Fieldwork Policies and Requirements

Policies on Immunization

First Year Students

Documented proof of current immunization against specific diseases must be provided at registration in the OS&OT program in order for the student to be permitted to carry out the fieldwork component of the curriculum. A Health Form (See Appendix A) is enclosed with each student’s registration package and is also available on the OS&OT website. Accepted applicants are required to have the Health Form completed by their Health Care provider. A student will not be permitted on fieldwork if his/her Health Form has not been completed and submitted to the Fieldwork office by the stated deadline submission date.

Required Health Forms and guidelines for the completion of the forms are found in Appendix A. All associated immunization and documentation fees are the responsibility of the student.

Second Year Students

Students are required to complete the Year 2 Health Form and submit it to the Fieldwork Office when commencing classes in September. A student will not be permitted on fieldwork if his/her Health Form has not been completed and submitted to the Fieldwork Office by the stated deadline date.

Required Health Forms and guidelines for the completion of the forms are found in Appendix A.  All associated immunization and documentation fees are the responsibility of the student.

Copies of Health Forms

Fieldwork facilities require proof of immunization; therefore students must keep a copy of their completed health form for their own records and bring a copy with them to their clinical placements.  Pursuant to the university schedule of administrative fees, a $15.00 charge applies to requests for duplicate copies of the health form once it has been submitted to the Fieldwork Office.

Communicable Diseases and Occupational Health
During the course of fieldwork placements, students may be required to take part in the care of clients with various infectious diseases. Students will be trained in infection control procedures prior to commencing fieldwork placement. The Faculty of Medicine guidelines below provide further information about communicable diseases and clinical education. These are within the document: “Guidelines Regarding Infectious Diseases and Occupational Health for Applicants to and Learners of the Faculty of Medicine Academic Programs.”
 

6.1. GUIDELINES for APPLICANTS TO ALL UNDERGRADUATE, GRADUATE, AND POSTGRADUATE EDUCATION PROGRAMS IN THE FACULTY OF MEDICINE

  1. The Faculty of Medicine will inform potential applicants that, if they are admitted into the program to which they are applying:
    1. they may be required to take part in the care of patients with various infectious diseases including Hepatitis, TB, and HIV/AIDS, during their studies;
    2. they will be trained in methods of preventing spread of infection to themselves, to other patients and other health care providers (including Routine Practices and hand hygiene);
    3. there is a risk that they may contract an infection during the course of their studies;
    4. they have a responsibility to prevent the spread of infection to others;
    5. they will be required to comply with the immunization requirements of the specific program to which they have applied within the Faculty of Medicine;
    6. if they have or contract an infectious disease (see examples in Section 7), they will be permitted to pursue their studies only insofar as their continued involvement does not pose a health or safety hazard to themselves or to others;
    7. they will be required to comply with the OMA/OHA Communicable Disease Surveillance Protocols that were developed in compliance with Regulation 965, Section 4, under the Public Hospitals Act. This regulation requires each hospital to have by-laws that establish and provide for the operation of a health surveillance program including a communicable disease surveillance program in respect of all persons carrying on activities in the hospital.
    8. they may be required to give body fluid specimens if they are exposed to or contract certain diseases while working in health facilities.
  2. The Faculty of Medicine requires successful applicants and learners to undergo TB and Hepatitis B testing, but does not require testing for Hepatitis C and HIV.
  3. Applicants with known/diagnosed active tuberculosis (TB), Hepatitis B, Hepatitis C, or HIV infection are required, upon acceptance, to inform the responsible party (as outlined in Section 4) of their condition. The diagnosis of any infectious disease in an applicant or learner shall remain confidential within a strict “need to know” environment.
  4. All applicants to Undergraduate Medical Education, Postgraduate Medical Education, graduate programs, Occupational Science and Occupational Therapy, Physical Therapy, Speech-Language Pathology, Medical Radiation Sciences, or the Physician Assistant Professional Degree program with a known/diagnosed Hepatitis B, Hepatitis C, HIV or active tuberculosis infection will be reviewed by the University of Toronto Faculty of Medicine Expert Panel on Infection Control, which will provide the relevant Pre-clerkship or Clerkship Director, Academy Director, Program Director, Graduate Coordinator, Clinical Coordinator, Fieldwork Coordinator or Medical Director with recommendations regarding necessary curriculum/rotation adjustments.
  5. As information on infectious diseases is a mandatory disclosure item on a learner’s application to the College of Physicians and Surgeons of Ontario (CPSO), the Faculty of Medicine may provide information and/or updates to the College regarding a learner’s immunization/infectious disease status and any recommendation regarding the learner from the Expert Panel on Infection Control.

