Clinical Clerk Wellness Chart
In 2011, the FMEQ conducted a survey on wellbeing. The survey allowed us to identify the causes of stress of clinical clerks in Quebec and aimed to improve their well-being. However, following the qualitative analysis of the results, we thought it necessary to create the following chart that contains concrete recommendations to improve the well being of clinical clerk medical students in Quebec.
These recommendations should help improve well-being for all students in clinical internships, despite a highly fluctuating individual level of stress and anxiety reported amongst students.
1. SCHEDULE AND WORK LOAD
1.1. Set a maximum of 10 hours shifts for a regular clinical clerkship day, which excludes on call shifts and schedules organized in shifts.
1.2. A regular day begins no earlier than 6:30 am and ends no later than 6:30 pm, excluding however the on call shifts and the schedules organized in shifts.
1.3. The schedule of each clinical clerkship, including the on call schedule, must be handed out to the students at least one week before the clinical clerkship starts.
1.4. Clerks must have the possibility of exchanging their on-call schedule.
1.5. The Christmas and New Year holidays are statutory holidays for all clinical clerks.
2. TRANSITION BETWEEN ROTATIONS
2.1. At the beginning of a new rotation, clinical clerks should be informed of the following: what is expected of them in the different parts of their rotations; receive a list of training objectives, as well as a list of academic and clinical activities; and finally receive an approximate schedule of what a typical training day should look like.
3. STUDY AND EVALUATION DURING EXTERNSHIP
3.1. One day of studying per month is offered to all clerks, which can be determined by the student himself.
3.2. Clerks are free from their rotations for the entire day when an exam is scheduled.
3.3. Clinical clerks are not scheduled an on-call shift two days before an exam.
3.4. The employers must be reminded that the rotation must always be perceived by students as a learning opportunity rather than a constant evaluation.
4. DIFFICULT SITUATIONS
4.1. Each clerks is assigned a mentor or resident physician with whom they can exchange when facing difficult situations (pain, death, etc.).
5. CRUCIAL STEPS OF THE MD PROGRAM AND APPLICATION TO THE RESIDENCY PROGRAM
5.1. All clerks must receive explanations during formal and informal information sessions on evaluations (ÉCOS and CMC exam)
5.2. All clerks can provide feedback on the evaluations that they have been through.
5.3. One or many information session on the CaRMS must be offered to clerks as soon as the first year of their rotations or the year preceding their application to the CaRMS.
5.4. A mentoring system must be in place to support the clerks in their application process to the CaRMS.
5.5. Clerks must be freed from their schedule for the entire day when an interview is scheduled during the CaRMS application process.
5.6. Nonattendance due to interviews are excluded from the calculation of the maximum number of absences for rotations.
6. FLEXIBILITY OF THE CLERKSHIP ENVIRONMENT
6.1. Québec medical faculties must support student involvement by showing flexibility when a day off is requested for extracurricular responsibilities.
7. HARASSMENT AND INTIMIDATION
7.1. The resources available in case of harassment and abuse must be presented and explained at the beginning of the clerkship and frequently reminded throughout the clerkship.
7.2. An anonymous feedback system must be established to report harassment of any type.
8. PSYCHOLOGICAL SUPPORT
8.1. Clinical clerks must have a fast access to psychological services, at reasonable prices.
8.2. Psychological support must be available at convenient times for students in their clerkship; for example, certain evenings a few days a week and a emergency phone line available 24/24 hours.
9. ON CALL SHIFTS
9.1 Clerks must benefit from the same conditions / discounts at the cafeteria as the on call resident physicians.
9.2. All clerks that finish late at night must have access to a parking space near the hospital.
9.3. All clerks must have access to a parking space at the same rate as the employees and / or medical residents.
9.4. The on call shifts must end no later than 11:00 pm to allow a safe return home and public transportation for all clinical clerks.
Psychological support services
Psychological support services
Here is an overview of support services, psychological and more, available for medical students across the province.
The assistance program for physicians of Quebec is a non-profit organization whose mission is to provide assistance to physicians, residents, and medical students who are experiencing personal difficulties.
The Medical Faculty and the Office of Student Affairs offer counselling services specifically for medical students. In addition, the university offers all its students mental health support services and spiritual help. Finally, the Students and Residents Affairs website offers several resources for the well being of students.
The Medical Faculty is supporting a Medical Assistance Network, comprised of students in their pre-clerkship and clerkship, that offers individual guidance, and organizes activities as well as conferences. The Board of Student Affairs also makes counsellors available that offer different services. Finally, the university also offers resources, psychological and others, available to all students via its student support center.
The AÉÉMUM supports the Support Network for Medical Students, which consists of students that are available to listen and to direct you to the appropriate services if needed, in absolute confidentiality. They also hold conferences on various topics. The Faculty of Medicine of the University of Montreal also offers the Support Office for students and residents who are experiencing psychological, financial, personal, academic or other problems. In addition, the university offers, via the SAÉ, a health clinic and psychological counselling for all its students.
In addition to the university services, which are open to all students (located at the main campus), the Faculty of Medicine and Health Sciences offers a student-life assistance service. Most teachers are also available to support students throughout their medical formation. They can be consulted confidentially for reasons of all sorts. The university also offers a counselling service for all its students. The AGÉÉMUS is currently working to make psychological counselling directly accessible at the Health Sciences campus.