Ontari Re-Entry Return f Service Qs and As 1) What are Return f Service (ROS) Prgrams? ROS prgrams ffer participants an pprtunity t partake in a ministry funded prgram in return fr a cmmitment t practise medicine in an eligible Ontari cmmunity. In the case f the Re-entry ROS prgram, participants are required t practise fr tw years in an eligible cmmunity in exchange fr pstgraduate medical training. Fr the Re-entry ROS, an eligible cmmunity is anywhere in the prvince f Ontari. 2) When and hw des my service begin? Service must begin within ne year after pstgraduate training has been cmpleted. If the participant is seeking additinal training r a fellwship, a deferral must be sught frm the Ministry f Health and Lng-Term Care (ministry) Fr service t cmmence, the participant must submit t the ministry a signed Practice Lcatin Agreement (PLA), which is an agreement between the participating physician, ministry and the practice cmmunity, which specifies the lcatin, and describes the terms and duratin f the ROS. The Practice Lcatin Agreement must be apprved by the ministry and als signed by an Agreed Representative(s). If a participant des nt begin returning service within ne year f cmpleting training, and the ministry has nt apprved a deferral (see questin 8), he r she will be cnsidered in breach f their cntract. 3) What service is eligible t cunt twards ROS? Only OHIP-insured services that are prvided n a full-time basis will cunt twards ROS. At the discretin f the ministry and with prir apprval, telemedicine services funded by the Ministry and prvided in an eligible cmmunity will cunt twards the ROS 1 P age
4) Are telemedicine services eligible fr ROS? Telemedicine services will be cnsidered fr ROS nly if these services are publicly funded and the participant can demnstrate that they are delivered t an eligible cmmunity. Please nte that nt all telemedicine services are OHIPinsured r publicly funded. Therefre any telemedicine prpsal will need t be cnsidered by the ministry prir t apprval. 5) Are academic appintments eligible fr ROS? Academic Appintments will be permitted at the discretin f the ministry and in specific circumstances. Physicians must demnstrate that 20 hurs f full time service per week will cnsist f clinical care that will be delivered in an eligible cmmunity. Requests fr the apprval f academic appintments must be accmpanied by: 1) A letter f appintment by the university clearly stating that 20 hurs f the appintment will be in clinical service in an eligible cmmunity; and 2) A PLA signed by an Agreed Representative f bth the university and the hspital where service will be returned. Please cntact the Prgram Officer by email at: PPUPrgramOfficer@ntari.ca fr additinal infrmatin r if yu have any questins. 6) Are ROS physicians permitted t apply fr fellwships? If a ROS physician is still in residency, he r she may apply fr a fellwship t be cmpleted after his r her training. Fellwships are cnsidered additinal training and thus d nt cunt twards the ROS bligatin. Physicians must seek a deferral f their ROS bligatin prir t cmmencing their fellwship training. Once a physician has cmpleted the fellwship, he r she must fulfill his r her ROS bligatin in the specialty r sub-specialty in which he r she received training. 7) Can exceptins be made t where ROS service is prvided? At the discretin f the ministry exceptins may be made nly in exceptinal circumstances; hwever, requests fr exceptins will be reviewed n a case-bycase basis and nly with the required dcumentatin and prir apprval f the ministry. 2 P age
8) What if I am unable t return service? The ministry recgnizes that circumstances may arise which can make it challenging fr participants t fulfill the terms f their ROS Agreement. These circumstances include a lack f emplyment pprtunities in a specialty within an eligible cmmunity; injury, illness r disability; r maternity/parental leave. In these instances, the fllwing tw ptins are available: a) Seek a deferral f ROS; r b) Repay csts incurred by the ministry. If participants cannt meet their ROS bligatin, it is their respnsibility t infrm the ministry by cntacting the Prgram Officer by email at: PPUPrgramOfficer@ntari.ca. There are substantial resurces and supprt fr physicians seeking emplyment, including the HealthFrceOntari Marketing and Recruitment Agency s Practice Ontari service. Practice Ontari is a free career-planning service fr pstgraduate medical residents that cnnects trainees with a persnal career advisr, knwn as a Reginal Advisr. The Reginal Advisr is a health human resurces expert with a wide prfessinal netwrk in Ontari s health-care sectr. 9) What if I have a disability and require special accmmdatin in rder t return service? When verified with the requisite dcumentatin, accmmdatins will be made in cmpliance with applicable legislatin. 10) What is the penalty fr breaching the ROS Agreement? If a participant breaches the ROS Agreement it terminates, subject t the ministry s discretin, and the participant must repay an amunt generally cnsisting f: The ttal amunt f training csts; Administrative csts; and Interest accrued n the ttal repayment amunt. Individuals in breach f the ROS Agreement must pay the amunt wing in full. Hwever, the ministry is cmmitted t balancing the fiscal respnsibility t Ontarians and will seek a reslutin that des nt cause undue hardship. The ministry may at its discretin prvide individuals with payment alternatives, such as a repayment schedule r an installment plan accrding t the debtr s financial capacity. 3 P age
11) Are individuals wh never cmpleted their pstgraduate training required t pay back their training csts? Yes. Any participant wh des nt cmply with the terms f the ROS Agreement is in breach. This includes participants wh d nt cmplete r have failed their residency training, including thse wh d nt pass their Assessment Verificatin Perid. These individuals are required t repay csts incurred by the ministry related t their pstgraduate training. 12) What happens if I g n maternity/parental leave during my ROS? A participant wh takes maternity/parental leave can request a deferral f his r her ROS. Once the participant returns t full-time practice, the ROS perid recmmences. Maternity/parental leave des nt cunt tward ROS. 13) Can my debt be reduced if I partially cmplete ROS? If an individual has partially cmpleted their ROS, upn request, the ministry will cnsider reducing the repayment amunt in prprtin t the length f service cmpleted. 14) What happens if a participant develps a medical issue r disability that prevents her r him frm fulfilling the ROS requirement? A participant wh requires a medical leave due t injury, illness r disability can request a deferral f the ROS fr up t ne year at a time. The deferral perid des nt cunt tward the ROS. 15) What if I transfer utside f Ontari t pursue a subspecialty? Residents with ROS bligatins may pursue sub-specialty training in Ontari r elsewhere in Canada. Fr thse matched t a psitin in Ontari, the existing ROS Agreement will carry frward t the sub-specialty training prgram and the participant will cmmence ROS fllwing the cmpletin f the sub-specialty prgram. Thse matched t a psitin utside f Ontari must cmmit t return t Ontari t return service in accrdance with their agreement upn cmpletin f the subspecialty training. They must submit an undertaking (letter) frm the ther prvince that any return f service in that prvince related t the sub-specialty training will be deferred until after the participant has cmpleted their ROS in Ontari. 4 P age
16) Where can I get further infrmatin? Enquiries regarding this dcument can be made t the ministry s Physician Planning Prgram Officer at: PPUPrgramOfficer@ntari.ca. 5 P age