Can you actually 'pay-off' your Return of Service contract...?

[Blitz2006]

So I'm looking through this link that Giemsa posted...

http://www.carms.ca/eng/r1_eligibility_prov_e.shtml

The only province that specifies a $ value for getting out of Return of Service is NFLD ($5K/month)...or 300K for a 5 year residency.

Does anyone know about other provinces, like Ontario or Nova Scotia charge to escape the RoS? Is it also around 300k?

Is it just a matter of giving these guys a big sum of cash...?

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[Giemsa]

Does anyone know about other provinces, like Ontario or Nova Scotia charge to escape the RoS?

Depends on what the contract says. If the contract says you can, then you can. Otherwise, don't count on it. Read your contract carefully.

For example, the most recent Ontario ROS contract that I could find says:

If you do not fulfill the service requirements identified in your return of service agreement you will be required to repay costs associated with your training or assessment position. These costs are identified in your agreement and may include:
• Salaries and benefits that you earned while in a funded training position
• Training costs associated with your position
• Administrative (e.g. exam and evaluation) costs that enabled you to access the position you accepted
• Stipends paid to you
• Interest

Note that salary alone (excluding all other items listed) for a 5-year residency is in excess of $300K. I would be very wary of "training costs associated with your position" - what exactly does that mean?

 

[med2UCC]

Nova Scotia lets you buy out. Not sure of the amount, but when I did my residency I was told it would be $5,000.00 per month of residency, so $120,000.00 for my contract. One of my colleagues did it last year. Cheers,
M

 

[Arb]

In Ontario, your ROS can be fulfilled anywhere outside Toronto and Ottawa. That's a big change in a short period time. When you go through the process, you'll find out the ROS is not so strict. If an academic program wants to hire you, the ROS will not be an issue so you do have a chance to work in Toronto. By the time you go through the match, there may not even be a ROS. Also, with the work hour regulations, programs will have to hire more residents in the coming years. Good news for IMGs hopefully.

 

[Giemsa]

In Ontario, your ROS can be fulfilled anywhere outside Toronto and Ottawa.

Do you have any references for this?

By the time you go through the match, there may not even be a ROS.

Based on what?

Also, with the work hour regulations, programs will have to hire more residents in the coming years.

What work hour regulations?

 

[Arb]

Reference is this year's ROS contract. I'm not sure where you can get an online copy. I assume you're at a major urban program so I'm sure you've met IMGs fulfilling/going to fulfill their ROS in highly desirable locations. The ROS is really not what it seems.

My (optimistic) prediction is based on current trends. In 3 short years, the ROS has changed from only communities north of the French River, to under-serviced communities, to any community not in Toronto or Ottawa. Large changes in THREE years.

Ontario will most likely adopt the 16 hour maximum work day for residents in June. Regardless if it becomes finalized, programs are already switching to the night float system in anticipation. The major issue is that residents will be stretched thin and the learning environment will become compromised. The proposed options are either hire hospitalists or more residents. Based purely on money issues, it will likely be more residents in my program. This is U of T so if they can't afford option 1, then no program will.

 

[Giemsa]

Reference is this year's ROS contract.

A copy of Ontario's ROS is available online at carms.ca

It says:

Eligible locations for your Return-of-Service are those communities that are listed on the ministry's "List of Areas Designated as Underserviced" (LADAU). The list designates northern and southern communities for family physicians or general practitioners (LADAU for FP/GP), and designates northern communities for specialists (LADAU for SP).

If you've got a different copy that says you don't have to return service in underserviced communities, do post it.

My (optimistic) prediction is based on current trends. In 3 short years, the ROS has changed from only communities north of the French River, to under-serviced communities, to any community not in Toronto or Ottawa. Large changes in THREE years.

The current ROS contract I have still says LADAU communities only. Can you post what your copy says?

Ontario will most likely adopt the 16 hour maximum work day for residents in June. Regardless if it becomes finalized, programs are already switching to the night float system in anticipation. The major issue is that residents will be stretched thin and the learning environment will become compromised. The proposed options are either hire hospitalists or more residents. Based purely on money issues, it will likely be more residents in my program. This is U of T so if they can't afford option 1, then no program will.

I'm an attending (not Toronto); which programs at the U of T have switched to the night float system?

