COVID-19 Information for Residency Programs - Week of April 15, 2021

Dear Program Directors and Program Administrators,

As promised – more information (and as always – subject to change because…..COVID). Thank you all again for your work during these challenging times.

  1. COVID–19 - Plans for additional physician ICU coverage:
    1. As discussed at PGME this week there are increasing numbers of patients with severe COVID requiring ICU care; ICU capacity is limited across Ontario and the GTA in particular is at/over capacity;
    2. For LHSC – ICU capacity is:
      1. Medical–Surgical ICU (MSCIU), 25 beds
      2. Cardiac Surgery Recovery Unit (CSRU), 15 beds
      3. Critical Care Trauma Unit (CCTC), 30 beds
    3. Plan is to increase ICU bed capacity at LHSC by 18 beds – 8 at UH and 10 at VH;
    4. For physician coverage additional night-time coverage will be required – the current plan is not to rely on redeployment, but to have residents/fellows volunteer for shifts in the ICU which would be paid - aka ‘moonlighting’ ;
      1. The advantage of ‘moonlighting’ for coverage is that it will be less disruptive to our programs and services, and for residents will be much better for their wellness and well-being than a redeployment. Moonlighting also has precedent, and will be easier to implement;
      2. Following a meeting this morning we have support from the hospital for this.
    5. Meetings and discussion are underway to move forward, but I am giving you a ‘heads- up’ and will provide more information and communication as things develop.
    6. The good news is that as of today, ICU capacity and physician/resident support is adequate to meet patient care needs.
    7. I have attached our ‘Moonlighting’ Policy (who knew it would be so handy?) for information, as well as a fact sheet re: the role of Program Directors.
    8. Also a caution that the problems we are facing are unprecedented, and if some of the modeling is correct even more bed requirements will be required – both ICU and non-ICU. How we will be able to achieve this would require changes in model of care, use of the Triage Tool for ICU admissions, more restrictions on surgery etc.
  2. Vaccinations – the second dose:
    1. I am so sorry, but a reminder that the health units are working under guidance from the Ministry of Health and will not provide exemptions to reschedule a second vaccination dose. PGME has reached out to advocate for residents being able to have a second dose scheduled earlier than 4 months, but the response has been very clear – no exceptions. This has been previously messaged out to PGME as well as our residents and fellows.

Thank you again for your work, your care, and your patience in these ever changing and challenging times,

Lois and your PGME Team