APPENDIX 44 APPENDIX APPENDIX 4446 - University of Toronto ... 46.pdf · Section for LCME and Accreditation Services ... University of Toronto Faculty of Medicine postponed the September

April 14, 2010

Nick Busing Secretary, Committee on Accreditation of Canadian Medical Schools President and CEO, AFMC The Association of Faculties of Medicine of Canada 265 Carling Avenue, Suite 800 Ottawa, ON K1S 2E1

&

Dan Hunt LCME Secretary and Vice President, Section for LCME and Accreditation Services Assn. of American Medical Colleges 2450 N Street, NW Washington, DC 20037

RE: Status Report ‐ Mississauga Academy of Medicine, Faculty of Medicine, University of Toronto

Dear Drs Busing and Hunt:

I am pleased to be able to provide you with this Mississauga status report in follow‐up to your July 3, 2008 request. Accompanied by the completed Expanded Branch Template for the Mississauga Academy of Medicine, this report will provide an update on the construction of the Health Sciences Complex, an overview of the Mississauga Academy of Medicine’s planned curriculum (with detailed description of the first two years) and an assessment of the adequacy of student support services.

Background: The Mississauga Academy of Medicine of the University of Toronto, Faculty of Medicine, with 54 first year students, will open in September 2011. As communicated to you in a July 21, 2009 e‐mail, the University of Toronto Faculty of Medicine postponed the September 2010 opening of the Mississauga Academy of Medicine until confirmation of funding was received in writing from the Ministry of Training Colleges and Universities and the Ministry of Health and Long Term Care for the capital and operating costs for the Mississauga Academy of Medicine (see Health Sciences Complex – Capital Cost and Funding table in the Expanded Branch Template for the Mississauga Academy of Medicine). Given this postponement, the original status report deadline of May 1, 2009 was amended to May 1, 2010, and recently adjusted to April 15, 2010 at your request.

A P P E N D I X 4 4APPENDIX 44APPENDIX 46

Status Report – Mississauga Academy of Medicine, Faculty of Medicine, University of Toronto

2 | P a g e

1. Health Sciences Complex

The Health Science Complex, a $36 million, 4‐storey building, is currently under construction on the University of Toronto Mississauga campus. This building will house the Mississauga Academy of Medicine and will provide the majority of the teaching and learning space for the first two years of the curriculum and includes dedicated student space, two 60 seat lecture theatres, multiple large and small group learning classrooms, a video‐conferencing studio, an anatomy study laboratory and offices for faculty and support staff. To date, 100% of the excavation, basement and waterproofing work have been completed with 85% of the concrete structure and site servicing remaining. The structure is scheduled to be complete by May 31, 2010 (see Appendix 8 ‐ Detailed Health Sciences Complex Status Summary the Expanded Branch Template for the Mississauga Academy of Medicine). The building will be ready for initial staff occupancy in June 2011 and fully operational by the end of July 2011, one month before classes are scheduled to begin.

2. Overview of Planned Curriculum (including detailed Year 1&2)

The undergraduate medical education (MD) program at the Faculty of Medicine, University of Toronto spans four years.

The students enrolled in the Faculty of Medicine, University of Toronto and assigned to the University of Toronto Mississauga campus and the Mississauga Academy of Medicine will receive the same curriculum as the students assigned to the St. George campus. This curriculum is outlined in full detail in the attached template. The preclerkship years 1 and 2 provide the necessary foundational biomedical and humanistic knowledge and skills, and appropriate professional attitudes that enable students to have a successful experience in their clerkship program and beyond.

During the clinical clerkship (years 3 and 4) the knowledge, skills and professional attitudes introduced in the preclerkship are applied in the practical context of the clinical setting where students participate as members of a working health care team. As clinical clerks, students learn to master patient care, both within the environment of the hospital and on an out‐patient basis at community‐based clinics and doctors’ offices.

A. Plan for Implementation of the Curriculum at the Mississauga Academy of Medicine

As an essential principle is to provide students at the Mississauga Academy of Medicine with a comparable program as the students receive at the St. George campus, the courses will have the same objectives, and students will be evaluated via identical assessment methods.

The curriculum will use varied instructional modalities outlined below:

Bedside clinical skills instruction for Art and Science of Clinical Medicine ‐ Students at the Mississauga Academy of Medicine will receive bedside teaching in groups of 4‐ 6 students to one/two tutors. Both specialist and generalist physician tutors are currently providing this course to current medical students, in the Mississauga hospitals (Credit Valley Hospital and Trillium Health Centre) and the experience of these students has been excellent, with the number of students receiving this course in Mississauga increasing


3 | P a g e

each year to build the capacity required for 2011. Next year there will be 42 students in year 1 and 18 students in year 2 receiving this clinical skills course in Mississauga.

Problem‐based learning tutorials ‐ The PBL tutorials and other small group learning will be housed at the University of Toronto Mississauga campus. These will be delivered in the same manner as at the St. George campus, in groups of 6 – 9 students, facilitated by a variety of clinicians, both generalists and specialists/ subspecialists.

Large group lectures. Videoconferencing will be used to deliver the same lectures to the students at the St. George campus and the University of Toronto Mississauga campus. The lectures will also be captured digitally to facilitate student viewing at later occasions. A minimum of 20% of lectures will originate at the University of Toronto Mississauga site.

Seminars ‐ These are case‐based sessions delivered to groups varying in size from 20 – 30 students, and are led by content experts. This teaching modality has been successfully piloted at the Mississauga Academy of Medicine already, and will occur at the University of Toronto Mississauga site.

Determinants of Community Health (DOCH) tutorials in year 1‐ Physician and allied health facilitators will lead small groups of 8 – 10 students at the Health Science Complex.

Field visits during DOCH ‐ These will be scheduled in Mississauga schools and at Mississauga community agencies in the same manner as currently occurs in Toronto.

Gross anatomy laboratories ‐ Dissection will take place in the anatomy laboratories at the Medical Sciences Building on the St. George campus during the 16‐week Structure and Function course. Travel will be facilitated and the students from the Mississauga Academy of Medicine will be scheduled into dissection groups together, and their schedule will be arranged to avoid rush hour traffic for the 22 scheduled sessions. A study and review laboratory with prosections and other anatomy resources is available at the Health Science Complex at University of Toronto Mississauga.

3. Student Services Assessment

All University of Toronto medical students have access to the services of the Faculty of Medicine Office of Health Professions Student Affairs. Students based at the Mississauga campus will have equivalent access and opportunities to these services as the St George campus‐based students. Timely triage of students’ needs will be provided by the Office of Health Professions Student Affairs counselors and students will be linked with the appropriate resources.

Services include personal/wellness counseling, career counseling, learning/study counseling, advocacy and general student support. Services in all of these domains will be provided on site for the Mississauga Academy of Medicine students and by webcast, linking the St George and University of Toronto Mississauga campuses. These are described in greater detail in the attached template.


4 | P a g e

In addition to the Faculty of Medicine Office of Health Professions Student Affairs, the University of Toronto Mississauga campus is a full service comprehensive University campus and has a Health & Counseling Centre that provides health care services to all students at University of Toronto Mississauga, including Mississauga Academy of Medicine students.

Regards,

Jay Rosenfield, MD, MEd, FRCPC. Vice Dean, Undergraduate Medical Education Faculty of Medicine, University of Toronto Cc: Catharine Whiteside, Dean, Faculty of Medicine

Encl: 1. Mississauga Academy Of Medicine ‐ Expanded Branch Template

Mississauga Academy of Medicine Template for Reporting New/Expanded Branch Campus

In submission to:

Committee on Accreditation of Canadian Medical Schools (CACMS) and

Liaison Committee on Medical Education (LCME)

Template for Reporting New/Expanded Branch Campuses Page 2

Template for Reporting New/Expanded Branch Campuses to the Liaison Committee on Medical Education (LCME) and, for Canadian Medical Schools, the Committee on

Accreditation of Canadian Medical Schools (CACMS) -------------------------------------------------------------------------------------------------------------------------- This template should be completed by schools planning to create a new branch campus or expand an existing campus, whether or not the result will be an overall increase in class size. If you are planning an increase in class size that includes sites in addition to the new/expanded branch campus (such as at the main campus), you will need to complete relevant portions of the “Template for Reporting Class Size Increases.” Consult with the LCME Secretariat for more information on how to report this situation. Description of Plans for Branch Campus: (including the curricular years for which the campus will be used) Description of Plans for Branch Campus:

Mississauga Academy of Medicine, Faculty of Medicine, University of Toronto (UT)

INTRODUCTION The Mississauga Academy of Medicine (MAM), scheduled to open in September 2011with 54 students in the first year (with a 4-year total enrollment of 216 by 2014), will be the fourth “Academy” of the University of Toronto (UT) Faculty of Medicine (FOM) undergraduate medical education (MD) program. It will build on the many positive attributes of the three academy system currently in place at the downtown St. George Campus of the UT FOM, which was recognized as an “institutional strength” at our last LCME/CACMS accreditation in 2004. The MAM will allow for further diversification of the largest medical school in Ontario and the expansion and integration of our MD program into a large suburban community campus. The MAM will be based at the University of Toronto’s Mississauga campus (known as the “University of Toronto Mississauga”, or “UTM”), and two major associated community hospitals. With a student body of 11,500 students, UTM is a full service university campus within the City of Mississauga (the sixth largest city in Canada with a population of more than 700,000) approximately 30 kilometers to the west of the St. George campus of the UT FOM in downtown Toronto (see maps below). Students will have access both to the comprehensive services offered to the whole UTM student body, and the specialized FOM services found both on the St. George campus and on site in Mississauga. Students will undertake their MD training both at the UTM, in the Mississauga community, and at the two large Mississauga hospitals, Credit Valley Hospital (CVH) and Trillium Health Centre (THC). The opening of the MAM will permit the development of a focused community-based clinical experience. The MAM will be fully open for students in September 2011. Building on the success of the current 3 academies (Wightman-Berris, Peters-Boyd and FitzGerald) at the UT FOM, it will accommodate 54 of the total 259 students registered in the first year of the MD program at the UT FOM in 2011.





While the undergraduate medical curriculum and all corresponding evaluations at the expansion campus will be the same as at the St. George campus, the MAM will be distinctive in relation to our existing academies, as it will be founded in primary association with 2 large comprehensive and complementary community affiliated teaching hospitals. Uniquely, students will remain in Mississauga for the first three years of the MD program and will very rarely need to attend lectures or seminars in Toronto at the Medical Sciences Building on the St. George Campus. This is a shared initiative between four partner organizations, the UT FOM (www.facmed.utoronto.ca), the University of Toronto Mississauga (www.utm.utoronto.ca), the Credit Valley Hospital (www.cvh.on.ca) and the Trillium Health Centre (www.trilliumhealthcentre.org), although it is clearly understood by all partners that the UT FOM will maintain its primacy as the foundation and governing base of the MD education program. The Academy will also capitalize on the ongoing growth of the City of Mississauga (www.mississauga.ca), UTM, CVH and THC. The City of Mississauga is a community which is ideally suited to the establishment of an undergraduate medical education program due to its diverse multicultural composition, its rich extracurricular opportunities and its emphasis on health as manifested through the “Healthy Cities” initiative (Healthy City Stewardship Centre). In December 2006, Mississauga won the World Leadership Award for its Healthy City Stewardship Centre. The UTM Campus will afford our students a healthy environment with access to green space, wellness facilities and interaction with a diverse and vibrant student body. Having undergone substantial development, with construction of approximately $200 million over the past ten years, the campus continues to grow with the construction of two new facilities, a $70 million Instructional Centre, and the $36 million Health Sciences Complex which will house the MAM. The hospital services (CVH and THC) will be described in more detail later in this template but both hospitals originated with strong community roots and continue to evolve due to the rapid population growth and demand for comprehensive care closer to home. Currently the hospitals are able to provide the full spectrum of medical care, including secondary and tertiary care to the majority of the population, as well as supporting the provision of primary care through family physicians or family health teams. There is a close integration between community based services and the acute care hospitals. These diverse clinical settings will provide MAM students with an ideal medical education environment. As a result of the creation of the new branch campus, the MAM quadrilateral partnership will allow expansion of the UT FOM class size, whilst preserving a lower learning density across the program (the downtown campus numbers will decrease to 205 students per year).

To complement the mission statement for the UT FOM which states that “We prepare future health leaders, contribute to our communities, and improve the health of individuals and populations, through the discovery, application and communication of knowledge” the four Mississauga Academy partners have developed the following additional vision and values to guide decision making for the expansion campus, whilst adhering to the vision and mission statements of the UT FOM.



Vision Statement of MAM To contribute to the health of our community, we will harness our collective strengths, innovations, energy and knowledge to create and sustain an outstanding academy of medical education.

Values of the MAM

Creative Thinking - The Academy will be creative in its approach to medical education and it will champion innovation and forward thinking. Embracing Excellence in Education – The Academy will have a solid foundation, traditions and reputation to build on as part of the University of Toronto FOM, UTM, Trillium Health Centre and Credit Valley Hospital. It will embrace the values of excellence, stemming from its four founding partners. Community and Patient Centered – The Academy will strive to educate and inspire physicians that provide the best patient care possible and it will be focused on improving the health and way of life for individuals and the community that they will one day serve. Supportive and Collaborative Learning Environment – The Academy will focus on providing its students and teachers with a strong network of mentorship making it a comfortable and open learning environment. The Academy will foster a community where through inter-professional interaction, a diversity of perspectives and flexibility in thought and collaboration are valued. Student Centered Learning – With leading educators and stimulating learning environment, the Academy will offer medical education of the highest quality ensuring long-term success in the field of medicine.

1. Proposed Number of Undergraduate Students

As previously reported to the LCME and CACMS, a total of 36 new student first year class seats were created through the Ontario Government Ministry of Training Colleges and Universities (MTCU) expansion plan announced in February 2006 (see timeline on next page). The current first year UT class size of 224 will be expanded to 250 beginning in academic year 2010-2011, and then will grow to 259 beginning with academic year 2011-2012. The expansion of undergraduate medical students will be accommodated through the creation of this fourth Academy. The CACMS and LCME have already reviewed and approved the UT class size expansion. The Mississauga Academy will have an enrolment of 54 students per year, comprised from the 26 expansion students originally allocated to the University of Toronto in 2005, and 28 of the additional 36 students noted above. Based on positive experience from the other FOM Academies, the figure of 54 students was deemed to be the optimal number for a community based Academy, in view of the teaching models employed at the University of Toronto medical school and the critical number appropriate for an exceptional student experience on par with the other Academies. Student entry to the Mississauga Academy will begin in the 2011/12 academic year with the first group of 54 students. The program will build over the subsequent three years so that all four years will be represented in Mississauga by 2014/15, as illustrated in Table 1. Thus, a total of 216 students will be designated to the Mississauga Academy once fully implemented.



Timeline of Mississauga Academy of Medicine Expansion Planning

26 new spaces /year allocated to UT from Provincial Ministry

(MTCU)

Future expansion spaces allocated to MAM =26/year

November 2005

February 200610 of 18 additional

spaces/year allocated to UT from MTCU re‐allocated to future

MAM

Future expansion spaces allocated to MAM

=36 /year

18 additional new spaces /year allocated

to UT from MTCU

Future expansion spaces allocated to MAM = 54/year

July 2009

September 2011‐September 201454 (26 +10+18)

students will begin studies at the MAM

each year until September 2014

Total 4 Year MAM enrollment = 216

a. How Will Students Be Assigned To The Branch Campus?

For the 2011 admission cycle, the University of Toronto MD program admissions process will not be changed with the inclusion of the Mississauga Academy of Medicine but rather, a new parallel campus assignment process (St. George Campus-current three academies; or Mississauga Campus-MAM) will be instituted. Although the admissions and campus assignment will proceed in a parallel fashion, they are independent and distinct from each other. At each admissions interview day, St. George campus and Mississauga campus representatives (both faculty and students) will present to applicants each campus’ strengths, including campus and associated academies, teaching/learning environment and surrounding community. Post interview days, applicants will designate either the Mississauga or St George campus, or no campus preference, and a campus preference list will be established. The admissions process will be completed as usual and our admissions rank order list established. As noted, the admissions rank order list will be completed separate from the campus preference list. The Admissions Committee will decide on the number of initial offers to be made based on the rank order list only, and the initial admissions offer list will only then be merged with the campus preference list to maximize students’ campus preferences as much as possible.

Each student’s admissions offer will read University of Toronto, ‘x’ campus. An acceptance to the Mississauga campus will de facto be an assignment to the Mississauga Academy at the time of admission.



Assignment to the Mississauga Academy of Medicine or to the St. George Campus will be for the first three core foundational years of medical school to enhance the community integrative experience of the MAM. The fourth year curriculum is largely elective or selective, and it is anticipated that many students will choose a variety of locations for these experiences. In exceptional circumstances, students who are dissatisfied with their campus assignment, or for compelling academic or other personal/health reasons may request reassignment with such matters adjudicated on a case by case basis as is done currently for our existing three academy assignments.

Mississauga Academy faculty will be provided with faculty development with respect to the admissions process in preparation for their involvement in the 2011 admissions process. Mississauga Academy faculty representation will be incorporated into the medical school admissions committee beginning this year. Several groups of medical students in our Years I and II clinical skills course are currently receiving their training at CVH and THC, as they do in other community hospitals. As well, opportunities for clerkship rotations in targeted areas in Mississauga have already begun; Emergency Medicine (2006), Family and Community Medicine (2008), and Paediatrics (2009). Other areas will be piloted prior to official MAM Year 3 clerkship in 2013. This ramping up prior to the official opening of the Academy with its full complement of students on site in 2011 has allowed CVH and THC to become familiar with our curriculum and students, and begin to recruit clinical faculty as teachers.

Table 1: Roll-out of Undergraduate Students to Mississauga Academy

Curriculum

Year Number of Students Enrolled at the Branch Campus During Each

Academic Year (start with the first year you plan to enroll students) 2011-2012 2012-2013 2013-2014 2014-2015 First Year 54 54 54 54 Second Year 54 54 54 Third Year 54 54 Fourth Year 54 Total 54 108 162 216

CURRICULUM AT THE BRANCH CAMPUS

Curriculum Structure and Delivery a. Will the curriculum at the branch campus be the same as or different from that on the

main campus? If different, please describe.

The undergraduate medical curriculum and all corresponding evaluations will be the same as at the St. George campus. A description of that curriculum and its implementation at the MAM follows below:



The Undergraduate Medical Education program at the Faculty of Medicine, University of Toronto spans four years. Years 1 and 2 constitute the preclerkship, while years 3 and 4 are the clerkship. The preclerkship as it currently exists consists of two types of courses; block and longitudinal, diagrammed in the figure below:

(Year 1) Preclerkship Schedule Sept Oct Nov Dec Jan Feb Mar Apr May

Structure and Function 16 weeks

<~ ORIENTATION

Metabolism and Nutrition 10 weeks

Brain and Behaviour 10 weeks

Art and Science of Clinical Medicine 1 (ASCM-1) - Hospital 4 hours/weeks

Determinants of Community Health 1 (DOCH-1)–Medical Science Building/Community 4 hours/week

(Year 2) Preclerkship Schedule

Sept Oct Nov Dec Jan Feb Mar Apr May Mechanisms, Manifestations and Management of Disease

36 weeks Art and Science of Clinical Medicine 2 (ASCM-2) - Academy/Hospital

4 hours/week Determinants of Community Health 2 (DOCH-2) - Community

4 hours/week

There are two longitudinal courses that run throughout the two years. Each of them is scheduled for one half-day per week. During Art and Science of Clinical Medicine (ASCM), students learn skills of interviewing, history-taking and physical examination, almost exclusively at the bedside in groups of six. In Determinants of Community Health (DOCH), first year students learn about the determinants of health, population health, the structure of the health care system, health promotion and occupational and environmental health. The instruction consists of a mixture of lectures, small group tutorial sessions and field visits to schools and community health agencies. In second year DOCH, students complete a research project on a community health topic.

The remaining courses are referred to as “block” courses. In first year, the first block course is called Structure and Function (16 weeks), in which students learn aspects of gross anatomy, histology, embryology and some aspects of physiology (cardiovascular, respiratory, blood) via a mixture of lectures, seminars and laboratories, with approximately 20 hours of scheduled time per week. Metabolism and Nutrition follows in the next 10 week block, and addresses genetics and biochemistry, together with the physiology, biochemistry, histology and pharmacology of the renal, gastrointestinal and endocrine systems. The instruction is a blend of lectures, seminars and problem-based learning tutorials with approximately 12 hours per week of scheduled time. The final block of 10 weeks is Brain and Behaviour that addresses all aspects of neuroscience (neuroanatomy, neurophysiology, clinical aspects of nervous system disease, neuropharmacology), via lectures and small group teaching as well laboratories. Ethics is taught throughout the preclerkship via lectures and seminars, as is pharmacology. There is a 2-week block of pharmacology teaching at the end of the Brain and Behaviour block.



In second year, the single block course, Mechanisms, Manifestations and Management of Disease (36 weeks) presents integrated teaching of pathobiology of disease, clinical reasoning, diagnosis and treatment. The teaching in this second year block course will continue to use a mixture of lectures, seminars and PBL tutorials for approximately 17 hours of scheduled time per week. Plan for Implementation of the Preclerkship Curriculum to the Mississauga Academy of Medicine The students at the MAM will receive the same program of instruction as delivered to the students at the St. George campus. Students will study exactly the same courses, are governed by the same objectives, and will be evaluated by the same methods including identical written examinations, OSCE’s and other written submissions. The discussion below is centered on instructional modalities. Bedside instruction for Art and Science of Clinical Medicine: Students at MAM will receive bedside teaching in groups of, at most, 6 students to one tutor. As noted earlier, both specialist and generalist tutors are currently providing this course in the Mississauga hospitals and the experience of the current students is a proven success, with the number of students receiving this course in Mississauga increasing each year to build the capacity required for 2011. Problem-based learning tutorials: The PBL tutorials will be housed at the UTM campus. These will be delivered in the same manner as at the St. George campus, in groups of 6 – 9 students, facilitated by a variety of clinicians, both generalists and subspecialists. Where possible, the teacher will be assigned to facilitate cases where the content is relatively close to the teacher’s clinical domain of interest. Large group lectures: Videoconferencing will be used to deliver the same lectures to the students at the St. George and the UTM campuses. All lectures are currently videotaped and digitally archived with corresponding power point presentations to facilitate student viewing at later occasions. A minimum of 20% of lectures will originate at the UTM site, reflecting the proportion of the total class at the MAM. Seminars: These are case-based sessions delivered to groups varying in size from 20 – 30 students, and are led by content experts. This teaching modality has been successfully piloted at the MAM already. DOCH tutorials in Year 1: Physician and allied health facilitators will lead small groups of 8 – 10 students at the Health Science complex. Field visits during DOCH: These will be scheduled in Mississauga schools and at Mississauga community agencies in the same manner as currently occurs in Toronto. Gross anatomy laboratories: Dissection will take place in the anatomy laboratories at the Medical Sciences Building on the St. George campus during the 16-week Structure and Function course for all students at the MAM. Travel will be facilitated and the students from the MAM will be scheduled into dissection groups together with their schedule arranged to avoid rush hour traffic for the 22 scheduled sessions. A study and review laboratory with prosections and other anatomy resources is available at the Health Science Complex at UTM, as well as faculty to advise.



b. Will the didactic portions of the curriculum at the branch campus be delivered solely by faculty on site, by faculty on the main campus (for example, by videoconferencing or other form of distance learning), or by a combination of on-site and main-campus faculty? (Describe, in general, how the content will be delivered) See above. Lectures will be attended by videoconference between the two sites. Initially a minimum of 20% of the lectures will originate in Mississauga. These will initially be delivered predominantly by St. George campus-based instructors, who have agreed to travel to Mississauga (or who already live in Mississauga) to do this lecturing. It is expected that some of the lectures in the program will be taken on by faculty members based either at the Mississauga hospitals or the science departments at the UTM campus. Lecturers will be available for students questions afterwards, both on site as appropriate, and via private email, and discussion board forums. Tutorials will take place on site at the UTM campus delivered by physicians from the Mississauga hospitals for the problem-based learning tutorials and by family physicians from the Mississauga hospitals together with hospital-based allied health staff for the tutorials in the Determinants of Community Health-1 course. Seminars will also take place at the MAM in the majority of courses. These will be led by teachers working in their areas of expertise, and they will be either clinicians from the Mississauga hospitals or basic science faculty members from the UTM campus. These seminars will occasionally be supplemented by videoconferencing where most appropriate.

c. Describe, in general, how students will be evaluated at the branch campus. Will the

methods to evaluate student performance at the branch campus be the same as at the main campus? How will grading for students at the branch campus be handled?

Student performance will be evaluated and graded using exactly the same standards, criteria, assessment methods and procedures as at the main campus. All students, regardless of campus designation will graduate with and receive the same UT FOM MD degree designation and certificate.

Curriculum Governance a. How will faculty at the branch campus be incorporated into the medical school committee

structure? Reporting to the Vice-Dean, Undergraduate Medical Education, the Mississauga Academy of Medicine Academy Director (recruited in 2006 - Dr. Pamela Coates) is a member of all major undergraduate committees (see table below) , including the Undergraduate Medical Education Curriculum Committee, the Undergraduate Medical Education Executive Committee, the Preclerkship Committee, the Clerkship Committee and the Committee of Academy Directors. The Preclerkship Director and the Clerkship Director of the UT FOM, and corresponding curriculum committees will continue to oversee the curriculum for courses for all 259 students.

The Preclerkship and Clerkship will each have a Mississauga-based curriculum leader who will assist in the implementation of curriculum, the development of the faculty and the development of teaching methods and strategies which are adapted to a community affiliated hospital



environment. Each course will have a site coordinator who will be a member of the central course development committee for that course and is chaired by the FOM course director who has the ultimate responsibility for each course and will ensure equivalency

Mississauga Academy of Medicine Representation on UT Faculty of Medicine, Undergraduate Medical Education Committees

Committee MAM Representation

1. UME Executive Committee • Academy Director

2. Student Curriculum Evaluation Committee • Student Representative

3. Mississauga Academy Steering Committee • Academy Director

4. UME Curriculum Committee • Academy Director

5. Academy Directors Committee • Academy Director

6. Curriculum Evaluation Committee • Mississauga faculty member

7. Preclerkship Committee • Academy Director • Preclerkship Curriculum Leader

Course Committees: • Site Coordinator for each course

Theme Committees: • Site Coordinator for each theme

8. Clerkship Committee • Academy Director • Clerkship Curriculum Leader

Course Committees: • Site Coordinator for each course

Theme Committees: • Site Coordinator for each theme

9. Examinations and Student Assessment Committee • Mississauga faculty member

10. Admissions Committee • Mississauga faculty member



Undergraduate Medical Education – Faculty of Medicine Committee Structure

Office of the Vice‐Dean, UMEFaculty of Medicine, Undergraduate Medical Education

UME Curriculum Committee

Academy Directors Committee

Curriculum Evaluation Committee (CEC)

Preclerkship Committee+(Course and Theme sub‐committees)

Clerkship Committee+(Course and Theme sub‐committees)

Examination and Student Assessment Committee (ESAC)

Admissions Committee

UME Executive Committee

Mississauga Academy Steering

Committee

Student Curriculum Evaluation Committee

(SCEC)

The overall operations of the MAM are managed through the Mississauga Academy Steering Committee (see Appendix 1.A) which reports through the existing committee structure of the Faculty of Medicine, as outlined in the diagram below:



Mississauga Academy Steering

Committee

Faculty of Medicine

Committees

Medical Advisory

Committee (CVH)

Senior Management

(CVH)

Academic Partnership Steering Committee

President/ Vice-

President Committee

Medical Advisory

Committee (THC)

Academic Committee Structure (as of December 2, 2009)

Narrative: This is a committee reporting structure Mississauga Academy Steering Committee (MASC) – provides overall governance and coordination for the Mississauga Academy of Medicine Reports to: UTM,FOM,CVH,THC

Legend: University committee Academic Committee Trillium Health Centre Committee (THC) Credit Valley Hospital Committee (CVH)

Medical Education

Medical Education

(THC) (CVH)

(See Appendix1.A-D for major committee terms of reference) b. How will the curriculum at the branch campus be managed?

• If the curriculum is the same as at the main campus, how will comparability of educational experiences and methods of evaluation be assured?

As the educational components at the Mississauga Academy will follow the MD curriculum of the FOM it is anticipated that the experience will be similar. Identical instruments will be used for all student assessment modalities, including all in-course oral and written examinations, progress tests, and OSCE’s. As well, all MD program students at the UT will complete the same extensive course and program evaluation surveys, and evaluation of teachers. This process will allow for the continuation of current practice of comparative analysis across sites to monitor and ensure that the experience is equivalent at all the academies. Academy Directors and Course Directors will also conduct focus groups to allow an opportunity for further qualitative evaluation, to ensure comparability of student experience. • If the curriculum at the branch campus is a separate curriculum track, how will the

ultimate authority of the medical school’s chief academic authority be assured?

Not applicable



RESOURCES FOR THE EDUCATIONAL PROGRAM Only complete the sections below that are relevant to the educational program at the branch campus. Complete all relevant sections, even if instruction has been ongoing at an existing branch campus.

