Saskatchewan. Physician Recruitment And Retention Handbook

Transcription

1 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

2 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): 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 JANUARY 2015) PAGE 2

3 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 SETTLEMENT COMMUNITY ORIENTATION & INTEGRATION SHARED LEAD PARTICIPANT 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 SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 3

4 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 Screening Candidates Human Rights Considerations Assessing Eligibility for Licensure Interview and Selection Checking References Appendix A Physician Recruitment Committee Master Contact List Appendix B Position Profile Appendix C Initial Contact to Practice Appendix D Interview Bank Appendix E Reference Bank The Site Visit Planning the Site Visit Organize Your Team Develop an Itinerary The Site Visit Site Visit Follow-up Picking up the Tab Appendix A SAMPLE Site Visit Needs Assessment Appendix B SAMPLE Site Visit Itinerary Appendix C SAMPLE Site Visit Feedback - Physician Appendix D SAMPLE Site Visit Feedback Community Team Appendix E - SAMPLE Confirmation of Employment SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 4

5 Retention Roles and Responsibilities Understanding the Needs Facilitating Relocation Facilitating Settlement Professional Settlement Personal Settlement Communication Strategies to Support Retention Integration Evaluation Celebrate your Physicians Spousal Employment Appendix A - Settlement and Integration Plan Appendix B Needs Assessment Appendix C Physician Arrival Itinerary Appendix D Community Contract Sample Appendix E - Orientation Checklist Appendix F - Satisfaction Survey Lean Business Process Innovative Practice Documents Physician and Family Settlement RHA Physician and Family Settlement Community Physician and Family Settlement Clinic Saskatchewan International Physician Practice Assessment The SIPPA Program The Team that Coordinates the SIPPA Assessment Process The Roles and Responsibilities Supporting the IMG through the Immigration Process APPENDIX A - Roles of Agencies Involved In SIPPA APPENDIX B - Links to Useful Websites References SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 5

6 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. SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 6

7 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: In addition RHA recruitment consultants Medical or administrative leaders within the RHA Local physicians or medical practices, health foundation 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, SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 7

8 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 SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 8

9 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: - Opportunities. Citizenship and Immigration Canada (CIC) 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. SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 9

10 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] SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 10

11 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 , 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: The saskdocs Ethical Recruitment Framework can be downloaded at: SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 11

12 Human Rights Legislation All through the recruitment process, proceedings must demonstrate a respect for human rights legislation governing Saskatchewan. The best way to protect yourself 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: Assessing Eligibility for Licensure The College of Physicians and Surgeons of Saskatchewan (CPSS) assess eligibility for a licence to practice medicine. The requirements for licensure are described in detail on the CPSS website at: 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 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] SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 12

13 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 SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 13

14 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 C) 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: SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 14

15 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] SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 15

16 Appendix A Physician Recruitment Committee Master Contact List Physician Name : Phone Number: Address: Family Members: RHA Contact Person: Address: Phone Number: address: Clinic contact Person: Address: Phone Number: Address: Community Contact Person: Address: Phone Number: Address: SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 16

17 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 Facility 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? 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 SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 17

18 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 Community 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. Geographical location Distance from major city/international airport Amenities offered SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 18

19 Appendix C Initial Contact to Practice 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. 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: 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 verify medical education credentials, etc. Fees: A physician who makes application to CPSS for a medical license must pay a fee prior to the assessment being performed. The fee is refundable if the physician becomes licensed within a period of 12 months after the assessment is completed. The cost is $315 for all applicants. This amount includes non-refundable Goods and Services Tax (GST) in the amount of $10. 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 Contact: 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. Fees: All candidates are required to pay a one-time account fee of C$250 and a $140 fee for each medical document submitted for source verification. Medical Council of Canada Evaluating Exam (MCCEE) The MCCEE is a four-hour, computer-based examination offered in both English and French at more than 500 centers in 80 countries worldwide. The MCCEE is a general assessment of the candidate's basic medical knowledge in the principal disciplines of medicine. It consists of 180 multiple-choice questions, each listing five possible answers of which only one is the correct or best answer. Contact: SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 19

20 Turn-around-time: The exam is offered in more than 500 centers in 80 countries worldwide approximately three times per year. The examination results are confirmed, approximately seven weeks after the last day of the examination session. Fees: First time applicant - $1,645 English Language Proficiency Test of English as a Foreign Language (TOEFL) The TOEFL test measures the ability to use and understand English at the university level, and it evaluates the ability to combine listening, reading, speaking and writing skills to perform academic tasks. Contact: Turn-around-time: The exam is offered 30 to 40 times a year at more than 4,500 authorized test centers throughout the world. Approximately ten days after the exam date, test takers will receive notification that their scores are available online. Official reports are mailed approximately two weeks after the test date. Fees: Varies by country where the test taker is located. 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: Turn-around-time: IELTS is available on 48 fixed dates a year up to four times a month, depending on local demand. Official reports are mailed approximately two weeks after the test date. Fees: $305. 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: Turn-around-time: one to two months turn-around-time once application is received. Fees: o Application process for recognition of training and certification from approved jurisdictions the processing fee is $ 530 o Certification Examination in Family Medicine $4,750 o Examination of Special Competence in Emergency Medicine $2,659 SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 20

21 Human Resources and Skills Development Canada (HRDC) - Labour Market Opinion The Labour Market Impact Assessment (LMIA) is an application issued by HRSDC that outlines the impact that hiring a foreign worker would have on Canada labour 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 LMO will be listed in the document. To recruit a temporary foreign worker, you must obtain a favourable LMO. Contact: o Turn-around-time: This has been highly variable. Fees: $1,000. 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: 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: Turn-around-time: Processing times for temporary resident visa applications processed by visa offices outside Canada vary. Check the website for timelines at: SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 21

22 Appendix D Interview Bank Questions you should be prepared to answer. You may choose to organize questions #1-12 into a practice overview/introduction. 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 centre 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 INFORMATION SHARED IN PRELIMINARY INTERVIEW INFORMATION SHARED IN SECOND/FINAL INTERVIEW SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 22

23 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? SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 23

24 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? SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 24

25 The following is a list of commonly used questions to build an interview. The questions can be adapted according to the interviewer s needs. 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 a 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? RESPONSE OBTAINED PRELIMINARY INTERVIEW RESPONSE OBTAINED FINAL/SECOND INTERVIEW SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 25

26 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/practising 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 SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 26

27 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, 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? SASKATCHEWAN PHYSICIAN RECRUITMENT & RETENTION HANDBOOK 2013 (UPDATED JANUARY 2015) PAGE 27