ABSTRACT
The purpose of this evaluation is to assess the effectiveness of the modifications made by the University of Toronto Postgraduate Medical Education to improve medical trainee compliance with the immunization standards set forth in national guidelines, provincial regulations and protocols and university policy. Trainee compliance with immunization requirements were evaluated as of January 2003, 2004 and 2005. Statistically significant increases in compliance rates for all required immunizations--hepatitis B virus, measles, rubella and chicken pox--and tuberculosis skin tests were observed. University of Toronto postgraduate medical trainees are now highly compliant with the Hospital Management Regulation 965 of the Ontario Public Hospitals Act, Canadian Immunization Guide, Public Health Agency of Canada guidelines for prevention and control of occupational infections in healthcare and the University of Toronto Faculty of Medicine immunization policy.
Subject(s)
Academic Medical Centers/legislation & jurisprudence , Education, Medical, Graduate , Guideline Adherence , Immunization Programs/statistics & numerical data , Internship and Residency , Medical Staff, Hospital/legislation & jurisprudence , Population Surveillance , Vaccination/statistics & numerical data , Blood-Borne Pathogens , Cross Infection/prevention & control , Evidence-Based Medicine , Female , Health Care Surveys , Humans , Immunization Programs/legislation & jurisprudence , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Ontario , Practice Guidelines as Topic , Program EvaluationABSTRACT
The author explains the history of the Professional Association of Internes and Residents of Ontario (PAIRO), Canada, founded in 1968-69 to represent postgraduate medical trainees in negotiations with the Ontario Hospital Association over issues of trainees' stipends. Over the years, the negotiations evolved to cover a number of other issues, including duty hours, and established the principle that binding arbitration would be used to resolve any disputes between the two parties that could not be resolved through negotiation. At present, PAIRO negotiates a biannual collective agreement with the Ontario Council of Teaching Hospitals (OCOTH), whose features the author describes. The most important provisions of the 2000-2002 PAIRO-OCOTH agreement on the limits of duty hours are described. The author then comments that while such limits have benefited programs and residents, there is concern that the limits decrease the opportunities for trainees to be involved in the care of patients with a wide variety of medical conditions. Also, the duty-hours limits have required some services to use attending physicians or outside health professionals to perform duties previously carried out by trainees, creating problems that the author describes.