Educational Facilities a. Complete the following table describing the educational space used for required courses in

the pre-clerkship curriculum, expanding the number of rows as necessary:

St. George Campus – Medical Sciences Building (renovation of existing facilities completed)

Type of Room1 Seating Capacity Main Educational Use(s)2 Lecture Theatre 250-seat 1st-Year Lecture Lecture Theatre 250-seat 2nd-Year Lecture Laboratory 32-station Anatomy Dissection Small Group 32-seat Small Group Teaching Studio/Meeting Room Videoconferencing Helpdesk Computing Helpdesk Video Control Room IT Workshop, and Equipment

Transfer Facilities Staff Offices Academic Computing

University of Toronto Mississauga Health Sciences Complex (currently under construction – to be completed June 2011)

Type of Room1 Seating Capacity Main Educational Use(s)2 2 Lecture Theatres 60-seat Lecture 6 Classrooms 30-seat Lecture/Seminar 12 PBL/Seminar Rooms 12-seat Seminar/Small group Student Lounge 25-seat Student Study Room 10-seat 1 Student Mail Room Student Lockers 1 Office (storage) Medical Society (students) 5 Offices Academy Director, Site Director for

DOCH, visiting faculty 6 Administrative offices, support rooms

office support, storage, archives, mail, reception, meeting room etc.

Studio/Meeting Room Videoconferencing

Helpdesk Computing Helpdesk Video Control Room Server Room, IT Workshop, Storage,

and Equipment Transfer Facilities Computing Services UTM Computing Services Staff Area



Outside of Mississauga Academy Cluster 3 Laboratories Research Laboratories and Support

Rooms 3 Faculty Offices Faculty Offices

University of Toronto at Mississauga Shared Services Type of Room1 Seating Capacity Main Educational Use(s)2 2 Offices Student Affairs Testing Facility for Students Requiring Accommodations

Office Library Information Specialist (within Academic Learning Centre)

Study/Resource Student Study/Resource Area (within Academic Learning Centre)

Credit Valley Hospital and Trillium Health Centre (new construction and renovation of existing facilities)

Type of Room1 Seating Capacity Main Educational Use(s)2 2 Classrooms.

30-seat Videoconferencing connections for small groups

6 PBL/Seminar Rooms 12-seat Seminar/Small group Patient Simulation Rooms 6-per hospital Central Observation Room 1 per hospital Patients' Waiting Room 1 per hospital "On-Call" Room(s) 18 in each hospital Computer Laboratory 10-station dedicated

- per hospital

Student Lounge 25-seat - per hospital Student Study Room 25-station -per

hospital

Student Mail Room 1 per hospital Student Locker Room 1 per hospital IT Office/Support In each hospital Offices In each hospital Academic Administrators Office (shared) 1 per hospital Visiting Faculty Offices In each hospital Administrative, office support,

storage, archives, mail, reception

1Lecture hall, multidisciplinary lab, conference room, small-group discussion room, etc. If several rooms of similar type and seating capacity are used, simply indicate the total number of such rooms in parentheses. 2Lectures, small-group discussion, dissection, slide study, wet lab, simulations, clinical skills practice or testing, etc.



b. Provide a brief narrative assessment of the adequacy of other physical facilities, including library resources, information technology or services, clinical skills learning and evaluation areas, and study space to accommodate the number of students at the branch campus.

(a) Lecture facilities In the Preclerkship, lectures will not be duplicated, but instead, will be videoconferenced between Mississauga and Toronto. A typical week would contain 9 hours of lectures. At opening, 80% of lectures will originate in Toronto and 20% in Mississauga. Ongoing evaluation will assess the need to adjust this ratio to provide for the best student experience. The University of Toronto FOM currently makes auditory capture with accompanying slides of all lectures available to students. Extensive consultations and high level planning between the Discovery Commons (the FOM home for administrative and academic computing) personnel at the UT FOM, and counterparts at UTM, CVH and THC have taken place over the past years, to ensure a successful outcome of on-going and future videoconferencing links and other shared IT initiatives. Videoconferencing is currently being used successfully for administrative meetings between the sites. The Trillium Health Centre (see Appendix 2.A) and the Credit Valley Hospital (see Appendix 2.B) have signed community affiliation agreements with the UT FOM. Use of educational technology, for example, videoconferencing of lectures, learning management systems, virtual microscope lab, will be optimized to reduce the need for duplicating or replicating lectures and selected seminars, and minimize student and faculty travel among sites. The new technology standards established by UT will be followed. On the St. George campus, both lecture theatres in the Medical Sciences Building (MSB) employed for the Preclerkship (one for each year, and each with priority booking by Undergraduate Medical Education) were extensively renovated in 2006. Both rooms are outfitted with state-of-the-art videoconferencing technology, featuring three screens (one to display the instructor, the second to display lecture materials such as slides or video presentations, and the third to display the class at the remote site). In the seating area, microphones will be located throughout the theatre so that students may interact with the lecturer and the students at both sites without leaving their seats. Each room also features the new University of Toronto standard teaching station, an electronic podium designed to be used easily by any instructor, with minimal training. In the Health Science Complex at UTM there will be two new lecture theatres, each with 60-seat capacity (see Appendix 3). These theatres, although available for use by UTM courses, will have priority booking by Undergraduate Medical Education to ensure that all Preclerkship lectures can be run simultaneously in Toronto and Mississauga. These rooms will have videoconferencing and other technology equivalent to the two MSB theatres. Furthermore, a dedicated connection between the two sites will minimize the risk of any disruption to sessions given by videoconference. A connection over the Ontario Telemedicine Network will be available as a backup network for videoconferencing.

The undergraduate medical curriculum is delivered in parallel at all academies. Lectures, seminars, PBL, bedside teaching, community experiences etc. are delivered at the same location in the curriculum plan. Clerkship course planning will meet the same core objectives and use the same evaluation methods. Under our present curriculum, large-group lectures at hospital sites are exceedingly rare.



Anatomy Facilities As the City of Mississauga is unable to accommodate cadaver storage, it was determined that all students – Mississauga Academy and otherwise – will receive anatomy instruction (gross dissection/labs) in Toronto, in the MSB. MAM student travel time will be minimized by scheduling laboratory study in such a manner to prevent the need for rush hour travel. There is adequate capacity at MSB to accommodate scheduling of the MAM students to attend some lectures and seminars in Toronto if necessary during the first 16 weeks of Year 1. The beginning of Year I will be the only time that MAM students are formally required to travel to the St. George campus. An additional anatomy teaching laboratory at the MSB and an extra associated small-group teaching room have already been constructed to accommodate the expanded class size. While all anatomy instruction will occur on the St. George Campus, students based at the Mississauga Academy will be able to study gross anatomy when they are at the Mississauga site. To accommodate this need, a gross anatomy laboratory suitable for storing and displaying pro-sected anatomical specimens is being constructed on the fourth floor of the UTM campus medical academy building. Anatomy faculty will be available to assist MAM students working with these on-site materials. In addition, there is an abundance of other resources to support student learning of anatomy, including digital media showing dissected specimens and radiological correlations. (b) Small-Group Meeting Rooms There are five basic categories of small-group instruction in our curriculum: anatomy dissection labs (the facilities for which were discussed above), seminars, problem-based learning (PBL) tutorials, community health tutorials, and clinical skills instruction. There are sufficient rooms for all small group teaching at the UTM campus building. Additional rooms for hospital-based small group teaching are also being constructed. • Seminars are currently conducted in groups of approximately 18-25 in both the teaching hospitals and the MSB in the Preclerkship and Clerkship (groups as high as 40 for the latter). No new facilities are required at the MSB, since there are 29 rooms available for this purpose, providing sufficient flexibility in booking alongside other users. For the rest of the undergraduate medical program, seminars will be conducted for the Mississauga Academy students in combination with the UTM campus and the partner hospitals, in groups of generally 18 (and in some cases of 27) for Preclerkship and 3-7 for Clerkship. At UTM, six new 30-seat classrooms are being built for this purpose. Two 30-seat classrooms are also being constructed at each hospital to satisfy seminar needs there. • Problem-based learning tutorials will take place at the UTM Health Sciences building in Preclerkship. There are 12 purpose specific rooms being constructed for these tutorials. • Community health tutorials will be accommodated within the 12 purpose designed 12-seat rooms within the new medical academy building at UTM. Given the smaller size of Clerkship seminars, these rooms will also be ideally sized for this purpose. When not in use for curricular activities, the rooms will be available for student group study and small meetings related to the Academy. Additional seminar rooms will also be constructed adjacent to clinical services at the hospitals.



• Clinical Skills Instruction is usually conducted in the hospital setting. As such, six patient simulation rooms, each equipped with an examination bed, sink, and other features designed to approximate a clinical office, a hospital inpatient room, and an emergency resuscitation room will be constructed at each hospital in Mississauga. Portable examination beds will also be available to be moved into the 12-seat rooms (or other spaces) at UTM when standardized patients are used. Significantly, the number of patient simulation rooms and 12-seat rooms that are planned are sufficient to permit running an Objective Structured Clinical Examination (OSCE) at any of the three sites of the Mississauga Academy. (c) Wet Lab Space The UT undergraduate medical education curriculum no longer has any wet laboratory component. Hence, no space or facilities considerations are necessary for this item. (d) Library Resources and Space All students at the University of Toronto, regardless of their home campus, have equal use of library holdings. As more resources – both journals and full-length books – become available online, all students will have increasing on-demand access. Resources that are only available in print can be transferred between campuses, should students or faculty be unable to retrieve them in person. The Hazel McCallion Academic Learning Centre opened in the fall of 2006 at UTM. Both CVH and THC have Health Sciences Libraries which make available print resources and a wide array of databases and full text online materials, some of which are unavailable through UTM such as relevant point-of-care e-resources. The Librarians at each location offer full library services including biomedical informatics support and training on literature searching, locating best evidence, and other critical skills. As members of the Health Science Information Consortium of Toronto, the Libraries can provide access to the shared resources of the Consortium. They can also facilitate access to UTM library resources for individuals affiliated with UTM. At CVH and THC, the health science librarians will be available to assist students with literature searching and the other necessary skills. As current members of the Health Science Information Consortium of Toronto, they are already connected to the extensive University of Toronto library collection in this area. (e) Clinical Skills Assessment Centres As noted above, patient simulation rooms and 12-seat classrooms are planned for use in clinical skills instruction and testing at both CVH and THC. Video cameras that capture and transmit clinical simulation sessions to a central observation area will be installed in each patient simulation room, permitting standardized assessment on par with the most advanced clinical skills testing centres elsewhere at the University of Toronto’s affiliated hospitals. Lockers, change rooms, and waiting rooms for standardized patients involved in assessment and teaching will also be constructed at each site.

(f) Information Technology and Computing Resources



Videoconferencing technology permitting remote delivery of lectures is discussed above, under “(a) Lecture facilities,” as is connectivity between all sites. Under the present curriculum, seminars and tutorials in the Preclerkship are designed as small-group learning, using identical materials for consistency. It is highly likely that some seminars and rotation-group lectures (for approximately 40 students) in the various Clerkship courses will be videoconferenced, both between the Mississauga sites and with the other teaching hospitals. Since rotation groups at each Mississauga hospital are expected to consist of only three or four students each, videoconferencing will reduce faculty time requirements and serve to equalize group size – and hence the learning experience – when appropriate. Consequently, teaching rooms at UTM, CVH, and THC will be constructed to allow for videoconferencing capabilities. The Ontario Telemedicine Network (OTN) has provided a comprehensive list of upgrades that would be of benefit for the MAM. Primary among these is a commitment to upgrade the transmission speed of the network between our Mississauga hospital partners and the University. They have also committed to improving the video-conferencing experience in other ways, including our ability to use a two-screen display rather than the current OTN standard of one screen (See Appendix 4). As hospital sites are further developing the integration of clinical and administrative services, the regional fiber network of Mississauga/Peel Region will be used to support this as well as medical education. This network will be available to augment the services provided by OTN. Aside from videoconferencing, other information technology initiatives are being introduced to benefit all students and enhance/ensure equality between sites. The latest developments in the area of library resources were discussed above (see “(e) Library resources and space”). In addition, the “Blackboard” internet portal has been introduced across the University of Toronto in autumn 2007, and has very effectively replaced the individual course websites and assorted security protocols and formats that have previously been employed in Undergraduate Medical Education. Students and faculty now access a single site that provides them with course materials, information, and discussion boards unique to their identity. Blackboard helps to ensure timely, equal access to course content and important notices, regardless of a student’s location. Similarly, the Medical Student Information System (MedSIS), deployed since autumn 2007, provides up-to-date web-based course timetables and evaluation opportunities for all courses.

Finally, computer and internet access will be assured for students regardless of site. A minimum of 10 dedicated stations will be available for students at each hospital. At UTM, close to 700 public-access computer stations – most of them available 24 hours a day, seven days a week – are already in place. Additional kiosks will be made available in the Health Sciences Complex. Moreover, wireless internet access is available in many locations throughout the three sites of the Mississauga Academy and will be extended to the new teaching spaces; it will also be provided in certain areas of the MSB, including the lecture theatres.

(g) General Study Space

No new study space will be required on the St. George campus of the University of Toronto, since the addition of 216 students in UME is minimal in the context of a total student population of almost 68,000. On the UTM campus, there is extensive student study space available in the Hazel McCallion Academic Learning Centre. Within the Academy cluster itself, students will have access to the 12-seat classrooms for group study when these are not in use for scheduled teaching. For informal study, a 25-seat student lounge will also be available. Other study space options are provided throughout the UTM campus. At the two hospitals, 25-seat study rooms



dedicated for use by undergraduate medical students will be constructed and, as at UTM, 12-seat classrooms and a 25-seat student lounge will allow for other study options.

Instructional Staff a. Complete the following table for each required course and clerkship offered at the branch

campus, expanding the number of rows as necessary. Include the number of staff that will be available when instruction begins in that course/clerkship. The Preclerkship course staffing and instructional responsibilities for the Mississauga Academy of Medicine can be found in the table below. The Clerkship schedule (See Appendix 5) has been used to create the recruitment plan which outlines current teaching and implementation of the full curriculum by 2013/2014 and 2014/2015 (See Appendix 6). There are clerkship rotations currently occurring in Mississauga in Emergency Medicine, Family Medicine and Paediatrics (in 2009-2010). Each year more clerkship rotations are developed with the recruitment of site coordinators and specialist faculty. The capacity of these rotations has also been steadily increased. As the 250 student 2010 entry class progresses through the 4 year curriculum capacity will continue to be developed in Mississauga in preparation for the 2011 entry class and the assignment of 54 students to the MAM.

Since there are several ASCM groups in place at present at the Mississauga Academy, recruitment for teachers in the Preclerkship is already occurring. Full recruitment for all first year small group teaching activities will begin in September 2010 in anticipation of the opening of the academy in August 2011. Recruitment for second year teaching activities will begin in September 2011, in anticipation of the inaugural second year iteration at the Mississauga Academy in September 2012.

Mississauga Academy of Medicine Preclerkship Course Staffing & Instructional Responsibilities

Course Number of Staff1 Instructional Responsibilities for Staff2 Art and Science of Clinical Medicine-1 (ASCM 1)

18 core clinical faculty and specialists (number of clinical faculty needed depends on number of times an individual instructor teaches a particular session)

Group size is 6 students. Each core clinician leads 12 sessions (4 hours each). Core clinical faculty will be drawn mainly from the Departments of Family and Community Medicine, Psychiatry and Medicine. Each specialty clinical faculty leads 1–3 sessions, 4 hours each (neurology, ophthalmology, rheumatology)

Determinants of Community Health-1

12 tutorial leaders Lead DOCH-1 tutorials (38 hours per tutor)

Structure and Function

6 seminar leaders Each seminar leader leads seminars in respiratory and cardiovascular physiology (~ 6 hours each, each seminar given 3 times)

Metabolism and Nutrition

6 (PBL tutors) 12 (seminar leaders)

Each PBL tutor leads 17 hours of PBL tutorials. Group size is 9 students. Seminar leaders lead between 6 and 10 hours of seminars (each seminar given 3 times). Group size is 18 students.



Brain and Behaviour 6 (PBL tutors) 6 (seminar leaders)

Each PBL tutor leads 24 hours of PBL tutorials. Group size is 9 students. Seminar leaders lead 2 hours each of seminars (each seminar given 3 times). Group size is 18 students.

Art and Science of Clinical Medicine-2

18 core clinical faculty and Specialty clinical faculty (number of clinical faculty needed depends on number of times an individual instructor teaches a particular session)

Group size is 6 students. Each core clinician leads 5 sessions (4 hours each). Core clinical faculty will be drawn mainly from the Departments of Family and Community Medicine and Medicine. Each specialty clinician (geriatrics, psychiatry, pediatrics, orthopedics, rheumatology, ENT, vascular surgery, breast, urology, ophthalmology, general surgery) lead between 1 to 4 sessions (4 hours each)

Determinants of Community Health-2

12 project leaders Each leader marks 4-5 student research papers throughout the year, and a final presentation

Mechanisms, Manifestations and Management of Disease

36 (PBL tutors) 63 (seminar leaders)

Each PBL tutor leads 20 hours of PBL tutorials. Group size is 9 students. Each seminar leader leads between 4 and 14 hours of seminars, each seminar given 3 times. Group size is 18 students.

b. Describe additional hiring that is planned, including the timetable for recruitment.

The teaching faculty delivering the Undergraduate Medicine curriculum at the new academy will be drawn from the following groups:

• Current Faculty of Medicine faculty (primarily for lectures and labs) that will either: (a) be delivered for the entire class at the St. George campus (e.g., Anatomy), or (b) be videoconferenced between the St. George campus and Mississauga Academy

• Faculty (current and newly recruited) at UTM in the Life Sciences and Psychology • Physicians and other health professional staff at the two Mississauga hospitals, Credit Valley and

Trillium Health Centre For the purposes of the Mississauga Academy, new teaching faculty, both physicians and non-physicians from a wide variety of specialties and disciplines will be engaged, as indicated in Table 3. Faculty will be recruited at least nine months in advance of the required teaching, as stipulated in our community hospital affiliation agreements.



Table 3: Faculty Recruitment Pool for the Mississauga Academy.

Non-physician teaching faculty Anatomy or Neuroscience Biochemistry Bioethics/Ethics (may also be clinicians) Clinical Biochemistry Counseling Immunology Law Library Science(Health Science) Midwifery

Nursing Pharmacology and Pharmacy Physiology Psychology Quality/Risk Management Respiratory Technology Social Sciences Social Work

Physician recruitment pool (# of physicians available to the MAM by specialization) Anesthesiology (45) Emergency Medicine (61) Cardiac Surgery (4) Cardiology (22) Diagnostic Radiology (35) Dermatology (7) Endocrinology and Metabolism (9) Family Medicine (157) Family Medicine(Emergency Medicine)(7) Gastroenterology (12) General Pathology (15) General Surgery (21) Geriatric Medicine (4) Hematology (1) Infectious Diseases (4) Internal Medicine (16) Medical Oncology (16)

Nephrology(8) Neurology (11) Neurosurgery (6) Obstetrics and Gynecology (24) Ophthalmology (12) Orthopedic Surgery (16) Otolaryngology (9) Paediatrics (27) Plastic Surgery (9) Psychiatry (29) Radiation Oncology (10) Physical Medicine and Rehabilitation (1) Respirology (10) Rheumatology (5) Thoracic Surgery (3) Urology (7) Vascular Surgery (4)

Given the large numbers of physicians at CVH and THC, sufficient numbers of clinical faculty for identified teaching needs exist. However, new medical staff may need to be appointed to our affiliated hospitals and to our Faculty to maintain the current clinical activity level at CVH and THC and support medical education. CVH and THC senior management have committed that all new physicians recruited to the two hospitals will have teaching medical students and residents as part of their job description. Sufficient numbers in the non-physician health professional pool are similarly anticipated. In addition, the Ministry of Health and Long-term Care (MOHLTC) has indicated that it will be forthcoming this spring with a provincial solution to community preceptor funding for teaching. CVH and THC physicians have initiated the formation of a Clinical Teachers Association to work with the Ontario Medical Association and the MOHLTC to seek physician funding for academic activities. The medical staff has carefully considered the responsibilities and obligations associated with the new Academy. Recruitment for teaching continues as the courses are implemented. Site coordinators for Family Medicine, Paediatrics, and Emergency Medicine have been recruited as these rotations are currently occurring in Mississauga. Over the next 3 years, until full implementation of the clerkship, additional



recruitment of site coordinators will occur along with the establishment of more clerkship rotations and the development of increasing teaching capacity. The Mississauga hospitals are staffed by a significant cadre of physicians in Family Medicine and across the medical specialties, who are looking forward to teaching and supervising medical trainees beyond the elective placements where students have traditionally gained experienced in the community. The recruitment of teaching faculty began with the initiation of the individual courses in Mississauga in 2006. Recruitment of faculty to teach pilot groups of students in Mississauga from the St. George campus has proven to be successful in allowing for the development of Faculty peer mentors and increasing the commitment to teaching. The delivery of the core curriculum began with Emergency Medicine Clerkship in 2006 and the first ASCM group in 2007. There has been a steady and progressive increase in the number of students receiving core curriculum in Mississauga. Prior to the full implementation of all 4 years of the curriculum at the Mississauga Campus there is a plan to continue to augment the number of courses and placements offered to the senior classes at the St. George Campus (see Appendix 6). Students from the St. George campus have preferentially selected Mississauga clerkship rotations as they have become available and so it is anticipated that we will be able to gradually build prior to accommodating the 54 MAM students in the clerkship in 2013. Active recruitment will continue with significant activity taking place starting in the fall of 2010 in preparation for the launch of the first year of the Mississauga Academy in fall 2011. For the Preclerkship, teaching faculty will be recruited through two processes:

1. The Mississauga Academy Director will direct the recruitment of ASCM tutors, DOCH tutors, assisted by the FOM Site Coordinators and FOM Course Directors

2. The FOM Preclerkship Curriculum Lead for the Mississauga Academy will assist the

FOM Course Directors or their designate with recruitment of seminar leaders, PBL tutors and lecturers.

Local coordination of Clerkship teaching will be provided by the Mississauga Academy Clerkship Curriculum Lead. Faculty will be recruited by the Site Clerkship Coordinators assisted by the departmental Clerkship Course Directors, in consultation with University Department Chairs and local hospital department chiefs and division heads. All teaching faculty will have an appointment at the University of Toronto FOM provided through the relevant Faculty of Medicine Department Chairs, as per the Policy for Clinical Faculty, Sec(1) (See Appendix 7). It is anticipated that most MAM faculty, with the exception of local course/site directors and academy leadership positions will fall under our part-time or adjunct faculty appointments. In addition to receiving appropriate administrative support, faculty involved in teaching will receive faculty development as noted elsewhere in this template, will be fully oriented to the UT FOM MD program, objectives, curriculum and evaluation processes.



c. Describe opportunities for faculty development that will be available for faculty at the branch campus (whether provided on site or at another location, such as at or through the main campus).

The Faculty of Medicine is committed to providing a range of supports to faculty preparing for or involved in teaching with the Mississauga Academy. As discussed in response to item 1, above, teaching faculty in Mississauga will contribute to a variety of educational formats, including problem-based learning tutorials, seminars, and other small-group learning formats, ambulatory and bedside clinical teaching, preceptorship, and supervision of clinical scholarly projects. In addition, it is anticipated that most teachers will also be responsible for the provision of feedback, assessment of student performance, and assistance with career mentoring. Faculty development for teachers is therefore, an essential component of preparations for the medical school expansion at the Mississauga Academy of Medicine. A Director of Faculty Development for the Mississauga Academy has been hired (January 2010) to oversee the Mississauga Academy faculty development program. This individual is accountable to the MAM Academy Director, and is a member of the UT FOM Centre for Faculty Development at St Michael’s hospital. The Director of Faculty Development is currently conducting a comprehensive needs assessment and assessment of existing resources and is developing a faculty development plan. Course specific faculty development will be offered starting in July 2010 and will continue until all faculty are recruited and prepared to deliver the program. Faculty development at the Mississauga Academy of Medicine will be developed with the following in mind: (1) the University of Toronto Faculty of Medicine currently has an internationally known Centre for Faculty Development located downtown at St. Michael’s Hospital that offers a broad range of modular faculty development programs; (2) the University of Toronto at Mississauga has an Academic Skills Centre that supports Faculty and Students in the development of academic skills; and (3) each of the Clinical Departments and their divisions at the Faculty of Medicine have discipline specific faculty development that they offer to their members. At the Mississauga Academy of Medicine, faculty development will be offered in formats that are accessible to all new faculty and it will be an expectation that faculty are prepared to teach. Faculty development will be provided by both experienced local faculty as peer mentors and by experienced educators from the St. George campus. Faculty will also have opportunities to participate as tutors (e.g., PBL) in our current program at the downtown campus, in order to gain experience before they commence teaching at Mississauga.

d. Will there be resident physicians at clinical facilities associated with the branch campus?

Yes.

The Family Medicine Teaching Unit at Credit Valley Hospital has been open since 2006 and currently has a total of 15 residents with 6 PGY1s and 9 PGY2s. They will have a total of 18 residents (9 PGY1 and 9 PGY2) when they reach steady state in 2010-2011. The Family Medicine Teaching Unit at Trillium accepted an initial 4 residents in 2009-10 and will also grow to 18 residents at steady state by 2012-13. In addition to dedicated Family Medicine residents, the Postgraduate Medical Education Office at UT is working in collaboration with CVH and THC, to roll-out an expansion of postgraduate training activity at the two sites. There are



presently a number of specialty rotations (core internal medicine, medical oncology and surgical specialties as well as others) taking place at both CVH and THC.

At present the plan is to phase in a further 42 entry level specialty residency positions in total at CVH and THC. An implementation plan is being developed to identify, by specialty, training site and training level, the expansion of resident numbers in Mississauga. The implementation plan will address specific issues such as the required infrastructure and administrative support at each site, faculty appointments, faculty development, the requirements of the collective agreement between the Professional Association of Interns and Residents of Ontario (PAIRO) and the Council of Academic Hospitals of Ontario (CAHO) contract, RCPSC accreditation requirements, and logistical issues such as space for teaching, travel and accommodations. Secure lockers and on-call rooms, dedicated study space, secure internet access, and teaching space will be provided for both undergraduate and post-graduate learners, as per accreditation and contract standards.

Residents will be educated on teaching skills, as part of their CanMEDS curriculum, and will be made aware in many venues of the objectives of the overall undergraduate program and the specific courses they will assist in teaching.

Clinical Facilities a. Complete the following table for any clinical teaching sites that will be used for students at

the branch campus:

Credit Valley Hospital and Trillium Health Centre will be the primary clinical teaching sites for the Mississauga Academy, providing the clinical learning setting for students. The majority of students’ time for Family Medicine rotations will be spent working in the surrounding area with community preceptors for the community medicine experience, as well as opportunities to work within each hospital’s Family Medicine Teaching Unit.

* FMTU - Family Medicine Teaching Unit

Clinical Teaching Sites at the Mississauga Academy of Medicine

Required clerkships in:

Facility Name Credit Valley FMTU*

Credit Valley Hospital

Trillium-Summerville FMTU*

Trillium Health Centre

Family Medicine √ √ √ √

Medicine √ √ Surgery √ √Paediatrics √ √Obstetrics & Gynaecology √ √ Psychiatry √ √ Emergency Medicine √ √Anesthesia, ENT and Ophthalmology √ √



b. For each inpatient facility noted in the preceding table, provide the following information: Trillium Health Centre is one of Canada’s largest community hospitals with regional programs in cardiac surgery and interventional cardiology, stroke, neurosurgery, vascular surgery, hepatobiliary/pancreatic surgery, as well as sexual assault and domestic violence services. THC is a two-site facility serving more than one million residents in Mississauga, West Toronto and from other communities across Ontario. Trillium-Mississauga houses Trillium’s acute care inpatient units and features a 24-hour Emergency Department, a Family Care Centre dedicated to women’s and children’s health, and a large concentration of tertiary services. A new seven-story wing, completed in spring 2009, provides modern facilities for in-patient care, an auditorium, library, learning centre and associated support functions. Five kilometres away, Trillium’s West Toronto location is a showcase ambulatory care centre, housing a 14-hour Urgent Care Centre, rehabilitation services, a large day surgery centre, spine centre, women’s health centre, mental health services, as well as medical and surgical out-patient clinics. A full complement of diagnostic, laboratory and pharmaceutical services supports both locations. The following table provides information on Trillium Health Centre’s inpatient facilities for the 2008/2009 fiscal year.

Trillium Health Centre – www.trilliumhealthcentre.org Key Contacts Janet Davidson, O.C, President and CEO

Dr. Norman Hill, Vice President, Medical & Academic Affairs Dr. Pamela Coates, Academy Director, Mississauga Academy

Beds

Total: 761 beds (acute – 541; chronic – 220) By program: • Medicine:136 • Surgery: 60 • Paediatrics: 15 • OB/GYN: 40; NB:39 (Bassinets) • Cardiac:100 • Neurosciences: 140 • Mental Health: 50 • Complex Continuing Care: 220

Average daily occupancy rate

97.3%

Average length of stay 6.5 days

Admissions (Separations)

31,329

Outpatient Visits 287,801

Emergency Visits 122,308



The Credit Valley Hospital is a community hospital with four regional programs providing leadership in the delivery of primary, secondary, and tertiary health care services to the people of Mississauga and the surrounding region. The existing facility covers approximately 770,000 square feet, and provides a broad spectrum of clinical services involving ten programs: general medicine, surgery, renal, oncology, emergency, mental health, continuing care/rehabilitation, obstetrics and gynaecology, paediatrics and cardiac services. Credit Valley provides a regional service for medical genetics, nephrology, oncology, and maternal/child care. The hospital is presently constructing a further 270,000 square foot building expansion to accommodate a new complex continuing care, paediatrics, labour & delivery and laboratory services. The following table provides information on Credit Valley’s inpatient facilities for the 2008/2009 fiscal year.

