2019-2020 Guide to Practice - Available positions: pages 40 to 54 - FMRQ
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Vol. 42 | No. 1 | FALL 2019
Guide
to Practice
2019-2020
Available positions: pages 40 to 54
MERCI À TOUS NOS COMMANDITAIRES
MERCI AUX PARTENAIRES, DONATEURS ET PARTICIPANTS
QUI ONT SOUSCRIT À L’ÉVÉNEMENT !
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Catégorie or
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Catégorie bronze
Association canadienne de protection médicale • Corporation Fiera Capital
Davies • Facturation médicale Fonds FMOQ • Fiducie Desjardins
Gestion privée Fonds FMOQ • Jarislowsky Fraser, Gestion mondiale de placements
La Personnelle • Le cabinet de relations publiques NATIONAL
Optimum Actuariat conseil • Placements Franklin Templeton • SSQ Assurance
Un événement au profit de la Fondation
du Programme d’aide aux médecins du Québec
Table of contents
President’s Message 4 Practice 25
– Regular permit 25
Family Medicine 5 – Moonlighting 25
– Glossary 101 5 – Certification exams 26
– Scope of a PREM compliance notice 8 – Maintenance of proficiency 27
– Effective date of PREMs 8 – Remuneration and billing 27
– Obtaining a PREM in family medicine 8 – Malpractice insurance 27
– Obtaining a PREM in a university family 10 – Incorporation 28
medicine group (PREM UFMG) – Life, health, and disability insurance 28
– Bursary recipients 11 – Automobile and home insurance 28
– Obtaining a PEM in an establishment 11 – Financial services 28
(for family physicians) – Income tax 28
– Your obligations 12 – Maternity, paternity, and adoption leave 29
– Specific medical activities (AMPs) 12 while in practice
– If you are practising without a PREM 12
(in the public system, not private practice) Information Sources 29
– Physicians returning from remote regions 13
after three years’ continuous practice Canadian Regulatory
– Opting for locums 14 Authorities Issuing Medical
– Financial incentives on entering practice 14
Licences 30
In Other Specialties 16 Resources and Organizations
–
–
Obtaining a PEM in an establishment
Practice exclusively in an office
16
18
Related to Medical Practice 32
– Further training/fellowships in Quebec 18 List of DRMGs 33
– Career in research 21
– Fellowships outside Quebec 21 List of DPSs 35
– Financial incentives in non-FM specialties 23
on starting out in practice
BOARD OF DIRECTORS 2019-2020 Staff
Christian Campagna, President Johanne Carrier, Director, Communications and Public Affairs
Valérie Massey, Secretary Sylvain Schetagne, Director, Research and Sociopolitical Action
Julien Dallaire, Treasurer Marie-Ève Breton-Soutière, Manager, IT and Human Resources
Samuel Bergeron, Director from AMRM Jocelyne Carrier, Co-ordinator, Academic Affairs – SP
Annick Bérard-Giasson, Director from ARM Stéphanie Chevance, Co-ordinator, University Affairs
Stéphanie Dufour, Director from AMReQ Geneviève Coiteux, Co-ordinator, Academic Affairs – FM
Eric Guimond, Director from AMReS Marie-Anik Laplante, Co-ordinator, Union Affairs
Alex Vignola, Director (University Affairs) Liliane Francoeur, Assistant
Olivier Fortin, Director (Academic Affairs – SP) Vicki Portelance, Assistant
Dany Afram, Director (Academic Affairs – FM) Edyta Zaniewska, Assistant
Patrice Savignac Dufour, Executive Director
Return undeliverable Canadian addresses to:
Johanne Carrier, Editor
FMRQ – 510-630 rue Sherbrooke Ouest, Montreal, QC H3A 1E4
Triade Marketing, Graphic Design
Tel.: 514 282-0256 or 1 800 465-0215
www.fmrq.qc.ca – fmrq@fmrq.qc.ca – Annual subscription: $20
ISBN/ISSN: Canada Post Publication Agreement 1484699
President’s Message
Obtaining a position in Quebec:
a priority for you and us
Dear Colleagues,
On October 4, 2019, the FMRQ held its yearly Quebec Career Day at Montreal’s Palais des
congrès convention centre, where it welcomed some 900 resident doctors, who had the chance to
meet with representatives of 100 or so Quebec facilities, and of the FMOQ, FMSQ, FMRQ, and
Quebec Ministry of Health and Social Services (MSSS). Following this discussion and information
forum, we present here our Guide to Practice for 2019-2020, which contains information on all
aspects of seeking a position or confirming a fellowship, including the transition to practice and
compensation (pay), among other topics.
As you know, the issue of PREMs in family medicine and PEMs in other specialties and hospital set-
tings is a priority for the Fédération des médecins résidents du Québec. On that front, I would like to
urge caution on all those seeking positions. Normally, if you are looking for a position in a university
setting, you have to hold a position in due form before performing a fellowship. If you decided to
do such additional training outside Quebec without having a position confirmed, you could have
an unpleasant surprise when you return. So I invite you to stay on the watch, and not to be lured
by offers from healthcare sites which, while in good faith, promise you a position with no formal
confirmation for your return from a fellowship outside Quebec. In such cases, they can guarantee
nothing, as they do not know the status of the upcoming five-year plan that will cover 2021 to 2015.
Also, in family medicine, terminating residents are subject this year to a brand new process which,
we hope, will meet our concerns as to the need for greater transparency and equity in the assign-
ment of positions. We will be monitoring very closely how this process plays out, and will make our
recommendations to the Ministry and the FMOQ, if we see anything that would be detrimental to
final-year resident doctors.
In other specialties, the number of positions remains limited in some disciplines, and finding a
position is very difficult, particularly in 2019-2020, as the 2015-2020 five-year plan is in its final
year and no positions have been added in the past three years. In that regard, the members of the
Physician Resource Management Committee – Specialties (COGEMS), which brings together the
FMSQ, MSSS, and FMRQ, plan to complete the task of drawing up a new five-year plan so it can
be posted for the next Quebec Career Day, to be held September 18, 2020. The FMRQ will also be
sitting on all the panels and committees responsible for physician resource planning and distribution
in Quebec, in both family medicine and other specialties, so as to intervene on a timely basis to put
forward the concerns and needs of doctors trained in Quebec.
To stay informed about changes and any new rules concerning the search for a position in Quebec,
don’t miss the Federation’s other activities, notably Outside Quebec Career Day and the General
Assembly meeting that will precede it, on February 20, 2020, or the Symposium on PREMs in Fa-
mily Medicine, scheduled for May 10, 2020. The FMRQ also offers a service providing detailed
information on the procedures involved in seeking a position.
