saskatchewan physician recruitment and retention handbook · the initial sections of the handbook...

Saskatchewan

Physician Recruitment and Retention

Handbook

GUIDE FOR THE SASKATCHEWAN REGIONAL RECRUITER NETWORK

AND PHYSICIAN RETENTION COMMITTEES

TO SUPPORT THE RECRUITMENT AND RETENTION OF FAMILY PHYSICIANS

Introduction

The physician supply issue is a significant concern in rural areas, here in Saskatchewan and throughout North America. This toolkit is the result of collaboration between saskdocs and the Saskatchewan Regional Recruiters Network (RRN). Membership of the RRN represents saskdocs, the twelve health regions, Northern Medical Services and the Saskatchewan Medical Association (SMA). Please contact saskdocs to get the most up to date provincial partners list. The purpose of the handbook is to assist all partners to better recruit and retain family physicians in the province of Saskatchewan.

Recruitment is the process of identifying the need for a physician, defining the requirements of the position, sourcing the candidate, choosing the most appropriate candidate, and settling the candidate.

Physician recruitment can be a lengthy and detailed process involving many stakeholders. Saskatchewan Regional Health Authorities (RHAs) have the primary responsibility to recruit physicians to Saskatchewan. RHAs are supported by a number of partners; saskdocs, the Ministry of Health, the Saskatchewan Medical Association, the College of Medicine, communities and individual doctors. The initial sections of the handbook provide an overview, tips and tools to provide assistance to the provincial RHA recruiters with preparation, posting, sourcing and recruitment of family physicians.

There is no single best way to recruit and retain family physicians. While general processes are similar across the province, each RHA has unique policies and processes related to the preparation, posting, sourcing and settlement of family physicians. Partners may be interested to review these sections to obtain an understanding of the complexities and intricacies of the procedures.

Retention is the critical support and follow-up that encourages the new recruit to stay within the community or organization

Communities can do their part by continuing to display the hospitality and support for which Saskatchewan is renowned. When people feel welcome in a community, they are more likely to stay. Several sections of the handbook provide techniques and tools to provide supports to assist physicians and their families with settlement and retention. These sections of the handbook may be of particular interest to community recruitment committees.

SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK- 2013 (UPDATED JULY 2017) Page | 2

There are many partners involved in the recruitment and retention of physicians. This manual can be utilized to provide guidance on important steps that support timely placement and lasting retention. Working together we can meet the challenge and enhance health care throughout the province.

The following chart provides an overview of the roles that each of the partners play in physician recruitment and retention. The chart applies primarily to regional centers and rural primary care clinics; there is recognition that private practices may share the responsibilities differently.

MEDICAL PRACTICE

COMMUNITY REGIONAL HEALTH AUTHORITY

saskdocs

RECRUITMENT SHARED LEAD SHARED

SITE VISITS PARTICIPANT SHARED LEAD

SETTLEMENT CLINICAL PRACTICE ORIENTATION & INTEGRATION

SHARED LEAD PARTICIPANT

SETTLEMENT COMMUNITY ORIENTATION & INTEGRATION

SHARED LEAD SHARED

The information found in this handbook is designed to provide accurate information in regard to the subject matter covered. It is shared with the understanding that it does not constitute, and is not a substitute for, legal, financial or other professional advice.

Materials may be reproduced, copied and redistributed without permission but citation to the source is appreciated


Introduction............................................................................................................................................ 2

Recruitment ........................................................................................................................................... 6

Roles and Responsibilities ...........................................................................................................................6

Preparing for Recruitment ..........................................................................................................................7

Form a Recruitment Team ............................................................................................................................ 7

Define the Opportunity and Build the Posting .............................................................................................. 8

Post the Position ........................................................................................................................................... 9

Sourcing a Candidate .................................................................................................................................... 9

Recruitment ............................................................................................................................................. 11

Screening Candidates .................................................................................................................................. 11

Human Rights Considerations .................................................................................................................... 11

Assessing Eligibility for Licensure ............................................................................................................... 12

Interview and Selection ........................................................................................................................... 13

Checking References ................................................................................................................................... 14

Appendix A – Physician Recruitment Committee Master Contact List .................................................... 16

Appendix B– Position Profile .................................................................................................................... 17

Appendix C – Initial Contact to Practice ................................................................................................... 19

Appendix D – Interview Bank ................................................................................................................... 23

Appendix E – Reference Bank .................................................................................................................. 29

The Site Visit ......................................................................................................................................... 33

Planning the Site Visit ...............................................................................................................................35

Organize Your Team ................................................................................................................................... 35

Develop an Itinerary ................................................................................................................................... 38

The Site Visit ............................................................................................................................................... 39

Site Visit Follow-up ..................................................................................................................................... 39

Picking up the Tab....................................................................................................................................... 40

Appendix A – SAMPLE Site Visit Needs Assessment .................................................................................41

Appendix B – SAMPLE Site Visit Itinerary..................................................................................................44

Appendix C – SAMPLE Site Visit Feedback - Physician ..............................................................................46

Appendix D – SAMPLE Site Visit Feedback – Community Team ...............................................................47

Appendix E - SAMPLE – Confirmation of Employment ............................................................................ 48


Retention ................................................................................................................................................ 49

Roles and Responsibilities ........................................................................................................................ 49

Understanding the Needs ........................................................................................................................ 51

Facilitating Relocation .............................................................................................................................. 53

Facilitating Settlement ............................................................................................................................. 55

Professional Settlement ............................................................................................................................. 55

Personal Settlement ................................................................................................................................... 56

Communication Strategies to Support Retention ...................................................................................... 60

Integration ............................................................................................................................................... 65

Evaluation ................................................................................................................................................... 65

Celebrate your Physicians ........................................................................................................................... 66

Spousal Employment .................................................................................................................................. 68

Appendix A - Settlement and Integration Plan ........................................................................................ 72

Appendix B – Needs Assessment ............................................................................................................. 74

Appendix C – Physician Arrival Itinerary .................................................................................................. 76

Appendix D – Community Contract – Sample ............................................................................................ 77

Appendix E - Orientation Checklist .......................................................................................................... 80

Appendix F - Satisfaction Survey .............................................................................................................. 85

Lean Business Process ....................................................................................................................... 87

Innovative Practice Documents .................................................................................................... 87

Physician and Family Settlement – RHA ...................................................................................................87

Physician and Family Settlement – Community .......................................................................................90

Physician and Family Settlement – Clinic ..................................................................................................93

Saskatchewan International Physician Practice Assessment............................................ 96

The SIPPA Program ....................................................................................................................................97

The Team that Coordinates the SIPPA Assessment Process .....................................................................97

The Roles and Responsibilities ..................................................................................................................98

Supporting the IMG through the Immigration Process ............................................................................98

APPENDIX A - Roles of Agencies Involved In SIPPA .................................................................................102

APPENDIX B - Links to Useful Websites ..................................................................................................106

References ........................................................................................................................................ 107


Recruitment Roles and Responsibilities Saskatchewan Regional Health Authorities (RHAs) have the primary responsibility to recruit physicians to rural and regional centers in Saskatchewan. Before initiating recruitment for a newly created position or a replacement physician position, it is important to contact the responsible RHA to ensure that the identified need aligns with the regional and provincial strategic plans.


Preparing for Recruitment Form a Recruitment Team

From a practical point of view a clearly defined team approach cuts down on the amount of work for any one person and assists the recruiter throughout the recruitment process.

The responsible RHA or practice will need to identify individuals responsible and/or involved with various pieces of the recruitment process. This may include:

RHA recruitment consultants Medical or administrative leaders within the RHA Local physicians or medical practices, health foundation

In addition

Community leaders, and Community representatives from a potential community where provider may live

may become a part of the site visit and settlement process.

It is important that each member has a clear role and is aware of the time commitment involved. Physician candidates have many opportunities and choices; therefore, each piece of the process must occur in an efficient and timely manner to ensure the candidate remains engaged.

Tools should be provided to each member to ensure that they are providing consistent information in a standardized manner. A break down or miss commitment on any one piece of the process may jeopardize the overall process and the relationship with the candidate.

All members of the committee should have full contact information of all the participants. [See Appendix A – Physician Recruitment Committee Master Contact List]

Some of the suggested roles that the RHA may establish are:

Sourcing Person - This person is responsible to ensure that they are familiar with the opportunities available and needs of the candidate to facilitate an initial match.

Coordinator - This team member assigns tasks and ensures completion. The position requires a person who possesses good organization and leadership skills. This person typically co-ordinates logistics with team members of the interview team, site visit team, and settlement team. He/she will also track the status of each candidate.

Contact Person(s) - This individual(s) will represent the first personal contact the candidate will have with the associated opportunity. The contact person should have strong interpersonal skills and possess knowledge about the community, practice, licensing and immigration. This person provides opportunity packets to interested candidates and maintains contact with the candidate throughout the process.

Candidate Interviewer(s) - The interviewer’s role is critical to the success of the recruitment and retention effort. He/she must gather as much information about the candidate as needed by the recruitment team to decide how closely the candidate matches the needs of the opportunity. It is critical the participating interviewers have the skills to assess the fit,


credentials, medical skills, competencies and behavioral responses of the candidate.

If multiple interviewers are used for various stages of the recruitment process they should have access to all information provided to the candidate and all questions asked of the candidate to avoid duplication and to ensure consistency.

Reference and Credential Reviewers - This individual’s role is critical to successful recruitment and is most often the responsibility of the RHA as it is the body responsible for hiring and granting privileges.

Site Visit Team - This team serves as a moderator and guide for the prospective physician and family to the practice and community. Information gathered by all other members of the team about the provider and family should be shared with the site visit team so they can tailor the site visit itinerary to the candidate and family’s interest.

Contract Negotiator - This team member is a duly authorized representative of the organization that underwrites the compensation package. This person is usually within the RHA and physician practice.

Define the Opportunity and Build the Posting

Your goal is to hire a physician who will be a good fit with the opportunity. Consider the practice's needs and the key attributes of your ideal candidate. Ask yourself questions such as:

What qualities are you looking for in a physician?

Clearly, you are looking for a physician who is willing to perform the duties of the position, according to its work schedule and at the designated locations. Does your ideal candidate have particular skills or credentials? Do you prefer a physician with roots in your community or region? Are you looking for a physician who is driven to become highly productive? Are you looking for a physician who will remain with your practice for just a few years or for the rest of his or her career?

What does the practice offer a physician?

Practice setting, community, and compensation are the three critical components to assist candidates to better understand whether your opportunity and community is right for them. Because physicians are extremely busy, they are often scanning online postings after hours. They want as much information as possible, up front, as opposed to contacting a recruiter during business hours to obtain information about the opportunity.

Provide as much detail as possible about:

Qualifications, expectations and abilities of the candidate you are seeking The responsibilities of the position The facility(s) that the candidate will be working in Other healthcare resources Hours of work expected On-call expectations


Remuneration model, level of earning Benefits and/or incentives available Programs and support for practice – relationships with nurse practitioner, midwives,

homecare, emergency medical services etc. Other details regarding specific characteristics and expectation of practice Technologies, and Community

Post the Position

RHA recruitment consultants arrange to have the position posted online. A provincial list of all physician opportunities can be found at: www.saskdocs.ca - Opportunities.

Immigration, Refugee and Immigration Canada (IRCC) requires that fully qualified Canadian citizens and permanent residents must be given preferential consideration. In the event that the employing organization is unable to recruit a qualified Canadian or permanent resident physician, posting a vacancy on this website is regarded by Service Canada as meeting the advertising requirements to allow for the recruitment of an international medical graduate.

Sourcing a Candidate

Who is most likely to be interested in your opportunity and how do you find them? Consider tools and mechanisms such as:

University of Saskatchewan Medical Learners

saskdocs and the RHAs work hard to stay connected to University of Saskatchewan medical learners and residents. One example is an annual event that connects family medicine residents with regions, communities and clinics throughout the province. These events provide a great opportunity to showcase the opportunities and make a face to face connection.

Career Fairs and Conferences

saskdocs advertises and attends events locally, across Canada and internationally to promote the province and the practice opportunities available. Interested candidates are provided information about licensure, immigration and opportunities. Information about personal and professional interests are gathered to facilitate a match. saskdocs coordinates and partners with RHAs who wish to advertise or attend events.

Access Professional Networks

Word-of-mouth referrals are very effective recruitment mechanisms because the referrer knows both parties. Practicing physicians are reportedly Saskatchewan’s best source of candidates.


http://www.saskdocs.ca/

Advertising

Health recruiters may also consider additional advertising options and/or marketing strategies that will give them the greatest flexibility in considering both Canadian and international candidates.

Advertising can be an effective recruitment strategy, although expensive. There are several publications and media to consider that are free:

Internet advertising – job hunting sites and specialty sites, such as professional associations

Advertising in international, national and specialty medical journals and newspapers Home webpage advertising Postings with medical schools, association or societies representing your target group

Search Firms

Depending on the urgency of the situation and the size of the budget, you may want to consider using third party recruitment firms. There are many firms who profess to have a large source of candidates; however, quality varies among search firms, as does the quality of the candidates they recruit. It is important to select a firm with a proven track record of the ability to provide candidates that are eligible to practice in Saskatchewan. Before entering into a contractual relationship it is advised that you interview several firms and conduct reference checks.

[See Appendix B - Position Profile Template]


Recruitment

Saskatchewan Regional Health Authorities (RHAs) have the primary responsibility to recruit physicians to Saskatchewan. Before initiating interviews, it is important to contact the responsible RHA to ensure that the identified need aligns with the regional and provincial physician resource plan.

Screening Candidates

It is important that once contact has been established either by phone or email, the candidate knows that you are interested in them. Every attempt should be made to provide an initial response within 24 hours.

First contact is typically to:

Request a curriculum vitae (CV)

Follow up responses are to:

Determine the status of Saskatchewan licensing Send a formal personalized information package to the candidate. Personalized

packages may include (but not be limited to) information about:

- Additional information about the opportunity(s) - Interesting information about the province, region or communities - Information about the process of obtaining a license to practice

Conduct the Saskatchewan International Practice Assessment (SIPPA) pre-screen (when appropriate) and assist candidate [see SIPPA section].

Human Rights Considerations

Ethical Recruitment

The 63rd World Health Assembly unanimously passed a resolution to adopt the World Health Organization (WHO) global code of practice on the international recruitment of health personnel. The code aims to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel and to facilitate the strengthening of health systems. Member states should discourage active recruitment of health personnel from developing countries facing critical shortages of health workers. saskdocs supports this resolution and incorporates the principles in all advertising and recruitment activities and asks for the support of all partners to protect the health care systems of underserved developing countries.

The World Health Organization (WHO) global code of practice can be found at: www.who.int The saskdocs Ethical Recruitment Framework can be downloaded at: http://saskdocs.ca/web_files/ethical-recruitment-framework-2013.pdf


http://www.who.int/

http://saskdocs.ca/web_files/ethical-recruitment-framework-2013.pdf

Human Rights Legislation

All through the recruitment process, proceedings must demonstrate a respect for human rights legislation governing Saskatchewan.

The best way to protect you from discrimination and from complaints is to know and respect The Saskatchewan Human Rights Code which directs that no employer shall refuse to employ or continue to employ or otherwise discriminate against any person or class of persons with respect to employment, on any term of employment, on the basis of a prohibited ground. Copies of the code and further information on it can be found at the following websites:

www.qp.gov.sk.ca/documents/English/Statutes/Statutes/S24-1.pdf www.shrc.gov.sk.ca/human_rights_code.html

Assessing Eligibility for Licensure

The College of Physicians and Surgeons of Saskatchewan (CPSS) assess eligibility for a license to practice medicine.

The requirements for licensure are described in detail on the CPSS website

at: http://www.cps.sk.ca/cpss/registration/Licensure.aspx?LicensureCCO=Licensure Overview

Canadian trained family physicians seeking to practice family medicine in Saskatchewan, who demonstrate the following credentials, may be eligible for registration:

Successful completion of a recognized undergraduate medical degree Successful completion of a Canadian family medicine residency training program, and Eligibility for the Certification Examination of the College of Family Physicians of Canada

International medical graduates seeking to practice family medicine in Saskatchewan must complete one type of assessment before they can be eligible for licensure in Saskatchewan.

The two assessment options are:

Recognition of foreign family medicine credentials by the College of Family Physicians of Canada (CFPC) – this option is currently available to family practice candidates who completed their medical education in Australia, Ireland, the United States or United Kingdom http://www.cfpc.ca/RecognizedTraining/

or

Completion of the Saskatchewan International Physician Practice Assessment (SIPPA) program; an option currently available for internationally educated family medicine physicians from any other country. Program parameters are described in detail later in this handbook.

[See Appendix C – Initial Contact to Practice]


http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/S24-1.pdf

http://www.shrc.gov.sk.ca/human_rights_code.html

http://www.cps.sk.ca/cpss/registration/Licensure.aspx?LicensureCCO=Licensure

http://www.cfpc.ca/RecognizedTraining/

Interview and Selection

When you've identified one or more viable candidates, schedule a mutually convenient time where you can begin the interview process. An interview is a two-way street. You are both trying to make a positive impression on each other in the hopes of finding a good match. Your goal is to learn about the physician's key needs and how those align with your needs.