Credit Valley Hospital – www.cvh.on.ca Key Contacts Michelle DiEmanuele, President and CEO

Dr. Matt Gysler, Chief of Medical Staff Connie Day, Associate Vice President, Medical Administration Dr. Pamela Coates, Academy Director, Mississauga Academy

Beds

Total: 377 beds (acute – 337; chronic - 40) By program: • Medicine: 84 • Renal: 15 • Cardiology: 16 • Surgery: 53 • Paediatrics: 22 • OB/Gyn: 41; NB:56 • Oncology: 20 • Rehab: 40 • Mental Health: 26 • ICU/CCU: 20 • Complex Continuing Care: 40

Average daily occupancy rate

94.2%

Average length of stay 5.04 days

Admissions (Separations)

22,994

Outpatient Visits 366,611

Emergency Visits 75,869

c. For each clinical teaching sites, briefly describe the number of students per clinical rotation

and the numbers of faculty members or residents that will be available as teachers and supervisors.

The assumption is that clerkship clinical rotations will be distributed equally between the two hospitals affiliated with the Academy. In Year 3 each rotation group will consist of two to five



students per hospital. The number of students could vary depending on the number of specialty faculty available at each hospital. The number of faculty in each discipline is outlined in the table provided on page 22 and although recruitment is not yet completed for clerkship there is an adequate supply of highly qualified medical staff to meet the need. In Year 4 the students will participate predominantly in electives and selectives. Students will be distributed evenly over all the clinical services, many of which will be community based.

The table below outlines the estimated intake number of Family Medicine and Specialty/Subspecialty residents at the two sites of 18 Family Medicine Residents and 42 Specialty Residents. This is predicated on a ratio of Undergraduates to PGYs of 1 to 1.1

Resident Intake

Family Medicine Specialty and Subspecialty

Total Intake

Credit Valley

9 21 30

Trillium 9 21 30 Total 18 42 60

d. For each required clerkship, provide a brief assessment of the adequacy of patient volume

and mix to accommodate students at the branch campus.

Both Trillium and Credit Valley are very large community hospitals that provide the full continuum of health care services and complementary services in sub-specialized areas to the million plus residents of Mississauga and surrounding areas. The students will receive a breadth of experience and will be exposed to unique learning opportunities only available in a community based setting (see Appendix 5). There are no concerns about patient volume or mix. The learning environment of CVH and THC is very similar to our other currently fully affiliated sites, and there is excellent collaboration between the two hospitals at many levels, including some joint senior management positions, their Boards, and coordinated physician recruitments.

ACADEMIC COUNSELLING AND SUPPORT Provide a brief narrative assessment of the capacity of each of the following student services to handle the students at the branch campus. Note if resources will be available on site and/or through the main campus. The Faculty of Medicine Associate Dean, Health Professions Student Affairs has been working closely with the Dean of Student Affairs at UTM to ensure appropriate access for MAM students to a wide range of student services and supports as follows: Space will be made available within the student services area at UTM to provide on-site service. This will include Faculty of Medicine specialized resources; for example, personal counselor/therapist, learning skills counselor, career counselor, financial aid officer, St. George-based staff will also be equipped with desktop 1-to-1 web-conferencing to enable remote ‘face-to-face’ discussions (using students’ computers, personal webcams and common, free software



like Skype). Services also will be provided by UTM based staff and at specific times where required by the FOM’s academic calendar. A communication strategy is being developed to increase student awareness of the Office of Student Affairs (OSA) services at both campuses. We will utilize a variety of modalities, including email, Facebook, UT portal, website, clicker surveys, and group ‘meet and greet’ sessions. Financial aid Needs based financial aid and counseling services offered will be identical for students on both the Mississauga and St. George Campus. Since the funding of financial aid comes predominantly from tuition revenue, and is therefore proportionate to student numbers, no decrement or risk to this funding for the MAM students is foreseen. In efforts to track and respond to financial hardship appropriately, the FOM will collect data and closely monitor student debt levels on both campuses in addition to providing access to debt management counseling at both sites. The CGQ will be closely analyzed as one of many tools available for debt benchmarking. On admission to the program, all students are invited to contact Financial Aid staff for information on financial aid programs and with respect to government loan programs, UT FOM bursaries, and scholarship programs. Students may meet in person if preferred or discussion can take place over the telephone or via e-mail. Provincial Loan documents will be distributed at the Mississauga campus through the academy office. The Associate Registrar, Student Financial Services and the Financial Aid Counselor will offer personal one-on-one sessions on site in Mississauga during the fall term and as necessary at other times during the year. Financial aid information sessions are also included in the orientation week.

Student Health & Personal Counseling All UT medical students have access to the services of the Faculty of Medicine Office of Health Professions Student Affairs (OHPSA). The Faculty of Medicine OHPSA has the responsibility to ensure that students based at the Mississauga campus will have equivalent access and opportunities to the OHPSA services as the St. George campus-based students. Timely triage of UTM students’ needs will be provided by the OHPSA counselors in the same manner as the St George campus based students. All incoming student requests to be seen will be reviewed by a triage counselor, either by telephone, email, or in person. The intake counsellor will then link the student with the appropriate service/resources. All health and counseling staff operate independently from the academic side of the FOM to avoid any conflict of interest, and observe appropriate confidentiality guidelines. Services include personal/wellness counseling, career counseling, learning/study counseling, advocacy and general student support. Services in all of these domains will be provided on site for the UTM students, and by webcast, linking the St George campus and UTM. The Faculty of Medicine Office of Health Professions Student Affairs will provide personal support to medical students at both campuses, through non-faculty personal wellness counselors, and the Associate Dean. Individual counseling and health promotion/wellness workshops are provided to medical students. Utilizing multiple modes of communication (i.e. confidential videoconferencing, in-person 1 on 1, and small group meetings), students based at the Mississauga Academy of Medicine will have comparable access to counselling to that of their peers at the other three



medical academies. Students can self-refer to the OHPSA counseling services or they can be referred/recommended by a concerned course director.

An additional 0.5 personal counselor has been added to the personal/wellness counseling staff, which will accommodate any additional time needed by the counselors to travel to UTM to see students face to face. Training is also being provided for one of the OHPSA counsellors’ in a new model of email-based counseling (integrated with some face-to-face sessions), as many students are more comfortable with this method of communication. The need for additional OHPSA staffing based at MAM will be reviewed as the academy roll-out is implemented. Student wellness is an important focus of the OHPSA – activities will be offered at both campuses to encourage/enhance student wellness. All students have access to University fitness centers at both campuses. A range of services are offered to all students of the University of Toronto, including personal counseling, accessibility services for students with learning or physical disabilities, health services, academic skills assistance, are available on the Mississauga and St. George campuses to Mississauga Academy students. Students with disabilities will register with Accessibility services at either campus, and the OHPSA will ensure that appropriate accommodations are provided by the course directors. The specific nature of the disability will remain private and confidential within the OHPSA. Present use of accessibility services by medical students suggests it is unlikely that the services on the St. George campus or at UTM will be affected adversely by the addition of 216 students. The UTM campus has a Health & Counseling Centre that provides health care services to all students at UTM, including psychological/emotional support, offering an additional, local, counseling resource to UTM medical students. The centre’s services, offered by a team of family physicians, registered nurses, psychiatrists, social workers/counselors, administrative staff, a health educator and student peer health educators, are comprehensive and include Health Service, Psychiatric Service, and counseling functions of the Counseling and Learning Skills Service. The Associate Dean of OHPSA will consult with these counselors as needed, to ensure the unique needs of medical students are appropriately recognized. Health care professionals provide a wide range of services, including physical exams, treatment of illnesses and injuries, referrals to specialists, provision of immunizations, allergy injections, TB testing, mental health assessment and care, sexual health education, and contraception counseling and dispensing. Scheduled and drop-in care is available weekdays year-round. Students of each of UT’s three campuses are eligible to use the health and counseling services of the other UT campuses as well, choosing the site that is most comfortable and convenient. A travel immunization and education program is available through the St. George Health Service, which is a designated Health Canada Travel Medicine Clinic. UTM also houses a sports medicine clinic through its Department of Physical Education, Athletics and Recreation. The Trillium Rehabilitation Program has a collaborative relationship with the UTM Fitness Centre, offering potential community service activity for the medical students. Academic /Learning Support Special support services are provided to our medical students to enable their optimal academic performance. The UTM Accessibility Resource Centre and the St George campus Accessibility



Services provide extensive learning assessment/skill development services. Accessibility services are offered at both campuses and students with disabilities will register with their local office to receive appropriate accommodations. The Associate Dean of OHPSA will advise on the implementation of the necessary accommodations for all students at both campuses. UTM has a very strong Academic Skills Centre which will, in consultation with the Faculty of Medicine OHPSA, provide learning assessment and study skill development to the UTM medical students.

In addition, the Faculty of Medicine provides remedial clinical learning support. Through the Office of Health Professions Student Affairs, the medical students also have access to a learning skills counselor and support from the Associate Dean. The St. George campus learning skills counselor will collaborate with the Director of the Academic Skills Centre to provide equitable learning workshops and 1:1 support to students at the UTM campus. Students in academic difficulty i.e., low pass or failure on any aspect of a course are identified and reviewed by course directors who may then refer the student to the FOM OHPSA for further assessment/intervention. The triage counselor will determine the appropriate resource(s) to meet the student needs, which can range from personal/family issues to learning/study issues, and then refer to the appropriate counselor/service. Students can also self-refer for learning/study assistance and/or a formal learning assessment. Students also have direct access to teaching faculty at both sites, primarily via email, followed with direct fact-to-face contact. Career Advising The UT Mississauga Career Centre offers career education, counseling and work-search support, in partnership with UT’s central Career Centre, to all students at UTM. Students of each of UT’s three campuses are eligible to use the career advising services of the other UT campuses as well. Also, the Mississauga Academy is providing office space in the UTM Health Sciences Complex to host rotating St. George-based Faculty of Medicine staff serving UTM Academy students on-site. St. George-based staff will also be equipped with desktop 1-to-1 web conferencing to enable remote ‘face-to-face’ discussions (using students’ computers, personal webcams and free software like Skype). The Faculty of Medicine Office of Health Professions Student Affairs provides medicine-focused career counseling to all 4 years of medical students, including some of the relevant aspects of the AAMC Careers in Medicine program. In year one, students are oriented to the CIM website and each student receives a token for their own access. Counseling workshops on CV development are offered in Year 2. Year 3 students are offered a series of career nights, to introduce them to all the different disciplines. CaRMS submission and interview preparation and coaching are also provided to all interested 4th year students. The OHPSA career counselor and the Associate Dean provide 1:1 counseling to any interested students throughout the 4 year program. This counseling/programming will be available to UTM-based medical students, in a variety of methods. The St. George counselor will assist in the development of UTM-based programming and web-casting will be utilized when appropriate. We plan to increase the career counselor position from a 0.6 position to full time, effective June 2010. This will provide a 40% increase in time available to conduct career counseling to individual students locally at UTM and to provide career workshops at Mississauga as well as the St George campus. All students have access to advice about electives, in relation to their career interests. Formal programming of shadowing/elective experiences are available to all students in Years I and II, enabling further career exploration. The Enriching Educational Experience (EEE) Program is an



online registration program accessible via the Portal. The program sits under "My Organizations Plus" in every students' account. We ask that students log any and all clinical experiences they have outside of their official curriculum. This may include an afternoon in a preceptor's office or an overnight experience in a community emergency room with a mentor. The purpose of these experiences is for early career exploration and for mentorship, as well as to bring to life what is learned in the classroom in the first two years of medical school.

Co-curricular and service learning activities are an important aspect of our curriculum and promote social accountability as well as student well-being. The Faculty of Medicine Office of Health Professions Student Affairs provides extensive support to students in all aspects of their co-curricular activities through its Senior Officer of Student Life and Service Learning. This support will include the students based at UTM, and will involve increased outreach with Mississauga community partners. We have initiated a Mississauga chapter of the ‘Saturday Program’ which is a mentoring program for at risk high school students and we are actively supporting the Medical Society “MedSoc” (student government) in ensuring equitable representation between the 2 campuses. MedSoc is committed to the principal that equitable representation will be made available to the Mississauga students.

FINANCIAL SUPPORT a. Briefly describe any increases in revenues that will be available from government sources,

the parent university, or other sources to accommodate the new/expanded branch campus.

The additional operational revenue required for the UTM expansion comes from the significantly enhanced per student revenues announced and implemented by the provincial government (Ministry of Training, Colleges and Universities (MTCU)) amounting to $49,526 per expansion student per year; 54 students per year. This enhanced per student operational funding is adequate to support all operational costs of the MAM at UTM, including the building, information technology and personnel costs, and allows for a balanced revenue/expense budget for the MAM at UTM. There is a signed UT Provostial level agreement between the FOM and UTM for the operating costs to be paid by the Faculty of Medicine and by UTM, based upon their space occupancy ratios. The provincial government has also provided significant capital funding which has allowed for the construction of the Health Science Complex (including the required information technology) housing the MAM at the UTM. The project summary capital budget is outlined in the table below (see Appendix 8 for a Construction Status Summary).

UTM Health Sciences Complex - Capital Cost and Funding

Cost Funding Source Project Budget $36,955,000 Provincial funding secured $24,237,000 Faculty of Medicine contribution $ 1,239,000 University of Toronto Mississauga $11,479,000 Total $36,955,000 $36,955,000



The Ministry of Health and Long-Term Care (MOHTLC) has recently provided CVH and THC with a capital planning grant, and a functional medical education space plan for the hospitals is being submitted shortly. Careful planning, coordinated between undergraduate and post-graduate programs is taking place regarding space allocations in the hospitals. The MOHLTC has indicated it will fund the capital needs for teaching space at the hospitals this year, to allow for the opening of the campus in 2011. As well, the MOHLTC has just released information indicating an enhanced level of operational funding for CVH and THC based on the total number of medical trainee days, including both clerks and resident trainees.

OTHER SUPPORTING DATA Note any other relevant data that you think the LCME should take into consideration when evaluating the adequacy of resources to support the new/expanded branch campus.

Student Housing The UT Mississauga’s Department of Student Housing & Residence Life offers UT’s largest and most diverse range of on-campus housing options. MAM students will share priority access in their first year for single-occupant bedrooms in shared townhouses or apartment-style residences. MAM students with families are welcome to apply for 2-, 3- and 4-bedroom family townhouses. All UTM residence communities have lounge spaces for social and academic use, laundry facilities, high speed and wireless internet, and access to meeting rooms. The department also offers web-based searching for off-campus housing listings in Mississauga/Peel. Flexible, on-campus meal plan options are available for residence and commuter students. Guaranteed availability of housing has been accorded to the medical students in year 1. Disability Accommodation Services The UT Mississauga AccessAbility Resource Centre provides on-campus academic support to students at UTM with mobility, sensory, medical and learning disabilities, including students of the MAM Academy. Recreation & Athletics The UT Mississauga Department of Physical Education, Recreation & Athletics provides a range of fitness opportunities, from cardio and strength workouts and training to instructional classes to recreational and competitive teams for all UTM students. The department also hosts a sports medicine clinic. Students of each of UT campus are eligible to use the recreation facilities of the other UT campuses as well. Family Care MAM students are eligible for the full range of supports from the University’s Family Care Office, including workshops, programming, and one-on-one advise for student-families dealing with childcare, elder-care, maternity and parental leave. Priority access to UT’s Early Learning Centres is also available. Computing



UTM Computing Services currently provides all information technology supports and services for its undergraduate students. These supports and services will be made available to the MAM Students. Some of these services are outlined as follows:

• UTORid – Every student receives an account which allows them to access the Internet through with Campus Wireless Network (UTORcwn) on their own laptop or through any machines in the computer labs on campus. Every account holder has access to general purpose productivity packages such as Microsoft Office, Internet Explorer, and course specific software. UTORid also allows students to have access to the University’s email system (UTORmail) as well as the Blackboard LMS.

• Buying a Computer – UT has a Student Computer Program through Dell Canada that offers discounts.

• Free Antivirus Program – All UT Students are eligible to install a copy of Symantec Antivirus Program on their computer.

• myfiles is a file storage service provided by UTM Computing Services to all students at UTM. It provides 30MB of personal disk space accessible anywhere on campus. Documents stored in myfiles are automatically backed up once a day every day, and the backups are kept online for up to a week.

• Printing Services – B/W printing is available in all computer labs and through the wireless network. Price for black and white printing: $0.10 a page. Colour printing is also available but only on specific labs. Price for colour printing: $0.40 a page.

• Students at the University of Toronto can obtain web space (UTORweb) for personal web pages, pictures, word-processing documents, course assignments, etc. There is no charge for this service, and the amount of space available is 50 MB.

• Help Desk - Hours are Monday to Friday 9am to 5pm (Sep-Jun) and 9am to 4:30pm (Jul-Aug). This is where all students come to get help. Helpdesk provide services such as wireless configuration of laptops, password resets, PC repairs, data recovery, etc.

• Students living in UTM Residences have access to the internet from their room.

Parking and Transportation Services

MAM students will have access to a range of transportation options, including a Mississauga public transit pass, intercampus shuttle service, inter-hospital service, and parking.

Mississauga Transit MAM students will receive a transit pass (“U-Pass”) allowing unlimited Mississauga Transit ridership between September and April. Although the campus and hospitals are well-serviced by Mississauga Transit, campus administrators and student governments are regularly involved in lobbying and negotiating on route improvements, while also seeking improved service by Peel Trans-Help and GO Transit. Work is on-going for route improvements and connections with GO Transit. Shuttle Bus Service (between UT St. George and UT Mississauga) MAM students are eligible to use the Intercampus Shuttle Service which runs between the UTM and St. George campus, with weekday scheduled departures in the regular academic year every 20 minutes during daytime hours and every 30 minutes early mornings and evenings, and modified schedules during exam periods, weekends, inter-sessions, summers and breaks, and no service on university holidays.




Shuttle Bus - Academy Transit It is anticipated that Mississauga Medical Academy students will require transportation service between the Mississauga campus and affiliated hospital locations. Dedicated bus service between hospital sites and UTM will be scheduled to begin in 2011-12 to serve first-and second-year students scheduled as groups, and expanded in 2013-14 to include circulating vans as upper-years medical students move to more independent schedules.

Library Resources and Information Services The University of Toronto Mississauga Library is located in the Hazel McCallion Academic Learning Centre, a state-of –the-art learning centre which opened in October 2006. This 108,000 square foot facility over four floors is located at the north end of the Mississauga campus, linked by indoor and outdoor walkways to the prospective Health Sciences Complex. The UTM Library is a full participant in the University of Toronto Library system. The University of Toronto Library system is the largest academic library in Canada, and is consistently ranked in the top five amongst research libraries in North America. The system consists of over 30 libraries which provide a wide range of services to support teaching, learning and research across all disciplines. In addition to more than 15 million holdings, the library system currently provides access to close to 61,000 full-text electronic journals, over 68,000 electronic books, close to 1000 indexes and abstracts and over 4,200 online newspapers. The on-site services and resources that students have at their disposal at the Hazel McCallion Academic Learning Centre, UT Mississauga campus, include extensive hours of regular service (i.e. 8am-12am, Monday –Thursday), 24 hour access during exam periods, 230 public computers, including 30 laptops for loan, 1277 study spaces, including 19 group student rooms bookable online, research and reference service and a Science Liaison Librarian whose portfolio will include the Academy of Medicine including participation in the teaching activities with the Gerstein and Hospital librarians. The Gerstein Science Information Centre is the University of Toronto’s flagship science and medicine library serving all science and health science disciplines. The Gerstein Science Information Centre librarians will continue to work closely with staff of the Faculty of Medicine’s Discovery Commons and the appropriate UTM librarians in matters related to the pedagogy and mechanics of distributed learning and e-learning to provide undergraduate medical students at the UTM Academy with library services appropriate and equivalent to those in the other three Faculty of Medicine Academies. The UTM Library makes available resources and information services to undergraduate medical students in the UTM Academy in accordance with the guideline Distribute Medical Education (DME). Library and Information Services as prepared by the Consortium of Ontario Academic Health Libraries.

Template for Reporting New/Expanded Branch Campuses

Appendices

1. Committees’ Terms of Reference

A Mississauga Academy Steering Committee – Terms of Reference

B Academic Partnership Steering Committee

C Credit Valley Hospital Medical Education Committee – Terms of Reference

D Trillium Health Centre Medical Education Committee – Terms of Reference

2. Community Affiliation Agreement

A. Trillium Health Center - Community Affiliation Agreement Template

B. Credit Valley Hospital - Community Affiliation Agreement Template

3. Health Sciences Complex – Floor Plans and Images

4. Ontario Telemedicine Network (OTN) Memo

5. Draft Clerkship Year 3 & 4 Rotation Schedule

6. Tutor Recruitment Plan

7. Policy for Clinical Faculty

8. Health Sciences Complex Detailed Construction Status Summary - April 2010

Template for Reporting New/Expanded Branch Campuses- Faculty of Medicine, University of Toronto

Appendix 1 Appendix 1.A – Mississauga Academy Steering Committee

Mississauga Academy Steering Committee

TERMS OF REFERENCE

Reporting: The Steering Committee reports to: • Ian Orchard (Vice President and Principal, UT Mississauga) • Catharine Whiteside (Dean, FOM/UT) • Michelle DiEmanuele (President & CEO, CVH) • Janet Davidson (President and CEO, THC).

Mandate: • Provide overall governance and

co-ordination for the Mississauga Academy. • Develop guiding principles for planning and implementation. • Review work plan and milestones • Establish scope, mandate, and membership for task forces. • Review and revise relevant policies and processes. • Approve teaching faculty recruitment process. • Accountable for the integration of undergraduate and postgraduate

education for the Mississauga Academy • Provide leadership and direction to the sub committees • Plan and monitor financial support. • Facilitate the partnership between the four organizations • Resolve critical issues, and monitor project risks

Membership: 1. Chair:

a. Pam Coates, Academy Director, Mississauga 2. Associate Chairs:

a. Jay Rosenfield, Vice Dean, Undergraduate Medical Education, Faculty of Medicine

b. Gage Averill, Dean, UT Mississauga 3. Curriculum:

a. Martin Schreiber , Director, Preclerkship b. Anita Rachlis, Director, Clerkship

4. Postgraduate Medicine:

a. Salvatore Spadafora, Vice-Dean, Postgraduate Medical Education

5. UT Mississauga

a. Paul Donoghue, Chief Administrative Officer, UTM

Appendix 1- Page 1


6. Faculty of Medicine a. Tim Neff, Chief Administrative Officer, FOM

7. Local Health Integration Network (LHIN)

a. Narendra Shah, LHIN Representative 8. Credit Valley Hospital/ Trillium Health Centre

a. Connie Day, Associate Vice President, Medical Administration, CVH

b. Norman Hill, Vice President, Medical Affairs, THC 9. Other Faculty of Medicine:

a. Leslie Nickell, Associate Dean, Health Professions Student Affairs

b. Mark Hanson, Associate Dean, Undergraduate Medicine Admissions and Student Finances

10. Student

a. Rami Shoucri, Medical Society President (or Representative)

11. Administration:

a. Mitzi Bindoo, Project Manager (CVH/THC) b. Laura Champagne, Medical Education Coordinator (CVH)

- Recorder c. Riet van Lieshout, Administrative Manager (UME) d. Neil Neebar, Special Projects Manager (UME) – Recorder

Guests members to be drawn from the Mississauga Academy Advisory Council (MAAC)

Note: CVH – Credit Valley Hospital THC – Trillium Health Centre UME – Undergraduate Medical Education UT – University of Toronto

Appendix 1- Page 2


Appendix 1.B – Academic Partnership Steering Committee

Academic Partnership Steering Committee

TERMS OF REFERENCE

Reporting: To the senior teams of each Hospital

Leadership: • UTM Academy Director - Co-Chair • Co-Chair CVH • Co-Chair THC

Mandate: • To provide the overall direction for the establishment of the full scope of inter-professional medical teaching at CVH and THC in affiliation with UTM and U of T by September 2012

Objectives: 1. To ensure integrated planning, development, and implementation of the academic program, process, people and capital elements of the clinical sites with the Academy; within the context of an inter-professional education model

2. To provide leadership to sub committees, management advice to respective organizations, and decision-making on key elements of the implementation of the Medical Academy;

Responsibilities: 1. Planning and Decision-making

a) To support the development and champion the implementation of a world class vision for Medical Teaching at CVH and THC

b) Guide the integrated implementation plan and foster an environment of cross functional planning, development, and implementation relative to all aspects of plan

c) Provide timely decision making and direction to committees and work groups;

d) Develop and apply a principled perspective to criteria and process for decisions, implementation and project management / evaluation oversight, and monitoring of risks.

e) To be actively involved in planning and negotiation for funding and other resources required to be delivered by the University; the Ministry of Health and Long Team Care

f) To ensure development of a comprehensive evaluation and impact analysis framework for both organizations

2. Implementation a) Establish a working budget for the implementation b) Ensure that the project is completed on time and on budget; c) Review any proposed variances to project scope and bring

forward any changes in scope to respective Senior Teams for approval;

d) Review work of sub-committees on a monthly basis to ensure timely completion of deliverables in relation to the overall implementation schedule;

Appendix 1- Page 3


e) Approve overall communication and marketing plans for all stakeholder groups;

3. Monitoring and Evaluation a) Monitor project risks in terms of cost, schedule, resources,

etc. b) Provide monthly reports & updates to Senior Teams c) Track progress against key milestones on a monthly basis to

ensure implementation remains on schedule

Membership: • Up to 4 representatives from each organization; CVH and THC • A senior Physician leader from each organization; CVH and

THC • UTM Academy Director • Director Post graduate Education • Project Manager • VP Education • Other resources as required

Frequency of Meetings:

• Bi – weekly, Tuesday, alternating locations CVH and THC

Appendix 1- Page 4


Appendix 1.C - Credit Valley Hospital Medical Education Committee– Terms of Reference

Credit Valley Hospital Medical Education Committee– Terms of Reference

TERMS OF REFERENCE

Accountability: Through the co-chairs to the MAC Mandate: • To develop a medical education program at CVH of quality and

excellence

• To provide leadership in creating a new culture at CVH as a “Community Teaching Hospital”.

• To coordinate the transition of CVH into a community teaching hospital.

• To oversee the integration of all medical trainees within the organization

Responsibilities: • To develop strategies to ensure wide and ample consultation with the physicians of CVH and two-way communication with the medical departments via their representatives regarding the emerging role of CVH in medical teaching.

• To receive feedback from academic directors, chiefs, faculty and trainees regarding the success of the teaching programs and to make recommendations for improvement.

• To participate in developing an interdisciplinary professional education committee in the hospital.

• To make recommendations regarding the appropriate hospital infrastructure necessary to support and maintain the medical teaching program

• To make recommendations regarding our participation in the University committees.

• To develop means to recognize excellence in teaching. • To coordinate our initiative with other community and fully

affiliated teaching hospitals • To evaluate the resource implications of the teaching initiative • To evaluate the impact of the teaching initiative on the

physicians of CVH • To link with Research Review Committee regarding the role of

CVH in academic research. • To make recommendations to ensure compliance with the

Community Hospital Teaching Affiliation Agreement including but not limited to the development of teaching plans;

• To make recommendations to ensure compliance with PAIRO; • To establish the policies and procedures governing all medical

trainees at CVH; • To ensure coordination of interdepartmental teaching

Appendix 1- Page 5


Membership: 1. Co-Chairs, one of whom shall be the academy director 2. Senior Administration 3. Anesthesiology Representative 4. Emergency Medicine Representative 5. Family Medicine Representative 6. Genetics/Lab Representative 7. Medical Imaging Representative 8. Medical Student Representative 9. Medicine Representative 10. MSA Representative 11. Nursing Representative 12. Obstetrics Representative 13. Oncology Representative 14. Pediatrics Representative 15. Pharmacy Representative 16. Psychiatry Representative 17. Resident Representative 18. Surgery Representative Department representatives should have an identified delegate to ensure regular attendance. Departments may have two (2) representatives.


• Monthly (excepting July and August) or at the call of either co-chair.

• Meeting will be held on the 2nd Wednesday of the month at 1145 to 1300 hrs.

Approved: January 2006 Revised: January 2008

Appendix 1- Page 6


Appendix 1.D Trillium Health Centre Medical Education Committee Terms of Reference

Trillium Health Centre Medical Education Committee– Terms of Reference

TERMS OF REFERENCE

Accountability: The MEC is accountable to the MAC and will report regularly through the Chief of Staff.

Purpose: • To advise the MAC on issues relating to the affiliation with the

University of Toronto (U of T) and the participation in medical education in cooperation with the University of Toronto and the Mississauga (UTM) Academy of Medicine.

• To provide leadership and coordinate the transition of THC into

a community teaching hospital. • To oversee the integration of medical students and postgraduate

trainees within the organization.

Responsibilities: Initial: • To recommend principles and protocols which provide a

foundation for excellence in teaching at THC. • To develop strategies to ensure wide and ample consultation with

the medical departments via their representatives regarding the emerging role of THC in medical teaching.

• Make recommendations regarding the necessary hospital infrastructure necessary to support the teaching program.

• Make recommendations regarding our participation in the University committees that require our participation.

• Coordinate our initiative with other community teaching hospitals (Credit Valley Hospital).

• Evaluate the resource implications of the teaching initiative. • Evaluate the impact of the teaching initiative on the physicians of

THC. • Support innovation in teaching and multidisciplinary teaching. Ongoing • To make recommendations to ensure compliance with the

Community Hospital Teaching Affiliation Agreement including but not limited to the development of teaching plans;

• To make recommendations to ensure compliance with PAIRO; • To establish the principles and protocols governing medical

students at THC;

• To ensure coordination of interdepartmental teaching.