The stress associated with looking for a position is considerable, with all the hurdles that arise in
our search for a PEM or PREM that meets our expectations, but above all that is aligned with our
competencies. So I invite you never to hesitate to get in touch with the Federation if you want further
information or help in your transition to practice
.
Christian Campagna, MD, FRCPC
President
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Guide to Practice 2019-2020
Family Medicine
This section contains detailed information on the new process for granting PREMs in family medicine. It begins with a glossary, to make the new rules easier
to understand, and includes full details on the procedure for obtaining a PREM in a university FMG or a PEM in an establishment, the 55%-45% rule, specific medical
activities (AMPs), and locums.
GLOSSARY 101 CAUTION
Special medical activity For this type of PREM, it is the director of the family medicine
(Activité médicale particulière, or AMP) program of the faculty concerned who selects the candidate and
confirms his choice with his region’s DRMG and the Ministry of Health
Medical activities listed in the Act respecting health services and social services
and Social Services (MSSS) by October 31.
as having a priority dimension. These are services delivered in an Emergency
department; care provided to patients admitted for short-term care; services
involving on-call duty provided in a long-term care centre or rehabilitation centre, (Please note that it is also possible to teach in a university family medicine group
or in connection with a local community service centre (CLSC) home care (UFMG) if a position is available in that UFMG, when you hold a regular PREM. You
support program; medical services in obstetrics; primary care services provided then have to go through the process of applying for a regular compliance notice.)
to vulnerable patients in their homes, in a private health facility, or in any centre
operated by an establishment; and, finally, services delivered in the context of Selection criteria
any priority activity determined by a regional department of general medicine
(DRMG) and approved by the Minister of Health and Social Services. Conditions When the number of candidates exceeds the number of positions available in
for physicians’ participation in AMPs have been determined through a special the PREM, a selection is made. This selection is made on the basis not of the
agreement between the Minister and the FMOQ. physician’s competence, but of his interest in practising in the priority needs
identified by the DRMG.
Upon obtaining a notice of compliance with the regional physician resource
plan (PREM), a physician with 15 years of practice or less must choose an AMP
offered by the region to meet local needs. This AMP will be performed in one of Locum
the services named, for the equivalent of 12 hours per week. Part-time locum
A physician who holds a compliance notice but wants to perform locums
Compliance notice part-time. Note that this practice is included in the 55%-45% ratio.
All family physicians practising under the Quebec health insurance plan are subject PREM exclusively for locums
to the Special agreement on compliance with regional physician resource plans A doctor wishing to practise exclusively under the locum mechanism can obtain a
(PREMs). Under that agreement, the physician has to obtain a notice of compliance waiver in lieu of a compliance notice if positions are available. He has to apply for
with the PREM from the Regional department of general medicine (DRMG) of the this on registering for locums with the provincial Centre national médecins-Québec. To
practice region in question. Obtaining this compliance notice implies the physician’s register for locums, the physician has to hold a permit to practise from the Collège des
commitment to maintaining the majority of his practice, i.e., 55% or more of his médecins du Québec and malpractice insurance corresponding to the areas of activity
billing days, in a sub-area of that region (local services network, or RLS). The covered by his locum practice. A practice is considered exclusive when it includes 95%
frequently used expression “to have a PREM” actually means holding a notice of or more of the physician’s total billing days.
compliance with a given region’s PREM.
University needs
(university physician resource plans, or PEMUs)
Compliance notice reserved for doctors wishing to teach. This involves teaching
positions set aside to meet priority academic needs.
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Guide to Practice 2019-2020
Opting out of a PREM Non-compliance with compliance
You may opt out of a PREM at any time if you have not started your practice. notice conditions
A physician who does not meet his commitment to perform 55% or more
of his billing days in the geographical area covered by his PREM compliance
Regional department of general medicine
(Département régional de médecine générale, or DRMG) notice is subject to a 30% cutback of his total compensation for the year
in question, i.e., from March 1 to February 28. The physician is notified
Each region has a regional department of general medicine (DRMG) consisting by the Quebec Health Insurance Board (RAMQ) around September 1 of
of all the general practitioners in the region who receive compensation from the following year. He may, however, request an exemption; his file will
the Quebec Health Insurance Board (RAMQ). The DRMG’s responsibilities are then be reviewed by the MSSS-FMOQ Parity Committee responsible for the
carried out by a Steering Committee consisting of physicians who belong to the Special Agreement concerning compliance with PREMs.
department. In particular, the DRMG’s mandate is to make recommendations
concerning PREMs, general medical services, and AMPs. It defines and proposes
a regional organization plan for general medical services and a network of New biller
access to general medical care. New billers are physicians who have not yet completed at least 200 days of
Head of DRMG practice under Quebec’s public health insurance plan. During those 200 days
Head of Regional department of general medicine of practice, the physician must have held a valid notice of compliance with the
The Head of the Regional department of general medicine is in charge of region’s PREM or a waiver in lieu of a notice of compliance with the PREM.
authorizing and signing compliance notices.
Physician resource plan
Healthcare establishment (Plan d’effectifs médicaux, or PEM)
A healthcare establishment is a group of healthcare facilities (hospital, local com- Physician resource plan of a facility, a healthcare establishment
munity services centre [CLSC], long-term care facility [CHSLD], etc.) which cover In family medicine, the term “PEM” is used to designate positions in hospitals.
services for a given region. Following the adoption of Bill 10 (2015), the Minis- You need a PEM to be able to work in a hospital setting.
ter grouped the 182 existing healthcare establishments into 34 establishments.
Rounding out the network are the university health centres, and institutes.
Initial application period
The initial application period runs from October 15 to October 31.
Facility
A facility is a physical site where healthcare services are delivered, i.e., hospitals,
local community services centres [CLSCs], long-term care facilities [CHSLDs], Practice without a compliance notice
rehabilitation centres, etc., which are grouped together under a healthcare A physician practising under the Quebec Health Insurance Plan (RAMQ) without
establishment within the meaning of the legislation. having obtained a notice of compliance with the PREM from the Head of the
Regional department of general medicine (DRMG) of a region will have his total
compensation cut back by 30%. A five-year waiting period will also be imposed
Billing day on him before he can apply for a compliance notice in that region. If, however,
A billing day is counted only if the compensation (pay) associated with that day the physician obtains a compliance notice from another region and meets his
is equal to or greater than $500. A half day can be counted if the compensation commitment there, this period will be only three years.
associated with that half day is equal to or greater than $250 and less than $500.
