Useful smart phone apps and online resources by subject
Smart Phone Application
ACLS Advisor 2013 (free)
WikEM – Emergency Medicine (free)
ERes – Emergency Medicine ($4.99)
Pepid (free or $299.99)
PalliCare.Ca (free WebApp)
AFP By Topic (free)
OCFP Handbook - NEW 2015!! (free)
Eye Chart Pro (free)
Lab Values Pro ($2.99)
MD on Call ($4.99)
MedCalc Pro ($4.99)
5-Minute Clinical Consult (subscription)
ACC Pocket Guidelines (free)
Harrison’s Manual of Medicine (subscription)
Perfect OB Wheel ($1.99)
Cancer Care Ontario Symptom Management Guides (free)
Pediatric Growth Chart (free)
Pedi Safe ($0.99)
Pedi STAT ($2.99)
CPS Essentials ($39.99 annually)
CPS RxTx (free)
STAT Depression Score PHQ-9 (free)
Psychiatry, Understanding Disease (free)
Helpful Reference Books
● Guide to the Canadian Family Medicine Examination. Authors: Megan Dash and Angela Arnold
● Family Medicine Notes Author: Danielle O’Toole
● Canadian Guidelines Online
● Rx Files (Objective Comparisons for Optimal Drug Therapy)
● Family Medicine Notes: Preparing for the CCFP Exam, Danielle O’Toole
● Mosby’s Family Practice Sourcebook. Author: Michael Evans
● Anti-Infective Guidelines for Community Acquired Infections
● Hypertension Guidelines for Family Practice
● Approach to Internal Medicine: A Resource Book for Clinical Practice. Author: David Hui
● Drug Pocket: Clinical Reference Guide. Author: Andreas Russ
● Tools for the Primary Care of People with Developmental Disabilities
● The CMA offers members free access to many medical textbooks
● American Academy of Family Physicians
OCFP Family Medicine Residency Guidebook
Ontario College of Family Physicians
OCFP Facebook Page
Canadian Family Physicians
Clinical Practice Guidelines and Protocols in BC
EM Case studies
Life in the Fast Lane
Canadian Task Force on Preventive Health Care
Cancer Care Ontario
Support for cancer patients and those who care for them
Number Needed To Treat
The Society of Obstetricians and Gynacologists of Canada
Drugs in Pregnancy
Canadian Pediatrics Society
Canadian ADHD Resources Alliance
ODB Formulary Search
CBT Training Program for patients
Centre for Clinical Interventions – Top 10 Patient Handouts
There are many opportunities for involvement within each family medicine program. Listed below are a few provincial and national committees to consider. Expect an email early in the year soliciting applications for these positions.
Three to four representatives per Ontario program,
four meetings per year in Toronto
One representative per year per Ontario program,
two meetings per year in Toronto and two teleconferences
One representative per year per Canadian program,
two meetings per year in Mississauga and two teleconferences
Michener Institute, Toronto
Sunnybrook Hospital, Toronto
Mount Sinai and North York General Hospitals
Hamilton Health Sciences
ACLS and PALS
ACLS and ATLS
ATLS, PALS and ACLS
Residency training can be exciting, challenging and full of great opportunities for learning and growth. It can also have moments that are exhausting, stressful and emotional. It is important to try to maintain a healthy balance between work and other aspects of your life in order to maintain your personal wellbeing and to provide better patient care. Maintaining your pre-residency interests can help you to stay balanced.
If you find yourself struggling at any point during residency, know you are not alone and that there are lots of resources available for help! The PARO website has a great section on Thriving During Residency that outlines some helpful resources available to residents here.
Some highlights include:
The following information in this section is not inclusive of all of the provisions under the PARO-CAHO Agreement, and provides answers to commonly asked questions. A full PDF version of the PARO-CAHO Agreement can be found on the PARO website.
The details provided in this package are of a general nature and may not necessarily be applicable to all residents in all situations. Please visit the PARO website for updates or feel free to contact the PARO office with any questions.
Information regarding taxation, incorporation and disability is information provided from MD Management and should not replace professional advice from an accountant or financial consultant.
The Professional Association of Residents of Ontario is the official representative voice for Ontario’s doctors in training.
PARO’s priority is to advocate on behalf of its members, addressing professional and educational concerns in order to optimize the training and working experience of Ontario’s newest doctors thus ensuring that patients receive the best possible medical care.
Members of PARO are, by definition, post-graduate medical residents training in accredited programs which lead to certification by either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of family Physicians of Canada (CFPC), in one of their recognized specialty or subspecialty programs.
All that to say, you are automatically a member of PARO and there is no need to register.