Appendix 1- Page 7


Appendix 1- Page 8

Membership: 1. Chair (Appointed by the Chief of Staff) 2. Co-Chair 3. Academy Director Co-Chair 4. Senior Administrator 5. Health System/Department Representatives (1 each) 6. Medical Staff Association Representative 7. Student Representative 8. Chief Nursing Officer/Delegate


• 10 meetings per year or at the call of the chair.

Approved Wednesday, September 30, 2009


Appendix 2 – Community Affiliation Agreement – Template Appendix 2. A. - Trillium Health Centre

THIS AGREEMENT made in duplicate as of the 1st day of January, 2007

BETWEEN

THE GOVERNING COUNCIL OF THE UNIVERSITY OF TORONTO

(“THE UNIVERSITY”) OF THE FIRST PART

AND TRILLIUM HEALTH CENTRE

(“THE HOSPITAL”) OF THE SECOND PART

CONTENTS PAGE

PREAMBLE ................................................................................................................................................... 3

I INTRODUCTION ....................................................................................................................................... 3 I.1 OBJECTIVE OF THE UNIVERSITY ....................................................................................... 3 I.2 OBJECTIVES OF THE HOSPITAL ......................................................................................... 3 I.3 BASIS FOR AFFILIATION ...................................................................................................... 4 I.4 DEFINITIONS AND INTERPRETATION ................................................................................ 4

I.4.1 Definitions .................................................................................................................. 4 I.4.2 Interpretation .............................................................................................................. 5

I.5 APPLICABILITY OF UNIVERSITY POLICIES TO THE HOSPITAL AND AMENDMENT OF UNIVERSITY POLICES .......................................................................................................... 6

II APPOINTMENT OF STAFF AND OVERSIGHT BY UNIVERSITY DEPARTMENT CHAIRS AND DEANS .................................................................................................................................................................... 8

II.1 INTRODUCTION .................................................................................................................... 8 II.2 POLICIES GOVERNING APPOINTMENTS ........................................................................... 8 II.3 APPOINTMENT OF HOSPITAL MEDICAL-DENTAL TEACHING STAFF ............................ 8

II.3.1 Staff Complement ...................................................................................................... 8 II.3.2 University Appointment and Promotions ................................................................... 9 II.3.3 Hospital Appointment ................................................................................................. 9 II.3.4 Terms and Conditions of Appointments .................................................................... 9 II.3.5 Clinical Faculty (Physicians) in the Faculty of Medicine ............................................ 9

II.4 APPOINTMENT OF HEALTH SCIENCE FACULTY TO THE UNIVERSITY ....................... 10 II.5 APPOINTMENT AND RE-APPOINTMENT OF HOSPITAL CHIEFS ................................... 11 II.6 APPOINTMENT OF CHAIRS OF UNIVERSITY DEPARTMENTS ...................................... 11 II.7 CONFLICT OF INTEREST AND COMMITMENT OF UNIVERSITY APPOINTEES ............ 11 II.8 REVIEW OF ACADEMIC APPOINTEES ............................................................................. 11

III TEACHING ............................................................................................................................................ 11 III.1 INTRODUCTION ................................................................................................................... 11 III.2 HOSPITAL TEACHING COMMITMENT ............................................................................... 12 III.3 STUDENTS ........................................................................................................................... 13

III.3.1 Placement of Students ............................................................................................. 13

1


III.3.2 Transfer of Students ................................................................................................ 13 III.3.3 Termination of Student Placement for Unacceptable Behaviour............................. 13 III.3.4 Code of Behaviour on Academic Matters ................................................................ 14

III.4 HOSPITAL CLINICAL PROGRAM PLANNING AND REVIEW ............................................ 14 III.4.1 Program Planning .................................................................................................... 14 III.4.2 Quality Control ......................................................................................................... 14 III.4.3 Responsibility to Inform of Circumstances Affecting Teaching Programs ............... 15 III.4.4 Availability of Patients for Teaching ......................................................................... 15 III.4.5 Facilities ................................................................................................................... 15 III.4.6 Continuing Education ............................................................................................... 15

IV NON-DISCRIMINATION AND HUMAN RIGHTS .................................................................................. 16

V RESEARCH ........................................................................................................................................... 16 V.1 INTRODUCTION ................................................................................................................... 16 V.2 GRANT ADMINISTRATION .................................................................................................. 16 V.3 INVENTIONS AND INTELLECTUAL PROPERTY ............................................................... 17 V.4 THE CONDUCT OF RESEARCH ......................................................................................... 17

V.4.1 Ethical Conduct ........................................................................................................ 17 V.4.2 Conflict of Interest .................................................................................................... 17

VI HEALTHCARE DELIVERY ................................................................................................................... 18

VII LIBRARY AND INFORMATION SERVICES ........................................................................................ 18

VIII UNIVERSITY AND HOSPITAL USE OF EACH OTHER’S NAMES AND INSIGNIAS ....................... 18

IX NOTIFICATION AND CONSULTATION ............................................................................................... 18

X COORDINATION AND LIAISON .......................................................................................................... 19 X.1 UNIVERSITY-HOSPITAL COMMITTEES/WORKING GROUPS/TASK FORCES .............. 19 X.2 LIAISON ................................................................................................................................ 19

XI CONFORMITY WITH OTHER COMMUNITY TEACHING HOSPITAL OR SITE AGREEMENTS ...... 20

XII MAINTENANCE OF AFFILIATION ...................................................................................................... 20

XIII LIABILITY, INDEMNIFICATION AND INSURANCE ........................................................................... 21 XIII.1 LIABILITY .............................................................................................................................. 21 XIII.2 INDEMNIFICATION .............................................................................................................. 21 XIII.3 INSURANCE ......................................................................................................................... 21 XIII.4 STUDENT WORKPLACE INSURANCE ............................................................................... 22

XIV TERM, TERMINATION AND AMENDMENT OF THIS AGREEMENT ............................................... 22

XV GENERAL TERMS .............................................................................................................................. 23 XV.1 ASSIGNMENT AND ENUREMENT ...................................................................................... 23 XV.2 INDEPENDENT CONTRACTORS ....................................................................................... 23 XV.3 GOVERNING LAW ............................................................................................................... 23 XV.4 FORCE MAJEURE ............................................................................................................... 23 XV.5 ENTIRE AGREEMENT ......................................................................................................... 23

2


XV.6 COUNTERPARTS ................................................................................................................ 23

APPENDIX ................................................................................................................................................... 25 PREAMBLE

The Hospital and the University share a joint mission of health and biomedical-related education and research. This Agreement provides a framework for that, and the parties agree to work cooperatively to respond to their evolving relationship. This relationship between the Hospital and University includes a willingness to identify joint academic missions and initiatives through mutual acknowledgments that recognize each other's contributions.

I INTRODUCTION

I.1 OBJECTIVE OF THE UNIVERSITY

The objective of the University is to enhance its teaching and research. In all its teaching and research programs the University is committed to collaborating with hospitals, community teaching sites and other public sector institutions, where appropriate, to achieve the highest academic standards, to provide the best possible facilities and libraries, and to recognize excellence in teaching. In seeking to achieve the above objective, the University is committed to four principles:

i) respect for intellectual integrity, freedom of inquiry and rational discussion; ii) the fair and equitable treatment of all who work and study in the University, including clinical

teachers at hospitals and other community sites; iii) a collegial form of governance; and iv) fiscal responsibility and accountability. The above objective and principles govern the University’s relationship with institutions with which it affiliates.

I.2 OBJECTIVES OF THE HOSPITAL

The Hospital’s mission is to transform the healthcare experience for patients and their families by providing an extraordinary healthcare experience. The Hospital meets the healthcare needs of more than one million residents in the growing communities of Mississauga, West Toronto, and the surrounding region. Trillium is committed to the development of innovative and collaborative patient-care services. This has led to its role as a regional centre for Stroke, Neurosurgery and Sexual Assault & Domestic Violence, and as a provincial centre for Cardiac Services. The Hospital has one of the busiest emergency services in Canada and the largest free-standing day surgery facility in North America. The Hospital is committed to the education and mentoring of the future generation of healthcare professionals and the professional development and growth of its staff.

The objectives of the Hospital include the following:

i) Creating spaces that support healing and wellness; ii) Exploring new and innovative ways of providing quality health care within today’s fiscal

constraints; iii) Developing partnerships to support a common vision and approaches to the education of

future healthcare professionals;

3


iv) Maximizing technology to enhance the ability to provide patient-centered care across the

healthcare system; and v) Fostering innovation and creativity in a collaborative environment.

I.3 BASIS FOR AFFILIATION

The University and the Hospital have a mutual interest in the enhancement of education of health professionals, research and evidence-based practice. In order for the University to offer programs of education and professional training in health and health-related fields, it must have access to the facilities of healthcare institutions and organizations, so that it may offer clinical and practical experience to its students enrolled in these programs. The University is committed to working with the Hospital to establish the Mississauga Academy and the Hospital is willing to develop the appropriate resources for the services necessary to support teaching and research. Because of its mission and facilities, the University has resources and services necessary for the support of teaching and research and is willing to make them available to the Hospital as appropriate. Both the University and the Hospital recognize the role and the responsibility of the Hospital in the provision of health care. Both the University and the Hospital recognize the importance of academic freedom and the need to safeguard the intellectual independence of all faculty members, including Hospital appointed or employed staff who have University appointments. Notwithstanding the mutual respect of the University and the Hospital for academic freedom, All faculty (as hereinafter defined) remain subject to applicable ethical and clinical guidelines or standards, laws and regulations and to the Hospital’s relevant policies or by-laws. Therefore it is the purpose of this Agreement to provide a foundation upon which the University and the Hospital may collaborate and cooperate in their efforts to accomplish their objectives. Thus, the parties agree as follows:

I.4 DEFINITIONS AND INTERPRETATION

I.4.1 Definitions

In this Agreement,

a. All faculty means all Hospital staff members who have appointments in a Faculty or Department at the University, including faculty in the categories defined in b) and d) to f) below.

b. All Health Professional faculty means all faculty who are engaged in health professional or

clinical practice; that is, all faculty in the categories defined in d) to f) below.

c. Chief means the Chief, Head, Director or other clinical leader of a Hospital Medical-Dental clinical Department or program.

4


d. Clinical faculty (physician) means an individual or individuals licensed to practice medicine in

Ontario, holding a Medical-Dental staff appointment at the Hospital and appointed in accordance with the University Policy for Clinical Faculty as Clinical faculty in a University Faculty of Medicine Clinical Department. Clinical faculty may be full-time, part-time or adjunct, and the criteria for each of these are set out in the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3).

e. Dentistry faculty means an individual or individuals licensed to practice dentistry in Ontario,

holding a Medical-Dental staff appointment at the Hospital and who is appointed in the University of Toronto Faculty of Dentistry.

f. Health Science faculty means an individual or individuals who are health professional staff or

employees of the Hospital and appointed in a Faculty or Department at the University. Health Science faculty are not Clinical faculty (physician) or Dentistry faculty.

g. Joint Committee means a Joint Committee as set out in section XII below.

h. Student means a person formally registered in a Faculty or Department of the University in a

course or program of study. A Student may be registered in a certificate, a diploma, an undergraduate, a health professional graduate, a doctoral (MSc/PhD) graduate or a postgraduate medical education program. Persons present in the Hospital in training situations who are not registered as Students of the University are not Students within the meaning of this section.

i. Teaching Programs means programs within various University Faculties or Departments

(including, but not limited to: Medicine, Dentistry, Nursing, Nutritional Science, Pharmacy, Psychology, Radiation Therapy, Medical Imaging Technology, Nuclear Medicine Technology, Social Work, Health Administration, Physical Therapy, Physical Education and Health, Occupational Therapy and Speech Language Pathology) that place Students in the Hospital and, if applicable, its research institute.

I.4.2 Interpretation

a. Subject to the terms of this Agreement, the University and the Hospital have the right and the authority to make decisions and to exercise their discretionary authority regarding their respective resource allocations, programmatic changes and/or use of or access to their respective premises or facilities.

b. No person who is not a party to this Agreement has any right to enforce any term of this

Agreement.

c. Except as may be provided herein, this Agreement shall not be interpreted or applied so as to fetter the respective authority, duties or responsibilities of the University or the Hospital under their respective constituting statutes, letters patent, governing legislation, by-laws or policies.

d. Nothing in this Agreement shall be interpreted or applied so as to interfere with statutory

obligations.

e. Nothing in this Agreement creates an employment relationship between any Student and either the Hospital or the University.

f. Where any person or position is referred to in this Agreement, except where the Agreement

specifies that the responsibility may be delegated, such person may delegate his/her

5


responsibilities only if such delegation has been approved by the Hospital and the University.

g. References to specific legislation in this Agreement include any amendments made from

time to time to such legislation and include any regulations, as amended from time to time, made under such specific legislation.

h. In the event a provision of any Schedule to this Agreement is inconsistent or conflicts with a

provision of the Agreement, the terms of this Agreement shall take precedence and govern to the extent of any such inconsistency or conflict.

I.5 APPLICABILITY OF UNIVERSITY POLICIES TO THE HOSPITAL AND AMENDMENT OF UNIVERSITY POLICES

i) The Hospital agrees that it is bound by the following University policies, procedures, guidelines and protocols (as amended by agreement of the Hospital and the University from time to time) attached as Schedules to this Agreement, to the extent that such policies, procedures, guidelines and protocols bind or create obligations for the Hospital:

• Policy for Clinical Faculty (Schedule 2) • Procedures Manual for Policy for Clinical Faculty (Schedule 3) • Faculty of Medicine/Affiliated Institutions Guidelines for Ethics and Professionalism in

Healthcare Professional Clinical Training and Teaching (Schedule 4) • Sexual Harassment Protocol: Sexual Harassment Complaints involving Faculty and Students

of the University of Toronto arising in University-Affiliated Health Institutions (Schedule 5)

Any proposed changes to the University’s Policy for Clinical Faculty (attached as Schedule 2) or its Procedures Manual (attached as Schedule 3) will be referred to the Clinical Relations Committee.

With respect to any proposed changes to the other three policies listed above in this subsection, the University’s Vice-Provost, Relations with Health Care Institutions will advise the Hospital of the proposed change, and work collaboratively with the Hospital with the goal of obtaining the Hospital’s agreement to be bound by the proposed changes. If agreement cannot be reached in that process, the matter will be referred to an ad hoc Joint Committee. Any amendment to any of the policies listed above in this subsection will not bind the Hospital unless the Hospital agrees to the amendment.

ii) The Harmonization of Research Policies (Schedule 6) provides that the University and the Hospital will work together to ensure the highest standards of ethical conduct in research, and to ensure the greatest possible degree of compatibility of their research policies and procedures. Both parties will work together and synergistically to update and harmonize their research environments in the areas addressed in Schedule 6. The University research policies listed below in this subsection are binding on Students and faculty but are otherwise not binding on the Hospital, and the University and the Hospital will work towards harmonizing and/or introducing them .The University and the Hospital will start the harmonization process in the first year of this Agreement, and new harmonized research policies may be added to this Agreement through amendments as they are agreed to by the parties. Harmonization will be undertaken in a two-step process: first by the Hospital/University Research Coordinating Committee of the Toronto Academic Health Science Network and then by the Community Research Coordinating Committee on which the Hospital will be represented.

6


• Policy on University Administration of Grants and Contracts when the Research is Being

Conducted at an Affiliated Hospital (Schedule 7) • Guidelines for Faculty of Medicine Graduate Students and Supervisors in the Context of

Commercialization of Inventions Based on Thesis-Related Research (Schedule 8) • Protection for Intellectual Freedom and Publication Rights (Schedule 9) • Policy on the Offer and Acceptance of Finders’ Fees or Completion Fees in Research

Involving Human Subjects (Schedule 10) • Principles and Responsibilities Regarding Conduct of Research (Schedule 11) • Guidelines to Address Allegations of Research Misconduct (Schedule 12) With respect to any proposed changes to the Harmonization of Research Policies (attached as Schedule 6), revisions will be made by mutual agreement of the parties and will be effective upon the written confirmation of the Hospital President and Chief Executive Officer and the President of the University or the Vice-Provost, Relations with Health Care Institutions. With respect to any proposed changes to the other policies listed above in this subsection, the matter will be referred to the Hospital/University Research Coordinating Committee of the Toronto Academic Health Science Network and to the Community Research Coordinating Committee. The Hospital will not be obligated to harmonize its policies to any proposed changes unless it agrees to do so. iii) With respect to the University policies, procedures, codes and similar documents that are listed below, the parties agree that the Hospital is not bound to these and is not obligated to monitor or enforce them: however Students and University appointees working in the Hospital are bound, and the Hospital recognizes and respects that. The Hospital will endeavour to avoid conflicts between these policies and Hospital policies and procedures and to advise the University of potential conflicts. For the purposes of this subsection, a “conflict” refers to a situation where a Hospital policy has the potential to impede the implementation of a University policy. • Provost’s Guidelines for Status-Only, Adjunct and Visiting Professor Appointments (Schedule

13) • Policy on Conflict of Interest Academic Staff (Schedule 14) • Guidelines for the Assignment of Postgraduate Medical Trainees (Schedule 15) • Code of Student Conduct (Schedule 16) • Code of Behaviour on Academic Matters (Schedule 17) • Policy on Ethical Conduct in Research (Schedule 18) • Policy on Research Involving Human Subjects (Schedule 19) • Research Involving Human Subjects: School of Graduate Studies Student Guide on Ethical

conduct (Schedule 20) • Publication Policy (Schedule 21) • Policy on Support of University of Toronto Sponsored Continuing Education Activities from

Commercial Sources (Schedule 22) If the University changes any of these policies, it will advise the Hospital of the changes if the Vice-Provost, Relations with Health Care Institutions determines that the Hospital should be advised. With respect to any changes of which it is advised, the Hospital will endeavour to avoid conflicts between the changed policies and Hospital policies and procedures and to advise the University of potential conflicts. Where the policies of the University referred to in this subsection and policies of the Hospital are in conflict, the matter will be referred to the Joint Committee as set out in Section XII or to other committees as specified in this Agreement or as otherwise agreed by the parties.

7


iv) If the University proposes to implement any new policy, procedure or guideline which could have an impact on the parties’ obligations under the Agreement, the University will advise the Hospital. If a proposed new University policy, procedure or guideline includes Hospital obligations, the University will work collaboratively with the Hospital with the goal of obtaining the Hospital’s agreement to be bound by the proposed policy, procedure or guideline. In no event will any new policy, procedure or guideline that is not agreed to by the parties be binding on the parties. v) The University and the Hospital will each use their best efforts to inform their appointees and staff of their respective policies and guidelines and of the importance of adhering to them.

II APPOINTMENT OF STAFF AND OVERSIGHT BY UNIVERSITY DEPARTMENT CHAIRS AND DEANS

II.1 INTRODUCTION

The parties recognize that it is primarily through their health professionals that they are able to achieve excellence in their endeavours, and that a primary instrument for effecting this affiliation is through the concurrent appointment of those clinical professionals who teach Students in the Hospital. In making such appointments, the parties acknowledge that each party has its own appointment and/or hiring policies and processes and will each respect the other’s policies and processes. In addition, they will cooperate with each other in their efforts and processes to maintain excellence, particularly in relation to staff assessment and promotion, program evaluation and Student evaluation of staff. Not all Hospital health professionals will have University appointments. Only those who are in clinical departments and programs that may be listed in the clinical Student teaching placements and who teach University Students will have a University appointment.

II.2 POLICIES GOVERNING APPOINTMENTS

The applicable policies of each party will be followed by that party in the hiring, appointment, promotion, disciplining, suspension and termination of staff by such party. The terms and conditions of the appointment of staff are detailed in the appropriate documents of the two parties. The review, renewal or non-renewal and termination processes for both University and Hospital appointments shall be done in accordance with the respective policies of the University and the Hospital as appropriate. The Hospital acknowledges that the University will appoint Clinical faculty (physicians) in accordance with the Policy for Clinical Faculty (attached as Schedule 2) and the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3). For all staff to whom the Policy for Clinical Faculty does not apply (i.e. non-physician staff), University appointments will be made in accordance with the Provost’s Guidelines for Status-Only, Adjunct and Visiting Professor Appointments (attached as Schedule 13).

II.3 APPOINTMENT OF HOSPITAL MEDICAL-DENTAL TEACHING STAFF

II.3.1 Staff Complement

The Medical-Dental teaching staff of each of the clinical departments and/or programs of the Hospital where Students are taught (as listed in the clinical Student teaching placement) shall

8


consist of a Chief and such other members as it is mutually agreed upon between the Hospital and the University as are necessary to render exemplary teaching and research.

II.3.2 University Appointment and Promotions

Those members of the Hospital Medical-Dental staff who teach Students and are responsible for a course or a substantial part of a course and/or grade Students must qualify for and hold University appointments in the appropriate Health Science Faculty of the University at such ranks and of such categories as the University may determine. The University will use its best efforts to apply its policies and guidelines respecting appointments and promotions consistently and equitably in all University Faculties and Departments for all affiliated hospitals and teaching sites. If any such staff member ceases to hold either a Hospital or University appointment, the party where this occurs shall promptly inform the other. This communication shall be the responsibility of the Hospital President and Chief Executive Officer (or delegate) and the Dean of the appropriate Faculty.

II.3.3 Hospital Appointment

Hospital appointments to the medical/dental staff of clinical departments and programs, now or hereafter established, of physicians or dentists who either will not hold University appointments or will also hold part-time or adjunct University appointments will be made in accordance with the Hospital’s by-laws, policies and/or procedures. The Chief of the Hospital Department may consult the Chair of the corresponding University department regarding the appointment. For greater certainty, the parties agree that the Hospital does not require the University’s approval with respect to such appointments. Hospital appointments of staff who will hold full-time University appointments may be made only upon the recommendation of both the Chief of the Hospital Department and the Chair of the University of Toronto Clinical Department, hereinafter referred to as “Chair”, or the Dean of a Health Faculty.

Nothing in this Agreement shall be interpreted to limit the Hospital’s right to unilaterally alter, suspend or terminate the privileges of its Medical-Dental staff in accordance with its by-laws and the Public Hospitals Act as amended from time to time or to require approval of the University in such circumstances.

II.3.4 Terms and Conditions of Appointments

The terms and conditions of appointment are set out in separate University and Hospital appointments. Appointments set out responsibilities for teaching, research and administration. Part-time and adjunct faculty are normally not funded through the University payroll for teaching. The University and the Hospital will negotiate, within the budgetary framework of the University, financial support from the University for administrative oversight of clinical teaching within specific programs, and will set out these terms in a separate letter of understanding as necessary.

II.3.5 Clinical Faculty (Physicians) in the Faculty of Medicine

i) Policy for Clinical Faculty and Procedures Manual for Policy for Clinical Faculty

The parties recognize that Clinical faculty (physicians) are essential to the University’s academic mission. They also recognize that the situation of clinical faculty (physicians) is

9


very different from that of University-salaried tenured faculty. Appointments of Clinical faculty are governed by the University’s Policy for Clinical Faculty (attached as schedule 2) and the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3). ii) Appointment of Clinical Faculty (Physicians) The Faculty of Medicine will appoint Clinical faculty (physicians) in accordance with the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3). Clinical faculty (physician) members may be appointed as part-time or adjunct Clinical faculty members, and on occasion as full-time. The criteria for each type of appointment are set out in Procedure 2.0, section VI in Schedule 3 attached.

iii) Academic Group Practices

Some Clinical faculty (physicians) will develop academic group practices through which funds from professional practice at the Hospital will be collected by the physician group and used for academic enrichment of the Hospital Department concerned (“Practice Plans”). The arrangements under which any such group practices function should be consonant with the patient care responsibilities of the Hospital and the academic missions of both the University and the Hospital.

If any Practice Plan now or in the future meets the definition of a “conforming practice plan” as defined in the Procedures Manual, its members shall be considered participants in a conforming practice plan for the purposes of the Policy for Clinical Faculty and its Procedures Manual. iv) Dispute resolution for Academic Disputes Academic disputes involving Clinical faculty (physician) members will be dealt with in accordance with the Procedures for Dealing with Academic Disputes (Procedure 3.0 in the attached Schedule 3). The Hospital accepts the jurisdiction of the (Clinical Faculty) Academic Clinical Tribunal (set out in Schedule 3) as regards disputes involving academic freedom concerns in the clinical setting. The Tribunal’s decision will consist of a determination of facts with respect to the complaint, a finding as to whether there has been a breach of academic freedom, and a delineation of the implications of the breach for the complainant. The decision shall be final and binding on the complainant and the Hospital and the University. The Tribunal has no powers to award remedies, or to change any of the provisions of a duly enacted policy or established practice of the University or the Hospital, or to substitute any new provision thereof.

II.4 APPOINTMENT OF HEALTH SCIENCE FACULTY TO THE UNIVERSITY

i) Health Science faculty of the University includes Hospital staff and employees appointed to one or more University Faculties and Departments other than Clinical Departments in Medicine and Dentistry. These include, but are not limited to: Nursing, Nutritional Science, Pharmacy, Psychology, Radiation Therapy, Medical Imaging Technology, Nuclear Medicine Technology, Social Work, Health Administration, Physical Therapy, Physical Education and Health, Occupational Therapy and Speech Language Pathology. ii) Health Science faculty may be given teaching appointments by the University in the appropriate Faculty at such rank and in such category as the University may determine. The University will not give University appointments to Health Science faculty without first obtaining the consent of the Hospital’s President and Chief Executive Officer or her/his delegate.

10


iii) Those Health Science faculty holding appointments at the Hospital who teach University Students and are responsible for a University course or a substantial part of a course and/or grade Students must qualify for and hold University appointments in the appropriate Faculty of the University at such ranks and of such categories as the University may determine. iv) The University recognizes the importance of developing further policies and guidelines governing the appointment and promotion of Health Science faculty, and agrees to engage in a consultative process with the community teaching hospitals and community teaching sites to develop these. No such policy or guideline will be binding on the Hospital unless the Hospital agrees to it.

II.5 APPOINTMENT AND RE-APPOINTMENT OF HOSPITAL CHIEFS

The Hospital will consult with the University Department Chair (or, in the case of Dentistry, the Dean) or his/her delegate before appointing or reappointing a Chief of a Medical or Dental Department in which significant teaching takes place. The parties acknowledge that it will be expected (although not mandatory) for the Chief of a Medical or Dental Department in which significant teaching takes place to hold a University appointment. The Hospital does not require the University’s approval to appoint a particular individual as Chief of a Medical or Dental Department. For greater certainty, except as set out above, the Hospital has no obligation to consult with the University with respect to leadership positions.

II.6 APPOINTMENT OF CHAIRS OF UNIVERSITY DEPARTMENTS

Collectively the community teaching hospitals and community teaching sites will have representation as appropriate in searches for Clinical Department Chairs, where there is teaching in the cognate community hospitals’ or teaching sites’ Departments or programs.

II.7 CONFLICT OF INTEREST AND COMMITMENT OF UNIVERSITY APPOINTEES

The University expects All faculty to perform their duties in accordance with the Policy on Conflict of Interest Academic Staff (attached as Schedule 14), which sets out the University’s expectations for its academic members of staff concerning their commitment to the University’s mission, goals and objectives in relation to their outside and related activities.

II.8 REVIEW OF ACADEMIC APPOINTEES

Upon request by the Vice-Provost, Relations with Health Care Institutions of the University, the Hospital will provide to the University for information, as soon as reasonably possible, a listing of All Health Professional faculty at the Hospital.

III TEACHING

III.1 INTRODUCTION

The Hospital acknowledges that the University is primarily responsible for the Teaching Programs in which Students are enrolled, whether those programs are located on or off the University’s property. Accordingly, the Hospital recognizes the University’s ultimate authority with regard to decisions made with respect to its

11


Teaching Programs. Nevertheless, the University acknowledges the valuable role and specific functions carried out by All Health Professional faculty who are engaged in the academic teaching mission, in the planning, administration, funding, presentation and review of its Teaching Programs, as well as the use of Hospital premises and access to the Hospital’s client populations for clinical teaching, and therefore will involve the Hospital in these processes as appropriate. The parties will support the efforts and requirements of each other to achieve and maintain excellence in teaching, particularly through such processes as departmental and institutional reviews, accreditation surveys, staff evaluations, program assessments, Student evaluations and constructive criticism and evaluation. The University and the Hospital agree to follow the Faculty of Medicine/Affiliated Institutions Guidelines for Ethics and Professionalism in Healthcare Professional Clinical Training and Teaching (attached as Schedule 4). The University (including faculty, staff and Students) and the Hospital share responsibility for creating a learning environment at the Hospital that promotes the development of explicit and appropriate professional attributes (attitudes, behaviours, and identity) in Students. The learning environment includes formal learning activities as well as attitudes, values, and informal "lessons" conveyed by individuals with whom the Student comes in contact.