By establishing a well-defined interview process that is fair, consistent and comprehensive, you will ensure that you select the right fit. Many organizations use a tiered interview approach, therefore this is the technique described here.

The first contact is generally an informal discussion that ideally establishes some common ground and trust and uncovers all expectations on both sides. Typically, these expectations include:

The physician expects to speak with a person who is able to elaborate on all facets of the opportunity

The interviewer expects to learn about the physician's key needs and how those align with the opportunity

A good approach to beginning this discussion is by saying, “tell me about yourself”. Most people will respond by talking about what is most important to them. As you listen to the candidate you may wish to consider the following questions:

Does he or she prefer the type of duties, schedule, size of practice and on call schedule you offer?

Does he or she seem to fit with the practice's culture? Will he or she be likely to remain in your community? Are there influences that may draw

him or her elsewhere? Are there hobbies or extracurricular activities, spiritual or family requirements that are

important? What is the candidate’s preferred practice profile, e.g., number of hours of work per week,

preferred calls frequency, etc.? What is the candidate’s earning expectations? What is the candidate’s motivation for relocation?

You may then wish to follow up with, “Tell me what you know about the opportunity, community, and province?” This will allow you to establish an understanding of what the candidate may have already learned from other sources and allow you to build upon the discussion from that point.

Consider providing information about:

The geographic location, community size, service area The community and the lifestyle the physicians enjoy The different remuneration options and the compensation package The assistance that may be available for relocation, settlement, benefits and incentives The practice Availability and access to hospital resources, operating room time, consultants and

coverage Earning potential and the weeks per year, days per week, hours per day, and patients per

day required to generate a reasonable income


The orientation and mentorship that is in place to support a “new doctor” Professional opportunities for the partner Education supports for the family Community’s housing availability and cost Licensing/immigration process and timelines and the supports that will be offered

With the information gathered and shared during this initial discussion, the candidate and the interviewers should be able to determine if there may be a fit and ascertain if there is an interest to move forward.

Depending on your interview structure, you may wish to invite strong candidates for a follow up interview. The persons involved in the follow up interview(s) may change so be certain that all questions and responses discussed at each stage of the interview process are documented to eliminate redundancy and ensure consistency.

You may choose to use a bank of questions (see Appendix D) to develop your own guide(s).

[See Appendix D – Interview Bank]

Once there is a mutual decision to proceed between the two parties you should generally adhere to the following steps:

Send a formal personalized information package to the candidate. Personalized packages may include (but may not be limited to) information about:

Real estate Schools Pertinent athletic, cultural, sporting, lifestyle pastimes A draft of the contract, and A request for references (consider global)

Discuss the possibilities and timelines for the candidate and their family to travel to your area or community for a site visit.

Checking References

Reference checking is absolutely essential to verify a candidate's background. Combined with proper interviewing techniques, reference checking should give you added assurance that the intuitive sense you have about a candidate is well-founded.

There are several tools and techniques that can be used to effectively check the references of a candidate’s clinical knowledge and skills, strengths and weaknesses, interpersonal skills, and ability to handle the responsibilities and challenges of the position. Some of the recommended tools and tactics include:

Telephone reference checks - Reference letters from candidates provide helpful insights but they do not replace the need for in-depth telephone conversations with at least three sources that have knowledge of the candidate’s past clinical experience.

In depth telephone calls can be conducted with:


• references that are provided by the candidate (i.e., chief of staff, medical practice colleagues, medical staff, and partners)

• global reference checks are those contacts made in the job application process that are not provided by the employee as a reference on their application. This approach allows you to reach out to others within the candidate’s reference circle to attempt to gather a complete picture. It is recommended that if you are going to use this approach you advise the candidate in advance.

Cyber reference checking involves the use of Google, Facebook, Twitter, MySpace, LinkedIn, and many other sites that a potential employer may use to assess character, cultural fit and other attitudes and characteristics. While this should not be the only source of your verification, it is important to know that if you do not check these resources, others in the community likely will.

Third party background verification firms, for a fee, will screen on a wide variety of factors such as identity, address, references, criminal background checks, drug test, financial records, court record checks and driver’s license verification.

When recruiting, it is imperative to obtain references, even though many do not like to provide them. Overcoming a referee’s hesitation to give a full reference can be something of an art form. If a recruiter senses some hesitation, one approach is to not ask immediately about job performance, but to instead ask for a description of the duties and responsibilities of the position held. That can naturally lead into a discussion of the particular applicant.

While checking references, you may learn negative information about a candidate that may influence your opinion of the candidate. Some rules of thumb to keep in mind in this event are:

Exercise caution prior to sharing the specifics of this reference with others, including the candidate. Doing so violates the confidentiality of the information the reference has shared.

When you do get a negative reference, try to understand the circumstances before eliminating that person as a candidate. For example, was it just a personality conflict? Is it the candidate’s personality or the supervisor’s?

[See Appendix E – Reference Bank]


Appendix A – Physician Recruitment Committee Master Contact List

Physician Name : Phone Number:

Email Address:

Family Members:

RHA Contact Person:

Phone Number:

Email Address: Email address:

Clinic contact

Person:

Phone Number:

Email Address: Email Address:

Community Contact

Person:

Phone Number:

Email Address: Email Address:


Appendix B– Position Profile

The following questions may assist you to make your profile more robust.

Logistics

Clinic name Clinic location Is there an opportunity for full time/part time/locum Average number of clinic hours worked per week Call rotation Overhead

Practice Setting

Are you seeking specific qualifications, educational requirements and certifications? Are you seeking an experienced candidate or will you accept a new graduate?

Responsibilities

Outline the scope of services you expect the physician to provide and when and where the services will be provided.

List typical number days per week the physician may be needed to provide medical practice, long term care and hospital care.

Describe the type and amount of clinical and administrative responsibilities at the office and the hospital.

Describe the standard work week, call expectations and coverage arrangements for the medical practice, long term care, hospital and emergency room.

Will the physician be required to assume any management or administrative responsibilities?

Describe the remuneration; model of payment, overhead, historical billings, any changes that have occurred recently or are projected that may impact the provider’s billings?

Facility

If the opportunity is hospital-based, then describe:

Number/type of beds Age and condition of facility Technology available (depending on special interest or importance to specialty) Scope of services, departments, clinical and administrative human resources

Is there an opportunity for inpatient care Is there an opportunity for procedures? Relationships with tertiary centers Hospital privileging process

If the opportunity is a medical practice, then describe:

The size, age of the facility Size of the group Average number of patients per practitioner Number of physicians doing obstetrics at the clinic


The technology available o EMR – and type o Telehealth

The administrative and clinical support staff – and the type of supports provided

If the opportunity includes Long Term Care/Personal Care Home settings, then describe:

The size and age of the facility Number of beds Scope of services Round expectations (weekly/monthly)

Other Healthcare Resources

If the position is part of a Primary Care Network, the role and relationship of independent practitioners with nurse practitioners, midwives, homecare, dieticians etc.

List or describe other healthcare facilities, providers or services available in the community, such as public health, mental health or substance-abuse counseling, physical therapy and rehabilitation, dietician, emergency medical services and dental services.

Describe the emergency medical system in terms of level of care, types of transport and distance in miles and minutes to advanced care facilities.

Community

Geographical location Distance from major city/international airport Amenities offered


Appendix C – Initial Contact to P r a c t i c e

Family Physicians must meet a number of requirements as a part of the licensure application process. This document will provide a general overview of the timelines and costs associated with the each of the processes that may be a requirement.

Encourage the Physicians to complete the following requirements concurrently (when appropriate) rather than sequentially.

Please note – the timelines below are estimates only and subject to change.

Specialist Physicians

The traditional route to certification is intended for those who complete their postgraduate residency training in a Canadian program accredited by the Royal College of Physicians and Surgeons of Canada.

The Traditional Route also applies for those who complete their postgraduate residency training in a program in the United States accredited by the Accreditation Council for Graduate Medical Education (ACGME).

http://www.royalcollege.ca/rcsite/credentials-exams/exam-eligibility/assessment-routes-residents-e

Many ACGME accredited programs are shorter than Royal College accredited programs. Review the Canadian training objectives and specialty requirements of specialty to ensure that the training fulfils Canadian requirements for eligibility to certification. USA applicants need to apply for an assessment of their ACGME residency training.

Assessment routes for international medical graduates

International medical graduates are people who have completed their postgraduate residency training outside Canada or the United States. Applicants do not have to live in Canada or hold Canadian citizenship to be eligible for Royal College exams.

Approved-jurisdiction route is for international medical graduates who have completed specialty training outside Canada or the United States in an approved jurisdiction.

http://www.royalcollege.ca/rcsite/credentials-exams/exam-eligibility/assessment-imgs/approved-jurisdiction-route-international-medical-graduates-e

College of Physicians and Surgeons of Saskatchewan (CPSS)

The College of Physicians and Surgeons is a statutory, self-regulating body established by legislation of the Government of Saskatchewan and charged with the responsibility of licensing properly qualified medical practitioners;

Contact: http://www.cps.sk.ca/ Turn-around-time: Varies for each applicant; however on average is six to eight weeks.

Variables include completeness of application, length of time medical schools takes to SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK- 2013 (UPDATED JULY 2017) Page | 19

http://www.royalcollege.ca/rcsite/credentials-exams/exam-eligibility/assessment-routes-residents-e

http://www.royalcollege.ca/rcsite/credentials-exams/exam-eligibility/assessment-route/traditional/training-objectives-specialty-requirements-e



http://www.cps.sk.ca/

verify medical education credentials, etc.

Physician Credentials Repository

The College of Physicians and Surgeons of Saskatchewan requires that physicians seeking registration/licensure in Saskatchewan who have completed medical education outside of Canada must submit notarized copies of relevant documents for source verification. The Medical Council of Canada (MCC) Physician Credentials Repository is offered through http://physiciansapply.ca

Contact: http://physiciansapply.ca/services/application-for-medical-registration/ Turn-around-time: Varies for each applicant and on average is currently three to four

months. Variables include motivation of physician, completeness of application, length of time medical schools takes to verify medical education credentials, etc.

Medical Council of Canada Exams (MCCEE, MCCQE1, MCCQE2)) The Medical Council of Canada offers several examinations to help Canadian and international medical graduates and physicians become eligible to practice in Canada:

Contact: http://mcc.ca/home/


http://physiciansapply.ca/

http://physiciansapply.ca/services/application-for-medical-registration/

http://mcc.ca/home/

English Language Proficiency

International English Language Testing System (IELTS)

The IELTS tests English language proficiency. The test is offered in over 800 centers and 130 countries across the world.

Contact: http://www.ielts.org/ Turn-around-time: IELTS is available on 48 fixed dates a year – up to 4 times a month,

depending on local demand. Official reports are mailed approximately two weeks after the test date.

College of Family Practitioners of Canada (CFPC)

The CCFP designation may be granted without examination by the College of Family Physicians of Canada (CFPC) to those physicians who have met a set of defined criteria and have the training and certification from approved jurisdictions.

Contact: http://www.cfpc.ca/RecognizedTraining Turn-around-time: One to two months turn-around-time once application is received.


http://www.ielts.org/

http://www.cfpc.ca/RecognizedTraining

Immigration Canada - Labour Market Impact Assessment

The Labour Market Impact Assessment (LMIA) is an application issued by service Canada that outlines the impact that hiring a foreign worker would have on Canada labor market. Sponsoring agencies need to obtain this assessment in order to recruit foreign workers. If the assessment is positive, a report outlining the conditions of the job being offered by the sponsor, the names of the physician, and also the expiry date of the LMIA will be listed in the document. To recruit a temporary foreign worker, you must obtain a favorable LMIA.

Contact: http://www.cic.gc.ca/english/work/employers/apply-who.asp

Turn-around-time: This has been highly variable.

Citizenship and Immigration Canada – Application for a Work Permit

For a temporary foreign worker to be legally eligible to work in Canada they require a valid work permit.

Contact: http://www.cic.gc.ca/english/information/times/temp/workers.asp Turn-around-time: Processing times for temporary work permit applications processed

by visa offices outside Canada are based on a complete application package. Check the website for timelines.

Citizenship and Immigration – Application for a Temporary Resident Visa

Citizens of the following countries (see link) and territories require a Visa to visit or transit Canada:

Contact: http://www.cic.gc.ca/english/visit/visas.asp Turn-around-time: Processing times for temporary resident visa applications processed

by visa offices outside Canada vary. Check the website for timelines at: http://www.cic.gc.ca/english/information/times/temp/visitors.asp


http://www.cic.gc.ca/english/work/employers/apply-who.asp

http://www.cic.gc.ca/english/information/times/temp/workers.asp

http://www.cic.gc.ca/english/visit/visas.asp

http://www.cic.gc.ca/english/information/times/temp/visitors.asp

Appendix D – Interview Bank

Questions you should be prepared to answer.

You may choose to organize questions #1-12 into a practice overview/introduction.

INFORMATION SHARED IN PRELIMINARY INTERVIEW

INFORMATION SHARED IN SECOND/FINAL INTERVIEW

Practice questions 1. Why is a new/additional provider needed? 2. Does the medical community support the recruitment of another

provider?

3. How many providers are currently in the community/clinic? 4. What is the average age of (your specialty) physicians in your

area?

5. Why did the last provider leave? 6. What types of support staff are at the facility?

What services are provided by the staff

7. How many patients are there in the practice/community/ catchment area?

8. Are there call groups and/or practices open to accepting new patients?

9. What is the closest referral center for patient care? How far is it? 10. Is there adequate availability and access to hospital resources, or

time, consultants and coverage?

11. What other health care resources are available to family physicians in the community? (i.e. pharmacy/massage, chiropractor, diabetes clinics/ dieticians/health educators/physiotherapists.)

12. Is there a “Hub and Spoke” arrangement? What communities are involved Is there compensation for travel?

13. Are many physicians planning to retire in the next five years? 14. What type of support will you provide me in developing my

practice?

15. What is the relationship between providers within the practice and between other offices in the community like?

16. Is there adequate and acceptable clinic space available in an existing practice? Or what other locations are available for office space?

17. What types of technology and equipment are available at the office?

18. Do practices have electronic medical records (EMR) in place? What type of EMT does the clinic use? If not what are the future plans and timelines?

19. Does the facility have access to Telehealth services? 20. Which services will be provided at the facility and which will be

provided by other centers?

21. What are the shared services/resources


22. What is the level of activity in the ER? 23. Are there physicians providing obstetrics at the clinic

How is the obstetrics call shared?

24. Where are the consulting physicians located? How would I access them?

25. Are hospital privileges required? 26. What type of emergency transportation is available? 27. Are tertiary center satellite services offered in the community? 28. How long does it take for patients to see a specialist? Surgery

waits? Waits for tests?

29. What other health care professional vacancies are currently not filled in your region? For example, surgeons, internists, obstetricians, nurses, physiotherapy, occupation therapy, etc.?

30. What other specialty services are available in your community/region? Obs/Gyn, General Internal Medicine, Surgery, etc.?

31. What is the current level of support for Primary Health Care services in the community/region?

32. How many hours per week will I be expected to spend in the office and in the hospital?

33. Will I have to go to satellite locations? 34. How many patients will I be expected to see in a day? In a week?

On a typical call rotation?

35. Is there an opportunity for full-time/part-time locum? 36. What are the opportunities for work outside of private practice?

(i.e. diabetes clinics, outpatient procedures, assisting in the operating room, etc.)

37. What are the administrative requirements in the community/ hospital? (i.e. committee, monthly meetings, etc.)

38. How much (weeks per year, days per week, hours per day) and how many patients per day will I have to see to generate a realistic gross income? A reasonable net income?

39. Is there locum coverage? 40. What is the model of remuneration? 41. If the current model is Fee for Service – is there an opportunity to

switch to contract, blend, and alternative payment?

42. What are the expected earnings for the first month, quarter, and year?

43. Is there an income guarantee? 44. What are the overhead costs and office administrative

responsibilities?

45. What incentives are offered? What is the signing bonus, relocation package if any?

46. Is there a return for service for the financial incentives/ relocation supports provided?

47. What are the costs associated with: i. Initial licensure, ongoing licensure? ii. Individual malpractice insurance premiums? iii. Overhead? iv. Taxation?


48. Would there be someone to act as a mentor? 49. Is there an allowance to support Continuing Medical Education? 50. Is there access to Continuing Medical Education sessions? 51. Are there family practice research opportunities? 52. Are there any journal clubs for physicians in the community? 53. Is there an opportunity to teach? Act as a preceptor?

Community Questions 1. What is your community’s geographic location/community size? 2. What is the cost of living in this community? In the province? In

the country?

3. Are there any negative aspects about the community? 4. How far away is the nearest major centre? International airport? 5. Are there professional opportunities for my present/future

partner?

6. Will the region/community/clinic provide assistance to find my partner employment?

7. What is the age structure of the community? (I.e. young families, retired community, etc.)

8. What is the demographic profile of the community? How culturally diverse is the community?

9. What types of educational opportunities are available for me? For my family?

10. How would you rate the quality and access to schools? 11. What types of housing are available in the area? Temporary?

