out in the real world. It’s a great opportunity to meet your future colleagues and employers, so I hope you will join us!

Resident annual dues are $20. In the past few years, however, this has been discounted to $10 due to resident sponsor Tyco Healthcare/Covidien. Hopefully, they will sponsor us again when the new fiscal begins this fall. Check our website for up-to-date details: www.oags.org

In the next column of the Resident Rostrum, the exciting results of your resident survey will be published. Thank you to those who have participated thus far. Those who haven’t yet are encouraged to do so, as it will only take five minutes: www.oags.org/resident.htm .

Please contact me anytime with questions, comments or concerns.

Karen Devon
416-357-0277
karen.devon@utoronto.ca

- Dr. Karen Devon, PGY4 UofT, is the OAGS Resident Representative. Comments and suggestions relating to resident matters can be emailed to: karen.devon@utoronto.ca or info@oags.org .



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