III.2 HOSPITAL TEACHING COMMITMENT

The University and Hospital agree that, subject to the mutual agreement of the parties on annual teaching placements, certain Hospital Departments and programs will engage in teaching, and that some or all of the Hospital staff or health professionals in those Departments and programs will have University appointments and will teach Students. The University and the Hospital agree to work together in a reciprocal planning process to determine the appropriate number of clinical Student teaching placements by program and in the context of curriculum requirements. University health professional education programs will prepare annually a curriculum outline and the proposed clinical Student teaching placements at the Hospital. The University will deliver the proposed clinical Student teaching placements to the Hospital at least 10 months in advance of the start of each academic year ordinarily commencing July 1. The Hospital will consider whether they can accommodate the proposed clinical Student teaching placements, and the Hospital and the University will negotiate in good faith to reach agreement on the proposed clinical Student teaching placements at least 8 months in advance of the start of each academic year commencing July 1. Any subsequent changes to the clinical Student teaching placements will be agreed upon by the program leader of the cognate University Faculty, Department or program and the Vice-President Education (or equivalent) at the Hospital at least 4 months in advance of the start of the academic year. If agreement cannot be reached at any stage, the appropriate Dean, or, if relevant, Department Chair, and the Hospital’s President and Chief Executive Officer will endeavour to negotiate an agreement. The University curriculum, the number of Students needing placements and the Hospital’s ability to take Students may change from year to year for various reasons, and these factors will be relevant to the negotiation of the annual clinical Student teaching placements. The parties will cooperate to implement the annual clinical Student teaching placements (attached as Schedule 1).

12


The Hospital undertakes that any teaching of students from other educational institutions will not compromise its ongoing teaching commitment to the University as set out in Schedule 1. The University undertakes that, subject to requirements of the Guidelines for the Assignment of Postgraduate Medical Trainees, any assignment of Students to other hospitals or teaching sites (or other clinical settings) will not compromise its ongoing commitment to assign Students to the Hospital as set out in Schedule 1.

Attached as Schedule 1 is a template clinical Student teaching placements form. The parties will develop a detailed clinical Student teaching placements form in the first year of the Agreement to replace the template on agreement of the parties. The parties will amend the form by agreement on an annual basis.

III.3 STUDENTS

III.3.1 Placement of Students

For periods of time agreed to by the University and Hospital, Students will be permitted to take instruction and gain clinical and/or practical experience in the Hospital, provided that appropriate services are offered at the Hospital, subject to the Hospital’s ability to offer such instruction and/or experience and the commitments in Schedule 1. The Hospital will provide services and facilities upon the terms and conditions hereinafter set out. The placement of Students will be based on pedagogic interests, including the need for a wide range of learning experiences, and on requirements of applicable regulatory bodies, and subject to the Hospital’s ability to offer such instruction and/or experience. Using the process set out in Part III, section 2 above, the number of undergraduate, postgraduate and graduate Students from each University professional program taking instruction in the Hospital shall be negotiated and agreed annually by the representatives of the heads of the appropriate University Faculties or Departments with the representatives of the heads of the appropriate Hospital teaching services.

The Faculty of Medicine will assign postgraduate Students to teaching hospitals and sites and other clinical institutions in accordance with the Guidelines for the Assignment of Postgraduate Medical Trainees (attached as Schedule 15). Students enrolled in Departments and Faculties including, but not limited to, the Departments of Occupational Therapy, Physical Therapy, Speech/Language Pathology and Radiation Oncology, and the Faculties of Nursing, Pharmacy, Dentistry and Social Work are assigned to the Hospital in accordance with the curriculum plan for each clinical course or program and with the Hospital’s ability to provide an appropriate placement. The University will be responsible for informing Students who are placed at the Hospital that they are required to comply with Hospital policies.

III.3.2 Transfer of Students

The Hospital will transfer Students of the University assigned to it for clinical training and experience to another hospital or site or clinical facility only in collaboration with and with approval of the appropriate Department Chair and Dean or their delegates. However, provided it informs the University, the Hospital may, at its discretion, assign Students to clinical training activities in community clinics for part of the Student’s rotation at the Hospital.

III.3.3 Termination of Student Placement for Unacceptable Behaviour

13


The University recognizes the right of the Hospital, after consultation with the appropriate University Dean or Department Chair, to terminate the placement in the Hospital of an individual Student, if the Student’s behaviour or activities are considered by the Hospital to be unacceptable. If the behaviour, conduct or activities of a Student is considered to be unacceptable, that Student will be treated by the University in accordance with the University’s Code of Student Conduct (attached as Schedule 16) and by the Hospital in accordance with any applicable Hospital policies.

Notwithstanding the above, if in its sole discretion the Hospital determines that a Student’s behaviour or activities is placing patient or Hospital staff safety at risk, or unreasonably interferes with the operation of the Hospital’s programs or services, the Hospital may remove the Student from patient or Hospital staff contact immediately and, after contacting the appropriate Dean or Department Chair so that the University can take interim measures under its Code of Student Conduct, may terminate the Student’s placement.

III.3.4 Code of Behaviour on Academic Matters

In order to protect the integrity of the teaching and learning relationship, the University’s Code of Behaviour on Academic Matters (attached as Schedule 17) will apply to its staff and Students in the Hospital.

III.4 HOSPITAL CLINICAL PROGRAM PLANNING AND REVIEW

III.4.1 Program Planning

While recognizing its own authority and responsibility for the content and quality of the programs in which it places its Students, the University notes the essential role of All faculty in the presentation of clinical and practical experiences and programs of instruction to Students. Thus, where there is core curriculum teaching in a department or program at the Hospital, the Deans of the University’s Faculties and Schools, or their delegates, will invite the Hospital to participate in the planning of the programs and experiences to be offered to Students in related Departments at the University. Hospital participation could range from representation on University divisional/departmental education/curriculum committees to informal meetings between course coordinators and Hospital preceptors. The University will assist the Hospital as required in setting up teaching programs. The Hospital will notify the appropriate Dean or her/his delegate(s) of any proposed change in Hospital strategic plans and Ministry of Health and Long-Term Care accountability agreements that would materially affect the teaching obligations of the Hospital as set out in this Agreement and, where feasible, will invite the University to comment prior to making any such changes.

III.4.2 Quality Control

In order to assess the quality of and maintain the highest standards in its Teaching Programs, the University employs a variety of evaluative tools. Foremost among these is the review process, using either internal or external reviewers as deemed appropriate. Some reviews are mandated by external organizations such as accreditation bodies, while others are initiated from within the University. In addition, Students are asked regularly to evaluate the performance of teaching staff following a particular course, part of a course or practical experience. Department Chairs and Deans also review annually the performance of academic staff in all areas of staff responsibilities including teaching.

14


The Hospital acknowledges the importance of these and other measures to the mission of the University, recognizes that they also bear upon the success of the Hospital in achieving its own objectives and accordingly agrees, subject to available resources, to support and assist the University and the Faculties corresponding to Hospital departments where Students are taught in their efforts to maintain the quality of its Teaching Programs. The University will use its best efforts to provide the Hospital with copies of the usual performance evaluations by Students of the Hospital’s teaching staff. The University acknowledges the importance of these evaluations to the mission of the Hospital and recognizes that they also bear upon the success of the Hospital in achieving its own objectives.

III.4.3 Responsibility to Inform of Circumstances Affecting Teaching Programs

The parties acknowledge that decisions of accreditation authorities, requirements of the Professional Association of Internes & Residents of Ontario and other circumstances may affect Teaching Programs, and they agree to inform each other of any such decisions or circumstances.

III.4.4 Availability of Patients for Teaching

The Hospital will allow Students, for teaching purposes, access to such of its patients and their personal health information, both in-patients and ambulatory patients, as are necessary to meet its teaching commitments set out in the clinical Student teaching placements (attached as Schedule 1, as amended from time to time by agreement), subject to such restrictions as are imposed by the Hospital staff for clinical reasons and by Hospital patients, including any exercise of their right to refuse Student access. The Hospital will use its best efforts to provide the necessary mix of patients to meet the educational needs of Students placed in the Hospital. In exceptional circumstances if the Hospital ascertains that it will not be able to meet Students’ needs in any program or area as previously agreed upon, it will promptly advise the appropriate Department Chair or Dean and assist in finding alternate arrangements for the Students. The University will comply with all applicable privacy laws, including the Personal Health Information Protection Act, 2004, and agrees that it will advise all Students that they are required to comply with all applicable privacy laws and Hospital policies and procedures.

III.4.5 Facilities

The Hospital will provide in the Hospital such facilities for Students and clinical teachers as are agreed to by the Hospital’s Vice-President Education (or equivalent) and the Faculty’s Office of Community-Academic Relations.

The sharing of infrastructure expenses between the University and the Hospital will be negotiated in good faith from time to time among the University Department Chairs, the Deans and the Hospital’s Vice-President Education (or equivalent).

III.4.6 Continuing Education The University is committed to providing opportunities for All faculty to enhance their education skills through faculty development. University Departments and programs will facilitate the professional development of All faculty through appropriate educational methods (such as interactive seminars, workshops and on-line education skill development programs) relevant to the delivery of clinical teaching and learning.

15


IV NON-DISCRIMINATION AND HUMAN RIGHTS The University and the Hospital are committed to human rights and shall comply with the Human Rights Code (Ontario) and other applicable rights and equity legislation. The parties will remain committed to the principle of fair and equitable treatment for all. The parties are committed to having an environment free of prohibited discrimination and harassment. Each party will adopt their own appropriate policies with respect to discrimination and harassment and will have guidelines as to how it will deal with allegations of prohibited physical and verbal harassment and sexual harassment. In the cases of allegations of sexual harassment, the parties agree to follow the Sexual Harassment Protocol: Sexual Harassment Complaints involving Faculty and Students of the University of Toronto arising in University-Affiliated Health Institutions (attached as Schedule 5) for determining which sexual harassment policy applies and whether the University or the Hospital is responsible for dealing with a complaint.

V RESEARCH

V.1 INTRODUCTION

In achieving their common goals in research, the parties will consult each other in their research strategic planning processes.

V.2 GRANT ADMINISTRATION

Concerning research projects of All Health Professional faculty, the following procedures will apply.

i) All grant applications to be administered by the University will be signed by a) the Chair of the University Department in which the principal investigator holds her/his primary appointment, and b) the Dean, and counter-signed on behalf of either or both the Hospital and the University, as follows below in ii) and iii). The Dean may delegate signing authority to the Vice-Dean Research. For grant applications to be administered by the Hospital, the Department Chair’s signature is not required. However, a copy of the cover sheet and a summary of each submitted grant should be provided to the Chair of the Department in which the principal investigator holds her/his primary appointment. ii) When the research grant is to be administered by the University, senior signing authority will be vested in the President of the University (or his/her delegate). A copy of the cover sheet and a summary of each submitted grant application should be provided to the Hospital if the Health Professional faculty reports to the Hospital Vice-President Research (or equivalent). iii) When the research grant is to be administered by the Hospital, senior signing authority will be vested in the President and Chief Executive Officer of the Hospital (or his/her delegate).

iv) When significant Hospital resources, such as salaries, space and services, are used in research projects, the grant will ordinarily be administered by the Hospital. Where the Hospital administers the grant, the Hospital will receive the indirect cost funds. v) The party that accepts senior responsibility for a research grant will also accept full responsibility for grant administration and record-keeping, and for liaison with the granting agency. If

16


a research grant is administered by one party and the research is conducted at the premises of the other, there may be an administrative cost to the party conducting the research. The Policy on University Administration of Grants and Contracts when the Research is being Conducted at an Affiliated Hospital is attached as Schedule 7.

V.3 INVENTIONS AND INTELLECTUAL PROPERTY

Both the University and the Hospital have their own policies regarding the ownership and treatment of inventions and intellectual property. The protocol as between the University and the Hospital regarding inventions and intellectual property is set out in a separate agreement, which is attached as an Appendix . Faculty of Medicine graduate Students and their supervisors are also governed by Guidelines for Faculty of Medicine Graduate Students and Supervisors in the Context of Commercialization of Inventions Based on Thesis-Related Research (attached as Schedule 8).

V.4 THE CONDUCT OF RESEARCH

V.4.1 Ethical Conduct

The parties expect the highest standards of ethical conduct in every aspect of research. To this end, All faculty and Students will be expected to adhere to all relevant policies on ethical conduct of research, following the University Policy on Ethical Conduct in Research (attached as Schedule 18) when conducting research at the University and following the applicable Hospital policy(ies) when conducting research at the Hospital. Faculty with appointments in the Faculty of Medicine of the University will also adhere to all relevant Faculty guidelines, including the Principles and Responsibilities Regarding Conduct of Research (attached as Schedule 11), Protection of Intellectual Freedom and Publication Rights (attached as Schedule 9), and the Policy on the Offer and Acceptance of Finders’ Fees or Completion Fees in Research Involving Human Subjects (attached as Schedule 10). Where there is an allegation of research misconduct against a faculty member in the Faculty of Medicine, the Faculty’s Guidelines to Address Allegations of Research Misconduct (attached as Schedule 12) set out the criteria to determine which representative of the Faculty and/or Hospital will deal with the allegations. The Hospital will develop and maintain policies regarding research misconduct within its jurisdiction which are harmonized with the University’s and Health Faculties’ policies and which have parallel processes for dealing with allegations of research misconduct. The Hospital will operate its own Research Ethics Board or Boards (or be part of an REB consortium) which will be separate and independent from the University Research Ethics Board. These will be operated in a manner consistent with the principle of harmonization of research ethics and research policies set out in this Agreement. In addition, with respect to human subjects, the Hospital agrees its own Research Ethics Board or Boards will adhere to the Tri-Council Policy Statement (and its updates) and applicable legislation, including but not limited to the Personal Health Information Protection Act, 2004 and O.Reg 245/06. In the event that the Hospital does not have its own REB, it agrees to accept the review of a Board accepted by the University. The Hospital and University agree to collaborate, as appropriate and reasonable, in arrangements designed to enhance the effectiveness, efficiency and consistency of ethical review processes.

V.4.2 Conflict of Interest All faculty conducting research at the Hospital will be governed by the conflict of interest policy of the Hospital.

17


VI HEALTHCARE DELIVERY In supporting the Hospital in achieving its objectives and carrying out its responsibilities in healthcare delivery and patient care, the parties acknowledge that the Hospital is solely responsible for all healthcare delivery and patient care that occurs on the Hospital’s premises or under the Hospital’s jurisdiction. Nevertheless, the Hospital recognizes that the University has an interest in patient care and healthcare delivery, as they impact on the teaching of Students and on research. The University will support the Hospital in its efforts and requirements to maintain excellence in its standards of patient care and healthcare delivery particularly with regard to such processes as accreditation and review, and through the offering of constructive evaluation to the Hospital.

VII LIBRARY AND INFORMATION SERVICES The parties recognize the necessity of the provision of excellent library and information services in order to achieve their common objectives in teaching and research. Thus, they will cooperate and collaborate in planning, providing and maintaining such services. The parties accept their responsibilities to each other with regard to these services, subject to the limits of their financial resources. The University will work with the Hospital to facilitate remote access by the Hospital to the University’s library and information services. VIII UNIVERSITY AND HOSPITAL USE OF EACH OTHER’S NAMES AND INSIGNIAS The University encourages the use by the Hospital of the University and Faculty names and insignia as appropriate on letterhead and on all other materials in the ordinary course of business (e.g., websites, correspondence, course materials) in matters that are directly relevant to the affiliation with the University. The University will similarly refer to its affiliation with the Hospital as appropriate on materials in the ordinary course of business in matters that are directly relevant to the affiliation. Each party has a responsibility for safeguarding the names and insignia of the other, and, if there is any doubt as to appropriate use, for seeking clarification from the other party. Authorization to each party to use the name and official form of the logo(s) of the other party is limited to the purpose of officially recognizing the affiliation between the parties. Use of the name or logo(s) of a party for any purpose other than officially recognizing the affiliation between the parties requires prior written authorization from that party.

IX NOTIFICATION AND CONSULTATION Unless otherwise specified in this Agreement, where the Hospital is required to give notification to or consult with the University, communication with the Vice-Provost, Relations with Health Care Institutions will meet that requirement.

18


Unless otherwise specified in this Agreement, where the University is required to give notification to or consult with the Hospital, communication with the President and Chief Executive Officer will meet that requirement. With respect to obligations of officials identified in this Agreement, if the Hospital or the University reassigns or reorganizes responsibilities within the institution such that the identified official is no longer appropriate to carry out the obligations assigned in this Agreement, the Hospital or the University will notify the other party of the change to the official carrying out the obligation under the Agreement. All notices sent to the other party pursuant to this Agreement which are required to be in writing shall be delivered by hand; or by certified or registered mail, postage prepaid, return receipt requested; or by overnight courier; or by FAX, as follows: If to University of Toronto: If to Hospital:

Vice-Provost, President and Chief Executive Officer Relations with Health Care Institutions Trillium Health Centre

University of Toronto 100 Queensway West Room 2109, Medical Sciences Building Mississauga, Ontario L5B 1B8 1 King’s College Circle FAX# 905-948-7562 Toronto, Ontario M5S 1A8 FAX # 416-978-1774 All notices shall be deemed received on the date of delivery or, if mailed, on the date of receipt appearing on the return receipt card.

X COORDINATION AND LIAISON

X.1 UNIVERSITY-HOSPITAL COMMITTEES/WORKING GROUPS/TASK FORCES

The Hospital will have representation on the Hospital University Education Committee. The University and the Hospital will establish a Community Research Coordinating Committee that will have representation from each community affiliate. This Committee will be chaired by the Vice-Provost, Relations with Health Care Institutions and meet at least twice a year. The Vice-Provost, Relations with Health Care Institutions will, in consultation with the Hospital, endeavour to identify additional committees, working groups and task forces that might need to be developed to advance the joint mission. These additional committees, working groups and task forces shall, in general, include representation from the University and the community teaching hospitals and community teaching sites. The Hospital and the University will liaise as appropriate on all task forces, committees and meetings as may be struck from time to time.

X.2 LIAISON

X.2.1 Hospital

19


Each health profession discipline will have an assigned leader in the Hospital, such as the Chief, with whom the leader of the University programs will work directly. Generally, teaching placement and evaluation are the responsibility of the assigned leader. All health professional teaching will be overseen by a senior executive of the Hospital who reports to the Hospital’s President and Chief Executive Officer. The Hospital will name an individual(s) who will act as a liaison with the University.

X.2.2 University The University will establish and maintain an Office of Community-Academic Relations and appoint a Director, Distributed Medical Education to assist with the liaison functions in advancing the clinical teaching in the Hospital and to support the implementation of new affiliation agreements.

XI CONFORMITY WITH OTHER COMMUNITY TEACHING HOSPITAL OR SITE AGREEMENTS

The University will use its best efforts to ensure that its agreements with other community teaching hospitals and community teaching sites contain substantially the same provisions as are contained in this Agreement. As new community affiliations are developed with other hospitals and community teaching sites, they may be governed initially by a developmental affiliation agreement for 2 years, with the goal of establishing longer-term agreements.

XII MAINTENANCE OF AFFILIATION In order to monitor and coordinate this Affiliation, there will be ongoing liaison between the Vice-Provost, Relations with Health Care Institutions (or delegate) and the President and Chief Executive Officer of the Hospital (or delegate). As needed, issues arising from this Agreement may be referred to an ad hoc Joint Committee. A Joint Committee may be struck by either party as needed to address issues arising from this Agreement, relations between the parties and proposed changes to the policies of either institution that are referred to it, and will be comprised of equal numbers of representatives from the University and Hospital. The Committee will be co-chaired by the Vice-Provost, Relations with Health Care Institutions and the Hospital President and Chief Executive Officer (or their delegates), each of whom will appoint members to represent their institution. The Committee may at its discretion add ad hoc members in equal numbers from the Hospital and University from time to time to assist it with any issue. A Joint Committee will meet on an as needed ad hoc basis, at times and locations to be mutually agreed to by the parties. Either party may call a meeting of a Joint Committee. The Committee shall consider and make recommendations to the University and to the Hospital with respect to matters referred to it and, in addition, the Committee shall perform any duties assigned to it by the terms of this Agreement. The Joint Committee will use its best efforts to reach mutually acceptable solutions to disputes between the University and the Hospital related to this agreement; if no agreement can be reached on a particular issue, the parties will continue to implement the balance of the Agreement so far as practicable.

20


XIII LIABILITY, INDEMNIFICATION AND INSURANCE

XIII.1 LIABILITY

The parties agree that the University shall not be liable to the Hospital for any bodily injury (including death), any loss or damage to the property of or to the Hospital, its Board members (or trustees), officers, employees and agents in any manner, arising during, occasioned by, resulting from or in any way attributable to the performance or non-performance of this Agreement, unless such injury, loss or damage is caused or contributed to by the willful or negligent act or omission of the University, its governors, officers, faculty, employees or agents while acting within the scope of their duties. The parties agree that the Hospital shall not be liable to the University for any bodily injury (including death), any loss or damage to the property of or to the University, its governors, officers, faculty, employees and agents in any manner, arising during, occasioned by, resulting from or in any way attributable to the performance or non-performance of this Agreement, unless such injury, loss or damage is caused or contributed to by the wilful or negligent act or omission of the Hospital, its officers, employees or agents while acting within the scope of their duties. The Hospital assumes legal liability for the proper maintenance of its facilities and services provided in respect of the subject matter of this Agreement.

XIII.2 INDEMNIFICATION

Subject to the provisions of section 1 above, the Hospital shall at all times indemnify and save harmless the University, its governors, officers, faculty, employees, agents and Students from and against all claims, demands, damages, costs, expenses, actions and causes of action, whether in law or equity, suits or other legal proceedings howsoever caused (collectively referred to hereafter as “losses”) made or brought, prosecuted or threatened to be prosecuted against the University by whomsoever arising out of the Hospital’s performance or non-performance of this Agreement. Subject to the provisions of section 1 above, the University shall at all times indemnify and save harmless the Hospital, its Board members (or trustees), officers, employees and agents from and against all claims, demands, damages, costs, expenses, actions and causes of action, whether in law or equity, suits or other legal proceedings howsoever caused (collectively referred to hereafter as “losses”) made or brought, prosecuted or threatened to be prosecuted against the Hospital by whomsoever arising out of the University’s performance or non-performance of this Agreement. Notwithstanding the provisions of the indemnity set out above and the limitation of liability in section 1 above, each party shall be responsible for all losses made or brought, prosecuted or threatened to be prosecuted by whomsoever arising out of:

i) the use by that party of any result of any research as contemplated by this Agreement, or ii) the infringement by that party of any patent, trade mark, industrial design, copyright or other

intellectual property right or as a result of the development, use or exploitation thereof.

XIII.3 INSURANCE

The Hospital shall maintain in full force and effect a policy of comprehensive liability insurance to include coverage for any negligence, malpractice and medical professional liability on behalf of its officers, employees, agents and Students that could arise in the performance or non-performance of this Agreement. This insurance shall include coverage against bodily injury (including death), property damage and personal

21


injury including cross-liability and severability of interest provisions with a combined limit of not less than $5 million per occurrence. Such insurance coverage will protect Students assigned to the Hospital against legal liability incurred by them while acting within the scope of their duties and arising from the instruction, direction or supervision provided by the Hospital. The University shall maintain in full force and effect a policy of comprehensive liability insurance to include coverage for any negligence, malpractice and medical professional liability on behalf of its officers, employees and agents that could arise in the performance or non-performance of this Agreement. This insurance shall include coverage against bodily injury (including death), property damage and personal injury including cross-liability and severability of interest provisions with a combined limit of not less than $5 million per occurrence. The Hospital shall maintain in full force and effect a policy of direct damage property insurance against normal risks of physical loss or damage as contemplated by a standard “All Risks” property insurance policy covering all equipment of the University which is located on Hospital premises for an amount not less than the full replacement value thereof. The Hospital and the University will produce satisfactory evidence of insurance coverage to each other as set out above upon written request so to do.

XIII.4 STUDENT WORKPLACE INSURANCE

Neither the Hospital nor the University is responsible for Workplace Safety and Insurance Board premiums for Students, but the University will be responsible for arranging the relevant WSIB documentation regarding coverage for eligible Students.

XIV TERM, TERMINATION AND AMENDMENT OF THIS AGREEMENT The term of this Agreement is for five (5) years from January 1, 2007 to December 31, 2011. The University and the Hospital will commence discussions regarding renewing this Agreement eighteen (18) months before its expiry date. If, at the end of the term, a new agreement has not been executed and neither party has given 12 months prior written notice of their intention not to renew this Agreement, then this Agreement will survive until such time as either a new agreement is executed or this Agreement is terminated by either party giving the other 12 months prior written notice. This Agreement may be terminated by either party as of January 1 in any year during the term of the Agreement by giving to the other party at least twelve (12) months’ prior written notice. This Agreement and the Appendix to it may be amended by the parties at any time provided that no amendment shall be binding unless in writing and signed on behalf of the parties by their proper officers. Notwithstanding the foregoing, each of the Hospital and the University may amend its own internal policies referred to in this Agreement (including the attached Schedules) in accordance with its normal amending procedures, subject to the requirements of Part I, section 5 herein.

22


XV GENERAL TERMS

XV.1 ASSIGNMENT AND ENUREMENT

This Agreement and the rights and obligations hereunder are not assignable by either party. This Agreement shall inure to the benefit of and be binding upon the University and the Hospital and their successors.

XV.2 INDEPENDENT CONTRACTORS

The parties are independent contractors, and no agency, partnership, joint venture, employee-employer, or franchisor-franchisee relationship is intended or created by this Agreement.

XV.3 GOVERNING LAW

The laws of the Province of Ontario and applicable Canadian law shall govern the terms of this Agreement and the parties agree to submit to the exclusive jurisdiction of the courts of the Province of Ontario for any legal proceedings arising out of this Agreement.

XV.4 FORCE MAJEURE

The parties acknowledge that in the event of circumstances beyond the control of either party such as a community disaster, a strike, a fire, an infectious outbreak or other situation in which the continued provision of facilities or assignment of Students pursuant to obligations under this Agreement would substantially interfere with the Hospital’s primary duty of care to its patients or its research obligations or with the University’s teaching or research obligations, each party reserves the right to suspend performing its obligations under this Agreement immediately without penalty and until such time as the party reasonably determines that it is able to resume performance of its obligations herein.

XV.5 ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the parties and supersedes all other prior or contemporaneous representations, agreements, understandings or commitments, whether written or oral, between the parties relating to the subject matter herein. For greater clarity, this Agreement shall mean collectively, the terms and conditions contained in sections I to XV of this document, and the attached and referenced Appendix and Schedules and any other specifically referenced documents. The invalidity of any provision of this Agreement shall not affect the validity of the remaining provisions and this Agreement shall be construed as if such invalid provision had been omitted. No provision of this Agreement may be terminated, modified or waived except as set forth in a written agreement executed by authorized representatives of the parties.

XV.6 COUNTERPARTS

This Agreement may be signed in counterparts and each of such counterparts will constitute an original document and such counterparts, taken together, will constitute one and the same instrument.

23


IN WITNESS WHEREOF the parties hereto have caused this Agreement to be signed by their duly authorized officers. Seal FOR THE GOVERNING COUNCIL OF

THE UNIVERSITY OF TORONTO _________________________________________ Vice-Provost, Relations with Health Care Institutions _________________________________________ Secretary of Governing Council

FOR THE HOSPITAL

______________________________ Chair of the Board of Directors ______________________________ President and Chief Executive Officer

24


APPENDIX

INVENTIONS AND INTELLECTUAL PROPERTY

THIS AGREEMENT dated the 1st day of January, 2007 (the “IP Agreement”).

BETWEEN

TRILLIUM HEALTH CENTRE (the “Hospital”)

and


(the “University”)

WHEREAS the Hospital and the University have an affiliation agreement and many Hospital staff and University faculty members are concurrently appointed; AND WHEREAS some of these staff members may, from time to time, create inventions and other intellectual property; AND WHEREAS both the Hospital and the University (individually a “Party” and collectively the “Parties”) have their own separate and distinct policies regarding the ownership and treatment of inventions and other intellectual property; AND WHEREAS it is important for the successful commercialization of such inventions and other intellectual property that there be no uncertainty regarding the application of those policies; NOW THEREFORE IN CONSIDERATION OF premises and mutual covenants contained within the parties hereto agree as follows: 1. Definitions In this IP Agreement, the following terms shall be deemed to have the following meanings:

(a) “Invention” – any new and useful art, product, service, discovery, innovation, process, pattern, machine, process of manufacture or composition of matter or a formula thereof, new life form, computer software, compilation of information in whatever medium whatsoever, and attendant know-how or any new and useful improvement thereof, whether or not protected or protectable by patent, copyright or registration as an industrial design or trademark or pursuant to any other intellectual property or trade secret protection law which now exists or may exist in the future which was created with financial support, staff support, or the provision of space, equipment or supplies from either or both parties.

25


(b) “Net Revenues” – all royalties, license fees and other income (excluding funds received in

support of direct and indirect costs of the sponsored research project) received by a Party from the assignment or commercialization of or licensing of rights to an Invention, minus legal and other fees reasonably and actually incurred directly in the process of establishing and maintaining the legal protection of those rights.

(c) “Owner” means the Party determined under section 3.1 to be the owner of all patents,

trademarks, copyright, proprietary and/or other intellectual property rights relating to an Invention.

(d) “Share” – the proportionate share of support and Net Revenues determined or assigned to

a Party as more particularly described in section 3.2. 2. Mutual Disclosure

2.1 When a staff member holding appointments in both the University and the Hospital makes or creates an Invention, he/she shall disclose it to one of the Parties, in accordance with the inventions and intellectual property policies of that Party. If the disclosure indicates that, in the process of creating the Invention, the individual used, in any way, facilities owned, operated or administered by the other Party and/or has received personal financial compensation from the other party and/or received funds from the other party that contributed to the direct costs of the project that resulted in the Invention, the Party to which the disclosure has been made will provide a copy of the disclosure to the other Party as soon as possible.

2.2 No Party shall enter into a research agreement or contract which imposes any obligation or

liability on the other Party, including a commitment of the personnel, students or facilities of the other Party or an obligation with respect to the past, present or future intellectual property rights of the other Party, without the express, written consent of the other Party. The Party wishing to enter into such a research agreement or contract shall provide a copy of the proposed research agreement or contract, in confidence, to the other Party and shall consult fully with respect to the obligation or liability that would be imposed on the other Party.