Interregional mobility
(Mobilité inter-régionale, or MIR)
Status of a physician who has worked a minimum of 200 days (synonymous
with “doctor already practising”).
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Guide to Practice 2019-2020
Regional physician resource plan Region 4 – Mauricie–Centre-du-Québec
(Plan régional d’effectifs médicaux, or PREM) Region 5 – Estrie
Regional physician resource plans (PREMs) in family medicine authorize, for Region 6 – Montreal
each of Quebec’s administrative regions, a quantitative target for recruitment of Region 7 – Outaouais
family physicians designed to distribute additional physician resources equitably. Region 8 – Abitibi-Témiscamingue
These plans are updated yearly on the basis of the differences observed between Region 9 – Côte-Nord
the resources in place and the needs to be met in each region. They take into
Region 10 – Nord du Québec
account the mobility of physicians already practising and the expected number of
new doctors. Since Quebec’s regions do not all enjoy the same level of access to Region 11 – Gaspésie–Iles-de-la-Madeleine
healthcare services, PREMs aim to provide Quebecers with more equitable access Region 12 – Chaudières-Appalaches
to medical services. Region 13 – Laval
In family medicine, the term “PREM” is used to designate positions allocated Region 14 – Lanaudière
in one of the 18 administrative regions, with priority hiring in a local services Region 15 – Laurentides
network (RLS). Obtaining a compliance notice implies that the doctor undertakes Region 16 – Montérégie
to maintain the majority of his practice, i.e., 55% of more of his billing days, in
Region 17 – Nunavik
a sub-area (RLS) of the region where he holds a PREM.
Region 18 – James Bay Cree Territory
PREMs are associated not with a type of practice but with a practice location.
Region Local services network
Quebec is divided into 18 administrative regions. When you apply for a compliance (Réseau local de service, or RLS)
notice, you do so to one of these regions:
Each region is divided into sub-areas. So you have a notice of compliance
Region 1 – Bas-Saint-Laurent with a region’s PREM, with priority hiring in a sub-area (RLS).
Region 2 – Saguenay–Lac-St-Jean
Region 3 – Quebec City (Capitale-Nationale)
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Guide to Practice 2019-2020
Scope of a PREM compliance notice
Positions in a PREM have a geographical scope and are not in any way associated with a facility, doctor’s office, or specific activity. None the less, the DRMG must, within the
framework of its mandate, identify its region’s priority needs, both primary and secondary. Identification of needs should guide the DRMG in the selection of candidates when
there are more applications than positions in the PREM. Also, the needs identified in a sub-area will guide candidates in their choice of location and activities.
Effective date of PREMs
The PREM for a year comes into effect on December 1 of the previous year and ends on November 30. So, for instance, the 2020 PREM will take effect on December 1, 2019
and terminate on November 30, 2020.
Obtaining a PREM in family medicine
Applying for a compliance notice
I. All compliance notice applications are emailed by the candidate to the Ministry of Health and Social Services (MSSS) at application_prem@msss.gouv.qc.ca.
II. The initial period of reception of applications for a PREM compliance notice runs from October 15 to 31 of the current year, inclusive. All applications received
during that period are deemed to be received on October 31.
III. Candidates may not submit their compliance notice applications for the following year’s PREM to the MSSS before October 15 of the current year.
IV. The application must be made on the appropriate form, which is to be sent by email only. The form is the sole document to be sent in.
V. The MSSS sends each applicant an acknowledgment of receipt.
VI. Any response to an applicant from a DRMG following the submission of a compliance notice application has to be made in writing on the compliance notice application form.
Processing of a compliance notice application by the DRMG
Effective November 1 of the current year, the MSSS forwards to the DRMGs the compliance notice applications for the following year’s PREM.
Applications received between October 15 and 31 inclusive are processed in three rounds between November 1 and April 1. Applications submitted after October 31
are processed at the end of the process, i.e., following the third round, as of April 1.
When the number of positions available in the PREM of a sub-area which candidates have marked as their first choice is greater than the number of applications
received for that sub-area, no selection is carried out, and the DRMG has to issue the compliance notice.
When the number of applications received for a sub-area exceeds the number of positions available in that sub-area’s PREM, all applications are evaluated by the DRMG.
This evaluation must comply with the following selection process.
EXAMPLES
1. There are fewer applicants than positions – automatic selection – all applicants receive their PREM:
• 10 candidates apply with RLS de Verdun as their first choice
• RLS de Verdun has 12 PREMs available
• All 10 candidates receive their PREM automatically
2. There are more applicants than positions – selection by interview:
• 15 candidates apply with RLS de Verdun as their first choice
• RLS de Verdun has 9 PREMs available
• ALL candidates are interviewed
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Guide to Practice 2019-2020
You accept it Completed
YES!
First choice
You refuse it Next round
NO ,
You accept it Completed
but offers 2nd RLS
INTERVIEWS
NO , You refuse it Next round
but other RLS
Selection process
NO Next round
First round
• From November 1 to December 30, only applicants’ first choice as entered on the compliance notice application is forwarded by the MSSS to the respective DRMGs.
• No later than November 11, the compliance notice applications in question are forwarded by the MSSS to the DRMGs.
• No later than December 6, interviews are conducted by the DRMG, and the candidates to whom the DRMG will be offering PREM compliance notices are identified.
• Between December 6 and 20, the DRMG responds to the applicant in writing, confirming the area corresponding to his first choice, offering another sub-area that
has remained vacant, or informing him that his application has been denied.
• No later than December 30, an applicant who has been offered a position responds to the DRMG, stating whether or not he accepts. WARNING: The applicant has
10 days to respond to the DRMG in writing. Should the applicant fail to respond within 10 days, the compliance notice is withdrawn.
• No later than December 30, the DRMG forwards to the MSSS and RAMQ the names of candidates who have accepted their compliance notices, and the names of
candidates not selected or who have refused their compliance notices.
Second round
From January 7 to February 15, the second choices entered on the compliance notice applications of candidates not selected in the first round are forwarded by the
MSSS to the respective DRMGs. If all the positions in the PREM are filled in the region marked as the candidate’s second choice, the MSSS will take the candidate’s
subsequent choices into account. For instance, some applicants may be offered their third choice in the second round.
• No later than January 11, the compliance notice applications in question are forwarded by the MSSS to the DRMGs.
• No later than January 25, interviews are conducted by the DRMG, and the candidates to whom the DRMG will be offering PREM compliance notices are identified.