Recent arbitration discussion has awarded a three-year Collective Agreement, retroactive to July 1 2013, and ending June 30, 2016 as detailed in the below chart:
July 1, 2013
July 1, 2014
As of July 1, 2015
Call Maximums: Based on the total days ON service (vacation and other time away are deducted from the total days, PRIOR to calculating maximum call).
It’s important to note that you can’t be scheduled to work two or more consecutive calls, unless you’ve agreed to it with your Program Director and PARO. Also noteworthy, is the fact that if you’re not on call or scheduled for work, you aren’t expected to be available on your pager, or to be in the hospital or clinic.
In Hospital Call: The maximum is 1 in 4. In hospital call maximums for rotations greater than 1 month are averaged over the length of the rotation (maximum averaging length is 3 months) with a maximum of 9 calls in any given month. The total number of calls on a rotation longer than one month can be calculated by taking the total of number of days ON service, dividing them by 4 and rounding to the nearest whole number (.5 rounds up).
Home Call: The maximum is 1 in 3, (or 10 per 30, or 11 per 31). A resident cannot be on home call on 2 consecutive weekends. Home call CANNOT be averaged over multiple months.
Blended Call: (In Hospital and Home Call): is calculated using the following formula:
HCA: Home Call Assignments
IHA: In Hospital Assignments
(Total HCA X 3) + (Total IHA X4)=Max Blended Call
Total must not exceed 30 for a 28-day rotation. For other examples please consult the PARO website.
Recent arbitration discussions have also awarded an increase to call stipends of just over 10%, effective July 1, 2015:
Home Call: $58
In-hospital Call: $116
Qualifying Shift: $58 (shifts worked where on full hour worked on shift occurs between 11pm and 6am)
Call stipend claims must be submitted to the person(s) designated by the hospitals to receive such claims within 30 days following the end of the month in which the call was worked, save and except for circumstances reasonably beyond the control of the resident. Otherwise, ultimately call stipends will not be paid.
Shift work: On rotations where residents are scheduled in shifts, e.g. Emergency Medicine or Intensive care, total maximum hours is 60 hours/week. This includes other scheduled responsibilities, such as academic half days. There must be a minimum of 12 hours off between shifts (unless the resident desires less time off between shifts).
Weekends: Each resident must have 2 COMPLETE weekends off per 28 days; including Friday night/Saturday morning as well as Saturday and Sunday. A resident cannot be on home call on 2 consecutive weekends. Residents cannot be required to round (or perform other clinical duties) on weekends when not on call.
Post Call Relief (Home after Handover): Residents must be relieved of ALL clinical and academic responsibilities post call 24+2 hours after the commencement of the working day. The following exceptions apply:
Home Call Conversion for Post-Call: Residents on out-of-hospital call are required to be relieved of their duties when they are in either of the following situations:
Family Medicine + ER Shifts: If a Family Medicine Resident works their normal weekly family medicine duties (i.e. multiple clinics or other FM responsibilities) IN conjunction with ER shifts during the same week (either on a weekday or weekend), then they are entitled to: a home call stipend if the ER shift does not extend beyond 11pm, or In-hospital call stipend if the ER shift extends beyond 11pm. Note: these rules do not apply to family medicine residents who are only scheduled for ER shifts and have no other family medicine responsibilities in the same week. If the resident were doing purely shift work for that block, then only the qualifying stipend would be applicable.
Rounding on Weekends: The 2011-2013 PARO-CAHO Agreement states that where residents who are not otherwise on-call are scheduled or required to round on weekends, and actually attend in hospital for such rounding, they will be paid the Home Call Stipend.
Family Medicine OB Call: Where a Family Medicine Resident carries a pager for obstetrics call to fulfill the requirements of the resident’s training program, you are only entitled to claim either the home or in hospital call stipend depending on the time in attendance at a delivery. If you not required or expected to respond to the page (e.g. you can opt out of carrying the pager on certain evenings), there should be no call stipend paid. Please note that if you respond to a page and are required to go to the hospital to perform clinical care, the normal conversion rules apply for post-call days.
Taxi: Residents on home call may be reimbursed up to $70 per month for taxi charges if:
Parking: When residents are required to travel between sites or return to a site for CLINICAL duties, the resident will be reimbursed for the cost of parking associated with the time spent at the second or subsequent sites provided the distance between sites exceeds one kilometre.
Travel Allowance: A travel allowance will be provided on presentation of appropriate receipts to the postgraduate medical education office.
Vacation: Residents are entitled to four weeks of paid vacation per year. A week of vacation is defined as five working days plus two weekend days. Vacation time may be delayed only where necessary, having regard for professional and patient care responsibilities. All requests must be confirmed or denied in writing within two weeks of the request being made. If denied, alternate times for vacation must be agreed to within two weeks. There can be no blanket policies restricting the amount of vacation in any rotation. You cannot be post-call on the first day of vacation.