2.3 For the purpose of this IP Agreement, undergraduate and graduate Students, clinical and

research fellows, and postdoctoral fellows will be treated in the same fashion as staff members holding appointments in both the University and the Hospital in all respects.

2.4 Any Invention disclosure disclosed by either Party to the other under this IP Agreement

shall be treated as confidential by the receiving Party unless the disclosing Party indicates in writing that it is non-confidential.

3. Ownership

3.1 Unless otherwise agreed among the Parties, due to extenuating circumstances, ownership of the patents, trademarks, copyright, proprietary and/or other intellectual property rights relating to the Invention shall vest with the Party on whose premises the Invention was made. If the Invention was made on the premises of both Parties or the Parties cannot agree on where the Invention was made, ownership shall vest with the Party that has provided the greater proportionate share of the salaries of the academic staff members named as inventors for the Invention at the time when the Invention was disclosed. The determination of that proportionate share shall be made by the Parties’ Vice-Presidents Research or their delegates.

26


3.2 For all Inventions, the Parties shall determine, by mutual agreement, each Party’s

proportionate share of support to the research project from which the Invention arose and proportionate share of Net Revenues from the Invention (the “Share”). This determination shall be made jointly by the Vice-Presidents Research of the Parties or by their designates. The Parties shall consider the following factors in determining each Party’s Share: use of the premises of each Party, personal financial compensation paid by each Party to the inventor(s) and any contribution by either Party to the direct costs of the project from which the Invention arose, excluding grants from third parties.

3.3 In all cases, the Invention will be subject to the policies of the Owner.

4. Negotiation and Commercialization

4.1 (a) Unless otherwise agreed, the Owner will assume full responsibility for applying for legal protection and/or for commercializing the Invention. The Owner will assume responsibility for all the costs and liabilities incurred in such activities. The Owner will also ensure that the other Party is kept informed about all patent applications, issued patents, licenses or other agreements or events which relate to commercialization of the Invention. (b) Inventions may arise involving two or more inventors where each Party is determined to be a joint Owner. In these circumstances, the Parties shall negotiate in good faith an agreement to cooperate to protect and commercialize the jointly-owned Invention and, unless otherwise agreed by the Parties, the Party whose inventors have made the predominant inventive contribution shall be responsible for protecting and commercializing such Invention.

4.2 If the Owner decides not to proceed with the application for legal protection and/or the

commercialization of the Invention, the Owner shall advise the other Party of its decision within three (3) months of the date of the Invention’s disclosure and, at that time, shall offer to assign all its rights to the Invention to the other Party and shall specify the applicable terms and conditions, if any, of such offer.

5. Proceeds from an Invention

5.1 All Net Revenues from an Invention will be divided between the Parties in proportion to each Party’s Share. Each Party’s Share will be distributed in accordance with the Party’s intellectual property policies.

5.2 If equity in a company is received by the Owner in lieu of revenue in whole or in part, the

equity shall be divided between the Parties in proportion to each Party’s Share. 6. Dispute Resolution

6.1 Any dispute arising under this IP Agreement which cannot be settled amicably between the Parties shall be submitted to arbitration by a panel composed of one member nominated by the University, one member nominated by the Hospital and one member selected by the first two arbitrators. The panel’s decision will be made by a majority of the three panel members within thirty (30) days of its appointment. The decision shall be final and binding upon the Parties.

6.2 If the nominees cannot agree on the identity of the third panel member, an application will

be made to the court for the appointment of a third arbitrator. 7. Notices

27


7.1 All notices required under this Agreement shall be in writing and, unless otherwise agreed, shall be delivered by mail, facsimile transmission (with confirmation of delivery), or in person to the Parties at the following addresses:

University: Vice-President, Research University of Toronto

27 King’s College Circle Toronto, Ontario M5S 1A1

Hospital: President and Chief Executive Officer Trillium Health Centre 100 Queensway West

Mississauga, Ontario L5B 1B8 8. Amendment

8.1 This IP Agreement may be modified at any time by mutual written agreement of the Parties. 9. Term and Termination

9.1 This IP Agreement shall enter into force as of the date first written above and shall remain in force until termination by mutual agreement of the Parties or thirty (30) days after presentation of written notice of termination by one Party to the other.

IN WITNESS WHEREOF the Parties hereto have caused this Agreement to be signed by their duly authorized officers on the day and date first above written.

FOR THE GOVERNING COUNCIL OF THE UNIVERSITY OF TORONTO _________________________________________ Vice-Provost, Relations with Health Care Institutions _________________________________________ Secretary of Governing Council

FOR THE HOSPITAL


28


Appendix 2. B.- Credit Valley Hospital

THIS AGREEMENT made in duplicate as of the 1st day of January, 2007

BETWEEN


(“THE UNIVERSITY”) OF THE FIRST PART

AND

THE CREDIT VALLEY HOSPITAL

(“THE HOSPITAL”) OF THE SECOND PART

CONTENTS PAGE

PREAMBLE ................................................................................................................................................... 3

I INTRODUCTION ....................................................................................................................................... 3 I.1 OBJECTIVE OF THE UNIVERSITY ....................................................................................... 3 I.2 OBJECTIVES OF THE HOSPITAL ......................................................................................... 3 I.3 BASIS FOR AFFILIATION ...................................................................................................... 4 I.4 DEFINITIONS AND INTERPRETATION ................................................................................ 4

I.4.1 Definitions .................................................................................................................. 4 I.4.2 Interpretation .............................................................................................................. 5

I.5 APPLICABILITY OF UNIVERSITY POLICIES TO THE HOSPITAL AND AMENDMENT OF UNIVERSITY POLICES .......................................................................................................... 6

II APPOINTMENT OF STAFF AND OVERSIGHT BY UNIVERSITY DEPARTMENT CHAIRS AND DEANS .................................................................................................................................................................... 8

II.1 INTRODUCTION .................................................................................................................... 8 II.2 POLICIES GOVERNING APPOINTMENTS ........................................................................... 8 II.3 APPOINTMENT OF HOSPITAL MEDICAL-DENTAL TEACHING STAFF ............................ 8

II.3.1 Staff Complement ...................................................................................................... 8 II.3.2 University Appointment and Promotions ................................................................... 8 II.3.3 Hospital Appointment ................................................................................................. 9 II.3.4 Terms and Conditions of Appointments .................................................................... 9 II.3.5 Clinical Faculty (Physicians) in the Faculty of Medicine ............................................ 9

II.4 APPOINTMENT OF HEALTH SCIENCE FACULTY TO THE UNIVERSITY ....................... 10 II.5 APPOINTMENT AND RE-APPOINTMENT OF HOSPITAL CHIEFS ................................... 10 II.6 APPOINTMENT OF CHAIRS OF UNIVERSITY DEPARTMENTS ...................................... 11 II.7 CONFLICT OF INTEREST AND COMMITMENT OF UNIVERSITY APPOINTEES ............ 11 II.8 REVIEW OF ACADEMIC APPOINTEES ............................................................................. 11

III TEACHING ............................................................................................................................................ 11 III.1 INTRODUCTION ................................................................................................................... 11 III.2 HOSPITAL TEACHING COMMITMENT ............................................................................... 12 III.3 STUDENTS ........................................................................................................................... 12

III.3.1 Placement of Students ............................................................................................. 12 III.3.2 Transfer of Students ................................................................................................ 13 III.3.3 Termination of Student Placement for Unacceptable Behaviour............................. 13

1


III.3.4 Code of Behaviour on Academic Matters ................................................................ 13 III.4 HOSPITAL CLINICAL PROGRAM PLANNING AND REVIEW ............................................ 14

III.4.1 Program Planning .................................................................................................... 14 III.4.2 Quality Control ......................................................................................................... 14 III.4.3 Responsibility to Inform of Circumstances Affecting Teaching Programs ............... 14 III.4.4 Availability of Patients for Teaching ......................................................................... 14 III.4.5 Facilities ................................................................................................................... 15 III.4.6 Continuing Education ............................................................................................... 15

IV NON-DISCRIMINATION AND HUMAN RIGHTS .................................................................................. 15

V RESEARCH ........................................................................................................................................... 15 V.1 INTRODUCTION ................................................................................................................... 15 V.2 GRANT ADMINISTRATION .................................................................................................. 16 V.3 INVENTIONS AND INTELLECTUAL PROPERTY ............................................................... 16 V.4 THE CONDUCT OF RESEARCH ......................................................................................... 16

V.4.1 Ethical Conduct ........................................................................................................ 16 V.4.2 Conflict of Interest .................................................................................................... 17

VI HEALTHCARE DELIVERY ................................................................................................................... 17

VII LIBRARY AND INFORMATION SERVICES ........................................................................................ 17

VIII UNIVERSITY AND HOSPITAL USE OF EACH OTHER’S NAMES AND INSIGNIAS ....................... 18

IX NOTIFICATION AND CONSULTATION ............................................................................................... 18

X COORDINATION AND LIAISON .......................................................................................................... 19 X.1 UNIVERSITY-HOSPITAL COMMITTEES/WORKING GROUPS/TASK FORCES .............. 19 X.2 LIAISON ................................................................................................................................ 19

XI CONFORMITY WITH OTHER COMMUNITY TEACHING HOSPITAL OR SITE AGREEMENTS ...... 19

XII MAINTENANCE OF AFFILIATION ...................................................................................................... 19

XIII LIABILITY, INDEMNIFICATION AND INSURANCE ........................................................................... 20 XIII.1 LIABILITY .............................................................................................................................. 20 XIII.2 INDEMNIFICATION .............................................................................................................. 20 XIII.3 INSURANCE ......................................................................................................................... 21 XIII.4 STUDENT WORKPLACE INSURANCE ............................................................................... 21

XIV TERM, TERMINATION AND AMENDMENT OF THIS AGREEMENT ............................................... 21

XV GENERAL TERMS .............................................................................................................................. 22 XV.1 ASSIGNMENT AND ENUREMENT ...................................................................................... 22 XV.2 INDEPENDENT CONTRACTORS ....................................................................................... 22 XV.3 GOVERNING LAW ............................................................................................................... 22 XV.4 FORCE MAJEURE ............................................................................................................... 22 XV.5 ENTIRE AGREEMENT ......................................................................................................... 22 XV.6 COUNTERPARTS ................................................................................................................ 23

APPENDIX ................................................................................................................................................... 24

2


PREAMBLE The Hospital and the University share a joint mission of health and biomedical-related education and research. This Agreement provides a framework for that, and the parties agree to work cooperatively to respond to their evolving relationship. This relationship between the Hospital and University includes a willingness to identify joint academic missions and initiatives through mutual acknowledgments that recognize each other's contributions.

I INTRODUCTION

I.1 OBJECTIVE OF THE UNIVERSITY

The objective of the University is to enhance its teaching and research. In all its teaching and research programs the University is committed to collaborating with hospitals, community teaching sites and other public sector institutions, where appropriate, to achieve the highest academic standards, to provide the best possible facilities and libraries, and to recognize excellence in teaching. In seeking to achieve the above objective, the University is committed to four principles:

i) respect for intellectual integrity, freedom of inquiry and rational discussion; ii) the fair and equitable treatment of all who work and study in the University, including clinical

teachers at hospitals and other community sites; iii) a collegial form of governance; and iv) fiscal responsibility and accountability. The above objective and principles govern the University’s relationship with institutions with which it affiliates.

I.2 OBJECTIVES OF THE HOSPITAL

The mission of the Hospital is to offer quality compassionate health care to the people of the growing communities of Peel and Halton. The Hospital attains its mission through living its corporate values: excellence in patient care, respect, leadership, teamwork, accountability, and partnership. The objectives of the Hospital are as follows:

i) To position the Hospital as one of the leaders and innovators in the provision of health professional education opportunities;

ii) To promote a culture of continuous learning; iii) To enhance the quality, accessibility and level of service presently provided to its

communities; iv) To enhance the quality of work life available to its medical staff, hospital employees and

volunteers; v) To sustain the health of its communities through educational leadership and mentoring of

our future health professionals; and vi) To provide additional opportunities to recruit and retain new physician and allied health

graduates for its communities and in affiliation with the Hospital.

3


I.3 BASIS FOR AFFILIATION

The University and the Hospital have a mutual interest in the enhancement of education of health professionals, research and evidence-based practice. In order for the University to offer programs of education and professional training in health and health-related fields, it must have access to the facilities of healthcare institutions and organizations, so that it may offer clinical and practical experience to its students enrolled in these programs. The University is committed to working with the Hospital to establish the Mississauga Academy and the Hospital is willing to develop the appropriate resources for the services necessary to support teaching and research. Because of its mission and facilities, the University has resources and services necessary for the support of teaching and research and is willing to make them available to the Hospital as appropriate. Both the University and the Hospital recognize the role and the responsibility of the Hospital in the provision of health care. Both the University and the Hospital recognize the importance of academic freedom and the need to safeguard the intellectual independence of all faculty members, including Hospital appointed or employed staff who have University appointments. Notwithstanding the mutual respect of the University and the Hospital for academic freedom, All faculty (as hereinafter defined) remain subject to applicable ethical and clinical guidelines or standards, laws and regulations and to the Hospital’s relevant policies or by-laws. Therefore it is the purpose of this Agreement to provide a foundation upon which the University and the Hospital may collaborate and cooperate in their efforts to accomplish their objectives. Thus, the parties agree as follows:

I.4 DEFINITIONS AND INTERPRETATION

I.4.1 Definitions

In this Agreement,

a. All faculty means all Hospital staff members who have appointments in a Faculty or Department at the University, including faculty in the categories defined in b) and d) to f) below.

b. All Health Professional faculty means all faculty who are engaged in health professional or

clinical practice; that is, all faculty in the categories defined in d) to f) below.

c. Chief means the Chief, Head, Director or other clinical leader of a Hospital Medical-Dental clinical Department or program.

d. Clinical faculty (physician) means an individual or individuals licensed to practice medicine in

Ontario, holding a Medical-Dental staff appointment at the Hospital and appointed in accordance with the University Policy for Clinical Faculty as Clinical faculty in a University Faculty of Medicine Clinical Department. Clinical faculty may be full-time, part-time or adjunct, and the criteria for each of these are set out in the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3).

4


e. Dentistry faculty means an individual or individuals licensed to practice dentistry in Ontario, holding a Medical-Dental staff appointment at the Hospital and who is appointed in the University of Toronto Faculty of Dentistry.

f. Health Science faculty means an individual or individuals who are health professional staff or

employees of the Hospital and appointed in a Faculty or Department at the University. Health Science faculty are not Clinical faculty (physician) or Dentistry faculty.

g. Joint Committee means a Joint Committee as set out in section XII below.

h. Student means a person formally registered in a Faculty or Department of the University in a

course or program of study. A Student may be registered in a certificate, a diploma, an undergraduate, a health professional graduate, a doctoral (MSc/PhD) graduate or a postgraduate medical education program. Persons present in the Hospital in training situations who are not registered as Students of the University are not Students within the meaning of this section.

i. Teaching Programs means programs within various University Faculties or Departments

(including, but not limited to: Medicine, Dentistry, Nursing, Nutritional Science, Pharmacy, Psychology, Radiation Therapy, Medical Imaging Technology, Nuclear Medicine Technology, Social Work, Health Administration, Physical Therapy, Physical Education and Health, Occupational Therapy and Speech Language Pathology) that place Students in the Hospital and, if applicable, its research institute.

I.4.2 Interpretation

a. Subject to the terms of this Agreement, the University and the Hospital have the right and the authority to make decisions and to exercise their discretionary authority regarding their respective resource allocations, programmatic changes and/or use of or access to their respective premises or facilities.

b. No person who is not a party to this Agreement has any right to enforce any term of this

Agreement.

c. Except as may be provided herein, this Agreement shall not be interpreted or applied so as to fetter the respective authority, duties or responsibilities of the University or the Hospital under their respective constituting statutes, letters patent, governing legislation, by-laws or policies.

d. Nothing in this Agreement shall be interpreted or applied so as to interfere with statutory

obligations.

e. Nothing in this Agreement creates an employment relationship between any Student and either the Hospital or the University.

f. Where any person or position is referred to in this Agreement, except where the Agreement

specifies that the responsibility may be delegated, such person may delegate his/her responsibilities only if such delegation has been approved by the Hospital and the University.

g. References to specific legislation in this Agreement include any amendments made from

time to time to such legislation and include any regulations, as amended from time to time, made under such specific legislation.

5


h. In the event a provision of any Schedule to this Agreement is inconsistent or conflicts with a provision of the Agreement, the terms of this Agreement shall take precedence and govern to the extent of any such inconsistency or conflict.

I.5 APPLICABILITY OF UNIVERSITY POLICIES TO THE HOSPITAL AND AMENDMENT OF UNIVERSITY POLICES

i) The Hospital agrees that it is bound by the following University policies, procedures, guidelines and protocols (as amended by agreement of the Hospital and the University from time to time) attached as Schedules to this Agreement, to the extent that such policies, procedures, guidelines and protocols bind or create obligations for the Hospital:

• Policy for Clinical Faculty (Schedule 2) • Procedures Manual for Policy for Clinical Faculty (Schedule 3) • Faculty of Medicine/Affiliated Institutions Guidelines for Ethics and Professionalism in

Healthcare Professional Clinical Training and Teaching (Schedule 4) • Sexual Harassment Protocol: Sexual Harassment Complaints involving Faculty and Students

of the University of Toronto arising in University-Affiliated Health Institutions (Schedule 5)

Any proposed changes to the University’s Policy for Clinical Faculty (attached as Schedule 2) or its Procedures Manual (attached as Schedule 3) will be referred to the Clinical Relations Committee.

With respect to any proposed changes to the other three policies listed above in this subsection, the University’s Vice-Provost, Relations with Health Care Institutions will advise the Hospital of the proposed change, and work collaboratively with the Hospital with the goal of obtaining the Hospital’s agreement to be bound by the proposed changes. If agreement cannot be reached in that process, the matter will be referred to an ad hoc Joint Committee. Any amendment to any of the policies listed above in this subsection will not bind the Hospital unless the Hospital agrees to the amendment.

ii) The Harmonization of Research Policies (Schedule 6) provides that the University and the Hospital will work together to ensure the highest standards of ethical conduct in research, and to ensure the greatest possible degree of compatibility of their research policies and procedures. Both parties will work together and synergistically to update and harmonize their research environments in the areas addressed in Schedule 6. The University research policies listed below in this subsection are binding on Students and faculty but are otherwise not binding on the Hospital, and the University and the Hospital will work towards harmonizing and/or introducing them .The University and the Hospital will start the harmonization process in the first year of this Agreement, and new harmonized research policies may be added to this Agreement through amendments as they are agreed to by the parties. Harmonization will be undertaken in a two-step process: first by the Hospital/University Research Coordinating Committee of the Toronto Academic Health Science Network and then by the Community Research Coordinating Committee on which the Hospital will be represented. • Policy on University Administration of Grants and Contracts when the Research is Being

Conducted at an Affiliated Hospital (Schedule 7) • Guidelines for Faculty of Medicine Graduate Students and Supervisors in the Context of

Commercialization of Inventions Based on Thesis-Related Research (Schedule 8) • Protection for Intellectual Freedom and Publication Rights (Schedule 9) • Policy on the Offer and Acceptance of Finders’ Fees or Completion Fees in Research

Involving Human Subjects (Schedule 10) • Principles and Responsibilities Regarding Conduct of Research (Schedule 11) • Guidelines to Address Allegations of Research Misconduct (Schedule 12)

6


With respect to any proposed changes to the Harmonization of Research Policies (attached as Schedule 6), revisions will be made by mutual agreement of the parties and will be effective upon the written confirmation of the Hospital President and Chief Executive Officer and the President of the University or the Vice-Provost, Relations with Health Care Institutions. With respect to any proposed changes to the other policies listed above in this subsection, the matter will be referred to the Hospital/University Research Coordinating Committee of the Toronto Academic Health Science Network and to the Community Research Coordinating Committee. The Hospital will not be obligated to harmonize its policies to any proposed changes unless it agrees to do so. iii) With respect to the University policies, procedures, codes and similar documents that are listed below, the parties agree that the Hospital is not bound to these and is not obligated to monitor or enforce them: however Students and University appointees working in the Hospital are bound, and the Hospital recognizes and respects that. The Hospital will endeavour to avoid conflicts between these policies and Hospital policies and procedures and to advise the University of potential conflicts. For the purposes of this subsection, a “conflict” refers to a situation where a Hospital policy has the potential to impede the implementation of a University policy. • Provost’s Guidelines for Status-Only, Adjunct and Visiting Professor Appointments (Schedule

13) • Policy on Conflict of Interest Academic Staff (Schedule 14) • Guidelines for the Assignment of Postgraduate Medical Trainees (Schedule 15) • Code of Student Conduct (Schedule 16) • Code of Behaviour on Academic Matters (Schedule 17) • Policy on Ethical Conduct in Research (Schedule 18) • Policy on Research Involving Human Subjects (Schedule 19) • Research Involving Human Subjects: School of Graduate Studies Student Guide on Ethical

conduct (Schedule 20) • Publication Policy (Schedule 21) • Policy on Support of University of Toronto Sponsored Continuing Education Activities from

Commercial Sources (Schedule 22) If the University changes any of these policies, it will advise the Hospital of the changes if the Vice-Provost, Relations with Health Care Institutions determines that the Hospital should be advised. With respect to any changes of which it is advised, the Hospital will endeavour to avoid conflicts between the changed policies and Hospital policies and procedures and to advise the University of potential conflicts. Where the policies of the University referred to in this subsection and policies of the Hospital are in conflict, the matter will be referred to the Joint Committee as set out in Section XII or to other committees as specified in this Agreement or as otherwise agreed by the parties. iv) If the University proposes to implement any new policy, procedure or guideline which could have an impact on the parties’ obligations under the Agreement, the University will advise the Hospital. If a proposed new University policy, procedure or guideline includes Hospital obligations, the University will work collaboratively with the Hospital with the goal of obtaining the Hospital’s agreement to be bound by the proposed policy, procedure or guideline. In no event will any new policy, procedure or guideline that is not agreed to by the parties be binding on the parties. v) The University and the Hospital will each use their best efforts to inform their appointees and staff of their respective policies and guidelines and of the importance of adhering to them.

7


II APPOINTMENT OF STAFF AND OVERSIGHT BY UNIVERSITY

DEPARTMENT CHAIRS AND DEANS

II.1 INTRODUCTION

The parties recognize that it is primarily through their health professionals that they are able to achieve excellence in their endeavours, and that a primary instrument for effecting this affiliation is through the concurrent appointment of those clinical professionals who teach Students in the Hospital. In making such appointments, the parties acknowledge that each party has its own appointment and/or hiring policies and processes and will each respect the other’s policies and processes. In addition, they will cooperate with each other in their efforts and processes to maintain excellence, particularly in relation to staff assessment and promotion, program evaluation and Student evaluation of staff. Not all Hospital health professionals will have University appointments. Only those who are in clinical departments and programs that may be listed in the clinical Student teaching placements and who teach University Students will have a University appointment.

II.2 POLICIES GOVERNING APPOINTMENTS

The applicable policies of each party will be followed by that party in the hiring, appointment, promotion, disciplining, suspension and termination of staff by such party. The terms and conditions of the appointment of staff are detailed in the appropriate documents of the two parties. The review, renewal or non-renewal and termination processes for both University and Hospital appointments shall be done in accordance with the respective policies of the University and the Hospital as appropriate. The Hospital acknowledges that the University will appoint Clinical faculty (physicians) in accordance with the Policy for Clinical Faculty (attached as Schedule 2) and the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3). For all staff to whom the Policy for Clinical Faculty does not apply (i.e. non-physician staff), University appointments will be made in accordance with the Provost’s Guidelines for Status-Only, Adjunct and Visiting Professor Appointments (attached as Schedule 13).

II.3 APPOINTMENT OF HOSPITAL MEDICAL-DENTAL TEACHING STAFF

II.3.1 Staff Complement

The Medical-Dental teaching staff of each of the clinical departments and/or programs of the Hospital where Students are taught (as listed in the clinical Student teaching placement) shall consist of a Chief and such other members as it is mutually agreed upon between the Hospital and the University as are necessary to render exemplary teaching and research.

II.3.2 University Appointment and Promotions

Those members of the Hospital Medical-Dental staff who teach Students and are responsible for a course or a substantial part of a course and/or grade Students must qualify for and hold University appointments in the appropriate Health Science Faculty of the University at such ranks and of such categories as the University may determine. The University will use its best efforts to apply its policies and guidelines respecting appointments and promotions consistently and equitably in all University Faculties and Departments for all affiliated hospitals and teaching sites.

8


If any such staff member ceases to hold either a Hospital or University appointment, the party where this occurs shall promptly inform the other. This communication shall be the responsibility of the Hospital President and Chief Executive Officer (or delegate) and the Dean of the appropriate Faculty.

II.3.3 Hospital Appointment

Hospital appointments to the medical/dental staff of clinical departments and programs, now or hereafter established, of physicians or dentists who either will not hold University appointments or will also hold part-time or adjunct University appointments will be made in accordance with the Hospital’s by-laws, policies and/or procedures. The Chief of the Hospital Department may consult the Chair of the corresponding University department regarding the appointment. For greater certainty, the parties agree that the Hospital does not require the University’s approval with respect to such appointments. Hospital appointments of staff who will hold full-time University appointments may be made only upon the recommendation of both the Chief of the Hospital Department and the Chair of the University of Toronto Clinical Department, hereinafter referred to as “Chair”, or the Dean of a Health Faculty.

Nothing in this Agreement shall be interpreted to limit the Hospital’s right to unilaterally alter, suspend or terminate the privileges of its Medical-Dental staff in accordance with its by-laws and the Public Hospitals Act as amended from time to time or to require approval of the University in such circumstances.

II.3.4 Terms and Conditions of Appointments

The terms and conditions of appointment are set out in separate University and Hospital appointments. Appointments set out responsibilities for teaching, research and administration. Part-time and adjunct faculty are normally not funded through the University payroll for teaching. The University and the Hospital will negotiate, within the budgetary framework of the University, financial support from the University for administrative oversight of clinical teaching within specific programs, and will set out these terms in a separate letter of understanding as necessary.

II.3.5 Clinical Faculty (Physicians) in the Faculty of Medicine

i) Policy for Clinical Faculty and Procedures Manual for Policy for Clinical Faculty

The parties recognize that Clinical faculty (physicians) are essential to the University’s academic mission. They also recognize that the situation of clinical faculty (physicians) is very different from that of University-salaried tenured faculty. Appointments of Clinical faculty are governed by the University’s Policy for Clinical Faculty (attached as schedule 2) and the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3). ii) Appointment of Clinical Faculty (Physicians) The Faculty of Medicine will appoint Clinical faculty (physicians) in accordance with the Procedures Manual for Policy for Clinical Faculty (attached as Schedule 3). Clinical faculty (physician) members may be appointed as part-time or adjunct Clinical faculty members, and on occasion as full-time. The criteria for each type of appointment are set out in Procedure 2.0, section VI in Schedule 3 attached.

iii) Academic Group Practices

Some Clinical faculty (physicians) will develop academic group practices through which funds from professional practice at the Hospital will be collected by the physician group and

9


used for academic enrichment of the Hospital Department concerned (“Practice Plans”). The arrangements under which any such group practices function should be consonant with the patient care responsibilities of the Hospital and the academic missions of both the University and the Hospital.

If any Practice Plan now or in the future meets the definition of a “conforming practice plan” as defined in the Procedures Manual, its members shall be considered participants in a conforming practice plan for the purposes of the Policy for Clinical Faculty and its Procedures Manual. iv) Dispute resolution for Academic Disputes Academic disputes involving Clinical faculty (physician) members will be dealt with in accordance with the Procedures for Dealing with Academic Disputes (Procedure 3.0 in the attached Schedule 3). The Hospital accepts the jurisdiction of the (Clinical Faculty) Academic Clinical Tribunal (set out in Schedule 3) as regards disputes involving academic freedom concerns in the clinical setting. The Tribunal’s decision will consist of a determination of facts with respect to the complaint, a finding as to whether there has been a breach of academic freedom, and a delineation of the implications of the breach for the complainant. The decision shall be final and binding on the complainant and the Hospital and the University. The Tribunal has no powers to award remedies, or to change any of the provisions of a duly enacted policy or established practice of the University or the Hospital, or to substitute any new provision thereof.

II.4 APPOINTMENT OF HEALTH SCIENCE FACULTY TO THE UNIVERSITY

i) Health Science faculty of the University includes Hospital staff and employees appointed to one or more University Faculties and Departments other than Clinical Departments in Medicine and Dentistry. These include, but are not limited to: Nursing, Nutritional Science, Pharmacy, Psychology, Radiation Therapy, Medical Imaging Technology, Nuclear Medicine Technology, Social Work, Health Administration, Physical Therapy, Physical Education and Health, Occupational Therapy and Speech Language Pathology. ii) Health Science faculty may be given teaching appointments by the University in the appropriate Faculty at such rank and in such category as the University may determine. The University will not give University appointments to Health Science faculty without first obtaining the consent of the Hospital’s President and Chief Executive Officer or her/his delegate. iii) Those Health Science faculty holding appointments at the Hospital who teach University Students and are responsible for a University course or a substantial part of a course and/or grade Students must qualify for and hold University appointments in the appropriate Faculty of the University at such ranks and of such categories as the University may determine. iv) The University recognizes the importance of developing further policies and guidelines governing the appointment and promotion of Health Science faculty, and agrees to engage in a consultative process with the community teaching hospitals and community teaching sites to develop these. No such policy or guideline will be binding on the Hospital unless the Hospital agrees to it.

