Residents' duty hours in the province of Ontario, Canada.
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.
Urowitz
Murray
M
Office of Postgraduate Education, the University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Crescenzi
Anne-Marie
AM
Muharuma
Loreta
L
D007396:Internship and Residency / Q000639:trends*; D009864:Ontario; D016526:Workload / Q000706:statistics & numerical data*