Permanent?

12. Will the region/community/clinic provide assistance to find a suitable temporary housing? Please describe the size/style/furnishings etc. of the temporary housing? Please define the terms of the assistance.

13. Will the region/community/clinic provide assistance to find a permanent home in a good neighborhood?

14. What types of churches are in the area? 15. Is there access and availability of cultural, and entertainment

venues?

16. What kinds of recreational activities are available in the community? (I.e. gyms, swimming pool, parks, walking trails, libraries, etc.)

17. What types of shopping and other consumer services are available locally? Provincially?

18. What is the cost of activities?


The following is a list of commonly used questions to build an interview. The questions can be adapted according to the interviewer’s needs.

RESPONSE

OBTAINED PRELIMINARY

INTERVIEW

RESPONSE OBTAINED

FINAL/SECOND INTERVIEW

Introduction

1. Describe how your work experience and education have prepared you for this position.

2. Please share with us what you consider to be your most important accomplishment in your current position.

3. What attracted you to this opportunity, or this particular hospital/clinic? Province?

4. How do you see yourself contributing long-term? Education

5. Where were you trained? Describe any other prior education. 6. Have you completed any of the Canadian medical exams?

MCCEE, MCCQ1, MCCQ2

Experience

7. Please describe your past practice situations and current: • Saskatchewan models of remuneration • Fee for service/salaried/other • Type of procedures you are performing • Solo or group practice group • Population group served (type of patients that you normally

provide care for)

8. What are your areas of special interests: • Procedures, etc. • Obstetrical care, etc. • Do you have any post grad courses?

9. Are you familiar with the procedures at this site (if not, describe)? Are there any procedures you like to add? Which procedures would you prefer not to perform?

10. Are you interested in a generalized/broad scope of practice? 11. What are your definite restrictions? 12. What is your experience working in an emergency setting?

How would you rate your current skill set?

13. What supervisory or leadership roles have you held? Is that an area of interest?

14. Are you interested in participating as a preceptor for medical students or residents?

15. XXX is a Primary Care Site, which means that health care is delivered in a team setting. What experience do you have working in teams and in multi-disciplinary settings?


16. Please describe your experience working collaboratively with other health care providers in a team based environment: • Specifically independent practice providers such as nurse

practitioners and midwives, and • Also community health providers such as emergency services

and public health.

17. How can you contribute to the efficient and cost-effective management of patients? • What patient management strategies have you been a part

of?

18. What is your experience with change management? 19. Describe one or two specific achievements which have given you

the most satisfaction

20. How would others (physicians in your practice/nurses in the hospital/your current Chief) describe you? (both professionally and personally)

21. Describe your relationships with nursing staff / other staff. 22. Describe your relationship/experience with administration. 23. What potential difficulties, if any, do you see associated with the

position?

24. How would you try to overcome those difficulties? 25. Describe your committee work and/or areas of interest. 26. What could you bring to the hospital/clinic that others could not? 27. What are you looking for in a community? 28. What is your comfort level in living/practicing long-term in a small

community (if applicable)?

29. What do you think the biggest challenge for you personally will be in the position?

30. How do you work under pressure? 31. What are your long-term goals? Where do you see yourself in 5

years? 10 years?

32. What are your interests away from medicine? What do you like to do in your spare time?

Behavioral Interview Questions

33. What is your ideal/perception of patient centered care? (Flexibility and Adaptability)

34. What do you believe are the responsibilities of a physician in a clinic (Teamwork)

35. Tell me about a time when you persuaded team members to do things your way. (Teamwork/Approach)

36. Give me an example of when you showed initiative and took the lead. (Leadership)

37. Describe a time when you anticipated potential problems and developed preventive measures. (Problem Solving)

38. What would you do if you had a concern about quality? Can you give an example of a time when you had to make an important decision with limited facts? (Problem Solving)

39. Have you ever been in the position of having to make an


unpopular decision? Describe it.( Approach) 40. Tell me about a time when you were tolerant of an opinion that

was different from yours. (Respect)

41. Tell me about a time when you were faced with an ethical dilemma. (Approach)

42. Tell me about a time when you had to go above and beyond the call of duty for a patient. (Approach)

43. Tell me about a time when you had too many things to do and you were required to prioritize your tasks. (Problem Solving/Time management)

44. Give me an example of a time when you had to make a split second decision. What was the outcome? (Problem Solving/Time management)

45. Describe a time when you anticipated potential problems and developed preventive measures. . (Problem Solving/Time management)

46. Give me an example of a time when you used your fact-finding skills to solve a problem. . (Problem Solving/Time management)

47. Describe your biggest professional failure. 48. Tell us about a situation in which you observed someone else not

using discretion. How would you have handled the situation if you had been in that individual’s shoes? (Personality)

49. How would you describe your outlook on life? (Approach) Logistics

50. What are your lifestyle needs – family, cultural, recreational, and personal (try to relate to local amenities, etc.)?

51. Tell me about your extra-curricular activities and interests. 52. What hours are you willing to work - how many per week total,

and of which, how many clinical?

53. Do you have any concerns/issues with the call rotation? Are you willing to work nights and weekends (describe what hospital requires, e.g. we require 3 days, 1 night, 1 day off and 1 Saturday in 4)?

54. How much vacation time would you expect per year (on average)?

55. When would you be available to start?


Appendix E – Reference Bank

Candidates Name

Name of Reference Title

Contact information Date of Reference

Review the details provided in the CV where this reference would be able to validate the information provided. Possible questions you may choose to ask the reference How do you and Dr. ______ know each other? What is your relationship? For how long? Describe a particular situation in which the candidate exhibited certain qualities or behaviors (i.e. leadership, teamwork, clinical excellence; etc.) Can you please briefly describe the candidate's style and approach to making clinical decisions? Can you please briefly describe the candidate's communication and interpersonal skills with superiors, subordinates and peers? What types of office or practice environments and cultures would be the most appropriate for this physician to excel? Please share any insight as to how the candidate comes across to patients. What would you suggest are the candidate’s key strengths? What is this physician like when he/she has made a mistake and has to correct it? What would you suggest are the candidate’s areas for development? What kinds of things get this physician upset? How might you describe the candidate’s professional appearance and demeanor? Would you hire/choose to work with this person if you had the opportunity? Would you feel comfortable having this physician treat a member of your family? Why/ Why not? Ask the reference if there is anyone else in the organization that may be a good person to speak to about this candidate (Global Reference) Additional comments.


Saskatchewan RHA Reference Form

Date:

Re: Reference Request for:

Dr. has made application to the Health Region in Saskatchewan, Canada, for privileges in the Department of and has given your name as a reference. In order to evaluate the clinical skills and character of Dr. , we would appreciate your answers to the following questions and also any other comments you believe are important concerning the applicant.

All information supplied will be held in the strictest confidence.

Thank you,

Name Title

What is your present position? (Please be specific)

1. How long have you known the applicant?

2. In what capacity do you know the applicant?

3. In which hospital did the applicant have privileges – their duration and status?

Hospital Duration Status (i.e., Active, Associate, Courtesy, Other)


4. Please rate the following:

Very Good Good Fair Poor

Clinical Knowledge □ □ □ □ Clinical Competence □ □ □ □ Emotional Stability □ □ □ □ Work Habits □ □ □ □ Participation in Staff and Committee Activities □ □ □ □ Relationship with Patients □ □ □ □ Relationship with Peers □ □ □ □ Professional Attitude □ □ □ □ Ability to Work with Others □ □ □ □

5. Has there ever been any restriction of privileges? □ Yes □ No

If “yes” please specify:

6. Has the applicant’s privileges to admit or treat patients ever been suspended or revoked, excepting temporary suspension for failure to complete medical records?

□ Yes □ No

If “yes” please explain:

7. Does the applicant regularly obtain consultations when needed? □ Yes □ No

8. What was the quality and timeliness of the applicant’s medical records?

Very Good Good Fair Poor

Quality □ □ □ □ Timeliness □ □ □ □


9. To your knowledge has the applicant:

a) Ever been a defendant in a medical malpractice action? □ Yes □ No

If “yes” give particulars you are aware of:

b) Ever been the subject of disciplinary action by a Licensing Body, Board or Trustees or Medical Staff for:

i) Unethical Conduct ii) For any other reason

□ Yes □ Yes

□ No □ No

c) Ever had a problem with alcohol or drugs?

If “yes” give particulars

□ Yes □ No

Any other comments:

Summary of Recommendation:

□ I would recommend without reservation. □ I would recommend. □ I would not recommend this applicant.

Signature

Date

Reply by fax to: Or by email to:


The Site Visit

The site visit is a critical component of any physician recruitment and retention strategy. An important component of retention is a result of making a good match in the first place. The site visit is an invaluable means to ensure this occurs.

The site visit further builds on that relationship and solidifies its credibility by demonstrating interest and establishing the basis on which to create a lasting relationship. In addition, the site visit provides an opportunity to align expectations; the physician is able to see the clinic, the hospital, the accommodations and meet the people that will become the center of his/her new life. Everyone can move forward with a clear understanding of what’s expected. The site visit also presents an opportunity to assess some of the more subjective aspects of the physician. It also allows you to better judge the physician’s compatibility with other members of the practice and his/her compatibility (and family) with the community.

Ideally, a site visit should be between two to three days and allow the physician and family enough time to meet key members of the medical and local community as well as time to explore on their own.

There is an upfront cost associated with a site visit. A site visit will not guarantee that the physician will join your practice/community, nor will it mean that the physician will make a life time commitment. A site visit will however begin to establish a platform to further build your retention strategies. It is also important to note that a mismatch and a premature termination will force you back to the beginning of the recruitment process, which can be very costly.

Ideally, a site visit should be between two to three days and allow the physician and family enough time to meet key members of the medical and local community as well as time to explore on their own.

When you are aware that the physician is considering other opportunities in the province, you may decide to conduct a multiple-site visit. Multiple site visits may save organizations money and may save the physician time. However, there is risk of creating competition between communities.

Take these steps to help your organization stay in the running:

1. Arrange a site visit that will sell itself. Find out what the physician wants to learn

about the opportunity and the community and organize the itinerary with those individuals who can share those details.

2. Effectively prepare for the site visit. While time is always limited, enlist the assistance

of appropriate people and prepare each participant.

3. Implement a winning visit. Portray a picture that is both positive and accurately representative of the opportunity and your community. Presenting an inaccurate picture is not only misleading, but can lead to negative outcomes down the road.


A site visits consists of three stages:

Planning the visit Conducting the visit

Follow-up


Planning the Site Visit

Arranging for the physician and his/her family to visit the practice and community can be one of the most critical and time-consuming aspects of the recruitment process. Best practice research suggests that “one owner” with many participants facilitates a well-organized and well- rounded visit. In Saskatchewan the site visit is usually coordinated by the RHA in conjunction with the medical practice. Many organizations find success in forming a team of interested community members to help coordinate the site visit. The team approach can be very effective when it is well organized and well led.

In planning a site visit, the coordinator of the visit should engage the physician and family to assist the development of a customized itinerary. This can only be achieved with sufficient knowledge about the physician and partner to decide what would interest them about the opportunity and community.

Involving the spouse/family early in the recruitment process is critical to retention. Research shows that partner/spouse/family is the second most important factor in selecting a practice and is the number one reason for leaving.

The first step of planning a customized itinerary is to gather information:

Information gathered through preliminary conversations with the physician and the interview provides a valuable basis for a tailored visit.

Using the information that you already know, tailor the Site Visit Needs Assessment form

[See Appendix A – SAMPLE Site Visit Needs Assessment Form]

Provide and have the physician fill out a Site Visit Needs Assessment form

o The questions asked will present the physician an opportunity to consider the information that they have gathered through the interview process and their research and areas where they would like further clarification

o The questions asked will present an opportunity for the partner to become involved in the process

Once the Site Visit Needs Assessment form is returned it is recommended that you follow up with the physician and the partner to refine details. This conversation will allow you to begin to develop a relationship with the partner and confirm a clear understanding of the visit. Confirmation of assumptions is critical. One administrator found out that his visiting physician liked boating. The recruiter had a 14-foot fishing boat and made arrangements to take the physician out on the local lake for an evening of fishing. The physician showed up in white pants and a sport coat ready to go out on a yacht. The misunderstanding was embarrassing

If you do not have the opportunity to have the physician and family in for a site visit, this form can be used just prior to the physicians arrival. It will provide you the opportunity to get to know the candidate better and to tailor the introductions and events for the first few weeks of settlement.

Organize Your Team

The specific needs of the physician and the partner will drive the itinerary and therefore the people who will need to be involved. Based on the information gathered and the needs that


have been identified, gather those who are interested establish a plan to address the physicians’ needs.

Assign responsibilities. It is critical that each participant has a full understanding of the physician, the opportunity and the information gathered through the Site Visit Needs Assessment Form. Ensure that everyone who will be in contact with the physicians and their family is given the information.

An important piece of information that you may wish to share with all the members of the team;

"Physicians are trained to make diagnostic decisions in the first seven minutes of seeing a patient. Many make a diagnostic decision sooner. Physicians are trained for many years to think episodically. In contrast, with management you are trained that everything is a process and through implementation of processes you make progress. Physicians usually do not make decisions such as management. Successful recruiters realize the number one reason a physician chooses a community, outside of a location close to family, is because they feel needed. They need to feel needed. Physician candidates determine if they are needed through heightened sensory awareness. Will I have a full practice? Are there enough patients in the area? Do the other physicians really want me there? Did the hospital make me feel wanted? Did the nursing staff make me feel wanted? Successful recruiters do extra things to make the physician candidates feel wanted.” - Nine Physician Recruiting Success Factors by Theodore V. Clemans and William K. Clayton.

Objectives assist to maintain alignment; therefore it is important for the team to have a brief discussion prior to establishing the agenda. General objectives are:

Confirm mutual compatibility Build relationships Verify assumptions and align expectations

Your committee may want to consider these objectives and further refine them to ensure the visit meets your needs.

Identify the coordinator

Identify the person who will be the point of contact for the physician, the medical team and the community team. This is most often the RHA recruiter. The coordinator:

o Drafts and shares the itinerary o Acts as the center of communication during the visit for all questions and inquiries o Conducts the post visit follow up

With the medical team:

Identify the components of the visit that are required to meet the needs of the medical practice and RHA

Identify the components of the visit that are required to meet the needs of physician such as:

o Schedule formal time with everyone who needs to meet the physician. While this may vary, consider not only department leaders, senior medical health officers


and peers, but also physician colleagues in other departments, referral specialists, residents, nurses, and other auxiliary staff.

o While not all medical team members need to participate in every meeting, enough search committee members should participate so that they can adequately review the physician.

Identify professional venues (such as the regional medical center) used by your medical staff and arrange the tour.

o It is recommended that the tour be led by another physician who can then answer their questions and provide casual introductions to colleagues, nurses, etc.

Determine if any “physician meet and greet” events will be arranged and the persons who will make the arrangements.

Discuss what information would be beneficial to the physician and how this information will be conveyed.

With the community team:

Determine who will coordinate travel plans with the physician. Consider picking the physician up from the airport or an arrival point when they arrive.

While this is not always practical, it makes a great first impression. Also consider: o If appropriate, you may wish to make a car available so that the physician

(and family members if applicable) can do some exploring on their own. o When traveling with children, make sure to have an appropriate car seat

available. Based on the Site Visit Needs Assessment you may:

o Discuss what information would be beneficial to the physician and how this information will be conveyed.

o Consider the persons, places and businesses in the community that should be profiled and identify a person who will coordinate these arrangements.

It is recommended that the tour of the community be led by a community member who can then answer their questions and provide casual introductions to community members and business owners, etc.

Consider if a welcome gift or memento of their visit to your community will be offered Consider introductions with municipal leaders. Determine if any “community meet and greet” events will be arranged and the persons

who will make the arrangements. Identify an opportunity to experience a popular activity in your area that is of interest to

the spouse and/or physician, such as horseback riding, hunting, fishing, boating, cross country or downhill skiing. Then determine who will coordinate the activity.

In the case of children – there may be a need to arrange for childcare or activities so physician and spouse can concentrate on interacting with colleagues.

Distribute to the members of the site visit team the following:

The CV/resume when appropriate A description of the physician’s needs and requirements Ensure that everyone is prepared to communicate:

o The ability to grow a successful practice; o The eagerness of clinical colleagues to work with them; and o The eagerness of the community to welcome and include the physician and the

family into the community.


Develop an Itinerary

A well-constructed itinerary can make the difference between a successful visit that meets the needs of all involved and a mediocre visit that is costly and time consuming and does not meet the needs.

Create a draft itinerary prior to the visit and send the draft itinerary to physician for review. This will give the physician and the family a chance to plan their day and to see who they will be meeting with, in case they would like to meet with someone who is not on their initial itinerary.

Itinerary tips

If the physician is coming to Saskatchewan from out of the country, allow time for the physician to adjust to the time difference.

Do not forget the spouse/partner. Be especially sensitive to the fact that he/she is critical to the decision making process.