Professional Leave: Maximum of seven working days per year (note: weekends are not considered “working days” for this purpose.) Residents DO NOT need to be attending a seminar, course or conference to take a professional leave day, and the resident does not need to provide proof of what the day was used for.
Residents are entitled to take paid leave for the purpose of taking any Canadian or American professional certification exam. This leave time includes the date(s) of the exam and reasonable travel time to and from the exam site.
All house staff are entitled to the following recognized holidays:
*A floating holiday is defined as a paid holiday taken at a time chosen by the resident. A program CANNOT tell a resident when to take their floating holiday.
Christmas/New Year’s: All house staff are entitled to five consecutive days off during the 12-day period encompassing Christmas Day and New Year’s Day. These five days account for Christmas Day, New Year’s Day, Boxing Day and two weekend days. Each resident must get either Christmas or New Year’s Day off. Residents do not get additional lieu days for working on either of the statutory holidays during the period.
Lieu Days: Where a resident works any part of one of the recognized statutory holidays, excluding Christmas Day, Boxing Day and New Year’s Day (see above), they are entitled to a lieu day to be taken at a time mutually convenient within 90 days of the holiday worked. This includes residents working home call for any portion of the 24 hours of the date of the holiday.
Religious Holidays: If you observe religious holidays that are not specifically listed in the Collective Agreement, your program may have a duty to accommodate your religious practice to the point of undue hardship (“undue hardship” may include a number of factors, such as patient safety, the hospital’s service requirements, and the resident’s educational or training requirements). It is your responsibility to request accommodation, explain what measures of accommodation are required and allow a reasonable time for a reply.
Overall Benefit Maximum: Unlimited
Deductible: $15 individual & $25 family per benefit year
Benefit Year: July 1 to June 30
Benefit Percentage (Co-insurance): 100% for hospital care, drugs, vision care, professional services, medical supplies and services
Your Pay Direct Drug Card provides your pharmacist with immediate confirmation of covered drug expenses. This means that when you present your Pay Direct Drug Card to your pharmacist at the time of purchase, you and your eligible dependents will not incur out-of-pocket expenses for the full cost of the prescription.
Eye exams, to a maximum of one exam in any 24 consecutive months, purchase and fitting of prescription glasses or elective contact lenses, as well as repairs, or elective laser vision correction procedures, to a maximum of $250 in any 24 consecutive months
The following services will cover $500 per benefit year:
Benefit Percentage (Co-insurance):
Benefit Maximums: Unlimited for Level I and Level II (some restrictions apply, check website for more details)
Dental Recall: Dental recall examination every nine months except for eligible dependent children age 18 and under, one examination every six months.
How do I get reimbursed?
At the beginning of every year, a $25 processing fee will be deducted from the first claim. This is standard and not negotiable. All required forms must be completed and signed. Option for direct bank deposit is possible.
Please refer to the PARO website for full details or to Manulife Group Benefits (log in required). Benefits are administered by a resident’s pay centre. Residents can obtain detailed benefits booklets from their pay centre.
As outlined in the PARO contract, a resident shall not suffer loss of salary or employee benefits because work cannot be performed due to illness or injury.
The contract allows for continuation of salary up to six months of the end of the appointment year. In essence, this time covers anything from a single sick day up to the end of the six-month time period. Benefits will be maintained and continued until the end of the appointment during such medical disability. For further information, please refer to Article 14.1 of the PARO-CAHO Agreement.
If you feel you are unable to report to work due to illness or injury, you should notify the appropriate team members on your rotation in sufficient time.
What Do I Do If I Have a Needle Stick Injury?
The majority of these cases are handled through the hospital / clinic you are working with. Protocols are usually in place through occupational health. Be sure to contact them immediately in such instances. You and the patient may be required to complete blood work.
What About a Work Place Injury?
Again, it would be important to report such injuries to the health centre’s occupational health department. In the event of a long-term illness or injury, the PARO contract guidelines outlined above also apply.
Many residents may contemplate having a child before their residency is complete. If so, congratulations! You may be wondering how a pregnancy or parental leave may affect your residency and/or income.
If you read nothing more, know that a great PARO resource exists that clarifies the PARO contract and guides you through the process. Click here to be directed to that resource.
The PARO office is also very helpful for clarifying questions related to your particular situation.
Benefits are government issued (EI).
Service Canada requires a person to have accumulated 600 insurable hours in the previous 52 weeks.
The PARO-CAHO agreement also provides a supplemental income top-up for those residents who are eligible for EI, for a maximum of 25 weeks.
The top-up will ensure you receive approximately 84% of your normal weekly earnings for those 25 weeks.
Note: To be eligible for the top-up, PGY-1’s must have worked 13 weeks of continuous service.