• Between January 25 and February 5, the DRMG responds to the applicant in writing, confirming the area corresponding to his first choice, offering another sub-area
that has remained vacant, or informing him that his application has been denied.
• No later than February 15, an applicant who has been offered a position responds to the DRMG, stating whether or not he accepts. WARNING: The applicant has 10
days to respond to the DRMG in writing. Should the applicant fail to respond within 10 days, the compliance notice is withdrawn.
• No later than February 15, the DRMG forwards to the MSSS and RAMQ the names of candidates who have accepted their compliance notices, and the names of
candidates not selected or who have refused their compliance notices.
Third round
From February 16 to April 1, the third choices entered on the compliance notice applications of candidates not selected in the previous rounds are forwarded by the
MSSS to the respective DRMGs. When all the positions in the PREM are filled in the regions requested, and upon authorization from the candidate, the application is
forwarded to all the DRMGs in regions where the PREM has not been filled.
• No later than February 22, the compliance notice applications in question are forwarded by the MSSS to the DRMGs.
• No later than March 13, interviews are conducted by the DRMG, and the applicants for whom the DRMG will be offering a PREM compliance notice are identified.
• Between March 13 and 22, the DRMG responds to the applicant in writing, confirming the area corresponding to his first choice, offering another sub-area that has
remained vacant, or informing him that his application has been denied.
• No later than April 1, an applicant who has been offered a position responds to the DRMG, stating whether or not he accepts. WARNING: The applicant has 10 days
to respond to the DRMG in writing. Should the applicant fail to respond within 10 days, the compliance notice is withdrawn.
• No later than April 1, the DRMG forwards to the MSSS and RAMQ the names of candidates who have accepted their compliance notices, and the names of candi-
dates not selected or who have refused their compliance notices.
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Guide to Practice 2019-2020
Following the three rounds
When positions are available in the PREM, the first come, first served principle is applied.
Nevertheless, if the number of applications received on the same date exceeds the number of positions available in the PREM, the DRMG has to conduct candidate
selection, in line with the following principles:
• A selection committee must be formed;
• The selection criteria have to be limited to matters within the DRMG’s jurisdiction;
• All candidates are interviewed;
• No letter of recommendation from a medical clinic may be considered in determining the choice of candidate.
Interview and selection criteria
All candidates are interviewed. These interviews are conducted in person, but could in exceptional cases be carried out remotely by means of a medium permitting
visual contact (e.g., Skype), if the candidate is unable to attend in person.
The objectives of the interview are the following:
• Evaluate the level of knowledge of special regional features, approach carried out, reason for this choice;
• Evaluate experience acquired, career path, achievements, challenges, and goals;
• Find out intentions in terms of professional interests and activities envisaged;
• Evaluate the level of knowledge of the healthcare system;
• Evaluate personality, capabilities and behaviour through scenarios whereby the candidate can show his qualities;
• Provide relevant information on the region;
• Answer the candidate’s questions;
• Interviews must be conducted in keeping with the hiring conditions established by the provincial human rights and youth rights commission.
WARNING
Questions should be asked about your interest in patient management, and not about your interest in a specific clinic.
The choice of clinic where you perform your patient management will be left up to you.
Acceptance and withdrawal
A candidate who accepts the compliance notice offered by the DRMG is removed from the process.
A candidate who refuses the compliance notice offered by the DRMG continues the process.
A candidate who does not respond within 10 days is deemed to have refused, and so continues the process.
A candidate who first accepted and then withdrew from his compliance notice will have to submit a new application if he wants to receive a PREM compliance notice
again. This new application will be processed in the order in which applications are received at the Ministry after October 31, i.e., once the third round has
been completed.
Obtaining a PREM in a university
family medicine group (PREM UFMG)
First, the DRMG has to set aside positions in the PREM to allow for the recruitment of physicians in the university family medicine groups (GMF-U, or UFMGs) to which
the MSSS gives priority.
As soon as a candidate is identified to fill one of these positions, but no later than October 31, the director of the family medicine department of the medical faculty
concerned must confirm his choice to the MSSS and the DRMG responsible for issuing the selected candidate’s compliance notice.
10 | LE BULLETINGuide to Practice 2019-2020
If, as of October 31, no UFMG applicant is recommended for the priorities identified, the sub-area PREM compliance notice is then released and returns to the regional
pool. The position in the PREM is then no longer set aside for a UFMG position, and can be attributed to another candidate, who will meet other available priorities.
When an academic applicant comes forward during the year to meet a UFMG priority recruitment recognized by the MSSS, recruitment will be possible provided the
candidate is selected by the director of the family medicine department of the medical faculty concerned and a position in the sub-area’s PREM is available. If no sub-
area target is available, but positions remain vacant in the regional pool, the DRMG will have to use positions from the regional pool to meet this need.
When a recruitment is used to meet priority academic needs, the DRMG may, on certain conditions and subject to approval from the Physician Resource Management
Committee – General Practice (COGEM), grant a compliance notice over and above its regional target for authorized recruitment. The physician contemplated by the
recruitment must :
• Qualify with respect to inter-regional mobility and have accumulated three years’ active practice within the meaning of the agreements
(i.e., 600 billing days at $518 per day);
• Have obtained the recommendation of the director of the university family medicine department of the medical faculty concerned;
• Have the expected practice profile in line with the guidelines recognized by COGEM;
• Carry out all his patient registrations within the UFMG concerned.
Bursary recipients
In late May, the MSSS forwards to the eligible DRMGs a list of bursary recipients to be designated for the upcoming year, along with the form to be completed to show
their interest in obtaining bursary recipients for their regions.
In late June, the DRMGs have to inform the MSSS, by means of the duly completed form, of the number of bursary recipients being requested, the areas targeted for
them to set up in practice, and the applications identified.
Bursary recipients are notified of the regions’ lists and the geographical areas accessible to them. They then have until September 30 to express their preferences as to the
designated area.
In early October, the MSSS-FMOQ advisory committee will analyse the applications and make its recommendations to the Minister for the designation of bursary recipients.
No later than October 15 of the current year, the DRMG is informed of the list of bursary recipients whose designation is officially recommended for its region and for
whom a position will have to be set aside in the PREM.
No later than October 15, bursary recipients are informed of the recommendation with respect to their designated region and their obligation to submit an application for
a notice of compliance with the PREM for that region between October 15 and 31 of the current year. After October 31, a bursary recipient who has not submitted his
compliance notice application for the recommended region is deemed to have withdrawn from his commitment as a bursary recipient.