Leave enough time for travel between meetings. Build in 15 minute “buffer times” into the day. This gives the physician regular breaks and

allows extra time for interviews that begin late or run over their allotted time. Coordinator provides “on-call” number/service in the event physician and family require

off hour assistance.

Make all the logistical arrangements:

Airline flights for the candidate and/or his family Transport the candidate to and from the location of landing All necessary hotel reservations Schedule and coordinate dinner arrangements

The site visit should be verified two days prior to the visit to confirm:

The physician's continuing interest That everyone on the applicant’s itinerary is available to fulfill their commitments

All the individuals involved in the process should be:

Provided the itinerary Provided the contact information of the site visit coordinator in the event of delays Reminded of their individual responsibilities

A sample sight visit itinerary has been provided for your use. This sample demonstrates a visit where the partner accompanies the physician on the site visit, however separate arrangements have been made for the partner. This itinerary also allows you to identify the organizer/owner of each of the activities.

[See Appendix B – SAMPLE Site Visit Itinerary]


The Site Visit

Make the most of this day and the chance to highlight everything that you have to offer. It can be a fun few days, but remember, it is still a formal part of the interview process and that the interview is a two way street.

The coordinator plays a critical role during the site visit acting as the point of contact for all participants. He/she should:

Work through any logistical issues or delays Note any requests for additional information for follow up

Site Visit Follow-up

The debrief starts informally as you escort the physician back to the airport. The casual chatter will allow you to determine the first impressions and commitment. Following departure, a quick email or an e-card to thank the physician for their time can go a long way in reinforcing positive first impressions. Before the physician leaves he/she should know the next steps and timelines for follow up.

In bringing the recruitment process to a successful conclusion, time is of the essence and is the best tool you have available to you. Make every effort to devote the time necessary to make your final selection and so inform the candidate in a timely fashion. Taking too much time to extend an offer of employment can be a deal breaker.

To facilitate timely decision making, the next step is a formal debrief with all those who participated in the site visit. Each person who played a role will have gathered critical information that should be considered as a part of the recruitment and retention process. If a formal meeting with all the members of the team is not possible, then individual follow-up is required.

The information gathered by the members of the community team and the medical team may assist you with:

The hiring body/partners to finalize the hiring decision Establish the welcome strategy, and Establish the retention strategy

Ideally the debrief meeting is scheduled the day after the site visit. Members can discuss:

Initial impressions Questions that the physician or partner raised

It is critical that the feedback is documented as it will become invaluable. While some information will undoubtedly be confidential and not widely shared; some of the learning’s may become the basis of the retention strategy.

The physician and partners should also be asked to participate in a formal debrief. A sample Site Visit Feedback Form is available to facilitate this process.

[See Appendix C & D – SAMPLE Site Visit Feedback Form]


Within a few days following the site visit, providing all feedback is positive and the physician remains interested, contact the physician to:

Discuss details of incentives and practice set-up Determine if there are any outstanding requirements to close the deal Provide a confirmation of employment or letter of offer

[See Appendix E – SAMPLE Confirmation of Employment]

If physician is not interested, debrief to determine the reason(s) why.

Picking up the Tab

Although RHAs and communities differ in their ability to pay, the cost of the site visit for the physician and spouse should be paid if possible. If your community is in a vacation area, you may wish to consider policies that prevent the "paid vacation syndrome”. One example is to arrange the visit under the terms that the expenses will be covered if the physician accepts the position. However if the physician does not accept the position he/she may be responsible for a portion or all of the costs.


Appendix A – SAMPLE Site Visit Needs Assessment

Name: Phone #:

Date(s) of visit:

Will your partner/children be travelling with you?

If yes, partner name:

Name(s) and age(s) of children:

Require childcare during site: Yes No

LOGISTICS:

Question Comments Flight information

Is a car rental needed? Will you require a child/baby seat?

Do you have a preference of hotel or hotel facilities?

PERSONAL PREFERENCES (please answer the following, where applicable)

Question Comments We plan to arrange meetings for you with [provide a list] Is there anyone else that you may be interested to meet?

We are planning to arrange a community tour. Is there anything that you noted on our website [provide] that you would be particularly interested to see?

Would your spouse/partner like information about a particular career option or volunteer organization?

Is your spouse/partner interested in meeting with potential employment contacts during your visit? If yes, please forward CV and provide details of areas of professional interest.


Please list the recreational activities, hobbies or organizations that interest you (and your family).

Would you like to meet with officials from local


schools and/or daycare centers? Would you like information about the locations of particular religious facilities? If so, please list. Please advise if you would like the opportunity to meet with clergy or members of their faith community.

Do you wish to meet with a realtor and be given a tour of local residential areas?

Is a split tour an option? i.e. While the physician tours the medical facilities, may we arrange for the partner to meet with school officials?

Do you have any dietary restrictions or foods you avoid?


Appendix B – SAMPLE Site Visit I t i n e r a r y

Introducing Dr(s) name, family members, etc. To Community(ies): Date: September 26, 20XX

Contact Person: Sask Recruiter Cell Phone: 306-456-7894

Thursday Who Activity Team Member responsible to organize the activity

2:00 pm Pick up physician and partner at airport. Sask - Recruiter 3:00 pm Physician and

partner Check in at (name of hotel) Sask - Recruiter

Rest Friday Who Activity Team Member

responsible to organize the activity

8:00 am Physician and partner

Meet for breakfast Attendees - Medical director - Executive director

Sask - Recruiter


Conduct brief drive-through of the community to orient physician and spouse to the community.

Jane Smith Community volunteer

10:00 am Physician Tour clinic location - Introduce to clinic staff - One-to-one with each physician in

the clinic (15 minutes per visit).

Sask - Recruiter and Medical team

10:00 am Partner Tour of school - Visit principal and/or school

counselor, teachers for grades appropriate to the age of the physician’s children.


11:30 am Partner Meet with the medical staff and clinic spouses at a colleague’s home.


1:00 pm Physician and partner

Lunch at health center’s board or conference room. Meet with physician and spouse - Discuss morning’s activities - Address any questions or concerns - Assess and adjust

Sask - Recruiter


Meet community and key civic leaders. [list]



Tour hospital and long-term care facility. Sask - Recruiter and Medical Team

5:00 pm Drop the physician and spouse off at the hotel.



Pick up and take to dinner at local supper club.



- Medical staff and spouses - Board representatives - Health center and hospital

administrators - Key civic leaders - Community recruitment committee

Saturday Who Activity Team Member responsible to organize the activity


Breakfast


Realtor - Temporary accommodations - Potential permanent

accommodations - The realtor will be ready to answer

questions regarding mortgages, lending rates and market values

Jo Johnson Community Volunteer

11:00 am Physician Administrator of recruiting organization and the physician meet to discuss the opportunity and the details of the offer: - Letter of offer - Draft contract - Remuneration &/or incentive

arrangements - The process for obtaining hospital

privileges - SMA programs and offerings

Sask - Recruiter and Medical Team

11:00 am Partner Introduce the partner to potential employers - Career or volunteer assistance



Conduct guided tour of community based on areas of interest - Scenic locations - Recreational and cultural sites - Places of worship



Drop the physician and spouse off at the hotel.


5:00 pm Dinner – free time. 7:00 pm Physician and

partner Pick up and take to community welcome event.


Sunday Who Activity Team Member responsible to organize the activity

9:00 am Return to the airport. Jo Johnson Community Volunteer

10:15 am Flight departs.


Appendix C – SAMPLE Site Visit Feedback - Physician

Thank you for taking the time to visit our community. Your feedback is important to us.

1. How did you first find out about our community?

2. Did you have previous exposure to the community you visited? (Please check all that apply.)

As a medical resident Lived in area previously As a medical student Friends/family/ colleagues in the area Other

3. Were the materials provided in advance of your visit valuable? (Information on region, the opportunities, the province, real-estate etc.?)

Please comment:

Yes No

4. During the site visit did you have adequate opportunity to learn more about:

The practice opportunity Yes The hospital Yes The community Yes The region Yes Spousal employment opportunities Yes Family supports Yes Recreational facilities Yes Cultural/spiritual amenities Yes Real estate Yes Other [specify] Yes

No No No No No No No No No No

NA NA NA NA NA NA NA NA NA NA

Please comment:

5. Did you see everything you wished to see? Yes No

Please identify if there were things that were missed or that you may have liked additional information about:

6. Did you meet everyone you wished to meet? Yes No If no, please specify who else you would have liked to meet:

7. Is there any additional information that we may be able to provide you with?


Appendix D – SAMPLE Site Visit Feedback – Community Team

These questions may be utilized to facilitate discussion with the members of the community team.

1. Based on your participation in the development and delivery of the site visit – are there any areas that we did really well? Are there any areas that we could improve upon for the next visit?

2. What was your overall impression of the candidate?

3. In your opinion, how confident are you that the doctor and partner will relocate and make a long-term commitment?

4. In your opinion, what are the negative factors, if any, that would present constraints to relocation?

5. In your opinion, based on your time with the candidate/partner, is there any additional information that we can provide to the candidate to assist them to make a decision?

6. What information did we gather about the physician/partner/family that can assist us to begin to tailor the transition, community welcome and ongoing retention?


Appendix E - SAMPLE – Confirmation of Employment

September XX, 20XX

Dr. Who Address City, Province Country

Dear Dr. Who:

On behalf of the Meadowlark Health Clinic we would like to confirm our offer of a medical practice opportunity.

Offer Title: Family Physician Meadowlark Health Clinic

Date Offer Accepted by candidate: September XX, 20XX

Anticipated start date: January XX, 20XX

Estimated Length of contract: 1 year contract

Type of Role Family physician – Meadowlark Health Clinic Emergency services - Whoville Hospital

Key Responsibilities: Full time medical practice with on call as required

Terms of Remuneration: Fee for Service

Terms of Incentive Package: As outlined on the attached

This offer is conditional upon licensure with the College of Physicians and Surgeons of Saskatchewan, upon successful compliance with all immigration provisions as outlined by Citizenship and Immigration Canada.

We are pleased that you have made the decision to choose Meadowlark Health Clinic and welcome you to XXXXX, Saskatchewan.

Please sign and return a copy of this letter for our files.

Signed on behalf for the RHA or Medical Clinic Date

Signed by Dr. Who Date


Retention

Roles and Responsibilities

Saskatchewan Regional Health Authorities (RHAs) have the primary responsibility to recruit physicians to rural and regional centers in Saskatchewan guided by the regional and provincial strategic plans.

Settlement and integration of a physician and the family are primarily the responsibility of the local clinic and the community.

The Saskatchewan Medical Association (SMA) has several programs designed to support physicians and encourage the long term of retention of physicians in Saskatchewan. Details about the SMA programs can be found at https://www.sma.sk.ca.

Good retention begins with good recruitment, but it extends well beyond that. The physician relationship should not end when the doctor signs the contract or begins their first day on the job. It must be an ongoing process of continuous relationship building activities that will help the physician and family adjust and develop their practice and establish personal connections. Constant turnover is both costly and has a significant impact on a practice, a community and an RHA. A well planned strategy that integrates factors such as appreciation, connection and active support can go a long way.

The Physician Retention Committee should meet prior to the arrival of the physician and physician’s family into the community. To ensure key team members are in place and the committee has a go forward strategy to address the needs of the particular physician and family. Committees are typically comprised of:

A member of the RHA (Recruiter or primary care coordinator) A member of the clinic (physician or clinic manager) A member of town council

These partners can engage additional persons to be part of the committee and carryout specific functions.

We know, based on the feedback of the 2011-2012 saskdocs/SMA Settlement survey that 54% of our newly recruited physicians did not receive any assistance with basic supports such as orientation to the community, practice or facilities and services. Literature shows that orientation and introduction is critical, but in addition to the basic introductions, a person must have an opportunity to become a part of the environment so they can foster a feeling of belonging and loyalty. Physician Retention Committees are the key stakeholders in the process of assimilation and integration that will then lead to retention. Partners, in consideration of the best practices and strategies for successful retention, can:

Take a proactive approach to meeting challenges of integration to a new community and practice by developing knowledge.

Develop a strategy and a plan for retention. Collaborate with other stakeholders.

Support collaborative retention activities described in the community and family sections of this toolkit.


https://www.sma.sk.ca/

Promote the full participation of all residents in the social, cultural and economic life of the region without discrimination

Settlement and integration should not be left to chance. It is recommended that an overall strategy is developed and each component is carefully managed. You may find the Settlement and Integration Checklist (Appendix A) useful as you begin to build a plan for success!


Understanding the Needs

It is important to have an understanding of the needs of physicians in order to establish an effective settlement and retention strategy. While the needs will be different for a Saskatchewan trained physician than it will for an international medical graduate (IMG), both will require a tailored integration and retention plan.

The 2012 the Physician Exit Survey conducted by saskdocs and the SMA indicates that 83% of Saskatchewan physicians who completed the survey were reportedly satisfied with their working conditions while in Saskatchewan. When asked why they left, the most common answers were:

Family Lack of mentorship/guide supports Lack of ability to balance work and life Excessive call rotation

To be successful, a retention strategy must be multifaceted and tailored to physicians of different backgrounds and career stages. A needs assessment may assist the PRC to gather factors to tailor the assessment. If a site visit has occurred, this information will have been gathered in advance and can be further used to tailor settlement.

Needs Assessment (Appendix B)

A. Understand Generational Differences

Understanding how physicians’ expectations and needs change as their careers progress will help provide a better fit for physicians. Physicians are comprised of three generations: late career, mid-career and early-career.

Late-career physicians were generally born prior to 1945 and for them medicine is a vocational calling. Generally, these physicians respect hierarchy and readily join civic and professional organizations. Practices are often paper based and work life balance is not part of their vocabulary.

Mid-career physicians are generally motivated by the acquisition of material wealth. This group usually prefers compensation that includes financial incentives based on productivity and opportunities for partnership. Many are looking for improved work-life balance, so be prepared to offer them flexible scheduling.

Early-career physicians want a balance between work and personal life. Being a physician is only part of their self-identity. Managing time and balancing life are their primary values. Therefore, they place emphasis on opportunities for their partner, family supports, a steady income, and lifestyle options. They are comfortable in a team-based approach, techno savvy, and are often looking for turnkey practices.

B. Understanding Cultural Differences

Saskatchewan is increasingly becoming multicultural. Communities in Saskatchewan must strive to demonstrate acceptance, respect and understanding for the uniqueness when it comes to race, ethnicity, gender, sexual orientation, status, age, abilities or beliefs. This means going


beyond simple tolerance to embracing and celebrating the rich diversity of the community. The goal should be to create opportunities to explore differences in a safe, positive and nurturing environment.

Learning all aspects of every culture would be impractical. However, there are practical, everyday steps we can take to develop our cultural awareness such as:

Learn o Read literature or invite in a speaker to provide insight to other cultures. o Ask questions to clarify and understand and show a willingness to learn.

Act o Do not judge or interpret actions or speech, verify that what you understand is

correct. o Speak clearly, avoid slang and colloquial expressions. o Listen not only to the words, but also to the emotion behind the words.

C. Understand the Individual

Through the interview and site visit process you will have gathered enough information about the physician to build a biography. The biography can be utilized to build the tailored retention strategy.

The information gathered through the informal interview, site visits, needs assessment and other conversations can be used to develop a Physician and Family Bio. The information on the bio should be shared with all off the members of the PRC.

groups and/or


Facilitating Relocation

Starting a new job, particularly in a new community or new country, can be very stressful.

The Holmes and Rahe Stress Scale provides a list of 433 of life’s most stressful events, ranging from 11 points for a minor violation of the law to 100 points for a death. Any score over 300 indicates severe stress. The life events associated with the factors; relocating, beginning work, establishing a new residence total over 325 points. Because of the stress associated with “starting new” it is important to realize that even small events can be magnified. The more assistance that you can provide to smooth out the adjustment will help increase the speed at which the physicians become fully productive and their families integrate into the new community. All of these efforts contribute to physician retention.

Pre Arrival

It is important to maintain close contact through the entire period of pre-arrival. It is critical to have a designated contact who can then liaise with all other parties to gather information and resolve issues. Although you do not want to appear intrusive, you will need to demonstrate support that will be available upon arrival. Some critical pre-arrival components are:

Provide responses to outstanding questions and/or issues that were raised at the site visit.

Monitor progress of the physician family’s move by:

o Providing information about the arrangements for temporary accommodations. To ensure that the physician is prepared and the assumptions are aligned, you may want to send photos of the place of residence with specific descriptions of what amenities will be available to them.

o Provide assurances about safety arrangements. Physicians coming from other countries may have very different concerns based on their experiences therefore it may also be important to address any concerns about safety. The security of the accommodations, the proximity of the family accommodation to the health facility, and assurances about safety arrangements provide an initial sense of security.

Link the physician and family to preferred moving companies who can support provincial, interprovincial or cross world moves.

Link the physician to preferred services such as banks, lawyers, a real estate agent, car dealerships and accountants.

Provide an itinerary for arrival and an outline of the first few days of activity.