6.2. GUIDELINES for LEARNERS IN ALL UNDERGRADUATE, GRADUATE, AND POSTGRADUATE EDUCATION PROGRAMS IN THE FACULTY OF MEDICINE

  1. The Faculty of Medicine will inform enrolled learners that:
      they may be required to take part in the care of patients with various infectious diseases including Hepatitis, TB, and HIV/AIDS, during their studies;
    1. they will be trained in methods of preventing spread of infection to themselves, to other patients and other health care providers (including Routine Practices and hand hygiene);
    2. there is a risk that they may contract an infection during the course of their studies;
    3. they have a responsibility to prevent the spread of infection to others;
    4. they are required to comply with the immunization requirements of their program in the Faculty of Medicine;
    5. if they have or contract an infectious disease at any point prior to or during their program(see examples in Section 7), they will be permitted to pursue their studies only insofar as their continued involvement does not pose a health or safety hazard to themselves or to others;
    6. they are required to comply with the OMA/OHA Communicable Disease Surveillance Protocols that were developed in compliance with Regulation 965, Section 4, under the Public Hospitals Act. This regulation requires each hospital to have by-laws that establish and provide for the operation of a health surveillance program including a communicable disease surveillance program in respect of all persons carrying on activities in the hospital.
    7. they may be required to give body fluid specimens if they are exposed to or contract certain diseases while working in health facilities.
  2. The Faculty of Medicine requires learners to undergo tuberculosis (TB) and Hepatitis B testing, but does not require testing for Hepatitis C and HIV.
  3. Learners with a known/diagnosed infection for any of active tuberculosis, Hepatitis B, Hepatitis C, or HIV are required to inform the responsible party (as outlined in 4) of their condition immediately. The diagnosis of any infectious disease in a learner shall remain confidential within a strict “need to know” environment.
  4. All learners in Undergraduate Medical Education, Postgraduate Medical Education, graduate programs, Occupational Science and Occupational Therapy, Physical Therapy, Speech Language Pathology, Medical Radiation Sciences, or the Physician Assistant Professional Degree program with a known/diagnosed Hepatitis B, Hepatitis C, HIV or active tuberculosis infection will be reviewed by the University of Toronto, Faculty of Medicine Expert Panel on Infection Control, which will provide the relevant Preclerkship or Clerkship Coordinator, Academy Director, Program Director, Graduate Coordinator, Clinical Coordinator, Fieldwork Coordinator or Medical Director with recommendations regarding necessary curriculum/rotation adjustments.
  5. As information on infectious diseases is a mandatory disclosure item on a learner’s application to the College of Physicians and Surgeons of Ontario (CPSO), the Faculty of Medicine will provide advice to the learner recommending required disclosure of information to the College regarding his/her immunization/infectious disease status.

6.3. GUIDELINES for LEARNERS WITH AN INFECTIOUS DISEASE

  1. The learner must comply with the infectious diseases surveillance protocols adhered to by the Faculty of Medicine and its affiliated training sites, provide body fluid specimens as requested, and agree to be monitored by an infection control specialist, with regular reporting, if required.
  2. All learners are expected to be in a state of health such that they may participate in their academic and clinical programs, including patient care, without posing a risk to themselves or to others. Learners with an infectious disease may pursue their studies only insofar as their continued involvement does not pose a health or safety hazard to themselves or others. Such a health or safety hazard, if protracted, may preclude them from participation in certain aspects of clinical work essential to the satisfactory completion of their program of study.
  3. Learners who have symptoms of an acute illness that is likely infectious in etiology should not attend in the teaching site until their symptoms have improved; this includes but is not limited to fever, “colds”, cough, sore throat, vomiting, diarrhea, rashes, and conjunctivitis. Learners who are absent from mandatory educational activities due to illness should notify their program in accordance with the program-specific attendance/absence guidelines/policies.
  4. The diagnosis of any infectious disease in a learner shall remain confidential within a strict “need to know” environment.