The DRMG is required to grant a PREM compliance notice to each of the bursary recipients recommended for its region who has submitted his compliance notice within the
prescribed deadline. The DRMG then informs the MSSS of the location where it will be deploying the services of the bursary recipients recommended for its region, to ratify
the designation officially.
Failing an adverse decision from the MSSS, the applicant’s designation as a bursary recipient remains valid, even in the event that the start of practice is deferred. In such
a situation, and in order to comply with the requirement provided for in the Special Agreement to set up in practice within 12 months, the candidate is required to submit
an application for a notice of compliance with the following year’s PREM, thus freeing up a position for a non-bursary recipient applicant who would set up in practice in
the meantime.
Obtaining a PEM in an establishment
(for family physicians)
Identification of sectors of activity authorized to recruit and priority needs
The DRMG, in conjunction with the directors of professional services (DPSs) of its region and its area partners, draws up a list, by sub-area, of the sectors of activity with
recruitment needs in its region. This list is analysed by the Physician Resource Management Committee – General Practice (COGEM) so it can make its recommendation.
From August 1 onward, the DMRG releases, in particular through the MSSS website, the list of needs for recruitment in establishments. Added to this list will be,
no later than October, the list of priority needs for delivering front-line care to patients in doctors’ offices.
FALL 2019 | 11Guide to Practice 2019-2020 These lists must be released before the initial application period, and may be updated during the year. A list of all medical clinics in the region should be drawn up, highlighting clinics that have shown they are actively recruiting family physicians. As the situation evolves, new needs can be submitted to COGEM during the year for approval. To seek a compliance notice in an establishment: • You must send your appointment application form to the executive director of the establishment; • You will receive a letter from the executive director confirming the status of the establishment’s PEM; • Your application will be reviewed by the Executive Committee of the Council of Physicians, Dentists and Pharmacists (CPDP); • The Credentials Review Committee will study your file and report to the Executive Committee; • The Executive Committee will make a positive (or negative) recommendation concerning your application to the establishment’s Board of Directors; • The Board of Directors will accept (or deny) your application, subject to approval from the DRMG. Your obligations Deadline for setting up in practice To be eligible for obtaining a notice of compliance with a region’s PREM, a candidate has to undertake to start his practice in that region within 12 months following the receipt of his compliance notice application by the DRMG. The physician may, however, ask for his start of practice to be deferred for a maximum of six additional months. It is up to the DRMG whether or not it agrees to the deferral request for reasons it deems fair and equitable. 55%-45% Rule The doctor must devote at least 55% of his annual billing days to the region or area where he holds his PREM compliance notice. A day is considered as soon as the physician has billed at least $518 in the area. A half day is considered as soon as the physician has billed at least $259, but less than $518. The distribution of the doctor’s practice is evaluated on an annual basis with regard to days worked, from March 1 to February 28-29 of the following year, from the date of issue of the PREM compliance notice. If the physician begins during the year, the calculation is prorated, from the date of issue of the compliance notice. A doctor may therefore devote up to 45% of his billing days to practising outside the area where he holds his compliance notice, either in another RLS in the same region, in one of Quebec’s 17 other regions, or on part-time locums. WARNING: Currently, only the Quebec City (Capitale-Nationale) region (except for the Portneuf and Charlevoix sub-areas) is subject to the following rule: a doctor who has no compliance notice from that region may not perform more than 5% of his billing days there. Specific medical activities (AMPs) Specific medical activities (AMPs) stem from the Act respecting health services and social services, and physicians with 15 years’ service or less are required to sign on to them. It is the DRMG that manages the AMPs of doctors in its region. It assigns them according to an established order and in line with its region’s priority needs. If several AMPs are available, an agreement may be reached with the DRMG. If you are practising without a PREM (in the public system, not private practice) • Your compensation will be cut back by 30%; • You will have to wait five years before applying for a compliance notice in that region; • But, if you obtain a compliance notice in another region and work there for three years, you will subsequently be able to apply for a position in the region where you practised without a PREM. 12 | LE BULLETIN
Guide to Practice 2019-2020
Physicians returning from remote regions after three
years’ continuous practice
A PREM compliance notice cannot be denied to a doctor who has practised continuously for at least three years in one of the areas listed in Appendix XII of the FMOQ-MSSS
Agreement,* even if the PREM is full:
• The doctor must undertake to practise principally in a sub-area;
• Practice carried out under the locum mechanism is not considered in the calculation of principal practice in a remote region;
• Principal practice is deemed to be continuous if it is carried out without interruption of more than 24 months in one or more regions contemplated in Appendix XII
of the Agreement.
The granting of compliance notices to physicians returning from remote regions evolves in line with the PREM implementation period and its status (full or not).
1. A doctor returning from a remote region after three years’ continuous practice who applies during the initial application period will be given priority by the DRMG for
obtaining a position in the sub-area of his choice in which inter-regional mobility positions (places MIR) are posted.
If the number of doctors returning from a remote region exceeds the number of positions available in a given sub-area, the DRMG will have to make a selection.
Unselected physicians returning from a region will be offered a sub-area in which positions are available, on a priority basis.
2. Following the initial application period, and as long as a region’s PREM is not full, a physician returning from a remote region must obtain a notice of compliance with the
PREM of a sub-area not filled via inter-regional mobility.
3. When all positions in a region’s PREM are filled, the DRMG submits to physicians eligible for this rule a list comprising at least three sub-areas among which they can choose to
obtain a compliance notice.
As long as the region’s PREM is not full, a doctor returning from a remote region cannot be counted as being surplus to the PREM.
FALL 2019 | 13Guide to Practice 2019-2020
Opting for locums
The locum mechanism enables a doctor to come to the assistance of sites designated by the MSSS-FMOQ Parity Committee in four sectors of activity, i.e., Emergency,
short-term, Anesthesiology, and Obstetrics.
There are two situations where a doctor may practise under the locum mechanism:
I. PREMs EXCLUSIVELY FOR LOCUMS
He holds a waiver in lieu of a compliance notice for practising exclusively on locums. He then undertakes to practise for at least 95% of his annual billing days on locums.
II. PART-TIME LOCUM
He holds a compliance notice from a region and registers as a locum (médecin dépanneur). In this scenario, the doctor has to maintain his commitment for the
majority of his practice (55% of his billing days) to be carried out in the area where he holds his PREM compliance notice.