Another thing to consider when planning your maternity leave is that you must give four weeks written notice of the intended timing of your pregnancy and/or parental leave.
For further information about pregnancy and parental leave benefits, consult the PARO-CAHO 2011–13 Agreement (specifically Articles 11.5, 14.1 and 15). You may also wish to consult the Service Canada website regarding Employment Insurance benefits.
No one plans for remediation to be a part of his or her career path. When it does happen, it can be extremely stressful. Fortunately, Ontario PGME programs are well equipped to deal with the process, as should you be. Below is a list of school-specific links to remediation policies outlining the process, who is involved and requirements. Also included are links to each program’s support services for residents, which may include how to obtain a family doctor and how to access wellness and mentorship programs. Many schools also offer Resident Guidebooks that include useful information.
Professional Association of Residents of Ontario
PARO is another great resource for residents undergoing remediation
Whether it’s offering strategic advice or acting as an intermediary, PARO can play a key role in an appeal process if necessary. While PARO won’t take sides in an academic dispute on its clinical or academic merits, we will take a position on procedural matters, helping you through the process of appealing a clinical assessment that you believe is incorrect or unfair, as well as providing some related advice.
In some cases, where PARO believes that the underlying issues raise matters of general importance to our membership, we may independently intervene on your behalf.
There have been recent changes to the certification examination in family medicine. In Spring 2014, residents began taking a Harmonized Exam, which combined both the LMCC Part II and the CCFP exam. However, as of 2016, the harmonized format will no longer be offered. Candidates will be required to register separately for the CFPC’s certification exam and the MCCQE Part II. Please refer to the CFPC website
Separate Exams (beginning 2016)
LMCC Part II: OSCE (Objective Structured Clinical Exam) with eight 10-minute stations and eight 5-minute stations with 5-minute post-encounter probes.
SAMPS (Short Answer Management Problems): 40-45 SAMPs to test recall of factual knowledge and problem solving abilities in the areas of definition and management of health problems and critical appraisal.
SOOs (Simulated Office Orals): 5 SOOs designed to simulate a real clinical encounter. East lasts 15 minutes and includes a patient (the examiner) who will present with a primary and secondary complaint, which the examinee must uncover. The examination will assess both the definition and management of each health problem. The scoring system focuses on the candidate’s approach to dealing with patients—including their ability to understand the patient's unique experience and to establish a positive doctor-patient relationship, using a patient-centered clinical method. Getting the "right diagnosis" plays only a minor role in the scoring.
Examination fee (2017) = $2,902
Each year, the Ontario College of Family Physicians offers several venues for continuing professional development, including the Emergency Primer for Family Physicians and many others. Please refer to the CME Event Calendar at ocfp.on.ca/cme/calendar
Rural and Remote Medicine
American Academy of Family Physicians: Family Medicine Experience (FMX)
CFPC Family Medicine Forum (FMF)
OCFP Annual Scientific Assembly
The CFPC program for Continuing Professional Development (CPD) allows physicians to document and maintain their continuing education and provides methods for evaluating CPD programs.
Please visit www.cfpc.ca for up-to-date details.
Journal Clubs, etc.
Online CPD Programs
Learning linked to Teaching, Research, etc.
AAFP Elective-Credit CPD
Uncertified Rounds, etc.
Podcasts, CDRoms, etc.
Simulation-based Activities, Practice Audits, 360° Reviews, Teaching Assessments, etc.
Note that only activities outside of your residency program can be claimed, for example mandatory teaching at your site does not count.
The CFPC Self Learning program is free to residents, allows you to collect M1 credits, and has practice SAMPs available for exam preparation. Visit http://cfpc.ca/sli/.
MainPro C+ is coming June 27, 2016. For more information click here
If you are thinking about adding a third year of residency to enhance your skills, there are a wide variety of programs to choose from across Canada.
Why do residents choose to pursue extra training through a PGY-3 program?
For program-specific information and exact time-lines please visit www.carms.ca.
Certifications at the end of PGY-3 year (12 months) are offered for the following specialities:
Please see program websites for complete descriptions, number of positions and application timelines.
SOO Success Infographic - Free for those who signup for the Review Course Study Tips e-mail
Select Guidelines/Helpful Links - Compiled by the Review Course
99 Topics for the CCFP Study Notes - Free and updated pdf for the exam
Calgary Overview of SAMPs - Last updated in 2016
McGill Family Medicine Orientation to the Exam - Last updated in 2015
CCFP Prep - Blog by UBC resident on the 99 topics (last update 2015)
UBC Wiki-Notes on the 99 topics - Initially compiled by class of UBC 2012
CFPC Self-Learning - Produced every 2 months and free for residents, great way to stay current on latest studies relevant to practice. SAMPs and CME credits available.