6.4. GUIDELINES regarding LEARNERS’ PARTICIPATION IN CARE OF PATIENTS WITH INFECTIOUS DISEASES

  1. Learners are required to participate in the care of all patients assigned to them, including patients with infectious diseases, to a level commensurate with their level of training. Such participation is necessary for the learner’s education as well as for satisfactory completion of academic and clinical training requirements.
  2. All learners are expected to understand and adhere to infection control policies, including the principles of Routine Practices and hand hygiene, when participating in the examination and care of all patients, regardless of the diagnosis or known health status of the patient.
  3. Learners are responsible for conducting themselves in a manner that is consistent with the health and safety of themselves and others, and shall be given appropriate training to do so. Learners who fail to meet these responsibilities may, depending on the circumstances, face sanctions under the provisions of the University of Toronto Standards of Professional Practice Behaviour for all Health Professional Students.

6.5. GUIDING PRINCIPLES regarding LEARNERS WHO ARE EXPOSED TO AN INFECTIOUS DISEASE OR OTHER ADVERSE EXPOSURE IN THE COURSE OF THEIR TRAINING

  1. The Faculty of Medicine requires that all educational programs have published documents outlining the course of action to be taken for learners who incur an injury or other medically-related incident, including an incident that may have placed them at risk of acquiring an infectious disease, during the performance of activities as a part of their educational program. Any such document must provide a course of action to promote both the emotional and physical wellbeing of the learner.
  2. Learners are expected to comply with the published documents in 6.5.1. Note: Under the UE:COFM Blood Borne Pathogen Policy Undergraduate Medical Education learners (MD students) are ethically obligated to know their serological status.
  3. Learners who develop markers of an infectious disease are required, as per 6.2.2, to inform the responsible party in their educational program of their status. The case will then be handled as described in 6.2.3.

6.6. GUIDELINES on LEARNERS WHO ARE EXPOSED TO AN INFECTIOUS DISEASE OR ADVERSE EXPOSURE DURING THE TIME PERIOD OF TRAINING OUTSIDE TRAINING ACTIVITIES

  1. Note: Under the UE:COFM Blood Borne Pathogen Policy, Undergraduate Medical Education learners (MD students) are ethically obligated to know their serological status. Learners who may suspect they may have become infected with any of the infectious diseases included in Section 7 should seek medical attention.
  2. Learners who develop markers of an infectious disease are required, as per 6.2.2, to inform the responsible party in their educational program of their status. The case will then be handled as described in 6.2.3.

6.7. GUIDELINES on CO-RESPONSIBILITY WITH TEACHING SITES

The Faculty of Medicine and its teaching sites are jointly responsible for ensuring that learners are adequately instructed in infection control. This will include the following:

  1. The Faculty will provide to learners in all educational programs an introductory program on Routine Practices, hand hygiene, and other core competencies of infection control and occupational health, and will inform learners of their responsibilities with respect to infection control and occupational health.
  2. All Ontario hospitals are required to comply with the Communicable Diseases Surveillance Protocols for Ontario hospitals developed under the Public Hospital Act, Regulation 965. Compliance with these Protocols requires the hospitals to provide instruction in infection control precautions and occupational health to learners.

7. SPECIFIC INFECTIOUS DISEASES INCLUDED IN THIS DOCUMENT but not limited to:

Blood-borne pathogens:
HIV/Hepatitis B, C
Enteric pathogens:
Salmonella / Shigella / Campylobacter / E-coli 0:157/ Norovirus/Rotavirus,
Other:
Influenza / Meningococcal disease / Measles / Mumps /Rubella / Tuberculosis / Varicella / Pertussis/ Hepatitis A/Adenovirus Conjunctivitis

  1. Graduate learners who do not have patient contact in their roles, while excluded from these guidelines must comply with existing protocols: graduate learners based on-campus comply with the regulations as set out by the University of Toronto’s Office of Environmental Health and Safety and graduate learners based off-campus comply with the protocols of the institute in which they work.
  2. The Expert Panel on Infection Control is advisory to the Dean, Faculty of Medicine. The Panel addresses matters pertaining to health professional students and learners in all Faculty of Medicine Programs and provides advice in all matters relating to the “Guidelines Regarding Infectious Diseases and Occupational Health for Applicants to and Learners of the Faculty of Medicine Academic Programs”
  3. Communicable Diseases Surveillance Protocols
  4. COFM Immunization Policy, November 2010
  5. UE:COFM Blood Borne Pathogen Policy
  6. Standards of Professional Practice Behaviour for all Health Professional Students, June 2008.