II.5 APPOINTMENT AND RE-APPOINTMENT OF HOSPITAL CHIEFS

The Hospital will consult with the University Department Chair (or, in the case of Dentistry, the Dean) or his/her delegate before appointing or reappointing a Chief of a Medical or Dental Department in which significant teaching takes place. The parties acknowledge that it will be expected (although not mandatory) for the Chief of a Medical or Dental Department in which significant teaching takes place to hold a University

10


appointment. The Hospital does not require the University’s approval to appoint a particular individual as Chief of a Medical or Dental Department. For greater certainty, except as set out above, the Hospital has no obligation to consult with the University with respect to leadership positions.

II.6 APPOINTMENT OF CHAIRS OF UNIVERSITY DEPARTMENTS

Collectively the community teaching hospitals and community teaching sites will have representation as appropriate in searches for Clinical Department Chairs, where there is teaching in the cognate community hospitals’ or teaching sites’ Departments or programs.

II.7 CONFLICT OF INTEREST AND COMMITMENT OF UNIVERSITY APPOINTEES

The University expects All faculty to perform their duties in accordance with the Policy on Conflict of Interest Academic Staff (attached as Schedule 14), which sets out the University’s expectations for its academic members of staff concerning their commitment to the University’s mission, goals and objectives in relation to their outside and related activities.

II.8 REVIEW OF ACADEMIC APPOINTEES

Upon request by the Vice-Provost, Relations with Health Care Institutions of the University, the Hospital will provide to the University for information, as soon as reasonably possible, a listing of All Health Professional faculty at the Hospital.

III TEACHING

III.1 INTRODUCTION

The Hospital acknowledges that the University is primarily responsible for the Teaching Programs in which Students are enrolled, whether those programs are located on or off the University’s property. Accordingly, the Hospital recognizes the University’s ultimate authority with regard to decisions made with respect to its Teaching Programs. Nevertheless, the University acknowledges the valuable role and specific functions carried out by All Health Professional faculty who are engaged in the academic teaching mission, in the planning, administration, funding, presentation and review of its Teaching Programs, as well as the use of Hospital premises and access to the Hospital’s client populations for clinical teaching, and therefore will involve the Hospital in these processes as appropriate. The parties will support the efforts and requirements of each other to achieve and maintain excellence in teaching, particularly through such processes as departmental and institutional reviews, accreditation surveys, staff evaluations, program assessments, Student evaluations and constructive criticism and evaluation. The University and the Hospital agree to follow the Faculty of Medicine/Affiliated Institutions Guidelines for Ethics and Professionalism in Healthcare Professional Clinical Training and Teaching (attached as Schedule 4). The University (including faculty, staff and Students) and the Hospital share responsibility for creating a learning environment at the Hospital that promotes the development of explicit and appropriate professional attributes (attitudes, behaviours, and identity) in Students. The learning environment includes formal

11


learning activities as well as attitudes, values, and informal "lessons" conveyed by individuals with whom the Student comes in contact.

III.2 HOSPITAL TEACHING COMMITMENT

The University and Hospital agree that, subject to the mutual agreement of the parties on annual teaching placements, certain Hospital Departments and programs will engage in teaching, and that some or all of the Hospital staff or health professionals in those Departments and programs will have University appointments and will teach Students. The University and the Hospital agree to work together in a reciprocal planning process to determine the appropriate number of clinical Student teaching placements by program and in the context of curriculum requirements. University health professional education programs will prepare annually a curriculum outline and the proposed clinical Student teaching placements at the Hospital. The University will deliver the proposed clinical Student teaching placements to the Hospital at least 10 months in advance of the start of each academic year ordinarily commencing July 1. The Hospital will consider whether they can accommodate the proposed clinical Student teaching placements, and the Hospital and the University will negotiate in good faith to reach agreement on the proposed clinical Student teaching placements at least 8 months in advance of the start of each academic year commencing July 1. Any subsequent changes to the clinical Student teaching placements will be agreed upon by the program leader of the cognate University Faculty, Department or program and the Vice-President Education (or equivalent) at the Hospital at least 4 months in advance of the start of the academic year. If agreement cannot be reached at any stage, the appropriate Dean, or, if relevant, Department Chair, and the Hospital’s President and Chief Executive Officer will endeavour to negotiate an agreement. The University curriculum, the number of Students needing placements and the Hospital’s ability to take Students may change from year to year for various reasons, and these factors will be relevant to the negotiation of the annual clinical Student teaching placements. The parties will cooperate to implement the annual clinical Student teaching placements (attached as Schedule 1). The Hospital undertakes that any teaching of students from other educational institutions will not compromise its ongoing teaching commitment to the University as set out in Schedule 1. The University undertakes that, subject to requirements of the Guidelines for the Assignment of Postgraduate Medical Trainees, any assignment of Students to other hospitals or teaching sites (or other clinical settings) will not compromise its ongoing commitment to assign Students to the Hospital as set out in Schedule 1.

Attached as Schedule 1 is a template clinical Student teaching placements form. The parties will develop a detailed clinical Student teaching placements form in the first year of the Agreement to replace the template on agreement of the parties. The parties will amend the form by agreement on an annual basis.

III.3 STUDENTS

III.3.1 Placement of Students

For periods of time agreed to by the University and Hospital, Students will be permitted to take instruction and gain clinical and/or practical experience in the Hospital, provided that appropriate services are offered at the Hospital, subject to the Hospital’s ability to offer such instruction and/or

12


experience and the commitments in Schedule 1. The Hospital will provide services and facilities upon the terms and conditions hereinafter set out. The placement of Students will be based on pedagogic interests, including the need for a wide range of learning experiences, and on requirements of applicable regulatory bodies, and subject to the Hospital’s ability to offer such instruction and/or experience. Using the process set out in Part III, section 2 above, the number of undergraduate, postgraduate and graduate Students from each University professional program taking instruction in the Hospital shall be negotiated and agreed annually by the representatives of the heads of the appropriate University Faculties or Departments with the representatives of the heads of the appropriate Hospital teaching services.

The Faculty of Medicine will assign postgraduate Students to teaching hospitals and sites and other clinical institutions in accordance with the Guidelines for the Assignment of Postgraduate Medical Trainees (attached as Schedule 15). Students enrolled in Departments and Faculties including, but not limited to, the Departments of Occupational Therapy, Physical Therapy, Speech/Language Pathology and Radiation Oncology, and the Faculties of Nursing, Pharmacy, Dentistry and Social Work are assigned to the Hospital in accordance with the curriculum plan for each clinical course or program and with the Hospital’s ability to provide an appropriate placement. The University will be responsible for informing Students who are placed at the Hospital that they are required to comply with Hospital policies.

III.3.2 Transfer of Students

The Hospital will transfer Students of the University assigned to it for clinical training and experience to another hospital or site or clinical facility only in collaboration with and with approval of the appropriate Department Chair and Dean or their delegates. However, provided it informs the University, the Hospital may, at its discretion, assign Students to clinical training activities in community clinics for part of the Student’s rotation at the Hospital.

III.3.3 Termination of Student Placement for Unacceptable Behaviour

The University recognizes the right of the Hospital, after consultation with the appropriate University Dean or Department Chair, to terminate the placement in the Hospital of an individual Student, if the Student’s behaviour or activities are considered by the Hospital to be unacceptable. If the behaviour, conduct or activities of a Student is considered to be unacceptable, that Student will be treated by the University in accordance with the University’s Code of Student Conduct (attached as Schedule 16) and by the Hospital in accordance with any applicable Hospital policies.

Notwithstanding the above, if in its sole discretion the Hospital determines that a Student’s behaviour or activities is placing patient or Hospital staff safety at risk, or unreasonably interferes with the operation of the Hospital’s programs or services, the Hospital may remove the Student from patient or Hospital staff contact immediately and, after contacting the appropriate Dean or Department Chair so that the University can take interim measures under its Code of Student Conduct, may terminate the Student’s placement.

III.3.4 Code of Behaviour on Academic Matters

In order to protect the integrity of the teaching and learning relationship, the University’s Code of Behaviour on Academic Matters (attached as Schedule 17) will apply to its staff and Students in the Hospital.

13


III.4 HOSPITAL CLINICAL PROGRAM PLANNING AND REVIEW

III.4.1 Program Planning

While recognizing its own authority and responsibility for the content and quality of the programs in which it places its Students, the University notes the essential role of All faculty in the presentation of clinical and practical experiences and programs of instruction to Students. Thus, where there is core curriculum teaching in a department or program at the Hospital, the Deans of the University’s Faculties and Schools, or their delegates, will invite the Hospital to participate in the planning of the programs and experiences to be offered to Students in related Departments at the University. Hospital participation could range from representation on University divisional/departmental education/curriculum committees to informal meetings between course coordinators and Hospital preceptors. The University will assist the Hospital as required in setting up teaching programs. The Hospital will notify the appropriate Dean or her/his delegate(s) of any proposed change in Hospital strategic plans and Ministry of Health and Long-Term Care accountability agreements that would materially affect the teaching obligations of the Hospital as set out in this Agreement and, where feasible, will invite the University to comment prior to making any such changes.

III.4.2 Quality Control

In order to assess the quality of and maintain the highest standards in its Teaching Programs, the University employs a variety of evaluative tools. Foremost among these is the review process, using either internal or external reviewers as deemed appropriate. Some reviews are mandated by external organizations such as accreditation bodies, while others are initiated from within the University. In addition, Students are asked regularly to evaluate the performance of teaching staff following a particular course, part of a course or practical experience. Department Chairs and Deans also review annually the performance of academic staff in all areas of staff responsibilities including teaching. The Hospital acknowledges the importance of these and other measures to the mission of the University, recognizes that they also bear upon the success of the Hospital in achieving its own objectives and accordingly agrees, subject to available resources, to support and assist the University and the Faculties corresponding to Hospital departments where Students are taught in their efforts to maintain the quality of its Teaching Programs. The University will use its best efforts to provide the Hospital with copies of the usual performance evaluations by Students of the Hospital’s teaching staff. The University acknowledges the importance of these evaluations to the mission of the Hospital and recognizes that they also bear upon the success of the Hospital in achieving its own objectives.

III.4.3 Responsibility to Inform of Circumstances Affecting Teaching Programs

The parties acknowledge that decisions of accreditation authorities, requirements of the Professional Association of Internes & Residents of Ontario and other circumstances may affect Teaching Programs, and they agree to inform each other of any such decisions or circumstances.

III.4.4 Availability of Patients for Teaching

The Hospital will allow Students, for teaching purposes, access to such of its patients and their personal health information, both in-patients and ambulatory patients, as are necessary to meet its teaching commitments set out in the clinical Student teaching placements (attached as Schedule 1, as amended from time to time by agreement), subject to such restrictions as are imposed by the

14


Hospital staff for clinical reasons and by Hospital patients, including any exercise of their right to refuse Student access. The Hospital will use its best efforts to provide the necessary mix of patients to meet the educational needs of Students placed in the Hospital. In exceptional circumstances if the Hospital ascertains that it will not be able to meet Students’ needs in any program or area as previously agreed upon, it will promptly advise the appropriate Department Chair or Dean and assist in finding alternate arrangements for the Students. The University will comply with all applicable privacy laws, including the Personal Health Information Protection Act, 2004, and agrees that it will advise all Students that they are required to comply with all applicable privacy laws and Hospital policies and procedures.

III.4.5 Facilities

The Hospital will provide in the Hospital such facilities for Students and clinical teachers as are agreed to by the Hospital’s Vice-President Education (or equivalent) and the Faculty’s Office of Community-Academic Relations.

The sharing of infrastructure expenses between the University and the Hospital will be negotiated in good faith from time to time among the University Department Chairs, the Deans and the Hospital’s Vice-President Education (or equivalent).

III.4.6 Continuing Education The University is committed to providing opportunities for All faculty to enhance their education skills through faculty development. University Departments and programs will facilitate the professional development of All faculty through appropriate educational methods (such as interactive seminars, workshops and on-line education skill development programs) relevant to the delivery of clinical teaching and learning.

IV NON-DISCRIMINATION AND HUMAN RIGHTS The University and the Hospital are committed to human rights and shall comply with the Human Rights Code (Ontario) and other applicable rights and equity legislation. The parties will remain committed to the principle of fair and equitable treatment for all. The parties are committed to having an environment free of prohibited discrimination and harassment. Each party will adopt their own appropriate policies with respect to discrimination and harassment and will have guidelines as to how it will deal with allegations of prohibited physical and verbal harassment and sexual harassment. In the cases of allegations of sexual harassment, the parties agree to follow the Sexual Harassment Protocol: Sexual Harassment Complaints involving Faculty and Students of the University of Toronto arising in University-Affiliated Health Institutions (attached as Schedule 5) for determining which sexual harassment policy applies and whether the University or the Hospital is responsible for dealing with a complaint.

V RESEARCH

V.1 INTRODUCTION

In achieving their common goals in research, the parties will consult each other in their research strategic planning processes.

15


V.2 GRANT ADMINISTRATION

Concerning research projects of All Health Professional faculty, the following procedures will apply.

i) All grant applications to be administered by the University will be signed by a) the Chair of the University Department in which the principal investigator holds her/his primary appointment, and b) the Dean, and counter-signed on behalf of either or both the Hospital and the University, as follows below in ii) and iii). The Dean may delegate signing authority to the Vice-Dean Research. For grant applications to be administered by the Hospital, the Department Chair’s signature is not required. However, a copy of the cover sheet and a summary of each submitted grant should be provided to the Chair of the Department in which the principal investigator holds her/his primary appointment. ii) When the research grant is to be administered by the University, senior signing authority will be vested in the President of the University (or his/her delegate). A copy of the cover sheet and a summary of each submitted grant application should be provided to the Hospital if the Health Professional faculty reports to the Hospital Vice-President Research (or equivalent). iii) When the research grant is to be administered by the Hospital, senior signing authority will be vested in the President and Chief Executive Officer of the Hospital (or his/her delegate).

iv) When significant Hospital resources, such as salaries, space and services, are used in research projects, the grant will ordinarily be administered by the Hospital. Where the Hospital administers the grant, the Hospital will receive the indirect cost funds. v) The party that accepts senior responsibility for a research grant will also accept full responsibility for grant administration and record-keeping, and for liaison with the granting agency. If a research grant is administered by one party and the research is conducted at the premises of the other, there may be an administrative cost to the party conducting the research. The Policy on University Administration of Grants and Contracts when the Research is being Conducted at an Affiliated Hospital is attached as Schedule 7.

V.3 INVENTIONS AND INTELLECTUAL PROPERTY

Both the University and the Hospital have their own policies regarding the ownership and treatment of inventions and intellectual property. The protocol as between the University and the Hospital regarding inventions and intellectual property is set out in a separate agreement, which is attached as an Appendix . Faculty of Medicine graduate Students and their supervisors are also governed by Guidelines for Faculty of Medicine Graduate Students and Supervisors in the Context of Commercialization of Inventions Based on Thesis-Related Research (attached as Schedule 8).

V.4 THE CONDUCT OF RESEARCH

V.4.1 Ethical Conduct

The parties expect the highest standards of ethical conduct in every aspect of research. To this end, All faculty and Students will be expected to adhere to all relevant policies on ethical conduct of research, following the University Policy on Ethical Conduct in Research (attached as Schedule 18) when conducting research at the University and following the applicable Hospital policy(ies) when conducting research at the Hospital.

16


Faculty with appointments in the Faculty of Medicine of the University will also adhere to all relevant Faculty guidelines, including the Principles and Responsibilities Regarding Conduct of Research (attached as Schedule 11), Protection of Intellectual Freedom and Publication Rights (attached as Schedule 9), and the Policy on the Offer and Acceptance of Finders’ Fees or Completion Fees in Research Involving Human Subjects (attached as Schedule 10). Where there is an allegation of research misconduct against a faculty member in the Faculty of Medicine, the Faculty’s Guidelines to Address Allegations of Research Misconduct (attached as Schedule 12) set out the criteria to determine which representative of the Faculty and/or Hospital will deal with the allegations. The Hospital will develop and maintain policies regarding research misconduct within its jurisdiction which are harmonized with the University’s and Health Faculties’ policies and which have parallel processes for dealing with allegations of research misconduct. The Hospital will operate its own Research Ethics Board or Boards (or be part of an REB consortium) which will be separate and independent from the University Research Ethics Board. These will be operated in a manner consistent with the principle of harmonization of research ethics and research policies set out in this Agreement. In addition, with respect to human subjects, the Hospital agrees its own Research Ethics Board or Boards will adhere to the Tri-Council Policy Statement (and its updates) and applicable legislation, including but not limited to the Personal Health Information Protection Act, 2004 and O.Reg 245/06. In the event that the Hospital does not have its own REB, it agrees to accept the review of a Board accepted by the University. The Hospital and University agree to collaborate, as appropriate and reasonable, in arrangements designed to enhance the effectiveness, efficiency and consistency of ethical review processes.

V.4.2 Conflict of Interest All faculty conducting research at the Hospital will be governed by the conflict of interest policy of the Hospital.

VI HEALTHCARE DELIVERY In supporting the Hospital in achieving its objectives and carrying out its responsibilities in healthcare delivery and patient care, the parties acknowledge that the Hospital is solely responsible for all healthcare delivery and patient care that occurs on the Hospital’s premises or under the Hospital’s jurisdiction. Nevertheless, the Hospital recognizes that the University has an interest in patient care and healthcare delivery, as they impact on the teaching of Students and on research. The University will support the Hospital in its efforts and requirements to maintain excellence in its standards of patient care and healthcare delivery particularly with regard to such processes as accreditation and review, and through the offering of constructive evaluation to the Hospital.

VII LIBRARY AND INFORMATION SERVICES The parties recognize the necessity of the provision of excellent library and information services in order to achieve their common objectives in teaching and research. Thus, they will cooperate and collaborate in planning, providing and maintaining such services. The parties accept their responsibilities to each other with regard to these services, subject to the limits of their financial resources. The University will work with the Hospital to facilitate remote access by the Hospital to the University’s library and information services.

17


VIII UNIVERSITY AND HOSPITAL USE OF EACH OTHER’S NAMES AND INSIGNIAS The University encourages the use by the Hospital of the University and Faculty names and insignia as appropriate on letterhead and on all other materials in the ordinary course of business (e.g., websites, correspondence, course materials) in matters that are directly relevant to the affiliation with the University. The University will similarly refer to its affiliation with the Hospital as appropriate on materials in the ordinary course of business in matters that are directly relevant to the affiliation. Each party has a responsibility for safeguarding the names and insignia of the other, and, if there is any doubt as to appropriate use, for seeking clarification from the other party. Authorization to each party to use the name and official form of the logo(s) of the other party is limited to the purpose of officially recognizing the affiliation between the parties. Use of the name or logo(s) of a party for any purpose other than officially recognizing the affiliation between the parties requires prior written authorization from that party.

IX NOTIFICATION AND CONSULTATION Unless otherwise specified in this Agreement, where the Hospital is required to give notification to or consult with the University, communication with the Vice-Provost, Relations with Health Care Institutions will meet that requirement. Unless otherwise specified in this Agreement, where the University is required to give notification to or consult with the Hospital, communication with the President and Chief Executive Officer will meet that requirement. With respect to obligations of officials identified in this Agreement, if the Hospital or the University reassigns or reorganizes responsibilities within the institution such that the identified official is no longer appropriate to carry out the obligations assigned in this Agreement, the Hospital or the University will notify the other party of the change to the official carrying out the obligation under the Agreement. All notices sent to the other party pursuant to this Agreement which are required to be in writing shall be delivered by hand; or by certified or registered mail, postage prepaid, return receipt requested; or by overnight courier; or by FAX, as follows: If to University of Toronto: If to Hospital:

Vice-Provost, President and Chief Executive Officer Relations with Health Care Institutions The Credit Valley Hospital

University of Toronto 2200 Eglinton Avenue West Room 2109, Medical Sciences Building Mississauga, Ontario L5M 2N1 1 King’s College Circle FAX# 905-813-4444 Toronto, Ontario M5S 1A8 FAX # 416-978-1774 All notices shall be deemed received on the date of delivery or, if mailed, on the date of receipt appearing on the return receipt card.

18


X COORDINATION AND LIAISON

X.1 UNIVERSITY-HOSPITAL COMMITTEES/WORKING GROUPS/TASK FORCES

The Hospital will have representation on the Hospital University Education Committee. The University and the Hospital will establish a Community Research Coordinating Committee that will have representation from each community affiliate. This Committee will be chaired by the Vice-Provost, Relations with Health Care Institutions and meet at least twice a year. The Vice-Provost, Relations with Health Care Institutions will, in consultation with the Hospital, endeavour to identify additional committees, working groups and task forces that might need to be developed to advance the joint mission. These additional committees, working groups and task forces shall, in general, include representation from the University and the community teaching hospitals and community teaching sites. The Hospital and the University will liaise as appropriate on all task forces, committees and meetings as may be struck from time to time.

X.2 LIAISON

X.2.1 Hospital Each health profession discipline will have an assigned leader in the Hospital, such as the Chief, with whom the leader of the University programs will work directly. Generally, teaching placement and evaluation are the responsibility of the assigned leader. All health professional teaching will be overseen by a senior executive of the Hospital who reports to the Hospital’s President and Chief Executive Officer. The Hospital will name an individual(s) who will act as a liaison with the University.

X.2.2 University The University will establish and maintain an Office of Community-Academic Relations and appoint a Director, Distributed Medical Education to assist with the liaison functions in advancing the clinical teaching in the Hospital and to support the implementation of new affiliation agreements.

XI CONFORMITY WITH OTHER COMMUNITY TEACHING HOSPITAL OR SITE AGREEMENTS

The University will use its best efforts to ensure that its agreements with other community teaching hospitals and community teaching sites contain substantially the same provisions as are contained in this Agreement. As new community affiliations are developed with other hospitals and community teaching sites, they may be governed initially by a developmental affiliation agreement for 2 years, with the goal of establishing longer-term agreements.

XII MAINTENANCE OF AFFILIATION In order to monitor and coordinate this Affiliation, there will be ongoing liaison between the Vice-Provost, Relations with Health Care Institutions (or delegate) and the President and Chief Executive Officer of the Hospital (or delegate).

19


As needed, issues arising from this Agreement may be referred to an ad hoc Joint Committee. A Joint Committee may be struck by either party as needed to address issues arising from this Agreement, relations between the parties and proposed changes to the policies of either institution that are referred to it, and will be comprised of equal numbers of representatives from the University and Hospital. The Committee will be co-chaired by the Vice-Provost, Relations with Health Care Institutions and the Hospital President and Chief Executive Officer (or their delegates), each of whom will appoint members to represent their institution. The Committee may at its discretion add ad hoc members in equal numbers from the Hospital and University from time to time to assist it with any issue. A Joint Committee will meet on an as needed ad hoc basis, at times and locations to be mutually agreed to by the parties. Either party may call a meeting of a Joint Committee. The Committee shall consider and make recommendations to the University and to the Hospital with respect to matters referred to it and, in addition, the Committee shall perform any duties assigned to it by the terms of this Agreement. The Joint Committee will use its best efforts to reach mutually acceptable solutions to disputes between the University and the Hospital related to this agreement; if no agreement can be reached on a particular issue, the parties will continue to implement the balance of the Agreement so far as practicable.

XIII LIABILITY, INDEMNIFICATION AND INSURANCE

XIII.1 LIABILITY

The parties agree that the University shall not be liable to the Hospital for any bodily injury (including death), any loss or damage to the property of or to the Hospital, its Board members (or trustees), officers, employees and agents in any manner, arising during, occasioned by, resulting from or in any way attributable to the performance or non-performance of this Agreement, unless such injury, loss or damage is caused or contributed to by the willful or negligent act or omission of the University, its governors, officers, faculty, employees or agents while acting within the scope of their duties. The parties agree that the Hospital shall not be liable to the University for any bodily injury (including death), any loss or damage to the property of or to the University, its governors, officers, faculty, employees and agents in any manner, arising during, occasioned by, resulting from or in any way attributable to the performance or non-performance of this Agreement, unless such injury, loss or damage is caused or contributed to by the wilful or negligent act or omission of the Hospital, its officers, employees or agents while acting within the scope of their duties. The Hospital assumes legal liability for the proper maintenance of its facilities and services provided in respect of the subject matter of this Agreement.

XIII.2 INDEMNIFICATION

Subject to the provisions of section 1 above, the Hospital shall at all times indemnify and save harmless the University, its governors, officers, faculty, employees, agents and Students from and against all claims, demands, damages, costs, expenses, actions and causes of action, whether in law or equity, suits or other legal proceedings howsoever caused (collectively referred to hereafter as “losses”) made or brought, prosecuted or threatened to be prosecuted against the University by whomsoever arising out of the Hospital’s performance or non-performance of this Agreement. Subject to the provisions of section 1 above, the University shall at all times indemnify and save harmless the Hospital, its Board members (or trustees), officers, employees and agents from and against all claims, demands, damages, costs, expenses, actions and causes of action, whether in law or equity, suits or other legal proceedings howsoever caused (collectively referred to hereafter as “losses”) made or brought,

20


prosecuted or threatened to be prosecuted against the Hospital by whomsoever arising out of the University’s performance or non-performance of this Agreement. Notwithstanding the provisions of the indemnity set out above and the limitation of liability in section 1 above, each party shall be responsible for all losses made or brought, prosecuted or threatened to be prosecuted by whomsoever arising out of:

i) the use by that party of any result of any research as contemplated by this Agreement, or ii) the infringement by that party of any patent, trade mark, industrial design, copyright or other

intellectual property right or as a result of the development, use or exploitation thereof.

XIII.3 INSURANCE

The Hospital shall maintain in full force and effect a policy of comprehensive liability insurance to include coverage for any negligence, malpractice and medical professional liability on behalf of its officers, employees, agents and Students that could arise in the performance or non-performance of this Agreement. This insurance shall include coverage against bodily injury (including death), property damage and personal injury including cross-liability and severability of interest provisions with a combined limit of not less than $5 million per occurrence. Such insurance coverage will protect Students assigned to the Hospital against legal liability incurred by them while acting within the scope of their duties and arising from the instruction, direction or supervision provided by the Hospital. The University shall maintain in full force and effect a policy of comprehensive liability insurance to include coverage for any negligence, malpractice and medical professional liability on behalf of its officers, employees and agents that could arise in the performance or non-performance of this Agreement. This insurance shall include coverage against bodily injury (including death), property damage and personal injury including cross-liability and severability of interest provisions with a combined limit of not less than $5 million per occurrence. The Hospital shall maintain in full force and effect a policy of direct damage property insurance against normal risks of physical loss or damage as contemplated by a standard “All Risks” property insurance policy covering all equipment of the University which is located on Hospital premises for an amount not less than the full replacement value thereof. The Hospital and the University will produce satisfactory evidence of insurance coverage to each other as set out above upon written request so to do.

XIII.4 STUDENT WORKPLACE INSURANCE

Neither the Hospital nor the University is responsible for Workplace Safety and Insurance Board premiums for Students, but the University will be responsible for arranging the relevant WSIB documentation regarding coverage for eligible Students.

XIV TERM, TERMINATION AND AMENDMENT OF THIS AGREEMENT The term of this Agreement is for five (5) years from January 1, 2007 to December 31, 2011. The University and the Hospital will commence discussions regarding renewing this Agreement eighteen (18) months before its expiry date.

21


If, at the end of the term, a new agreement has not been executed and neither party has given 12 months prior written notice of their intention not to renew this Agreement, then this Agreement will survive until such time as either a new agreement is executed or this Agreement is terminated by either party giving the other 12 months prior written notice. This Agreement may be terminated by either party as of January 1 in any year during the term of the Agreement by giving to the other party at least twelve (12) months’ prior written notice. This Agreement and the Appendix to it may be amended by the parties at any time provided that no amendment shall be binding unless in writing and signed on behalf of the parties by their proper officers. Notwithstanding the foregoing, each of the Hospital and the University may amend its own internal policies referred to in this Agreement (including the attached Schedules) in accordance with its normal amending procedures, subject to the requirements of Part I, section 5 herein.

XV GENERAL TERMS

XV.1 ASSIGNMENT AND ENUREMENT

This Agreement and the rights and obligations hereunder are not assignable by either party. This Agreement shall inure to the benefit of and be binding upon the University and the Hospital and their successors.

XV.2 INDEPENDENT CONTRACTORS

The parties are independent contractors, and no agency, partnership, joint venture, employee-employer, or franchisor-franchisee relationship is intended or created by this Agreement.

XV.3 GOVERNING LAW

The laws of the Province of Ontario and applicable Canadian law shall govern the terms of this Agreement and the parties agree to submit to the exclusive jurisdiction of the courts of the Province of Ontario for any legal proceedings arising out of this Agreement.

XV.4 FORCE MAJEURE

The parties acknowledge that in the event of circumstances beyond the control of either party such as a community disaster, a strike, a fire, an infectious outbreak or other situation in which the continued provision of facilities or assignment of Students pursuant to obligations under this Agreement would substantially interfere with the Hospital’s primary duty of care to its patients or its research obligations or with the University’s teaching or research obligations, each party reserves the right to suspend performing its obligations under this Agreement immediately without penalty and until such time as the party reasonably determines that it is able to resume performance of its obligations herein.

