As the representative voice of Ontario’s 3,500 medical students, the Executive of the Ontario Medical Students Association has voted to endorse the 2016 tentative Physician Services Agreement (PSA) between the Ontario Medical Association (OMA) and the Ontario Ministry of Health and Long Term Care (MOHLTC).
The Executive consulted a wide variety of information while determining this decision regarding the Physician Services Agreement. These sources included information and legal analyses from the Ontario Medical Association, Concerned Ontario Doctors, the Professional Association of Residents of Ontario, and OMSA’s own pre-existing analysis and understanding of the Physician Services Agreement and its impact on students. Both Co-Chairs of the Ontario Medical Students Association have been observers on the Board of the Ontario Medical Association and have seen the PSA’s development firsthand.
From our analysis of the PSA 2016, we encourage all OMSA members to support the tentative Physician Services Agreement 2016 for the following reasons:
- The 2016 PSA will create a bilateral working group between the OMA and the MOHLTC to ensure an evidence-based and consultative approach is taken when managing Ontario’s health human resources. Given ongoing student concerns regarding residency position allocations, and underemployment, medical student representation in the future of health human resources will be of crucial value to both the needs of the healthcare system and its medical students. OMSA will continue to collaborate with the MOHLTC and OMA to ensure medical students concerns are represented at these discussions. Moving forward, OMSA will represent students on the OMA and the MOHLTC’s own policy groups on health human resources planning. As was recently announced this week, the Professional Association of Residents of Ontario (PARO) will also be included on the bilateral committee, ensuring strong stakeholder engagement.
- The previously withdrawn contracts in non-high needs areas for Family Health Network (FHN) and Family Health Organization (FHO) practice models (team-based Family Medicine models that are typically the training setting for medical students and residents) will be restored to 2012 levels under the 2016 PSA. Income stabilization during the early years of practice will still be provided to FHNs and FHOs in high needs areas. This will enable new graduates of family medicine who have previously been unable to secure a FHN or FHO contract in their chosen area of practice to become eligible for these contracts.
- The MOHLTC has provided written assurances that any future modernizations, or cuts due to co-management associated with the PSA 2016 will not disproportionately impact new graduates and early career physicians as has been the case with programs like the New Grad Entry Program (NGEP). Furthermore, by restoring FHN/FHO contracts, NGEP no longer remains a concern for new graduates.
- The OMA’s hired legal team, Fasken Martineau, one of the premier law firms in this country has declared that this contract will not compromise the OMA’s Charter of Rights and Freedoms Challenge demanding binding arbitration as a future dispute resolution mechanism. The case is currently making its way through the courts. This PSA is a bridging contract that enables stability in healthcare system funding until a decision is rendered. Binding arbitration was not incorporated into this contract, but the Charter Challenge could later grant this right. In the interim, the system and physicians are protected from further unilateral reductions until a court decision is released.
Undoubtedly, this has been a challenging time for Ontario’s physicians, residents, and medical students. This contract, while controversial, offers stability to a strained healthcare system and an opportunity for physicians and government to develop shared solutions that both balance the budget and are acceptable to frontline physicians through a co-management process. As medical students, this is not news to us. In our training we are made well aware of the strains facing our healthcare system and the need for future physicians to fulfill a dual role as a care provider and a steward of the healthcare system.
With these assurances, OMSA believes that students can vote confidently in this contract without fear that their educational experiences, ability to secure a residency position, and future practice opportunities will be compromised. Conversely, voting against this agreement could potentially lead to less stability in healthcare funding, ongoing unilateral actions, difficulty securing permanent positions, and unpredictable human resource planning that lacks engagement with medical students.
Finally, we would like to underscore the importance of every medical student’s participation in this election. The Physician Services Agreement is a critical component of the future healthcare system that all medical students will inherit. It is therefore of utmost importance that every student takes the time to make an informed decision. Following the initial announcement of the tentative PSA, a Special Meeting of Council was scheduled for August 6, at which time the OMA Council would have voted on ratification of the agreement. Prior to this, a referendum was planned where all OMA members (including medical students) would have cast their votes for or against this agreement. However, the referendum was cancelled on Monday July 25th due to a petition that invoked Article 15:2 of the OMA’s By-Law No. 1. By invoking this article, the referendum has been cancelled and instead a general meeting of OMA membership will be called in the coming weeks, the details of which are yet to be announced.
For the time being, OMSA has created several documents including a FAQ providing additional detailed analysis of the PSA, and a summary of OMSA’s health human resources work over the past year along with the history leading up to this tentative PSA. As details become clearer around how the voting process will work in light of these significant developments, we will update you.
Thank you for your consideration and please do not hesitate to consult our attached documents or contact the Co-Chairs or your local VP External Affairs for further clarification regarding the PSA 2016.