Guidelines approved: UME Executive – January 17, 2012
HUEC – January 25, 2012
UPAR – February 23, 2012
Medical Radiation Sciences – March 2012
PGMEAC – April 27, 2012
Graduate Affairs – May 23, 2012
Physician Assistant Program – July 16, 2012
Faculty Council, Education Committee – September 20, 2012
Faculty Council, February 11, 2013

Infection Control Measures

Students are required to complete an online Infection Control Module as instructed prior to commencing fieldwork. Students are expected to follow appropriate infection control practices while on placement and to notify the placement facility Occupational Health Department following needle stick injuries and following contact with patients with communicable diseases. Students should be aware of and practice proper hand washing techniques. For resources and instructions, please see the following:

Some facilities may have a policy that requires all staff and students to either be vaccinated against influenza or wear a protective mask during influenza season in areas where patients are present and patient care is delivered. The fieldwork site coordinator will advise students if the facility has such a policy.

Mask Fit Testing

One of the key pieces of personal protective equipment to decrease the spread of infectious disease is a properly fit-tested mask. The Ministry of Health has developed directives for health care professionals to wear an approved respirator/mask when droplet protection (as in the case of SARS) is required. In order to protect the health and safety of health care students, the use of N95 respirators (masks) may be required if there is evidence of potential exposure to airborne infectious agents, chemicals, etc.

Please note, as part of a student’s clinical/fieldwork education criteria, mask fit testing and an education session is mandatory for all students. The Rehabilitation Sciences Sector arranges mask fit testing for all students. All students will receive a memorandum from the Administrative Assistant, Clinical Affairs, Rehabilitation Science Sector, in reference to the education session and mask fit testing. Students will be provided with principal documents regarding the policies and procedures for completing their education session and mask fit testing. In addition, students will receive information regarding the date, time and room number of the education session and the mask fit testing at 500 University Avenue or at the Terrence Donnelly Health Sciences Complex at UTM. No additional fees are required.

Important Notice: Failure to attend the scheduled date and time of the education session and mask fit testing will result in the student taking full responsibility for making alternative mask fit testing arrangements and paying the required mask fit testing fee at a private clinic. Students are required to bring their mask fit testing card with them to all placements so should ensure that they keep this card in a safe location. Students should contact the Rehabilitation Sciences Sector office if their mask fit testing card is lost.

Cardiopulmonary Resuscitation and First Aid

Students are required to obtain their CPR certification at the Health Care Provider (HCP) level and provide a copy of the certificate to the Fieldwork Office. The course must include one and two person CPR on adults, children, and babies. The HCP level contains all required elements. Annual recertification is required as indicated on the certificate. It is strongly recommended that students take this course after August 1 and prior to September 3 each year to ensure adequate coverage is maintained annually throughout the two years of the MScOT programme. A copy of this certificate may also be required by individual fieldwork facilities, therefore students are advised to take a copy of the certificate with them on fieldwork placement. A student will not be permitted on fieldwork if a copy of a valid certificate in CPR has not been submitted to the fieldwork office with evidence of annual renewal as indicated on the certification certificate.

Certification in First Aid is strongly recommended and may be required by individual fieldwork facilities. The student is responsible for the expense of these courses.
 
Appropriate CPR certification and First Aid courses are run by the following agencies:
 

Student Safety Training
A provincial regulation (Bill 18) requires health and safety awareness training for every worker and supervisor under Ontario’s Occupational Health and Safety Act (OHSA). Under Bill 18, students completing an unpaid work term are now considered employees and need to complete Health and Safety Education Modules. Students in the Department of Occupational Science and Occupational Therapy are required to complete 2 specific modules: Basic Health and Safety Awareness Program, and WHMIS training.

Instructions on how to access these modules are provided to students in Term 1 and are also available on the online Year 1 and Year 2 Fieldwork Quercus course sites. Students need to submit proof of completion of these modules before beginning placement. Students must keep a copy for their own records to show to fieldwork sites, if requested.

Another component of student safety is processes related to student injury while on placement. For information about procedures to follow if injured while on placement, please see section titled “Contracts and Insurance”.

Consequences of Failure to Submit Mandatory Health and Safety Requirement Documentation

It is the student’s responsibility to submit all required documentation to the Fieldwork Administrative Assistant by the due dates communicated. If completed Health Forms, CPR certification documentation and mask fit testing documentation have not been submitted by the due dates, students will not be allowed to participate in fieldwork courses. No fieldwork placement will be assigned for a student who has not submitted the required documentation.

Police Checks

Students are required to obtain a police check if the clinical placement facility to which they are assigned requires the check. There are two kinds of police checks; a Clearance Letter and a Vulnerable Sector Screening (VSS). Information on the police checks is below.