Information handbook for general practitioners performing locums: h38.pub.msss.rtss.qc.ca/Fichiers/H38_Depannage_20181011132054.pdf
Locum mechanism registration form: h38.pub.msss.rtss.qc.ca/Fichiers/H38_Depannage_20190830142914.pdf
Financial incentives on entering practice/
establishment and maintenance (retention)
bonuses and premiums in family medicine
In remote or designated regions
Family physicians setting up in practice in remote or designated regions have their pay increased. They receive availability and professional development premiums.
In remote regions, allowances are provided for remote area bonuses, home leave expenses (with or without dependants), and food transportation expenses.
Establishment and maintenance premiums are also awarded by the region. Premiums vary depending on the remote sector in question. Below is a table showing
increased pay percentages in establishments and doctor’s offices.
INCREASED PAY FOR FAMILY PHYSICIANS BY PRACTICE REGION
1st year 4th year 7th year 20th year
% % % %
Establishment 130 135 135 140
Group 1
Office 120 125 125 125
Establishment 135 140 140 140
Group 2
Office 120 125 125 125
Establishment 130 130 130 130
Group 3
Office 120 120 120 120
Establishment 120 120 120 125
Group 4
Office 115 115 115 115
Establishment 120 125 130 130
Group 5
Office 105 105 105 105
Establishment 115 115 115 115
Group 6
Office 105 105 105 105
For further information, call the Ministry’s Physician Resource Branch at 418 266-8868 or 1 888 708-0393.
14 | LE BULLETINGuide to Practice 2019-2020
Rémunération différente des médecins omnipraticiens
No Région
1re année 4e année 7e année 20e année
• Ivujivik ✈ 01 Bas-Saint-Laurent
• Salluit ✈ Groupe 1 Établissement 130 135 135 140
• Umiujaq
02 Saguenay–Lac-Saint-Jean Cabinet 120 125 125 125
• Kangiqsujuaq ✈
03 Québec Groupe 2 Établissement 135 140 140 140
• Akulivik ✈ Cabinet 120 125 125 125
• Quaqtaq ✈ 04 Mauricie–Centre-du-Québec
• Puvirnituq ✈ BAIE D'UNGAVA 05 Estrie Groupe 3 Établissement
Cabinet
130
120
130
120
130
120
130
120
Carte de la rémunération différente
des médecins omnipraticiens
• Kangirsuk ✈
06 Montréal-Centre
Groupe 4 Établissement 120 120 120 125
07 Outaouais Cabinet 115 115 115 115
Région éloignée ou isolée
• Aupaluk ✈
• Inukjuak ✈ • Tasiujaq ✈ 08 Abitibi-Témiscamingue Groupe 5 Établissement 120 125 130 130
• Kangiqsualujjuaq ✈
09 Côte-Nord Cabinet 105 105 105 105
• Kuujjuaq ✈
Groupe 6 Établissement 115 115 115 115
17 10 Nord-du-Québec
Cabinet 105 105 105 105
BAIE D'HUDSON • Umiujaq
11 Gaspésie–Îles-de-la-Madeleine
Note : Les majorations en « établissement » s’appliquent pour les services dispensés dans un centre hospitalier,
12 Chaudière-Appalaches dans un centre de réadaptation, dans un centre d’hébergement et de soins de longue durée ou dans un CLSC
du réseau de garde intégré lorsque le médecin participe à la garde.
• Kuujjuarapik ✈ 13 Laval Les majorations en « cabinet » s’appliquent pour les services dispensés en cabinet, à domicile ou dans un
• Whapmagoostui ✈ CLSC hors du réseau de garde intégré lorsque le médecin ne participe pas à la garde.
• Poste-de-la-Baleine ✈ 14 Lanaudière
La rémunération de base est de 100 % (zone beige sur la carte).
15 Laurentides Quelques établissements ont cependant une rémunération majorée à 105 % ou 115 % dans d’autres régions du Québec :
• Schefferville ✈ Québec, Mauricie et Centre-du-Québec, Estrie, Chaudière-Appalaches, Saguenay-Lac-Saint-Jean, Montérégie.
• Baie-James ✈
16 Montérégie Le médecin omnipraticien reçoit 105 % pour les services dispensés à l’urgence de certains CLSC du réseau de garde
• Chisasibi ✈
BAIE-JAMES intégré des régions de la Mauricie et du Centre-du-Québec, de l’Outaouais, de Chaudière-Appalaches et de Lanaudière.
17 Nunavik
• Wemindji ✈ 10 Cette carte de rémunération est présentée à titre illustratif seulement. Il faut se référer à l’annexe 19
09 18 Terres-cries-de-la-Baie-James de l’Accord-cadre pour les données officielles.
• Fermont ✈
• Eastmain ✈
• Waskaganish ✈
• Waskaganish ✈
• Rivi • Blanc
• Vieu
x-Foèr
rt
e Sain Sablon
t-Paul ✈
09
• Sain
• Mistissini t-Augu
✈
stin
an
re
ng ain rre
(Baie-du-Poste) ✈
10
er
• La
Je
tz
Mi e S nne
am
• Baie Tabatière
Pi
e
an t-
Be
t-
èr -To
én
• Tête -des-Mou
lio ✈
in
Ké hq nt
51e parallèle
-
a ✈
th
Ri -au
an
Ma es
Sa
• tas are
sk n
-à-la tons
oh
ne
h
e
l
ga ua
-Î
-Balei
e
èr
is
• Aylm
Na te-P
vr
-J
ai
pt
vi
vi
an
er-Sou ne
Ha
m
ie
Ri
Se
•
u
in
• Harr
Ro
Ba
nd
Ag
•
•
•
•
Po
•
• Matagami • Chibougamau ✈ ington
La
•
• Chev
•
-Harbo
•
•
ery ✈
•
• Waswanipi • Chapais • Port-Cartier ur
02
• Port-Menier ✈
ni
• Lebel-sur-Quévillon Groupes de rémunération
si
as
ÎLE D'ANTICOSTI
✈
• La Sarre
st
Le médecin omnipraticien reçoit une rémunération majorée selon le taux applicable
u
Mi
ea
• Macamic • Baie-Comeau ✈
•
lb
• Mont-Louis au groupe auquel appartient la région.