Be sure to describe all of the logistical arrangements in detail. Temporary accommodations in some countries may be a spacious apartment with servants but in rural Saskatchewan the temporary accommodations may be a small semi-furnished basement suite. Clear communication, with photos and detailed description, will assist to align assumptions and eliminate potential problems on arrival.

Regular contact during the moving process to assist as needed with problem-solving, demonstrating the support of the RHA, as well as the new community and practice, ensures that the physician and family do not feel alone throughout the process.


Incentives

Research confirms that financial incentives may assist to attract physicians to rural areas, however, in the long term research has confirmed that efficacy of financial incentives is limited. It is important when providing incentives that the terms of the agreement are clearly defined.

Many communities /RHAs use a Return of Service ROS Contract.

The contract should list:

The monetary assistance that will be provided. The length of service required to fulfil the commitment A clearly defined penalty

See Appendix C –Contract Community Sample

Settlement and integration should not be left to chance. It is recommended that each component is part of the overall strategy and tasks are assigned. You may find the Settlement and Integration Checklist useful.

[See Appendix D – Settlement and Integration Checklist]


Facilitating Settlement

Arrival

Your new physician is here! You don’t get a second chance to make a good first impression. The initial welcome should clearly say, “You are important to us!”

Newly relocated physicians have identified the following as important:

Airport greeter who is there to welcome and assist with transportation to the new residence

Temporary accommodations that meet the expectations of the candidate A contact person who is available and ready to troubleshoot and provide assistance

Access the vehicle needs:

Determine needs Register and deliver the vehicle Review insurance coverage and any other obligations Review Saskatchewan Driving Rules:

https://www.sgi.sk.ca/pdf/handbook/2016_drivers_handbook.pdf If it is possible offer assistance to move into the new home:

Secure such things as the keys, garage door opener and the remote codes. Provide civic address and assist to secure a post office box.

Assist to set up utility accounts. Provide an overview of the heating and water system in the house.

A welcome gift is always a nice touch to welcome the physician and family. Suggestions for a welcome gift are:

A basket with information about the area, restaurant gift certificates, health spa memberships, maps, a long-distance calling card, etc.

A picnic basket with sparkling fruit juice, fruit, cheese and crackers. Breakfast in a box may be helpful for the first morning in the new location. Items to

include may be fresh baking, coffee, tea and homemade jams. Scotia Bank provides a New Comers Handbook that may be of assistance to those who

are new to Canada: http://www.scotiabank.com/startright/common/pdf/startright-english-handbook.pdf

Saskatchewan Tourism will provide discovery guides that you may wish to include in the basket to introduce the family to the province and all it has to offer: http://discovery-guide.sasktourism.com/app.php?RelId=6.7.0.14.6

Professional Settlement

New physicians require timely orientation to their practice, facility, and region. Ideally the orientation should occur before the physician starts, or shortly thereafter.

An introduction to peers, clinical staff, senior physicians and staff will start things off on the right path.


https://www.sgi.sk.ca/pdf/handbook/2016_drivers_handbook.pdf

http://www.scotiabank.com/startright/common/pdf/startright-english-handbook.pdf

http://discovery-guide.sasktourism.com/app.php?RelId=6.7.0.14.6

o One way to facilitate the introduction is to host a come and go reception in honour of the new physician. Physicians, referring specialists, hospital administration and clinic staff can meet and greet the new physician, partner and family there.

The best way to ensure the physician feels part of a practice is to ensure that he or she is well-oriented on items such as:

o The practice's strategies, clinical programs, residency teaching, rotation schedule, continuing education and research opportunities.

o Adequate training on the fee schedule and computer systems. o Information about procedures to make a referral, order lab and liaison with

specialists. o Details about the business arrangements.

The Orientation Checklist may be a useful tool to assist to develop an orientation plan.

[See Appendix D – Orientation Checklist]

A mentorship or advisor relationship between an established physician and the new physician will provide the new physician with a clinical resource. The physician guide should ideally be another physician in the practice or community who has experience with the environment, processes and systems. Physician guides typically:

Helps new physician to network with other physicians.

Provides support with clinical and operational questions.

Welcomes the new physician into the medical community.

Helps provide acceptance.

The practice or health region may wish to consider helping the new physician to market their new practice to generate an adequate patient flow. A story in the local newspapers may help to introduce the new physician to the area.

Personal Settlement

One of the most important roles of the Community Retention Committee is settlement and integration. Physician Retention Committees will typically assign one member of the committee to establish a relationship and act as a community guide. The community guide, like the professional guide/mentor, will serve to provide an invaluable ongoing connection. The community guide should ideally be a member of the Community Retention Committee who has experience with the environment, processes, and systems. Community guides typically:

Help the new physician and their family to network with other community members.

Provide support with community, regional and provincial questions. Serve as the first point of contact for any questions or issues that may

arise. Provide assistance to integrate the physician and family into the community. Provide acceptance.

Bring back important information to PRC.


If the physician and their family have participated in a site visit, they will be somewhat familiar with their new community. The first few days after relocation will then provide the guide an opportunity to assist the physician and their family to settle.


The first few days

If the physician is from outside of Canada additional supports will be required to establish a bank account, obtain a social insurance card, connect utilities, and obtain a telephone, etc. These activities should be conducted in specific order as they are interdependent.

A. Social Insurance Number

Application for a Social Insurance Number (SIN) is the first step. Service Canada information and locations can be found at: http://www.servicecanada.gc.ca/eng/sin/apply/proof.shtml

B. Banking/Financial

The lack of a financial history in Canada can make finances difficult in the early months in a new country. Several pieces of Canadian identification are required to open a bank account. The SIN can be for this purpose: http://www.cba.ca/opening-a-bank-account

Physicians who are referred by recruiters are entitled to financing as low as prime rate on floating term loans. This allows a physician to purchase/lease a vehicle.

There is also a mortgage program for temporary residents who have a written reference from the current employer.

C. Services

Application for other services can then be conducted once the SIN and banking have been confirmed:

Cell phone or SIM card Connections – Utility hookups Buying groceries

D. Saskatchewan Health Coverage

As a general rule, coverage will begin on the first day of the third calendar month following the date that residency was established. Application for health care coverage may be made once the physician is able to produce verification of:

Legal entitlement to be in Canada Saskatchewan residency Support of identity

Examples of documentation that are acceptable to prove each of the requirements, as well as the application form, may be found at: https://www.ehealthsask.ca/residents/health-cards

E. The Education System

Families that are new to the area appreciate a package of information, advice and introductions to school resource contacts. The quality of education at the primary, secondary and high school level can impact the retention of families. It is important to know what components are


http://www.servicecanada.gc.ca/eng/sin/apply/proof.shtml

important to the family, to provide adequate information to facilitate their understanding, as well as connect the family to contacts within the school district who can facilitate integration.

F. Regional Newcomer Gateways

Regional Newcomer Gateways welcome all immigrant newcomers, whether coming to Saskatchewan directly from abroad or from another province. Settlement advisors are qualified and knowledgeable individuals who are available to provide information, resources, services, and people necessary to make the move to Saskatchewan a success: https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/language-training-and-settlement-services/settlement-services#regional-newcomer-gateways

G. Citizenship and Immigration

Citizenship and Immigration Canada have an excellent guide that provides an overview of what it’s like to live in Canada, a citizen’s rights and responsibilities, Canadian society and Canadian values and its cultural practices: http://www.cic.gc.ca/english/resources/publications/welcome/index.asp

H. Important community contacts

Many of the new recruits that we have had interaction with have been flattered and extremely appreciative about the formal welcome offered by town officials such as the Mayor.

Within the first few weeks

Physicians who can balance work, family, and physical, emotional, and spiritual needs in some harmony are happier, healthier and more productive. How well the partner and family adapt can have a significant impact on the physicians’ job satisfaction and their relationship with the health system.

The physician and their family must have an opportunity to understand their immediate community and the province. The guide can play a significant role in this area by providing introduction to recreational attractions. Saskatchewan is known for fun filled evenings and weekends where local residents participate in events such as fishing derbies, ATV rallies, tournaments, bonspiels, parades and rodeos. These events present a wonderful opportunity to formally introduce the physician and their family as well as to provide ongoing recognition for the service that they provide.

Some communities have found that providing the family with tickets assists them to get out into the community. Some other suggestions include:

Local golf lessons Season tickets to local sporting events such as ball tournaments, or hockey games Invitation to and entrance fees waived for classes or clubs such as a quilting class Invitation to the upcoming local supper events such as Saskatchewan Wildlife

Association or the local Lions Club Tickets to events that are hosted in a nearby city


http://www.cic.gc.ca/english/resources/publications/welcome/index.asp

Spouse/Partner supports

Keeping physicians connected to their respective community means paying attention to their family needs. Access to employment for spouses who already have a professional qualification can be difficult in rural locations. Active assistance in this area is critical to long-term retention.

Saskatchewan Immigration can assist to connect partners with career and employment services to assist them to prepare for work and look for a job in Saskatchewan: https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/working-in-saskatchewan

The partner may require access to English language classes or tutoring. Access to such services is a building block for establishing a social support network. They can find resources to help them at the Saskatchewan Immigration website: https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/language-training-and-settlement-services/language-training Communities have access to invaluable networks. These business contacts are often able to facilitate meaningful employment for the partner.

Some communities have had success with a healthcare provider partner network. Partners of healthcare professionals understand the unique lifestyle challenges of health care providers and can provide an opportunity for the new partners to connect, meet new people and learn new ways to love where they live. If you do not have a partner network in your area, you may consider facilitating the development of one. A network may offer:

Workshops, seminars and other opportunities to learn Networking opportunities Family and spousal events at medical conferences Camaraderie, understanding and support Opportunities to socialize with other spouses and their families

Supports for the Children

Children need access to recreation and the valuable social networking that it brings. An introduction to local services and an invitation to join local teams, activities and events is important and needs to be incorporated into the welcoming plan.

Communication Strategies to Support Retention

One of the elements of a physician retention strategy is to announce and welcome the arrival of a physician to an individual community or clinic. One of the most economical ways to do this is to issue a Public Service Announcement (PSA) that could be sent out to local media outlets. A PSA is not a news release; it is a short announcement to relay specific information about a public service, such as a new physician taking patients in a community or clinic. The benefit of a PSA is the fact that it is a free service, however, the down side of a PSA is that is not guaranteed that the announcement will be broadcast.


https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/working-in-saskatchewan

https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/working-in-saskatchewan

https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/language-training-and-settlement-services/language-training

https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/language-training-and-settlement-services/language-training

Clinic Release

The following guidelines can be used to draft the PSA. The basic rule of thumb when writing a PSA is to remember the five W’s: Who, What, Where, When and Why. You can also use the attached template and fill in the blanks so each time you draft a PSA it has a consistent look and messaging.


PSA Guide – Five Points to Consider

The general rule of thumb to follow is to make sure you answer the following five questions.

1. What are you announcing? 2. Who are you sending the message to (who is your audience) and who is it that you’re

talking about (i.e. what is the name of the new physician?) 3. Where is the new doctor going to practice? (community and clinic/hospital if applicable) 4. When is the new physician going to start practicing (if not already) and include the hours

of the clinic’s operation or when the physician would be available. 5. Why are you announcing this? You’re announcing that a new physician is going to be

practicing in your community and/or clinic and that it is important since there is still a general need for doctors in the province.

The above guide is by no means a rule. Any PSA can be edited as necessary.

Above all else, the PSA should include: a date or date range (i.e. for use between date and date), a title (Dr. Smith Joins Clinic), a contact number if applicable and the information or answers from the above five questions.

Most outlets prefer 30 second or very short (minimal copy) PSAs. If you are writing a television PSA, you will want to keep the announcer's copy 2 or 3 seconds shorter than the entire length of the PSA as television stations have a more rigid schedule than radio stations, and you may find that if your PSA runs exactly 30 seconds the station may sometimes cut off the end.

Table 1 gives you a general idea of how long a piece of copy would take to be read by an announced on-air.

Table 1

Length of PSA 10 seconds 15 seconds 20 seconds 30 seconds Number of words 20-25 words 30-35 words 40-50 words 60-75 words

Once the PSA is drafted and approved by all parties it can be sent to local media outlets via fax or email.

Template Sample

Use: Immediately Time: 20 seconds Community/Clinic/Health Region Title: "Dr. Smith Begins Practicing in Community" “Community” has a new doctor. “Dr. Smith” arrived in “community” on “date” and is now taking patients. Please help us welcome Dr. Smith to the community and contact the clinic to book an appointment. Contact Number: 111-555-1212


Community Release

Quite often local and community minded media outlets will do this for you as their reporters already have the skills and resources required to write the stories on their own. If media coverage of the physician’s arrival does not occur, then another option is to place an ad in other local mediums announcing their arrival. Since available resources may limit the organization from pursuing this option, the onus is on the community and/or clinic to draft and submit the article on their own. While writing your own story ensures key messages are delivered, it is not the same as paid advertising, which means the story may not get picked up by a media outlet. However, if your target media outlet is a rural (weekly) newspaper, there is a greater likelihood that the story in its entirety, or pieces of it, will be published.

Typically, such articles will be printed verbatim in local newspapers giving the employer or community an opportunity to not only announce the physician’s arrival, but to also deliver key messages they want delivered. In these cases, using the question and answer guide below will assist clinics and communities to drafting the article.

News Article Guide – Potential Questions to Ask

Q.1 Please tell me a little bit about yourself (i.e. where you are originally from, why did you choose to practice here, where were you trained)? Asking this question is always a good ice breaker and usually the interviewee gives you more information that will almost always lead to further questions you could ask later on during the interview.

Q.2 What do you think of the community and clinic thus far? Q.3 Are there any major differences between where you came from and where you are now?

If so, has it been difficult or easy for you and your family to adjust to those changes? Is there anything in particular that is helping you with that change?

Q.4 (Only if the physician is an International Medical Graduate) You’re joining many other international colleagues already practicing here in the province. Was that a factor in choosing to practice here in Saskatchewan? In this community? In this region?

Q.5 (Only if the physician is a Canadian Medical Graduate) Was being close to family and friends a big reason for your decision to practice here?

News Article Guide – Things to Keep in Mind

Tip 1 Always keep in mind that you’re not only presenting facts, but you are telling a story. Readership and engagement will increase if the facts tell a story.

Tip 2 Be factual and do not assume anything. If you are unsure about something, especially what someone’s name is and how to spell it, ask. Printing wrong information is not only detrimental, it is also unethical.

Tip 3 Check for grammar and spelling mistakes. This doesn’t mean running spell check. It involves carefully reviewing the article for spelling and grammar mistakes before it is sent. It is also beneficial to review the copy carefully several times before sharing it with someone who has never seen it before. This person will most likely pick up on something you have missed.


Sample Article – Originally published in saskdocs’ December 2014 e-newsletter

Dr. Nicole Dressler – Born and Raised in Regina, She’s Choosing to Practise Close to Home

Dr. Nicole Dressler loves the fact that she can live in a coveted neighbourhood in Regina, one that has all the amenities she’s looking for, and still only have to drive five minutes to work every day. This is not a typical commute time for many people living in any of the country’s larger cities and it is something Dr. Dressler really likes about where she works, lives and plays.

Dr. Dressler is practising emergency medicine with the Regina Qu’Appelle Health Region (RQHR) and one of the first things she pointed out in her interview with saskdocs was the fact that she really loves what she does.

“I love emergency medicine because of the fast pace, the high acuity, the undifferentiated patients, the variety of patients, the mix of clinical medicine and procedures, and the collegiality in the department amongst the staff. The nurses, physicians, and

unit clerks are all fun to work with.”

Like many of her colleagues in RQHR, the draw of family, friends and a familiarity with her home city were all reasons for Dr. Dressler deciding to stay and practise medicine in Regina. The fact that she can do what she loves best and still be close to everything she needs outside of work is really appealing.

“I enjoy living in Regina Cathedral neighbourhood. I love that my commute time to work is only five minutes and I am close to downtown and all its amenities. I also enjoy being within walking distance to Wascana Park as well as the dog park where we let our French bulldog, Louis, run. My husband and I always planned to settle in Regina where our friends and family live. It’s important to us to spend time with these people who are special to us.”

As with any career, there are good days and there are challenging days. When asked what a good day was like for her in the emergency department, Dr. Dressler’s answer was doing what she loves – practising emergency medicine – and going home to be with family and friends.

We look forward to hearing more stories like Dr. Dressler’s, and to working with RQHR, other health regions, clinics, physicians and other partners to make sure more people like Dr. Dressler continue to do what they love to do, at home in Saskatchewan.


Integration

Integration occurs on many levels. For the physician, it is both professionally and personally, but equally as important is the integration of their spouse and family. To retain the highest percentage of new physicians you should plan to work with them for three years. To achieve a multi-faceted integration strategy, you will require a well-established plan and many participants. Some of the scheduled activities that you may choose to incorporate into the retention strategy are:

Year 1

Professional

RHA Recruiter surveys recruit and spouse after first three months to see if anything could be improved in the recruitment and relocation process.