There are fees associated with applications of both types of police checks. The fees vary based on the type of check performed and the police region. Students are responsible for all associated fees.

Results of any police record check are sent directly to the student’s home. The Department of OS&OT does not see or keep copies of the results. If a police check is required by the site, then the student must show the police check results to their assigned placement facility on the first day of placement. Upon receipt of the results of the police check, the facility will make a decision regarding the student being able to participate in the placement.

Clearance Letter and Vulnerable Sector Screening

Fieldwork sites may require either one of the police checks that are outlined in the box below. Although the Department of Occupational Science and Occupational Therapy (OS&OT) does not require a police check for admission into the program, we strongly recommend that students obtain the Vulnerable Sector Screening each year (the highest level of police check), as students will then have satisfied all site requirements, including those requiring just the Clearance Letter.
 
From the Toronto Police Service website

“A Clearance Letter is a formal document issued by the Toronto Police Service and produced on secured paper indicating that the subject applicant of the Clearance Letter has no criminal convictions in the National Repository of Criminal Records maintained by the RCMP. With our new online program you can request a clearance letter at your convenience.

A Clearance Letter is not suitable for individuals being employed and/or volunteering with vulnerable persons*. A more comprehensive process, known as the Vulnerable Sector Screening (VSS), is required in those situations. Further information about the VSS is available here.

* Vulnerable person means a person who, because of their age, a disability, or other circumstances, whether temporary or permanent, are (a) in a position of dependence on others or (b) are otherwise at a greater risk than the general population of being harmed by person(s) in a position of authority or trust to them.”

If students do not have a recent (within the past 12 months) VSS, they will not be allowed to select fieldwork preferences that have this as a requirement. The Department of OS&OT does not keep a copy of the VSS therefore students must keep the original copy in a safe place so that it is available for them to take to all fieldwork placements.

A VSS must be obtained from police services in the region where a student lives. Police checks can take anywhere from 2 to 12 weeks to process depending on the area in which the student lives and which check is requested. In some areas, expedited services (2-3 days) are available at an additional cost to students. University Fieldwork Instructors will advise students on the timing of applications for these checks so that students will be prepared in advance for fieldwork placements. Toronto Police VSS application forms are available from the OS&OT Fieldwork Office.

Procedures for Obtaining the Vulnerable Sector Screening in Various Regions

Metro Toronto Residents

If the postal code of your residence begins with “M” you must obtain a “Consent to Disclosure of Personal Information” form/package from OT Reception. Please contact Fieldwork Administrative Assistant at ot.clined@utoronto.ca or at 416-978-8234 to obtain a copy of this form. It is important for you to read all attached information and follow the instructions carefully.

Once you have completed the form, you must submit it to the Toronto Polices Services Headquarters located at 40 College Street, Toronto. For more information please see the Metro Toronto Website.

York Region Residents

The University has been set up as an agency with the York Regional Police Services. If you are a York Region resident, you must go the York Region Police Services website and fill in the form. Under the agency field, enter “University of Toronto”. Once completed, print the form and take it to one of the two sites listed on their website. For more information please see the York Region Police Services website.

Halton-Peel Region Residents

The Department of OS&OT has been set up as an agency with the Halton-Peel Region Police Services. If you are living in Peel Region and need the Vulnerable Sector Screening performed, you must go to the Peel Regional Police Station, ask for the Vulnerable Sector Screening, stating that they are a student in OS&OT at the University of Toronto, pay the fee, fill in the form, produce photo ID, and then just await the results in the mail.

Please see the Peel Regional police services website.

Durham Region Residents

Currently no agency status is required, however, to qualify for the reduced fee, students must take a letter from the University of Toronto indicating the reason for the check (available upon request). Residents must make the application in person and information on how to apply can be found on the Durham Police Website.

Go to How Do I? (right side of the home page), select Information Requests then choose Police Record Checks.

If you live outside of these regions, please contact your local police department and ask about how you would obtain a Vulnerable Sector Screening.

If you have further questions or problems with obtaining a Police Check VSS, please contact the Fieldwork Administrative Assistant at ot.clined@utoronto.ca or at 416-978-8234.

Information on site requirements such as immunizations, police checks, etc. is collected and updated regularly by the Fieldwork Office. This information is made available to the students and it is expected that, prior to placement, students consult and thoroughly read the information related to their assigned placement site. Site requirements should be confirmed in the student’s introductory letter to the site.