Do
• Amos • Betsiamites • Grande-Vallée
•
• Sainte-Anne-des-Monts Ces territoires sont désignés aux fins de rémunération de la façon suivante :
an
• Rivière-au-Renard
Je
• Murdochville
t-
• Forestville
• Senneterre GROUPE 1
in
• Gaspé ✈
Sa
• Matane
•
• Rouyn-Noranda ✈
n
• Les Escoumins
se
rv cie
•
• Malartic • Mont-Joli ✈ Secteurs isolés I et II à l’exception de Chibougamau et du territoire de la Côte-Nord
An
11
be éli
ho l ✈
à l’Est de la Rivière Moisie jusqu’à Havre Saint-Pierre inclusivement.
m n•
•
Ro t-F
• Rimouski • Amqui
a
•
•
Ba •
• Clova
tim re
in
ua
Tadoussac
•
• Val-d'Or ✈
✈
ou iè
• Chandler
Sa
La i ✈
• Causapscal Secteurs isolés III, IV et V à l’exception des régions 17 et 18 et du territoire de la
ie
a
ic qu
•
tc
Al
Ch Jon
• Trois-Pistoles
08
be
• Parent Côte-Nord à l’Est de Havre Saint-Pierre.
ta
• Paspébiac
01
Mé
• Maria ✈ ÎLES-DE-LA-MADELEINE Territoires désignés autres que les secteurs isolés à l’exception des secteurs géographiques
• Matapédia
• Casey d’Alma et de Rimouski et des MRC de Kamouraska, de Rivière-du-Loup et d’Antoine-Labelle
• Sanmaur • Rivière-du-Loup
• Ville-Marie
La Tuque
La Malbaie • Cabano excluant les municipalités de Saint-Cyprien, Saint-Hubert, Saint-François-Xavier-
•
• Baie Saint-Pascal de-Viger et Saint-Paul-de-la-Croix.
• • Notre-Dame du Lac • Cap-aux-Meules ✈
Saint-Paul • Pohénégamook
03 • GROUPE 2
• Témiscaming
04 • Qué
✈
bec • La Pocatière Secteur isolé I : Chibougamau et le territoire de la Côte-Nord à l’Est de la Rivière Moisie
Mont-Laurier • Montmagny jusqu’à Havre Saint-Pierre inclusivement.
• Lévis
L'Annonciation GROUPE 3
• Shawinigan 12 Secteurs isolés III, IV et V des régions 17 et 18 et territoire de la Côte-Nord à l’Est
Maniwaki • 14 de Havre Saint-Pierre jusqu’à la limite du Labrador y compris l’Île d’Anticosti.
15 • Trois-Rivières ✈
Chapeau • Gracefield • GROUPE 4
07 Saint-André-Avellin Joliette •
04 • Saint-Georges Secteurs géographiques d’Alma et de Rimouski.
Fort Coulonge • • Low • • Arthabaska
• Buckingham Saint-Jérôme
• Wakefield
• Sorel • Drummondville GROUPE 5
Shawville • • Gatineau
• Laval
Municipalité régionale de comté d’Antoine-Labelle.
Aylmer • • Hull ✈
• Montréal ✈
GROUPE 6
Légende • Granby
• Saint-Jean • Sherbrooke MRC de Kamouraska et de Rivière-du-Loup excluant les municipalités de Saint-Cyprien,
Aéroport Saint-Hubert, Saint-François-Xavier-de-Viger et Saint-Paul-de-la-Croix.
✈
Traversier 16
Remote areas
SECTOR I SECTOR II SECTOR III SECTOR IV SECTOR V
Chibougamau Fermont Nord du 51e degré de Wemindji Tasiujak
Chapais Territoire de la Côte-Nord, latitude incluant : Mistissini, Eastmain Ivujivik
situé à l’est de la Rivière Kuujjuak, Kuujjuarapik,
Matagami Whapmagoostui, Chisasibi, Waskagheganish Kangigsualuajjiuaq
Moisie
Joutel et s’étendant jusqu’à Havre Baie-James, Schefferville, Nemiscau Aupaluk
Lebel-sur-Quévillon Saint-Pierre inclusivement Kawawachikamach et Inukjuak Quaqtaq
Waswanipi à l’exception
Témiscaming Îles-de-la-Madeleine de Fermont et des localités Puvirnituk Akulivik
Ville-Marie spécifiées aux secteurs IV Umiujaq Kangigsujuaq
et V
Kangirsuk
Parent
Salluit
Sanmaur
Tarpangajuk
Clova
Territoire de la Côte-Nord,
s’étendant à l’est de Havre
Saint-Pierre, jusqu’à la lim-
ite du Labrador, y compris
l’Île d’Anticosti
FALL 2019 | 15Guide to Practice 2019-2020
In Other Specialties • The grounds for any refusal must also be given in writing;
• The physician must confirm his decision and acceptance of his conditions of
appointment in writing within 60 days following the notification date in order
Obtaining a PEM for his privileges to be validated.
in an establishment For positions in university settings, candidates must perform a fellowship of 3 to 12
months’ duration. A second year is possible, but requires justification from the
Holding a position in an establishment’s physician resource plan (PEM) is a establishment to the Ministry. Note that the medical faculties often demand
prerequisite for delivering care there. A doctor may obtain privileges in more than at least a 1-year fellowship to award those positions, owing to the teaching
one establishment, but will be counted only in the PEM of the establishment responsibility associated with them. Training of 6 months or less does not require
where he performs most (75%) of his practice. He may also obtain privileges MSSS approval, and is negotiated with the department concerned and the
as an associate member in another establishment’s PEM for a maximum of faculty Associate Dean. Some non-university establishments may also require a
25% of his practice. Positions in establishments’ PEMs are announced in the fellowship in order to cater to a specific need that will meet the requirements of
fall each year, during the FMRQ’s Quebec Career Day, and are posted on the the population in their territory. For further information on fellowships, consult
Ministry website under Plans régionaux d’effectifs médicaux/pour la médecine the section on that topic on page 18.
spécialisée/postes disponibles, at:
www.msss.gouv.qc.ca/professionnels/medecine-au-quebec/prem/postes-dispo- To start your practice, you must at least:
nibles-medecine-specialisee/ • Have your specialist certification
Positions on the MSSS table are now posted by establishment rather than facility • Have confirmation of your participation in an ALDO-Quebec
(hospital). But posting by facility (hospital) should be brought back during the information session
coming year, to facilitate consultation of the site. Also, note that it is possible • Have your permit to practise
for the establishment to impose on you the obligation of practising in two of
• Have your proof of malpractice insurance coverage
its facilities, on the basis of needs identified in the different areas covered by
the establishment. This is the final year of the 2015-2020 five-year plan. It is • Be registered on the membership roll of the Collège des médecins
establishments which consider that they have needs exceeding the number of du Québec, and have paid your annual membership fee
positions allocated to them in that plan, and not resident doctors, who will have
to apply for a waiver to add a position to their PEMs. The rules concerning waiver
applications are available on the FMRQ site, in the Specialty Physician Resource Recruitment in anticipation
Handbook. The 2021-2025 five-year plan is currently being drawn up, and will be of a departure during the year
finalized for the FMRQ’s Quebec Career Day on September 18, 2020.