RHA Recruiter keeps in touch with recruit and spouse on a monthly basis to ensure that all is well and provides assistance where needed. Sometimes showing support to a physician may be as simple as asking open-ended questions, such as “Is there anything I can do to help?”

Physician guide maintains monthly contact with the recruit: introducing them to staff, connecting with them at departmental meetings, etc.

Quarterly lunch with the RHA’s top administrator such as the Chief Executive Officer (CEO) or Senior Medical Officer (SMO).

Personal

Community guide reaches out to the family on a monthly basis. The guide may wish to: o Organize the recognition of birthdays/holidays o Invite spouse to events to introduce him/her to community

The Community Recruitment Committee monitors the retention and integration checklist to ensure all identified components have been addressed.

Year 2 and 3

Professional

CEO/SMO will meet with recruit quarterly with an ‘open-door’ policy Physician guide keeps in touch with recruit bi-monthly with an ‘open-door’ policy

Personal

Best practice suggests that community guide meetings may move to a quarterly basis; however there may be a need for more frequent meetings dependent on the particular situation.

Evaluation

The final portion of settlement is evaluation. This includes an evaluation of orientation, mentoring programs, and other methods used to welcome new physicians

Surveys are a valuable tool to gauge satisfaction and develop action plans. Research shows that physicians who are satisfied will:


Remain loyal. Recommend the community and organization to colleagues.

While it is difficult to conduct an anonymous survey in a smaller community, there are several other options for consideration:

Consider partnership of the RHA and communities to conduct and analyze the results of all the physicians in the greater community.

Consider the data gathered by saskdocs and the SMA surveys to develop a community strategy and action plan.

Consider the results gathered by the National Physicians Survey to develop a community/region strategy and action plan: http://nationalphysiciansurvey.ca

[See Appendix E – Satisfaction Survey Template]

Celebrate your Physicians

Physician appreciation is a key component of any retention strategy. It is usually pretty easy to pull off with little budget, and it is a great way to set a healthier work environment, which will ultimately help with your recruitment efforts as much as your retention.

Many benefits come through physician appreciation including:

Fostering good will by letting your physicians know the community appreciates their hard work and commitment

Encouraging good working relationships

There are many ways to demonstrate your community’s appreciation including:

Cards of appreciation Communication through the local newspaper Recognition Event and/or Award Ceremony Newsletters Hosting a Physician Appreciation Day or Week

Cards

A personal note can be a great way to acknowledge the hard work of an individual or group. With a relatively low investment in time and money, you can achieve excellent outcomes. To organize this activity you may want to create a spreadsheet or small database to track the communication and ensure that the cards are sent out on an ongoing basis from a variety of people. What appears to be a random act to the recipient is in fact a calculated and organized activity with a very specific goal.

Communication through the Local Newspaper

It is important to recognize and congratulate those in health care who are making a difference, whether in their own individual communities, provincially or nationally. One cost-effective way to do this is by writing a letter to the editor or a short story to the local newspaper. This allows you to effectively reach out to an entire community and showcase the individual or practice being recognized.


http://nationalphysiciansurvey.ca/

Recognition Event/Awards Ceremony

A recognition event or awards ceremony would typically take place on an annual basis, so be sure to plan it well the first time so that in the future years it will be much less work.

Long service awards recognize a certain number of years of practice in the community. Physicians celebrating the first year and the longest practicing physician can be celebrated equally.

A community-wide award may be developed to recognize excellence of practice for a particular outstanding physician or a special effort on the part of that physician.

Newsletters

Many communities and hospitals publish newsletters to communicate to their stakeholders. The frequency, theme, and topics of these newsletters may vary, but they offer a great opportunity to reach a wide audience:

Newsletters are a great way to introduce new physicians to the community. Providing a bit of background or personal information, and a quote or a photo assists the community to get to know the physician.

RHAs will often utilize newsletters to highlight achievements that have occurred. It is important that the Community Retention Committee “keeps alert” for any achievements that may be suitable for recognition. The approach can be tailored to reflect the best fit.

Physician Appreciation Day

Appreciation is a basic human need. Everyone responds well to appreciation because it confirms that they are valued. Declare a day or even a week to physician appreciation. This time will provide an opportunity to ensure that physicians see how much they are appreciated and valued by their fellow colleagues and the community they are working in.

United States hosts National Doctors Day on March 30 each year. Canada does not have a declared National Doctors Day, but some communities have taken the initiative and hold a Physician Appreciation Day annually as part of their retention efforts. Across Canada, the day varies depending on the community. Hallmark has also selected March 30.

When organizing a physician appreciation day: build on your partnerships, engage your community, and plan ahead to ensure it is a success. Considerations should include:

Brainstorming ideas that will engage the community Establish a budget Consider the physicians preferences Consider cultural sensitivities

Here are a few creative ideas that have been utilized by others:

Hold a social event such as a:

Wine and cheese event for the community. Box lunch delivered to the clinic. Potluck gathering at a local home. Picnic for the physicians as well as other community members.


Provide breakfast or lunch for the physicians in the community in hospital lounges, clinics, etc.

Engage local business to obtain discounts on small gifts or gift certificates to be given to the physicians.

Ask the CEO or Mayor of the community to send ‘thank you letters’ to each of the physicians.

Engage the children of the community to create thank you cards or promotional posters.

Ensure that your event is well planned so that it has an appropriate impact.

Retention, integration and appreciation are ongoing processes. But no matter how good of a job you do, it is important to recognize that very few practitioners remain in one community or practice location for their entire career. When a medical provider leaves your community, learn something from your loss. Determine the reasons behind his or her decision to leave and try to address them before recruitment begins.

Spousal Employment

Research suggests that successful retention of physicians is dependent to a large extent on the degree to which a physician and their spouses/partners are satisfied with their life in the community. In particular, spousal employment has a significant influence on the commitment and retention of the physician.

While medical practices and communities cannot guarantee employment for a spouse or partner, general assistance and support to facilitate the search for employment is a key consideration for the recruitment, hiring and retention of a physician.

To ensure success, it is critical that the Community Retention Committee is engaged early in the recruitment process to ensure that it can:

Develop a proactive approach to spousal/partner employment needs prior to the arrival of the physician and family.

Pursue relationships with local employers. Provide an introduction to potential employers.

Determine if there may be barriers to employment. Assist with establishing childcare supports.

Networking

Saskatchewan has a strong economic base and is home to a vast array of large, mid-sized and small private sector companies; as well as an array of non-profit and public organizations. Because of this diverse business climate, many jobs in Saskatchewan are not advertised. Information about available work is circulated through managers, employees, family, friends and acquaintances. The most effective way to find work in the hidden job market is through networking.

One of the values of a Community Retention Committee is its connection to the local community and the surrounding area. This connection allows the membership to initiate the networking opportunities in advance of the arrival of the physician and the family.


Before the physician and family arrive in the community, the Community Retention Committee may begin informal networking by contacting everyone they know about job leads, information and advice. This information can then be utilized to arrange formal introductions.

Contacting strangers can be difficult. Once the physician and family arrive, the Community Retention Committee can alleviate the difficulty by arranging and facilitating the contact. Introducing the physician and their partner or spouse to various employers or to various community service, cultural clubs and organizations such as the Chamber of Commerce, Knights of Columbus and District Hospital Foundation can initiate personal networking opportunities.

The Saskatchewan Chamber of Commerce is an example of a Community Service Organization that can provide an excellent networking opportunity. The provincial chamber membership includes over 80 Chambers of Commerce and Boards of Trade who have over 10,000 members. Each local Chamber is member driven so they are all slightly different. Several of the Chambers have job boards and a few have employment coordinators who are available to assist to coordinate employment. Making contact with local Chamber members can assist the Community Retention Committee with valuable contacts to local employers who may be positioned to support spousal employment. http://www.saskatoonchamber.com/

Service Centers

Government of Canada Labour Market Service Centers

http://www.servicecanada.gc.ca/eng/home.shtml

Canada- Saskatchewan Career and Employment Services helps those looking for employment through a variety of mechanisms. There are a number of tools available to assist with a job search, resume creation and skills assessment.

Canada - Saskatchewan Career and Employment Services

https://www.saskatchewan.ca/residents/jobs-working-and-training/find-the-labour-market-services-office-near-you

Canada - Saskatchewan Career and Employment Services provides assistance to link the abilities of Saskatchewan's workers with the needs of employers. There are 19 Canada- Saskatchewan Labour Market Service offices across Saskatchewan. They provide assistance with career and job opportunities, training, and/or education options.

Government of Saskatchewan

https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/working-in-saskatchewan/finding-work

The Government of Saskatchewan provides assistance with job search and career planning by providing valuable links to information on opportunities, programs and services.


http://www.saskatoonchamber.com/

http://www.servicecanada.gc.ca/eng/home.shtml



Regional Newcomer Gateways

https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/language-training-and-settlement-services/settlement-services#regional-newcomer-gateways

There are eleven Gateway welcome centers throughout the province. They welcome all immigrant newcomers, whether coming to Saskatchewan directly from abroad or from another province. Settlement advisors are knowledgeable individuals who can assist newcomers to understand Saskatchewan and use of its services.


http://www.saskimmigrationcanada.ca/immigration-gateways

https://www.saskatchewan.ca/residents/moving-to-saskatchewan/immigrating-to-saskatchewan/language-training-and-settlement-services/settlement-services%23regional-newcomer-gateways



Child Care

Families new to a rural community may face challenges in finding care solutions for their children because they do not know who to contact or how to access child care services. This combined with the need for flexible child care due to working hours of their spouse or partner (the physician), may become a barrier to employment and therefore a barrier to retention.

The Community Retention Committee can be the mechanism to research and introduce the physician’s family to other members of the community who may be willing to provide short-term assistance during the job search as well as long-term child care providers.


Appendix A - Settlement and Integration Plan

Settlement and integration should not be left to chance. It is recommended that each component is part of the overall strategy and each task is assigned and managed.

Activity

assigned to Planned date

Date delivered

Understand the Needs Create a physician / family biography Provide cultural education

Pre Arrival Provide responses to outstanding questions and issues that were raised at the site visit

Make arrangements for temporary accommodations Provide information about the arrangements for temporary accommodations

Link the physician and family to preferred moving companies Link the physician to preferred services such as banks, lawyers, a real estate agent, car dealerships and accountants

Confirm travel plans and advise the physician of the name and contact person who will be available to pick up

Provide an itinerary for arrival and the first few days of activity Add items as identified during this site visit or interviews (i.e. if the physician has been promised use of a car for a period of time, those arrangements should be added)

Ensure the ROS requirements are explained and a contact is in place

Arrival Ensure the airport greeter has the travel itinerary Identify the contact person who is available and ready to trouble shoot and provide assistance

Make arrangements to build and deliver the welcome gift Professional Settlement Determine logistics for the introduction to peers, clinical and support staff, senior physicians

Determine who will lead and deliver the various components of the Orientation (See the Orientation Checklist-Appendix B)

Identify, assign and introduce the Physician Guide Consult with the new physician about the market strategy

Personal Settlement Assign and introduce the community guide Provide support with banking/financial arrangements Provide support to obtain Saskatchewan Health Coverage Provide important information and introductions into the education system

Provide introduction to the Regional Newcomer Gateways Provide introduction to Citizenship and Immigration - application for permanent residency

Provide introduction to community recreation, and cultural activities


Provide active assistance to assist the partner with employment Provide introduction to the local Partner Network Provide the children with introduction to local teams and activities

Ongoing Activities Conduct a satisfaction survey on the new physician and their partner Schedule regular contact meetings with the physician and their family

Arrange quarterly lunch with the organization’s top administrator such as the CEO / SMO

Maintain contact with the family and recognize birthdays / holidays Invite family to events to introduce him / her to community Conduct a satisfaction survey of all physicians in the community, region, and province.

Celebrate Cards - track the communication and ensure that the cards are sent out on an ongoing basis from a variety of people

Communications through the local newspaper: Track the communication and ensure that articles are placed at regular intervals to introduce, recognize and congratulate

Plan a recognition event or awards ceremony Utilize local newsletters or websites. Track the communication and ensure that articles are placed at regular intervals to introduce, recognize and congratulate

Track achievements that may be suitable for recognition Declare and plan a Physician Appreciation Day


Appendix B – Needs Assessment

Name: Phone #:

Date of arrival:

Will your partner/children be travelling with you?

If yes, partner name:

Name(s) and age(s) of children:

LOGISTICS:

Question Comments

Flight information

Vehicle logistics – rental/bring your own vehicle?

Will you require a child/baby seat?

PERSONAL PREFERENCES (please answer the following, where applicable)

Question Comments We plan to arrange meetings for you with [provide a list] Is there anyone else that you may be interested to meet?

We are planning to arrange a community tour. Is there anything that you noted on our website [provide] that you would be particularly interested to see?

Would your spouse/partner like information about a particular career option or volunteer organization?

Is your spouse/partner interested in meeting with potential employment contacts? If yes, please forward CV and provide details of areas of professional interest.

Please list the recreational activities, hobbies or organizations that interest you (and your family).

Would you like to meet with officials from local schools and/or daycare centers?

Would you like information about the locations of particular religious facilities? If so, please list.


Please advise if you would like the opportunity to meet with clergy or members of their faith community.

Would you like information about the locations of particular religious facilities?

Do you wish to meet with a realtor and be given a tour of local residential areas?


Appendix C – Physician Arrival Itinerary

Physician Name: CONTACT INFORMATION Family Members: Phone Numbers:

Email Numbers: Date of Arrival: Arrangements for transportation :

PHYSICIAN RETENTION COMMITTEE CONTACTS RHA Contact: Community Contact: Clinic Contact :

TIME: ACTIVITY


Appendix D – Community Contract – Sample

THIS AGREEMENT made effective the day of , 2017. BETWEEN:

AND:

, a qualified medical practitioner residing in the Town of , Saskatchewan, hereinafter referred to as “the Physician”

TOWN OF , a municipal corporation with offices at , Saskatchewan, hereinafter referred to as “the Town"

WHEREAS the Physician provides health care services for the Town through, among other facilities, the Health Centre (the "Clinic");

AND WHEREAS the Physician wishes to provide full-time health care services in the Clinic;

NOW, THEREFORE, THIS AGREEMENT WITNESSETH that in consideration of the premises and the mutual covenants and agreements hereinafter contained, the parties hereby agree as follows:

AGREEMENT TO PRACTICE MEDICINE

1.1 In accordance with the terms and conditions of this Agreement, the Physician hereby agrees to practice the profession of medicine in the Clinic for at least three (3) years.

1.2 The parties agree to works towards recruitment and retention of other physicians to join the practice in the town.

COMMENCEMENT AND DURATION OF AGREEMENT

2.1 This Agreement shall commence (“The Commencement Date”), and in exchange for the covenants of the Town herein continue for a three (3) year period ending .

ARTICLE 3 VEHICLE, HOUSING AND EXAM COSTS

3.1 The Town agrees pay for the Physician’s vehicle costs for the first 6 months following the Commencement Date, as follows:

3.1.1 The Town will supply a vehicle to the Physician, for the Physician’s personal and or business purposes, including that the Town will pay the minimum insurance for the vehicle in the amount of $665.00 for six (6) months;

3.1.2 The Physician shall be responsible for all costs associated with the vehicle including but not limited to fuel, repairs, regular service, and any additional insurance policies over and above the minimum insurance provided through the registration of the vehicle;

3.1.3 Upon the expiration of six (6) months from the Commencement Date, the vehicle will be returned to the Town in the same condition as when supplied to the Physician, and the Physician shall be responsible for all repair costs, except those related to reasonable wear and tear due to regular usage;

3.1.4 The Physician shall fully indemnify and save harmless the Town with regard to any costs or damages arising from the Physician’s use of the vehicle, including but not limited to any repairs or replacement costs not covered by insurance, any costs or damages arising out of any legal action taken against the Town, including legal costs to defend such actions, and any costs to repair the vehicle due to the negligence of the Physician; and


3.1.5 The Town’s costs in association with the vehicle are limited to a maximum of $750.00 per month, for a total of $4,500.00 after six (6) months.

3.2 The Town agrees to pay for the Physician’s housing costs for the first six (6) months following the Commencement Date as follows:

3.2.1 The Town shall sublease the property civically described as Unit 3, 701 Mesa Way, Shellbrook, Saskatchewan, to the Physician for a term of six (6) months, with no rent payable to the Town, in accordance with the terms of the Residential Tenancies Act, as applicable, with the following specifics:

3.2.1.1 The Physician shall take out a tenant insurance policy on the property and the Town shall, upon review and approval of the policy, pay the insurance premiums;

3.2.1.2 Any breach of this Agreement by the Physician or the Town shall give grounds for immediate termination of the sublease at the option of the non- breaching party, including but not limited to immediate eviction of the Physician.

3.2.1.3 The Physician shall be responsible for all costs for the property other than rent and taxes, including but not limited to all utility costs, telephone and internet costs, and all such costs shall be arranged to be invoiced to the Physician directly by the Utility Companies and paid by the Physician.

3.2.2 The housing costs covered by the Town shall be limited to a maximum of $1,000.00 per month plus the costs of the tenant insurance policy premiums, for a total cost of $6,000.00 after 6 months.