 

[Arb]

I think what you posted is the Repatriation Program which is different. Furthermore, the only document on carms.ca is from 2007 and a new one is drawn every year. Mine is dated "IMG Training 2010/11 Nov 3 10". The ROS in MY HAND for specialties states:

"Eligible Community" means any community in Ontario except the City of Ottawa and the Toronto area (defined as the City of Toronto and neighbouring municipalities of Mississauga, Brampton, Vaughan, Markham, and Pickering), in which the Participant has returned service, is returning service, proposes to return service, or is committed to returning service.

Maybe someone else will be able to scan and upload the latest contract for those interested.

 

[Giemsa]

I think what you posted is the Repatriation Program which is different. Furthermore, the only document on carms.ca is from 2007 and a new one is drawn every year. Mine is dated "IMG Training 2010/11 Nov 3 10". The ROS in MY HAND for specialties states:

"Eligible Community" means any community in Ontario except the City of Ottawa and the Toronto area (defined as the City of Toronto and neighbouring municipalities of Mississauga, Brampton, Vaughan, Markham, and Pickering), in which the Participant has returned service, is returning service, proposes to return service, or is committed to returning service.

This means that we could recruit these IMGs (we've got a rads spot to fill). I wonder why we didn't know about this . . . .

Which of the U of T residencies have switched to the night float system?

 

[Blitz2006]

Don't know if this is redundant info, but figured I'll post it anyways..

http://news.ontario.ca/mohltc/en/2010/03/increasing-the-availability-of-doctors-in-ontario.html

http://www.health.gov.on.ca/english/providers/program/uap/uap_hfo_ros.html


Hey Arb, do you know then about Ontario...as in, how to get out of RoS? Can you just pay off 60k/year like NFLD/Nova Scotia?

 

[jnuts]

This is the breech language in the current contractfor Ontario; so who knows if you can pay it off.

If you do not fulfill the service requirements identified in your return of service agreement you will be required to repay costs associated with your training or assessment position. These costs are identified in your agreement and may include:
• Salaries and benefits that you earned while in a funded training position
• Training costs associated with your position
• Administrative (e.g. exam and evaluation) costs that enabled you to access the position you accepted
• Stipends paid to you
• Interest

Don't know if this is redundant info, but figured I'll post it anyways..

http://news.ontario.ca/mohltc/en/2010/03/increasing-the-availability-of-doctors-in-ontario.html

http://www.health.gov.on.ca/english/providers/program/uap/uap_hfo_ros.html


Hey Arb, do you know then about Ontario...as in, how to get out of RoS? Can you just pay off 60k/year like NFLD/Nova Scotia?

 

[jnuts]

Likely its been a moot point thus far as there aren't that many Rad grads in Ontario (if any) with an ROS yet.

In classic MOHLTC style they announced the changes to the ROS in a press release without making the current contract holders sign a new contract. Here's the Ministry's current take on "under serviced":

http://www.health.gov.on.ca/english/providers/program/uap/uap_hfo_ros.html

The other funny thing about that web link is this line: "Under ROS commitments, physicians agree to work for a designated period of time in a particular location in exchange for a postgraduate training opportunity in Ontario."

I know I haven't agreed to any particular location; its just not in the current contract. It would be knid of amazing if they were expecting me somewhere I don't know about considering 1)I don't know when I'll be finished residency; 2)I haven't picked a sub-specialty and no orthopods are working without a fellowship; 3)There are no jobs that I know about for orthopaedic surgeons anywhere in Ontario anyway.

That kind of stuff is typical of how the MOHLTC has been treating these things. Should be fun to see how it all works out...

And I know the standard response to this type of stuff is "don't sign anything that you're not comfortable with" but my bottom line was that I didn't really have a choice. By the time they decided to give me a copy of the ROS contract, I'd already contracted to start my Residency through the CaRMS agreement because I'd already matched. That's a contract I entered into in July the year before I matched. And its not like in June they left me a lot of options to find other employment if I wasn't comfortable signing their standard form, non-negotiable contract.

This means that we could recruit these IMGs (we've got a rads spot to fill). I wonder why we didn't know about this . . . .

Which of the U of T residencies have switched to the night float system?

 

[UniqueDoc]

J nuts, please check inbox.

 

[Bingo2018]

Does anyone know what the training costs would be for a payout from ROS Ontario . (5 year PMR residency )
They recently updated the terms of ROS agreement .

 

[summergirl]

Edited due to misinterpretation

 

[summergirl]

Edited due to misinterpretation