Even when an establishment’s PEM is full, a compliance notice may be issued for a
Process recruitment in anticipation of the departure of a physician who has provided written
notice of his intention to cease practising in the establishment and whose resignation
• Get in touch with the head of department and the deputy director or director will take effect within 1 year. The recruited physician may not, however, take up his
of professional services (DPS); duties until six months prior to the departure date of the incumbent doctor.
• When you have made your choice, send the appointment notice application
form to the Director of Professional Services of the establishment Locum
concerned (this form is available from the DPS’s office);
The purpose of a locum (temporary replacement) is to enable a doctor to take
• The application will then be evaluated by the Credentials Review Committee,
on the clinical and administrative duties of another physician who holds a PEM,
which makes a positive or negative recommendation concerning your
who has to take time away from his or her position (illness, sabbatical leave,
application to the Council of Physicians, Dentists and Pharmacists (CPDP),
maternity, etc.). This position does not constitute a permanent position for
which follows the same procedure with respect to the establishment’s Board
the replacing doctor, who loses his privileges once the locum is over. It is also
of Directors;
possible in an emergency to obtain authorization to practise in an establishment
• If your application is accepted, the establishment’s Board of Directors submits without a position in the PEM. But this measure is valid for no more than
an application for this position to the Ministry of Health and Social Services three months, and cannot be renewed, barring exceptional circumstances
to obtain confirmation that this appointment is in compliance with the determined by the establishment and accepted by the MSSS.
establishment’s PEM;
• If the MSSS agrees, it issues a notice of compliance with the establishment’s
physician resource plan (PEM) and forwards it to the establishment;
• The establishment (CISSS, CIUSSS, institute, etc.) must, as early as possible
or within 90 days following receipt of an application for privileges, send
the applicant a written decision setting out his privileges;
16 | LE BULLETINGuide to Practice 2019-2020
Network positions (PROs/PRFs) Recruitment via waiver
Some agreements allowing for positions to be added are associated with a When an establishment’s needs warrant, the Director of Professional Services
network position. These positions may be used to recruit a specialist physician (DPS) may apply for its physician resource plan (PEM) to be exceeded tempo-
in the establishment holding the position, or to recruit a specialist physician in rarily via waiver. A PEM waiver is an exceptional measure, and requests to
another establishment, i.e., an optional network position (known by its French that effect have to meet strict criteria: candidate’s specific expertise; volume
acronym, PRF, for poste en réseau facultatif), provided a service agreement of activity; waiting lists; development (addition of equipment); stabilization
has been reached between two establishments. Some establishments have a of teams (age of practising physicians); establishment of a service agree-
mandatory network position PEM (PRO, for poste en réseau obligatoire). These ment; and, in very rare cases, humanitarian grounds. The waiver confers a
positions are generated when a service corridor is created permanently between permanent position on the candidate. The PEM will then have been exceeded,
two establishments. and the next departure in the specialty concerned will not be replaced. Waiver
applications are reviewed by the members of the Physician resource manage-
ment committee for specialties (COGEMS), which includes the Fédération des
IMPORTANT
médecins spécialistes du Québec (FMSQ) and the Ministry of Health and Social
These positions cannot be based on a single individual, and a commitment Services (MSSS). The Fédération des médecins résidents du Québec (FMRQ)
from the establishments’ medical team and administrations to fulfil the also sits on the COGEMS as an observer.
associated undertakings (service corridors) has to be demonstrated.
WATCH OUT FOR VIRTUAL PREMs
If you see virtual positions, i.e., positions available in the physician
Research scientist positions resource plan on the Ministry site but that the establishment tells you
There are certain situations where a doctor can be hired outside the PREM. It is, have already been filled or that it has no intention of filling,
however, necessary for the candidate to obtain a PEM from the establishment we advise you to take the following steps:
where he wishes to practise and conduct his research. The position will then be 1) Send in a formal appointment application anyway;
recognized by the Ministry as being outside the PREM, for the purposes of hiring 2) Wait for the establishment’s response;
other candidates in the department. Research scientists must sign on to the Me-
morandum of understanding concerning the establishment of special pay terms 3) If the position is denied and the letter specifies that the
and conditions for research scientists (Protocole d’accord concernant la mise en establishment does not intend to recruit for the position
place de modalités de rémunération particulière pour les chercheurs-boursiers). allocated by the MSSS, get in touch with the FMRQ so we
can investigate the situation and lobby the Ministry to
In the event of a change in a research scientist’s career, he may ask to remain have the position moved elsewhere.
in his facility even if he withdraws from the Memorandum of understanding. He
will then be considered surplus to the PEM, which will come back to normal on
the departure of a colleague in that specialty. The same rule applies to those
with an exclusive practice in palliative care and intra-operative assistance. For WATCH OUT FOR PROFESSIONAL SUICIDE PREMs
further details, consult the management rules for physician resource plans in Some positions are located in regions where practice in a given
specialties on the Ministry site (search under PREM en spécialité). specialty is limited, owing to the quantity and diversity of cases, or
because the doctor will have to practice on his own. These positions
Returning from the regions (three-year rule) are seen as professional suicide, because they could mean the phy-
After three years’ continuous practice in a remote or isolated region, a physician sician is unable to return to practise in another setting owing to the
cannot be refused entry to another region on the grounds that the region’s PREM loss of expertise, which is known to occur rather quickly in medicine,
or establishments’ PEMs are full. Nevertheless, if he wishes to obtain a position depending on the conditions. In such cases, the FMRQ recommends
in a university hospital, he will have to meet the fellowship requirements that service corridors (network positions) be established instead, to
and receive the agreement of the region’s medical faculty. A physician taking enable candidates for these positions to maintain their knowledge and
advantage of this rule will be able to do so once only, within no more than technical skills, by sharing responsibility for delivering care with the
12 months from the date on which he left the establishment in the regions. To other doctors in the partner hospital department.
obtain a position in a new region, the physician will first have to fill the positions
available in the PEMs of the new region where he will be setting up in practice.
If all the PEMs in his discipline are full, he will receive a list of five establish-
ments determined according to Ministry priorities, from among which he may
choose. In such cases, the MSSS may authorize the PEM of the establishment
concerned to be temporarily exceeded.
FALL 2019 | 17You can also read