3.2.3 The Physician agrees to pay one month’s rent as a refundable damage deposit, $1,000.00.

3.3 The Town agrees to reimburse for the Physician’s cost for the MCCEE exam, in the amount of $1,500.00

ARTICLE 4 TERMINATION

4.1 This Agreement may only be terminated by either party for cause and upon Thirty (30) days' written notice to the other party.

4.2 At any time prior to proper termination of this agreement for cause or the expiration of the two (2) year term of this agreement, if Physician discontinues practicing medicine full-time in the Shellbrook area, the Physician shall pay to the Town an amount equal to all costs paid by the Town in accordance with this agreement for housing and vehicle costs as liquidated damages, pro-rated such that the Physician shall pay to the Town an amount equal to the percentage of the full costs the Town would have paid if this Agreement had continued to the full three (3) year term ( ) (“the Full Costs”) for the percentage of the contract term remaining under this Agreement, that is ( ) (to be reimbursed)*(Number of months remaining on term).

4.3 Notwithstanding any provision to the contrary, the parties may terminate this Agreement at any time by mutual consent.

ARTICLE 5 MISCELLANEOUS

5.1 The Physician covenants and agrees to at all times indemnify and save harmless the Town from and against any and all liabilities, claims, costs, damages, expenses and legal fees resulting from, or attributable to, any and all acts or omissions of the physicians, whether willfully or otherwise, in the performance of the physician’s obligations hereunder.

5.2 The provisions of Section 5.1 shall survive the expiration or termination of this Agreement.


5.3 This Agreement shall not be assignable by any party. 5.4 This Agreement is limited to the scope of the covenants given by the parties to each other

herein and does not govern the parties relationships with any other institutions or health districts with regards to the Physician’s practice of medicine.

5.5 Each provision contained in this Agreement is declared to constitute a separate and distinct covenant and to be severable from all other such separate and distinct covenants. In the event that any provision herein or part thereof shall be deemed to be void or invalid by a Court of competent jurisdiction, the remaining provisions, or parts thereof, shall be and remain in full force and effect, unamended.

5.6 No waiver of any term or condition hereof or any obligation, duty or responsibility of a party hereto shall constitute a continuing waiver of such term, condition, obligation, duty or responsibility or waiver of any other term, condition, obligation, duty or responsibility. No waiver shall be valid unless in writing and signed.

5.7 This Agreement shall be governed by and construed in accordance with the laws of the Province of Saskatchewan and the laws of Canada applicable therein. The parties agree that court proceedings that may be brought by any party against the other party under or by virtue of this Agreement may be brought in a court of competent jurisdiction in the Province of Saskatchewan, and each party irrevocably submits, and covenants and agrees to submit, to the non-exclusive jurisdiction of such court in the event that such party is named as a party in any such proceedings.

5.8 The headings utilized in this Agreement are for convenience only and are not to be construed in any way as additions to, or limitations of, the covenants and agreements contained in this Agreement.

5.9 Each of the parties hereto, by their execution of this Agreement, acknowledges that such party has carefully read and understands the terms of this Agreement, and that such party has had the opportunity to obtain independent legal advice with respect to this Agreement.

5.10 This Agreement may be signed in two or more counterparts. Counterparts containing signatures of each party to this Agreement shall together constitute a fully executed copy of this Agreement. This Agreement shall not have been fully executed until each party has signed at least one counterpart and delivered the same to the other party or to other party’s lawyer. A counterpart bearing a facsimile copy of a party’s signature shall be considered an original.

IN WITNESS WHEREOF the parties have hereunto executed this Agreement effective the day and year first above written.

Per:

Doctor’s Signature Per:


Appendix E - Orientation Checklist

Topic of the Orientation Date delivered Method of Delivery The System The Canadian Health Care System Legal Responsibilities – the College of Physicians and Surgeons of Saskatchewan (CPSS)

Orientation to the Health Region Strategy, Goals and Objectives Performance Indicators The Organization Organizational chart and contact information Introduction to the Senior Leadership Team Introduction to the Board of Directors Medical Staff Bylaws Medical Staff Rules and Regulations Programs and Services Clinical programs, residency teaching, rotation schedule, continuing education and research opportunities

Health Services Primary Health Care Community Services Emergency Medical Services Other Services Demographics and other factors Communities Facilities Departments Procedures to make a referral, order lab, liaise with specialists

Medical Staff Policies Practices for Infection Control Reportable Events Advanced Directives Acute Care Admissions, Discharges and Transfers Emergency Protocols Medical Records Relocation Assistance policies and procedures

Facility Orientation Checklist Privileges General Site Orientation Building Access Photo ID Parking Network Access Dictation and Transcript

Clinic Orientation Mission, goals, priorities and values Administrative organization


Employment agreement, shareholders agreement, operating agreement

Physician Compensation – Business Arrangement Billing and coding adequate training on the fee schedule, computer systems

Relocation Assistance policies and procedures Professional Information Licensing Rights and Responsibilities Saskatchewan Medical Association Practice Enhancement Program Canadian Medical Association College of Medicine, Continuing Professional Learning

Physician Resources and Links


Sample - PAPHR Physician Orientation - Primary Health Care

Orientation item Date of 1st Review Date and Initial

Date of 2nd R Date and Initial

Comments

Keys to Work Site PAPHR acct access Med. Access Account set up Review Clinic Operations Binder

- SBAR / LTC communications

- ALC bed policy - Admitting criteria / process

LTC - Medication reconciliation

Review of roles and responsibilities of staff in clinic

Training (level one) completed with EMR med access

Training (level two) completed with med access

e-health viewer access completed

PIP access completed Orientation to facility completed Has met and had over-view off community based programs

Regional over-view completed – organizational charts

Payment – ERCP, CDM-QIP CDM program Shadow Billing number obtained Scope of practice of NP Oath of confidentiality Terms of use for EMR Diabetic clinic services / support SLRR access completed INR – standing orders and process for INR adjustment

Parking pass

Signature Signature


Sample - PAPHR Physician Orientation - Schedule

With Day 1 1000 To Community

1200 Lunch PM To clinic

Review orientation schedule Regional over view – PHC Organizational chart

Day 2 Tuesday

AM Program access PIP / E-health Viewer / Med Access Watch training videos

Regional overview – meeting other programs

PM Regional overview - meeting other programs

Review Clinic operations manual -Narcotics policy - empaneling patients - clinic operations amongst physicians - LTC

Day 3 AM Orientation with MOAs – floor and Front

person Review of narcotic contracts and other clinical protocols

PM Physician Orientation bundle - Contract / ERCP / CCP /

Day 4 AM AM Rounds with Colleague

LTC Rounds with Colleague Community ER / Hospital walk through / orientation

PM EMR training Day 5 AM Shadow Billing

PM Clinic day – Buddy with Colleague Week 2 Day 1

AM ER Shift PM ER shift

Week 2 Day 2

AM ER shift PM ER Shift

Week 2 Day 3

AM ER Shift PM ER Shift

Week 2 Day 4

AM ER Shift PM ER Shift

Week 2 Day 5

AM Intubation PM Intubation

Week 3 Day 1

AM EMR Training PM Clinic day - double appts

Week 3 AM Clinic day - double appts


Day 2 PM Clinic day - double appts Week 3 Day 3

AM Chronic disease program PM Clinic day - double appts

Week 3 Day 4

AM PM

Week 3 Day 5

AM PM

Week 4 Day 1

AM Kaizen Basics training PM

Week 4 Day 2

AM PM

Week 4 Day 3

AM PM

Week 4 Day 4

AM PM

Week 4 Day 5

AM PM

Review of INR policy


Appendix F- Satisfaction Survey

The following is a list of commonly used questions to build a satisfaction survey. The questions can be adapted according to needs. They may be utilized for a formal survey or to facilitate a conversation.

The objective of this survey is to obtain information about the views and opinions of the physicians practicing within the region /community.

1 = Very unsatisfied 2 = Somewhat unsatisfied 3 = Neutral 4 = Satisfied 5 = Very satisfied

RECRUITMENT and SETTLEMENT 1. How long did your overall recruitment and onboarding

process take? (Time from the initial contact to the first week of employment)

0-2 months 2-4 months 4-6 months >6 months

2. When I interviewed for employment I felt free to ask questions and responses were provided in a timely and accurate manner

1 2 3 4 5

3. In advance of my arrival, was provided a good overview of the expectations of my peers, other medical staff and administration

1 2 3 4 5

4. When I consider my expectations prior to coming on board, I am pleased with how things turned out

1 2 3 4 5

5. I was provided adequate support to facilitate relocation 1 2 3 4 5 6. I was provided adequate support during the first few days

after my arrival to facilitate my/my family’s settlement 1 2 3 4 5

7. The ongoing support has been very helpful to assist us to settle into the community

1 2 3 4 5

JOB SATISFACTION 8. I was provided an adequate orientation that enabled me to be

successful in my region and clinic 1 2 3 4 5

9. Please rate your experience with the following processes: (Red=needs immediate attention; Yellow=needs improvement; Green=works well)

Employment Agreement/Contract Red Yellow Green N/A Credentialing Red Yellow Green N/A Relocation package - overview of terms Red Yellow Green N/A Orientation to the clinical and Hospital environment Red Yellow Green N/A Office setup(email, business cards, billing, etc.) Red Yellow Green N/A IT systems Access Red Yellow Green N/A Integration into:

Medical Group Hospital Community

10. I feel I am able to meet my professional and personal goals with my current position

1 2 3 4 5

11. In my clinic setting, I am satisfied with the equality of patient load, hospital admissions (if applicable), and on-call responsibilities

1 2 3 4 5

12. I am satisfied with my relationship with the other physicians


and healthcare providers. My level of earnings meets my expectations 1 2 3 4 5 Overall, I am satisfied with my job and don’t anticipate departure

1 2 3 4 5

APPRECIATION / RECOGNITION 13. I feel valued and appreciated 1 2 3 4 5 14. I receive recognition from my peers, administration and the

community 1 2 3 4 5

15. I feel accepted and appreciated by the patients I serve 1 2 3 4 5 COMMUNITY INVOLVEMENT

16. I feel accepted and welcomed into the community 1 2 3 4 5 17. I have adequate opportunity for social interaction to occur 1 2 3 4 5 18. I am able to enjoy the leisure, cultural and spiritual activities

that are important to me 1 2 3 4 5

We value your opinions. Thank you for taking the time to complete this survey. If there is something you would like for us to address, it will be easier for us to act on your concerns if you identify yourself or your work location.


Lean Business Process Innovative Practice Documents

Physician and Family Settlement – RHA

Week -10

Identify members of the Physician Retention Committee and Create and email a master list for PRC members (Page 17)

Understand the needs. Assess physician Bio (provided by saskdocs), expand the bio based on info gathered in site visit, interview, and needs assessments. (Page 50-51 and 71-72)

Arrange meeting with PRC (Page 48-49) Confirm travel plans with physician Create a travel itinerary and provide copy to PRC (Page 72) Ensure credentialing documents are completed Contact physician regarding contract or outstanding concerns Provide PRC update regarding any concerns Update Physician Family Bio as additional information is gathered. (Page 51) Receive standard work forms from community and clinic to ensure all items are on track

Week-2

Contact physician regarding any outstanding documents, arrival, etc. Contact PRC regarding physician status, travel plans and any outstanding information Provide physician with RHA orientation schedule (RHA specific – see samples 78-82) Receive standard work forms from community and clinic to ensure all items are on track

Week 1

Ensure all orientation activities are assigned Complete orientation checklist for physician (Page 76-77) Receive standard work forms from community and clinic to ensure all items are on track

Week 2

Conduct an informal follow up with physician regarding practise and community. Confirm status of physician orientation Receive standard work forms from community and clinic to ensure all items are on track

Week 3-4

Obtain the results satisfaction survey (provided by saskdocs) Address any concern regarding satisfaction survey Provide PRC with feedback from satisfaction survey Receive standard work forms from community and clinic to ensure all items are on track

Follow Up

Follow up with physician


Complete 2 month chart review Complete 3 month assessment 6 month- If applicable create application for Saskatchewan international nomination

program (SINP) (see website for form) 6 months- Remind physician to start application for permanent residency (if applicable) Complete 1 year assessment (1 year- If applicable recommend for active staff Discuss Recognition plan with PRC and establish go forward strategies (Page 63-65)


Physician and Family Settlement – Community

Week -10

Identify community member(s) that will lead and participate on the PRC (Page 48-49) Develop community guide system (see doc 1) Review needs assessment (from RHA) Identify additional information required (see page 12) Appoint community guide based on interests and age of the Physician, and their

spouse and family (Pages 36-37 and 55) Provide website, booklets and contact information re: community services/amenities

and guide (Community specific) Prepare for transportation from the airport (if required) and ongoing transportation

(Pages 52-54) Provide photo(s) of potential accommodations (Page 52-54) Inform spouse of employment opportunities (Pages 66-67) Update Physician Family Bio as additional information is gathered (Pages 51) Complete standard work form and send to RHA contact

Week -2

Arrange temporary accommodations (community specific) Arrange vehicle for use of physician and family (community specific) If incentives are offered – provide Community Contract (Pages 53 & 74-76) Plan to identify and to provide options for meals/nutrition for the initial meetings etc.

(community specific) o Review *Post Site Visit Feedback (Pages 45-46) o Physician and Family Bio o If a site visit did not occur – conduct Needs Assessment (Pages 70-71)

Complete standard work form and send to RHA contact

Week 1 – Arrival to practice (Pages 54-58)

Transport physician/Family to community Assist them with moving into their home Access vehicle for physician and their families use Provide welcome package (community specific) Tour community with physician and their family (community specific) Consulate with physician and their family re: any outstanding needs Create a news release for local newspaper/website (Pages 60-62) Complete standard work form and send to RHA contact

Week 2

Arrange community guides for physician/family meeting (Page 55) Ensure guides invite physician and their family to individual/family activities (community

specific) (Pages 50-52) Ensure return for service contract is signed by physician if required (ie housing)

(community specific)


Complete standard work form and send to RHA contact

Week 3-4

Arrange community appreciation for physician and their family (Pages 64-66) Ensure guides maintain contact and they invite physician and their family to age

appropriate family activities Complete standard work form and send to RHA contact

Week 4 & Follow Up

Ensure guides maintain contact with physician and their family on a weekly basis Quarterly- Ensure guides maintain “in person” contact with physician and their family Biannually- Ensure guides reports the status of retention to the PRC Annually- Request an update from saskdocs re: community responses related to

satisfaction survey Complete standard work form and send to RHA contact


Physician and Family Settlement – Clinic

Week -10

Update Physician Family Bio as additional information is gathered. (Page 51) Provide job description/position profile (if applicable) Complete standard work form and send to RHA contact

Week -2

Clinic manager contact physician to welcome them to practice and review job description Determine logistics for peer and clinic introduction (Pages 54-55) Identify and introduce physician mentor (Pages 55) Create newspaper article introducing new physician to community (Pages 59-60) Complete standard work form and send to RHA contact

Week 1 – Arrival Provide physician resource guide

(in development) Provide orientation to peers and clinic staff/referrals Provide clinic orientation (clinic specific) Provided one on one with physician mentor Arrange future mentor meetings Meet and greet physicians family (ie lunch) Complete standard work form and send to RHA contact

Week 2

Informal follow-up with physician regarding practice and community Confirm status of physician orientation Complete standard work form and send to RHA contact

Week 3-4

Continue ongoing mentor debriefs Complete standard work form and send to RHA contact

Monthly/Quarterly Follow on

MONTHLY

Continue professional follow-up meetings (Page 64) Schedule recognition events – ie Birthday celebrations( Pages 64-65) Complete standard work form and send to RHA contact

QUARTERLY

Conduct goal setting and performance review Celebrate anniversary (clinic specific) Conduct patient quality survey (connect with region regarding this form) Complete standard work form and send to RHA contact


Physician and Family Settlement – saskdocs

Confirm Innovative Practices:

o Develop a strategic communication strategy and presentation to engage partners o Ensure community engagement, understanding and supports are in place o Educate the Innovative Practice Physician Retention Committee participants o Provide ongoing support to the Innovative Practices o Conduct a post innovation assessment and revise the process as required o Facilitate continued roll out

Revise and roll out the Physician Settlement Survey Develop a centralized information access site to support PRCs Host an annual event to offer an opportunity for committees to come together and

share their experiences to ensure continuous improvement


Saskatchewan International Physician Practice Assessment

Internationally educated family physicians who meet the registration requirements of the College of Physicians and Surgeons of Saskatchewan (CPSS) may now apply for a pre-licensure assessment for the purpose of practising medicine in Saskatchewan. It is important to note that not all family physician IMGs are required to participate in SIPPA. IMGs trained in countries where the education programs are recognized by the College of Family Physicians of Canada (CFPC) may apply through the CFPC recognition process which is described on their website located at: http://www.cfpc.ca/Home/.

With implementation of SIPPA, Saskatchewan residents can be assured that IMGs have the appropriate mix of academic knowledge, technical skills, and clinical judgment to provide safe patient care. SIPPA offers the opportunity for IMGs in family medicine to be assessed before they are settled in their new community. Regional Health Authorities (RHAs), in partnership with saskdocs, play a critical role in recruiting IMGs, resolving logistical issues with their arrival into Canada, supporting IMGs through the SIPPA process and helping them to settle in their home communities. Early evaluation of the SIPPA program is showing success and satisfaction of IMG participants, SIPPA faculty and RHAs.

This toolkit is intended to provide you with:

An overview of the SIPPA process and roles Tools and links to information to support the IMG throughout the process

Contact information to provide assistance with questions as they arise

Links to websites rather than specific forms or documents are provided to make sure you have the most current information in each step of the process. saskdocs is your first stop for information about recruiting IMGs. They can be reached at [email protected], (306) 933-5000 or toll free 1-888-415-3627 or by visiting their website http://www.saskdocs.ca.


http://www.cfpc.ca/Home/

mailto:[email protected]


The SIPPA Program

SIPPA comprises an orientation, centralized assessment and clinical field assessment. The program consists of two parts:

Centralized Assessment (CA) - which consists of orientation and examination; and Clinical Field Assessment (CFA)

The University of Saskatchewan’s College of Medicine, Continuing Professional Learning (The SIPPA office) administers SIPPA. The SIPPA office also recruits and trains the clinical field assessors and manages an online resource with specific study aids. The SIPPA website is: https://www.usask.ca/cmelearning/sippa/what-is-sippa.php

The Team that Coordinates the SIPPA Assessment Process

SIPPA is a collaborative effort and many organizations play a role. The SIPPA office provides the main coordination of the assessment process; saskdocs source the RHAs with IMGs interested in coming to Saskatchewan, but not being recruited by a particular RHA. The RHA assists their locally sourced candidates through the pre-licensure assessment process; CPSS verifies licensure eligibility and issues the appropriate license during each phase of the assessment process; and, the Ministry of Health, Medical Services Branch is responsible for funding the program. A detailed organizational chart can be found in the appendices, but the main contacts regarding the SIPPA process for each organization are listed below:

Organization Primary role Contact Information The SIPPA Office Administers

SIPPA 447 St. Andrew's College 1121 College Drive, Box 306 Saskatoon SK S7N 0W3 Phone: (306) 966-8072 Fax: (306) 966-8116

College of Physicians and Surgeons of Saskatchewan (CPSS) http://www.cps

Licenses physicians

101-2174 Airport Drive Saskatoon, SK S7L 6M6 Phone: (306) 244-7355 Fax: (306) 244-0090

Regional Health Authorities (RHAs)

Local recruitment of physicians Contact saskdocs for the most up-to-date list of

recruiters. Physician Recruitment Agency of Saskatchewan (saskdocs) www.saskdocs.ca

Provincial coordination for recruitment of physicians

1 – 311 Wellman Lane Saskatoon, SK S7T 0J1 Phone: (306) 933-5000 OR 1-888-415-3627 (toll free) Fax: (306) 933-5115

Ministry of Health (MOH)

Funding and oversight

Medical Services Branch – Non Fee for Service Negotiations Unit Ministry of Health 3475 Albert Street Regina, SK S4S 6X6 Phone: (306) 787-3424






The Roles and Responsibilities

RHAs, working collaboratively with saskdocs, have an important role to play in the SIPPA process.

This role includes:

Recruiting, selecting, interviewing and screening IMGs Support the immigration process by preparing letters of offer. If required, obtaining a

positive Labour Market Impact Analysis (LMIA) so Work Permits (WP) for the assessment process and the second WP pending the successful completion of SIPPA can be obtained

Working with the CPSS to monitor the IMG progress through the immigration process, confirming SIPPA dates, coordinating with CPSS and CPL (if required)

Developing an arrival plan Paying the weekly stipend to IMGs participating from the RHA. Working with the SIPPA office to find housing for IMGs during the clinical field

assessment Arranging for credentialing of IMGs locating to their regions for the clinical field

assessment Arranging for any supports needed to settle IMGs in the region after passing SIPPA or,

alternately, arrangements if the candidate is not successful in SIPPA; and Troubleshooting the many and varied questions SIPPA candidates have that relate to

recruitment, relocation and settlement

Supporting the IMG through the Immigration Process

Step 1: Pre-Final Ruling

The regional recruiter network has an agreed upon process for recruiting doctors provincially in order to eliminate the competition within Saskatchewan, and eliminate duplication of work by regions.

As saskdocs is the recruitment agency for the province and saskdocs works with all provincial stakeholders, they are considered the central point of contact for the physicians wanting to work in Saskatchewan.

Any physician wanting to take part in the SIPPA process will be redirected to saskdocs to receive

next steps in the process. If a region knows that they want to support this doctor further, saskdocs will still assist the doctor throughout the process, but they will attach the physician file to the region within the database.

Only at the time that a final ruling is given by CPSS, will saskdocs start the matching process.

(note: unless there are extenuating circumstances, or where a candidate is already tagged to a region).

Step Two: After Final Ruling

Once the Final ruling is issued, saskdocs will ensure that the doctor fills out a questionnaire

(created provincially) and will also ensure that the doctor works to fill out any documents required to make the matching a smooth process for all stakeholders.

saskdocs will wait (if possible) to match a doctor until all documents are in order for the regions to SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK- 2013 (UPDATED JULY 2017) Page | 98

review a complete file. Notification will be given to the region that saskdocs has allowed permissions to access the file via the database and will have time to review the candidate and share the file with those involved in the hiring process.

The region must then notify saskdocs whether they are going to keep the file and continue

through the hiring process with the doctor, or whether they are going to pass on the file. (timelines for the “accepting/declining” of candidates haven’t been nailed down yet, but provincially we have agreed to work as diligently as possible in order to accommodate both regions and candidates).

If a region declines a physician, the field of “decline date” should be filled and saskdocs will get an

automatic response that an update has occurred. Once a region passes/declines on a file, the file is considered inactive and will be re-matched to another region.

Step Three: Selection of physicians to attend SIPPA

The provincial process for selection of candidates is slated for 8 weeks prior to start of SIPPA. Each region has one (1) protected seat. You will be required to fill out the CPSS SIPPA candidate selection form and email to CPSS to [email protected] and put SIPPA selection form in the subject line, please copy [email protected] on this email. Any additional candidates that regions would like to put forward please submit the Additional SIPPA seat selection form and submit to [email protected] for consideration. Please indicate the doctors names in order of preference and include the practice location. The ranking will be done as soon as possible and the physicians that rank the highest (according to the ranking criteria) will be placed in the extra seats. Regions will receive notification of candidates ranked and allocated an extra seat. CPSS will then work to finalize and approve the candidate for SIPPA. As soon as they are approved, the SIPPA coordinator will send documents, agendas and timelines to the selected candidates.

STEP 4 - Facilitating Candidates in SIPPA - Tasks for RHAs/saskdocs

RHAs with a candidate in the SIPPA program will:

Prepare a pre-arrival package that includes cell phone contact numbers for the RHA, saskdocs, the SIPPA office (or other emergency number), a request for the list of personal needs they need for the first week; and a reminder to bring a stethoscope, driver’s license, lab coat and laptop and any other information you think would be valuable for new doctors coming to Saskatchewan.

Inform candidates of the three year return-of-service contract that will be signed before he/she starts SIPPA.

Be invited to attend the welcome social. Arrange for weekly honorarium to be paid to the candidate with funds available the first

full week (rate will be set by the Ministry of Health). Ensure credit card information is on file for the centralized assessment (in case of

additional charges for accommodation/incidentals like telephone, etc). Coordinate credentialing for the clinical field assessment with the RHA to which the

candidate is assigned. Arrange transportation for the candidate to their clinical field assessment. Find suitable accommodation for the clinical field assessment for candidates (if required) and apply for the second work permit for successful candidates. Support successful candidates with their return to recruiting RHA following completion of

the clinical field assessment. (Note: There is approximately one week between completion of the assessment, scoring of the results and issuing a Provisional License.





During that period accommodation and honoraria are NOT provided). Support unsuccessful candidates in determining their next steps.

Question - What is the weekly honorarium and who pays?

SIPPA candidates receive a weekly honorarium (rates are determined by the Ministry of Health) for the duration of their participation in SIPPA (i.e. centralized orientation part 1, centralized clinical assessment, centralized orientation part II, and clinical field assessment). RHAs should make arrangements to pay this amount directly to their recruited physicians. RHAs then submit an invoice to Medical Services Branch – Non Fee for Service Negotiations Unit for reimbursement.

Question - What costs are covered for the Centralized Orientation and Assessment periods?

Accommodation is arranged by the SIPPA office and some costs associated with the assessment are paid by the program. However, incidental costs (i.e. telephone calls, parking, transportation, etc.) are the responsibility of the candidate or the recruiting RHA (outstanding invoices are forwarded to the RHA by the SIPPA office).

Question - What happens if you have an IMG in your RHA for the Clinical Field Assessments (CFA)?

You may have a SIPPA candidate being assessed in your RHA and will be asked to find accommodations and support in getting the appropriate privileging within your region. Host RHAs will be informed of the name of the assessing physician and the location of the SIPPA candidate. You may also be asked to assist with coordination of local travel and making sure the candidate has an emergency contact in the RHA. Sponsoring RHAs will be asked to advise the assessing physician of the accommodation and transport arrangements made in the event the candidate has any difficulties arriving in the CFA community.

Cost of accommodation for participants in your RHA is paid by the program. All invoices should be sent to the SIPPA office. If a facility is owned by your region, please invoice SIPPA directly; but if it is a privately owned facility please pay and ask for SIPPA to reimburse.

Question - What happens after completion of the Clinical Field Assessment?

It is between the IMG and the recruiting RHA whether the candidate remains in the CFA site until the results are distributed (usually after five business days) or alternate arrangements are made. Please note that the cost of accommodation during this period is not covered and many IMGs choose to leave their CFA site. It is important for the recruiting RHA to contact the IMG and confirm plans, accommodation and transportation needs.

Question - When will the RHA receive results of the SIPPA assessment?

Results of the assessment are usually available approximately one to two weeks after the final day of the assessment. The SIPPA office informs the candidates and forwards the results to CPSS, Ministry of Health, and RHAs. Successful IMGs must then contact CPSS to obtain a Provisional License and the RHA must complete and submit the documentation to CIC to obtain the IMG’s second Work Permit, if applicable.


Question - What happens if the IMG does not pass either the Centralized Assessment or the Clinical Field Assessment?

Candidates who do not pass the Centralized Assessment are not permitted to move into the Clinical Field Assessment. They exit the SIPPA process after the exam results are delivered. The results of all examinations in the Centralized Assessment are reviewed by SIPPA. Each candidate, regardless of the outcome, is offered a chance to discuss the outcome with the SIPPA Director.

Candidates who fail either component of the assessment have the opportunity to have a second attempt to be successful. Only one repeat is permitted. Candidates who are unsuccessful in SIPPA can apply again, but must sit out one iteration. Ie: if January fail, sit out May and attempt September pending candidate still has valid final ruling.

STEP 5 - Settlement Post SIPPA - Tasks for RHAs/saskdocs

After the SIPPA assessment is complete, the RHAs and saskdocs are responsible for:

(If required) A second Work Permit Settlement of IMG into the RHA Confirming the IMG has completed the required paperwork for Provisional License and

insurance Assisting IMGs who are not successful make arrangements

saskdocs, in close collaboration with regional recruiters has developed a handbook that can further assist with the settlement and retention of IMGs and their families.

Question: What is the process if my candidate fails and wants to reapply?

The SIPPA Director will need to send a letter to CPSS and saskdocs to confirm that the doctor has expressed interest in reapplication for a second attempt at SIPPA and confirming the iteration of SIPPA in which he/she may participate.

Once CPSS has the letter from the SIPPA Director, the physician must start from the beginning of the process by submitting the pre-screen checklist to saskdocs. The process will continue as per usual.

Congratulations on your recruitment and good luck with your SIPPA candidates!


APPENDIX A - Roles of Agencies Involved In SIPPA

Item College of Physicians and Surgeons (CPSS)

The SIPPA office Ministry of Health (MoH)

Regional Health Authority (RHAs)/ recruiting organization

saskdocs Other (specify)

Program management (general) Funding Signs contract and

budget with MoH Negotiates with the SIPPA office

Weekly stipend (centralized assessment and CFA)

Reimburse RHAs

Pay to IMGs and issue T- statements

Communications Overall responsibility Documentation review and update

Annual review of forms

Evaluation Overall responsibility Oversight Committee

Eligibility for SIPPA Pre-screening for eligibility for licensure

Regular review of pre-screen form

Review pre-screen forms

Screening for eligibility licensure

Process licensure applications; provide result to candidate, saskdocs/ RHA; letter of ruling will include CFA duration required

Matching candidate to RHA

Coordinate with saskdocs

saskdocs leads matching




Regional Health Authorities (RHAs)/ recruiting organization


Immigration process

Manage with candidate

Entering candidate to SIPPA pool

Provides background information to the SIPPA office

RHAs advise the SIPPA office, CPSS and saskdocs

Maintains list of doctors and shares with stakeholder as the doctors are selected

Ranking of candidates

Conduct academic ranking, collate other rankings and produce final ranking. If required

Tallies the final rankings from stakeholders

On-Site Preparation for SIPPA Arrival Lead;

Coordinate with saskdocs

Supports RHAs as requested

Credentialing for clinical field assessment

Manage for those with CFAs in their RHA

Licensure Interview & award educational license

Malpractice insurance (CMPA)

Arrange for all candidates

Centralized Orientation and Assessment Accommodations (starting 2 days prior to SIPPA)

Manages reservation Credit card on file for incidentals






Orientation Review legislation and relevant information

Overall responsibility (CoM agreement, collect outstanding candidate info, schedule, content, presenters, logistics and evaluation)

Prepare and Review ROS agreements

SMA

Social Events Responsible for one event in collaboration with the SMA

Centralized Assessment

Overall responsibility (schedule, M exam, logistics, evaluation)

Testing/ Candidate success

Provide performance report to candidates, assessors; pass standing to CPSS and RHAs; Provide collated report to MoH

Initiate application for 2nd work permit for successful applicants; Determine next steps for unsuccessful candidates

Psycho- metrician

Clinical Field Assessment Assessors: - Recruitment

Overall responsibility

- Training Overall responsibility Matching of candidates


Communication of placements

Communicate to RHAs and assessors

Accommodations Advise of availability and identify resource… Make and pay for reservations; coordinate needs with the SIPPA office

Relocation to CFA community







Testing Receive results from Assessors; provide to Psychometrician

Assessors, Psycho- metrician

Candidate success

Communicate to candidate & their recruiting RHA, saskdocs, CPSS; Provide collated report to MoH

Determine next steps for unsuccessful candidates

Settlement of candidates at conclusion of CFA Week following CFA

Coordinate with candidate

Support for settling in permanent community


SIPPA Governance Secretariat support


Policy decisions Oversight Committee


APPENDIX B - Links to Useful Websites

College of Family Physicians of Canada: http://www.cfpc.ca/RecognizedTraining/

saskdocs IMG site: http://www.saskdocs.ca/work/family-physician---international-medical-graduate-img/

CPSS registration page: https://www.cps.sk.ca/imis/cpss/registration/Licensure.aspx?LicensureCCO=3#LicensureCCO

Citizen and Immigration Canada – form page: http://www.cic.gc.ca/english/information/applications/work.asp

Ministry of Economy - Immigration and Program Services http://www.economy.gov.sk.ca/immigration

Saskatchewan Ministry of Health – resources for health professionals: http://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/resources-for-health-care-businesses-and-career-development

https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/resources-for-health-care-businesses-and-career-development/physician-career-resources

The SIPPA office: http://www.usask.ca/cme/programs/sippa-program/general-information/index.php


http://www.cfpc.ca/RecognizedTraining/

http://www.saskdocs.ca/work/family-physician---international-medical-graduate-img/

https://www.cps.sk.ca/imis/cpss/registration/Licensure.aspx?LicensureCCO=3%23LicensureCCO

https://www.cps.sk.ca/imis/cpss/registration/Licensure.aspx?LicensureCCO=3%23LicensureCCO

http://www.cic.gc.ca/english/information/applications/work.asp

http://www.economy.gov.sk.ca/immigration

http://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/resources-for-health-care-businesses-and-career-development






http://www.usask.ca/cme/programs/sippa-program/general-information/index.php

References

Arizona Association of Community Health Centers, Illinois Primary Health Care Association, Mississippi Primary Health Care Association Virginia Primary Care Association. (2005). Recruitment & Retention of Clinicians

HealthForceOntario Marketing and Recruitment Agency. (n.d.). Recruiter U

Heath Match BC. (n.d.). Planning for Recruitment, Sourcing Candidates and Advertising, Interviewing and Selection.

Association of Staff Physician Recruiters (ASPR) - Toolkit

Canadian Association of Staff Physician Recruiters (CASPR) 101 Fellowship Royal College of Physicians & Surgeons of Canada http://www.royalcollege.ca/rcsite/credentials-exams/exam-eligibility/assessment-routes-residents-e