XV.5 ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the parties and supersedes all other prior or contemporaneous representations, agreements, understandings or commitments, whether written or oral,

22


between the parties relating to the subject matter herein. For greater clarity, this Agreement shall mean collectively, the terms and conditions contained in sections I to XV of this document, and the attached and referenced Appendix and Schedules and any other specifically referenced documents. The invalidity of any provision of this Agreement shall not affect the validity of the remaining provisions and this Agreement shall be construed as if such invalid provision had been omitted. No provision of this Agreement may be terminated, modified or waived except as set forth in a written agreement executed by authorized representatives of the parties.

XV.6 COUNTERPARTS

This Agreement may be signed in counterparts and each of such counterparts will constitute an original document and such counterparts, taken together, will constitute one and the same instrument.

IN WITNESS WHEREOF the parties hereto have caused this Agreement to be signed by their duly authorized officers. Seal FOR THE GOVERNING COUNCIL OF

THE UNIVERSITY OF TORONTO _________________________________________ Vice-Provost, Relations with Health Care Institutions _________________________________________ Secretary of Governing Council

FOR THE HOSPITAL


23


APPENDIX

INVENTIONS AND INTELLECTUAL PROPERTY

THIS AGREEMENT dated the 1st day of January, 2007 (the “IP Agreement”).

BETWEEN

THE CREDIT VALLEY HOSPITAL (the “Hospital”)

and


(the “University”)

WHEREAS the Hospital and the University have an affiliation agreement and many Hospital staff and University faculty members are concurrently appointed; AND WHEREAS some of these staff members may, from time to time, create inventions and other intellectual property; AND WHEREAS both the Hospital and the University (individually a “Party” and collectively the “Parties”) have their own separate and distinct policies regarding the ownership and treatment of inventions and other intellectual property; AND WHEREAS it is important for the successful commercialization of such inventions and other intellectual property that there be no uncertainty regarding the application of those policies; NOW THEREFORE IN CONSIDERATION OF premises and mutual covenants contained within the parties hereto agree as follows: 1. Definitions In this IP Agreement, the following terms shall be deemed to have the following meanings:

(a) “Invention” – any new and useful art, product, service, discovery, innovation, process, pattern, machine, process of manufacture or composition of matter or a formula thereof, new life form, computer software, compilation of information in whatever medium whatsoever, and attendant know-how or any new and useful improvement thereof, whether or not protected or protectable by patent, copyright or registration as an industrial design or trademark or pursuant to any other intellectual property or trade secret protection law which now exists or may exist in the future which was created with financial support, staff support, or the provision of space, equipment or supplies from either or both parties.

(b) “Net Revenues” – all royalties, license fees and other income (excluding funds received in

support of direct and indirect costs of the sponsored research project) received by a Party

24


from the assignment or commercialization of or licensing of rights to an Invention, minus legal and other fees reasonably and actually incurred directly in the process of establishing and maintaining the legal protection of those rights.

(c) “Owner” means the Party determined under section 3.1 to be the owner of all patents,

trademarks, copyright, proprietary and/or other intellectual property rights relating to an Invention.

(d) “Share” – the proportionate share of support and Net Revenues determined or assigned to

a Party as more particularly described in section 3.2. 2. Mutual Disclosure

2.1 When a staff member holding appointments in both the University and the Hospital makes or creates an Invention, he/she shall disclose it to one of the Parties, in accordance with the inventions and intellectual property policies of that Party. If the disclosure indicates that, in the process of creating the Invention, the individual used, in any way, facilities owned, operated or administered by the other Party and/or has received personal financial compensation from the other party and/or received funds from the other party that contributed to the direct costs of the project that resulted in the Invention, the Party to which the disclosure has been made will provide a copy of the disclosure to the other Party as soon as possible.

2.2 No Party shall enter into a research agreement or contract which imposes any obligation or

liability on the other Party, including a commitment of the personnel, students or facilities of the other Party or an obligation with respect to the past, present or future intellectual property rights of the other Party, without the express, written consent of the other Party. The Party wishing to enter into such a research agreement or contract shall provide a copy of the proposed research agreement or contract, in confidence, to the other Party and shall consult fully with respect to the obligation or liability that would be imposed on the other Party.

2.3 For the purpose of this IP Agreement, undergraduate and graduate Students, clinical and

research fellows, and postdoctoral fellows will be treated in the same fashion as staff members holding appointments in both the University and the Hospital in all respects.

2.4 Any Invention disclosure disclosed by either Party to the other under this IP Agreement

shall be treated as confidential by the receiving Party unless the disclosing Party indicates in writing that it is non-confidential.

3. Ownership

3.1 Unless otherwise agreed among the Parties, due to extenuating circumstances, ownership of the patents, trademarks, copyright, proprietary and/or other intellectual property rights relating to the Invention shall vest with the Party on whose premises the Invention was made. If the Invention was made on the premises of both Parties or the Parties cannot agree on where the Invention was made, ownership shall vest with the Party that has provided the greater proportionate share of the salaries of the academic staff members named as inventors for the Invention at the time when the Invention was disclosed. The determination of that proportionate share shall be made by the Parties’ Vice-Presidents Research or their delegates.

3.2 For all Inventions, the Parties shall determine, by mutual agreement, each Party’s

proportionate share of support to the research project from which the Invention arose and proportionate share of Net Revenues from the Invention (the “Share”). This determination shall be made jointly by the Vice-Presidents Research of the Parties or by their designates.

25


The Parties shall consider the following factors in determining each Party’s Share: use of the premises of each Party, personal financial compensation paid by each Party to the inventor(s) and any contribution by either Party to the direct costs of the project from which the Invention arose, excluding grants from third parties.

3.3 In all cases, the Invention will be subject to the policies of the Owner.

4. Negotiation and Commercialization

4.1 (a) Unless otherwise agreed, the Owner will assume full responsibility for applying for legal protection and/or for commercializing the Invention. The Owner will assume responsibility for all the costs and liabilities incurred in such activities. The Owner will also ensure that the other Party is kept informed about all patent applications, issued patents, licenses or other agreements or events which relate to commercialization of the Invention. (b) Inventions may arise involving two or more inventors where each Party is determined to be a joint Owner. In these circumstances, the Parties shall negotiate in good faith an agreement to cooperate to protect and commercialize the jointly-owned Invention and, unless otherwise agreed by the Parties, the Party whose inventors have made the predominant inventive contribution shall be responsible for protecting and commercializing such Invention.

4.2 If the Owner decides not to proceed with the application for legal protection and/or the

commercialization of the Invention, the Owner shall advise the other Party of its decision within three (3) months of the date of the Invention’s disclosure and, at that time, shall offer to assign all its rights to the Invention to the other Party and shall specify the applicable terms and conditions, if any, of such offer.

5. Proceeds from an Invention

5.1 All Net Revenues from an Invention will be divided between the Parties in proportion to each Party’s Share. Each Party’s Share will be distributed in accordance with the Party’s intellectual property policies.

5.2 If equity in a company is received by the Owner in lieu of revenue in whole or in part, the

equity shall be divided between the Parties in proportion to each Party’s Share. 6. Dispute Resolution

6.1 Any dispute arising under this IP Agreement which cannot be settled amicably between the Parties shall be submitted to arbitration by a panel composed of one member nominated by the University, one member nominated by the Hospital and one member selected by the first two arbitrators. The panel’s decision will be made by a majority of the three panel members within thirty (30) days of its appointment. The decision shall be final and binding upon the Parties.

6.2 If the nominees cannot agree on the identity of the third panel member, an application will

be made to the court for the appointment of a third arbitrator. 7. Notices

7.1 All notices required under this Agreement shall be in writing and, unless otherwise agreed, shall be delivered by mail, facsimile transmission (with confirmation of delivery), or in person to the Parties at the following addresses:

26


27

University: Vice-President, Research University of Toronto

27 King’s College Circle Toronto, Ontario M5S 1A1

Hospital: President and Chief Executive Officer The Credit Valley Hospital 2200 Eglinton Avenue West Mississauga, Ontario L5M 2N1

8. Amendment

8.1 This IP Agreement may be modified at any time by mutual written agreement of the Parties. 9. Term and Termination

9.1 This IP Agreement shall enter into force as of the date first written above and shall remain in force until termination by mutual agreement of the Parties or thirty (30) days after presentation of written notice of termination by one Party to the other.

IN WITNESS WHEREOF the Parties hereto have caused this Agreement to be signed by their duly authorized officers on the day and date first above written.

FOR THE GOVERNING COUNCIL OF THE UNIVERSITY OF TORONTO _________________________________________ Vice-Provost, Relations with Health Care Institutions _________________________________________ Secretary of Governing Council

FOR THE HOSPITAL


Template for Reporting New/Expanded Branch Campuses‐ Faculty of Medicine, University of Toronto

Appendix 3 – Health Sciences Complex – Floor Plan and Images

1


2


3


4


5


6


7


8

\


1

Appendix 4 - Ontario Telemedicine Network (OTN) Memo

Appendix 5: CLERKSHIP ROTATION SCHEDULE Year 3 August 23, 2010 - September 4, 2011

Class of 1T2

ROTATION

1

WEEK

ABC

DEF

RAMADAN: Wednesday, August 11 – Thursday, September 9, 2010 FAMILY DAY: Monday, February 21, 2011LABOUR DAY: Monday, September 6, 2010 MARCH BREAK: Monday, March 14 - Sunday, March 20, 2011ROSH HASHANAH: Wednesday, September 8 (p.m.) – Saturday, September 11, 2010 FIRST TWO DAYS OF PASSOVER: Tuesday, April 19 (p.m.) – Thursday, April 21, 2011EID-AL-FITR: Friday, September 10 & Saturday, September 11, 2010 GOOD FRIDAY/ HOLY FRIDAY (Orthodox): April 22, 2011YOM KIPPUR: Friday, September 17 (p.m.) – Sunday, September 19, 2010 EASTER (Western & Orthodox): April 24, 2011SUKKOT: Wednesday, September 22 (p.m.) – Saturday, September 25, 2010 EASTER MONDAY: April 25, 2011SHEMINI ATZERET/SIMHAT TORAH: Thursday, September 30 (p.m.) – Saturday, October 2, 2010 LAST TWO DAYS OF PASSOVER: Monday, April 25 (p.m.) – Wednesday, April 27, 2011THANKSGIVING: Monday, October 11, 2010 VICTORIA DAY: Monday, May 23, 2011DIWALI: Friday, November 5, 2010 SHAVUOT: Wednesday, June 8 (p.m.) - Friday, June 10, 2011EID-AL-ADHA: Tuesday, November 16 & Wednesday, November 17, 2010 ABORIGINAL DAY OF PRAYER: Tuesday, June 21, 2011HANUKKAH: Thursday, December 2 (p.m.) – Thursday, December 9, 2010 CANADA DAY: Friday, July 1, 2011WINTER BREAK: Saturday, December 18, 2010 – Sunday, January 2, 2011 (2 weeks) CIVIC HOLIDAY: Monday, August 1, 2011FEAST OF THE NATIVITY: Thursday, January 6, 2011 RAMADAN: Monday, August 1 – Tuesday, August 30, 2011CHRISTMAS (Orthodox): Friday, January 7, 2011 EID-AL-FITR: Wednesday, August 31 & Thursday, Setpember 1, 2011LUNAR NEW YEAR: Thursday, February 3, 2011

HOLIDAYS/SIGNIFICANT DATES (August 2010 - September 2011)

OSCE

OSCE

Aug. 23 - Sep. 103 Weeks

TRANSITION

TO CLERKSHIP

PAEDS FAMILY O/G

Sep. 13 - Oct. 246 Weeks

Oct. 25 - Dec. 56 Weeks

Dec. 6 - 172

Weeks

PSYCH OB/GYN PEDSFAMILY PAEDS PSYC

SURGERY ANES/OPT/ENT/EM

Sep. 13 - Nov. 78 Weeks

Nov. 8 - Dec. 196 Weeks

ANES/OPT/ENT/EM MEDICINEMEDICINE SURGERY

BREAK

Dec. 18 -Jan. 2

2 Weeks

OB/GYN

MED SURGERYSURG ANES/OPT/ENT/EM

AOENEM MEDICINE

Jan. 3 - 304 Weeks

Jan. 31 - Mar. 136 Weeks

Jan. 3 - 162

Weeks

Jan. 17 - Mar. 138 Weeks

PSYCHPAEDS FAMILYPSYCH OB/GYN

PSYCH

BREAK

ANES/OPT/ENT/EM MEDICINE SURGERYMEDICINE SURGERY ANES/OPT/ENT/EMSURGERY ANES/OPT/ENT/EM

OB/GYNPSYCH OB/GYN PAEDS FAMILY

May 2 - Jun. 126 Weeks

Jun. 13 - Jul. 246 Weeks

Jul. 25 - Sep. 46 Weeks

MEDICINE

Mar. 21 - May 158 Weeks

May 16 - Jul. 108 Weeks

FAMILY PAEDS PSYCH

PAEDS FAMILY OB/GYN

Jul. 11 - Sep. 48 Weeks

Mar. 21 - May 16 Weeks

Appendix 5: CLERKSHIP ROTATION SCHEDULE Year 4 September 6, 2011 - April 20, 2012

Class of 1T2

Dec. 12 - 16

1 Week

Feb. 13 - 17

1 Week

Apr. 9 - 202 Weeks

VACATION (2 Weeks) + ELECTIVES (12 Weeks)

CENTRAL

BREAK

SELECTIVE

CaRMS

CENTRAL

FUSION

Feb. 21 - Mar. 113 Weeks

Sept. 6 - Dec. 1114 Weeks

Dec. 17 - Jan. 1

2 Weeks

Jan. 2 - 203 Weeks

Mar. 12 - Apr. 84 Weeks

Jan. 21 - Feb. 123 Weeks

GROUP A

SELECTIVE

COMMUNITY


CENTRAL

BREAK

SELECTIVE

CaRMS

CENTRAL

FUSION

GROUP A

GROUP B COMMUNITY

SELECTIVE

Feb. 21 - Mar. 184 Weeks

Mar. 19 - Apr. 8

3 Weeks

SELECTIVE

COMMUNITY


CENTRAL

BREAK

SELECTIVE

CaRMS

CENTRAL

FUSION

GROUP B COMMUNITY

SELECTIVE

Appendix 6: Mississuaga Academy tutor Recruitment Plan

Mississauga Medical Academy

Undergraduate ProgramTutor Resource & Recruitment Plan

Gradual introduction of Students and

Prepared by Dr. Pamela Coates & Mitzi Bindoo

Version: 3

As at: Friday January 22, 2010

UG1Total Hours per Tutor

Revised Number of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

Hours

Number of Students 54 18 42 54 54 54 54

ASCM I Clinical Skills / Bedside ‐ Core 48 18 864 6 288 14 672 18 864 18 864 18 864 18 864Clinical Skills / Bedside ‐ Rheumatology 4 9 36 2 8 7 28 9 36 9 36 9 36 9 36Clinical Skills / Bedside ‐ Neurology 4 9 36 2 8 7 28 9 36 9 36 9 36 9 36Clinical Skills / Bedside ‐ Ophthalmology 4 9 36 2 8 7 28 9 36 9 36 9 36 9 36OSCE 4 18 72 6 24 14 56 18 72 18 72 18 72 18 72 Total ASCM I 64 1,044 336 812 1,044 1,044 1,044 1,044

DOCH I Community Health Tutorials 38 12 456 0 0 0 0 12 456 12 456 12 456 12 456Large Group 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total DOCH I 38 456 0 0 456 456 456 456

2012/13 2014/152013/14

Mississauga Medical Academy ‐ Tutor Recruitment Plan (DRAFT)Using 2006 business case updated to 54 students (Credit Valley Hospital and Trillium Health Centre)

2009/10 2010/11Steady State 2011/12

Structure & Function Respiratory Physiology Seminars 6 6 36 0 0 0 0 6 36 6 36 6 36 6 36

Biochemistry Seminars 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Pulmonary Function Lab (Field Vist) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Cardiovascular Physiology 6 6 36 0 0 0 0 6 36 6 36 6 36 6 36Health Informatics Session 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Pharmacology Sessions 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total Structure & Function 12 72 0 0 72 72 72 72

Metabolism and Nutrition PBL turorials (including introduction) 17 6 102 0 0 0 0 6 102 6 102 6 102 6 102

Endocrine Seminars 6 4 24 1 6 1 6 4 24 4 24 4 24 4 24Renal Seminars 3 4 12 1 3 1 3 4 12 4 12 4 12 4 12Gastrointestinal Seminars 6 4 24 1 6 1 6 4 24 4 24 4 24 4 24Lipoprotein Seminar 3 4 12 1 3 1 3 4 12 4 12 4 12 4 12Diabetes Seminars 6 4 24 1 6 1 6 4 24 4 24 4 24 4 24Reproductive Seminar 3 4 12 1 3 1 3 4 12 4 12 4 12 4 12Adrenal Seminar 3 4 12 1 3 1 3 4 12 4 12 4 12 4 12 Total Metabolism and Nutrition 47 222 30 30 222 222 222 222

Brain and Behaviours PBL Tutorials 24 6 144 0 0 0 0 6 144 6 144 6 144 6 144Behaviours PBL Tutorials 24 6 144 0 0 0 0 6 144 6 144 6 144 6 144

Neuroscience Seminars 2 6 12 0 0 0 0 6 12 6 12 6 12 6 12 Total Brain and Behaviour 26 156 0 0 156 156 156 156

Total UG1 Tutor Hours 187 1,950 366 842 1,950 1,950 1,950 1,950

3/31/20102:53 PM 2 Medical Academy Tutor Recruitment Summary


UG2Total Hours per Tutor

Revised Number of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

HoursNumber of

Tutors Total Tutor

Hours

Number of Students 54 17 18 42 54 54 54

ASCM II Clinical Skills / Bedside ‐ Core 20 18 360 8 160 8 160 14 280 18 360 18 360 18 360Clinical Skills / Bedside ‐ Geriatrics 16 10 160 3 48 3 48 7 112 10 160 10 160 10 160Clinical Skills / Bedside ‐ Rheumatology 8 10 80 3 24 3 24 7 56 10 80 10 80 10 80Clinical Skills / Bedside ‐ Orthopaedic Surgery 8 10 80 3 24 4 32 7 56 10 80 10 80 10 80Clinical Skills / Bedside ‐ Pediatrics 20 18 360 9 180 9 180 14 280 18 360 18 360 18 360Clinical Skills / Bedside ‐ Psychiatry 16 10 160 5 80 5 80 7 112 10 160 10 160 10 160Clinical Skills / Bedside ‐ General Surgery 4 10 40 3 12 4 16 7 28 10 40 10 40 10 40Clinical Skills / Bedside ‐ Vascular Surgery 4 10 40 2 8 3 12 7 28 10 40 10 40 10 40Clinical Skills / Bedside ‐ Breast 4 10 40 3 12 3 12 7 28 10 40 10 40 10 40Clinical Skills / Bedside ‐ Neurology 4 10 40 2 8 3 12 7 28 10 40 10 40 10 40Clinical Skills / Bedside ‐ Ophthalmology 4 10 40 2 8 3 12 7 28 10 40 10 40 10 40Clinical Skills / Bedside ‐ ENT 4 10 40 2 8 3 12 7 28 10 40 10 40 10 40Clinical Skills / Bedside ‐ Urology 4 10 40 3 12 3 12 7 28 10 40 10 40 10 40

Steady State 2011/122009/10 2010/11 2014/152012/13 2013/14

Clinical Skills / Bedside ‐ Urology 4 10 40 3 12 3 12 7 28 10 40 10 40 10 40OSCE 4 40 160 13 52 13 52 30 120 40 160 40 160 40 160 Total ASCM II 120 1,640 636 664 1,212 1,640 1,640 1,640

DOCH II Research Advising / marking 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Library Searching Session 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total DOCH II 0 0 0 0 0 0 0 0

Pathology of Disease PBL Tutorials 20 12 240 0 0 0 0 0 0 12 240 12 240 12 240

Path ‐ Hospital 6 4 24 0 0 0 0 0 0 4 24 4 24 4 24Path ‐ University 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Immunology Seminars 6 4 24 0 0 0 0 0 0 4 24 4 24 4 24Microbiology Seminars 14 4 56 0 0 0 0 0 0 4 56 4 56 4 56Neoplasia Seminars 4 4 16 0 0 0 0 0 0 4 16 4 16 4 16Ethics Seminars 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total Pathology of Disease 50 360 0 0 0 360 360 360

Foundation of Medical Pratice PBL Tutorials 20 24 480 0 0 0 0 0 0 24 480 24 480 24 480

Ethi S i 1 4 4 0 0 0 0 0 0 4 4 4 4 4 4Ethics Seminars 1 4 4 0 0 0 0 0 0 4 4 4 4 4 4Miscellaneous Seminars 4 50 200 0 0 0 0 0 0 50 200 50 200 50 200 Total Foundation of Medical Practice 25 684 0 0 0 684 684 684

Total UG2 Tutor Hours 195 2,684 636 664 1,212 2,684 2,684 2,684

Total Pre‐Clerkship (Credit Valley and Trillum Health Centre) 382 4,634 1,002 1,506 3,162 4,634 4,634 4,634



UG3Weeks per Rotation Trainees

Teaching Weeks Trainees


Teaching Weeks Trainees*




Teaching Weeks

Number of Students 54 TBD TBD 54 54

Transition to Clerkship 1 54 54 0 0 54 54 54 54DOCH III 2 54 108 0 0 54 108 54 108

Core Clerkship Pediatrics 6 54 324 6 12 12 36 54 324 54 324Psychiatry 6 54 324 0 0 0 0 54 324 54 324Family Medicine 6 54 324 12 24 24 72 54 324 54 324Obstetrics and Gynecology 6 54 324 0 0 0 0 54 324 54 324Emergency Medicine 4 54 216 10 20 12 24 54 216 54 216Anesthesiology 2 54 108 0 0 0 0 54 108 54 108Ophthalmology 1 54 54 0 0 0 0 54 54 54 54Otolaryngology 1 54 54 0 0 0 0 54 54 54 54Medicine 8 54 432 0 0 0 0 54 432 54 432Surgery 8 54 432 0 0 0 0 54 432 54 432

Steady State 2013/14 2014/152009/10 2010/11 2011/12 2012/13

Surgery 8 54 432 0 0 0 0 54 432 54 432 Total Core Clerkship 48 2,592 56 132 2,592 2,592

UG4Weeks per Rotation Trainees



Teaching Weeks Trainees*




Teaching Weeks

Number of Students 54 0 0 TBD TBD TBD 54

Clerkship Electives 12 54 648 0 0 0 0 54 648

Transition to Residency Central 2 54 108 0 0 0 0 54 108

Selectives 6 54 324 0 0 0 0 54 324Community 4 54 216 0 0 0 0 54 216 Total Transition to Residency 12 648 648

Fusion 2 54 108 0 0 0 0 54 108

Total Clerkship (Credit Valley and Trillum Health Centre) 77 4,158 56 132 0 0 2,754 4,158

Steady State 2013/14 2014/152009/10 2010/11 2011/12 2012/13



Appendix 7.0- Policy for Clinical Faculty – See Section (1)

University of Toronto Governing Council Policy for Clinical Faculty December 16, 2004 [Effective July 1, 2005] Website: http://www.governingcouncil.utoronto.ca/

Policy for Clinical Faculty

The purpose of this policy is to formalize the status and recognition of clinical faculty members by the University of Toronto, provide a framework for the governance of clinical faculty relations with the University, enhance processes for addressing grievances of individual clinical faculty regarding University matters, and establish a mechanism to protect the academic freedom of eligible clinical faculty members as regards their work in clinical settings.

1. Clinical Faculty are licensed physicians who hold joint appointments between a clinical entity (fully affiliated hospital, or partially-affiliated hospital, or an affiliated community practice or other entity with a relationship to the University of Toronto) and a clinical department in the Faculty of Medicine at the University of Toronto. While some clinical faculty draw some of their income as employees of the University of Toronto, most are not on the University payroll and almost all draw additional income from a variety of sources. Their compensation normally involves remuneration through, variously independent medical practice (solo or group), a practice plan which pools independent clinical earnings, or alternative funding arrangements with block payments for clinical services within a practice plan, or salaries from an affiliated institution, or combinations thereof. This policy covers all clinical faculty who hold an academic appointment in a clinical Department of the University of Toronto Faculty of Medicine, regardless of employment relationships.

2. Eligible clinical faculty are those who have a major engagement in academic work, participate in a practice plan that meets specific core principles as defined in the Procedures Manual and approved by the Clinical Relations Committee, and that accepts the University’s role in protecting academic freedom of clinical faculty, work in an affiliated hospital (or setting) that continues to meet the terms and conditions of a University-Hospital affiliation agreement, and who generally have no outside clinical or other employment.

3. A Clinical Relations Committee will be established to provide accountability for relations between the University of Toronto, clinical entities, and clinical faculty members. The committee will be chaired by

1


the Vice-Provost, Relations with Health Care Institutions and will consist of the Provost of the University or delegate, plus four clinical estates

• The Presidents of the Medical Staff Associations of all fully-affiliated teaching hospitals (or their delegates)

• The Chairs of the Medical Advisory Committees of all fully-affiliated teaching hospitals (or their delegates)

• Clinical Department chairs, appointed by the Dean • The CEOs of the fully-affiliated teaching hospitals (or their delegates).

4. The Clinical Relations Committee will be responsible for the approval of procedures related to matters including but not limited to:

a. Definition of categories of clinical faculty (e.g., part-time, full-time, adjunct)

b. Appointment of clinical faculty

c. Dispute resolution mechanisms for clinical faculty

d. Composition of the Clinical Relations Committee itself

Any member of the Clinical Relations Committee may bring forward a proposal for revision to the procedures, but ratification requires the approval of a two-thirds majority of the members of each of the four clinical estates listed at point 3 above plus the concurrence of the Provost.

Prior to implementation, ratified changes in procedures must be reported for information to the Council of the Faculty of Medicine by the Dean of Medicine, and to the Academic Board of the Governing Council of the University of Toronto by the Provost.

5. The Committee will receive and review annual reports from the Clinical Faculty Grievance Review Panel (charged with arbitration of disputes involving University administrators) and the Academic Clinical Tribunal (charged with adjudication of allegations of breaches of academic freedom in the clinical setting).

The Clinical Relations Committee is responsible for recommending to the President of the University the nominees for these dispute resolution committees for clinical faculty. Again, approval of nominations for the Clinical Faculty Grievance Review Panel or Academic Clinical Tribunal will require two-thirds majority of each of the four clinical estates plus the concurrence of the Provost.

6. The University appointment of a clinical faculty member who has passed probationary review will not be terminated unless there is cause. Cause includes, but is not limited to, gross misconduct, failure to maintain necessary qualifications and privileges, and failure to maintain reasonable competence

7. Eligible clinical faculty members have a right to academic freedom, which is defined as the freedom to examine, question, teach and learn, and the right to investigate, speculate and comment without reference to prescribed doctrine, as well as the right to criticize the University and society at large. Specifically, and without limiting the above, academic freedom entitles eligible clinical faculty members to have University protection of this freedom in carrying out their academic activities, pursuing research and scholarship and in publishing or making public the results thereof, and freedom from institutional

2


3

censorship. Academic freedom does not require neutrality on the part of the individual nor does it preclude commitment on the part of the individual. Rather, academic freedom makes such commitment possible

8. The University and fully affiliated teaching hospitals affirm that eligible clinical faculty have academic freedom in their scholarly pursuits. All clinical faculty remain subject to the applicable ethical and clinical guidelines or standards, laws and regulations governing the practice of medicine and the site-specific relevant site’s policies or by-laws.

9. The University of Toronto has a fundamental role in the protection of academic freedom for clinical faculty. This includes:

• University Chairs acting as advocates on behalf of the academic freedom of clinical faculty members when issues of academic freedom arise in the clinical setting

• The Dean promptly investigating referrals to his or her office of allegations of breach of academic freedom

• Appointment of an independent tribunal of colleagues from the Faculty of Medicine to adjudicate disputes involving an apprehended breach of academic freedom in the clinical setting, as noted above (Academic Clinical Tribunal).

The affiliated clinical entities and practice plans where eligible clinical faculty work have agreed to accept the decisions of the Tribunal. If the plan or relevant site dispute resolution process fails to consider the finding of breach of academic freedom within specified time periods, the complainant can request that the Tribunal make its finding public.

Where the finding that there has been a breach of academic freedom does not lead to any remedial action by the affiliated hospital or practice plan, the Vice-Provost - Relations with Health Care Institutions must intercede with the hospital Chief Executive Officer (or equivalent in the relevant site) or with the governance of the practice plan.

If there is no remedial action taken as a result of the said Vice-Provost’s actions, the President of the University must intercede with the hospital Board (or equivalent in the relevant site)

Appendix 8 - University of Toronto Mississauga

Health Sciences Complex

Project Update – April 1, 2010

General description of the project: The Health Sciences Complex (HSC) at the University of Toronto Mississauga involves the construction of a new four-storey reinforced concrete structure. The following are features of the building:

1 partial below grade mechanical and electrical room to connect to service tunnel

Ground floor two 60 seat lecture theatres, four 30 seat classrooms, video conferencing

studio and computer room

2ndnand 3rd

floor will house various office, and research spaces

4th

floor is a multi discipline lab floor

1 mechanical penthouse

A bridge on the 3rd floor that links the HSC to the South Building

Total square meters: 5,960 m2

Chilled water and steam will be provided from the central plant.

Building will be LEED Silver

Major milestones:

Project Start November 28, 2007

Schematic Design Complete February 14, 2008

Design Development Complete March 21, 2008

Contract Documents Complete Sept 30, 2008

Bid and Award Complete June 11, 2009

Construction Start Date June 29, 2009

Structure Complete May 31, 2010

Building water tight August 23, 2010

Power on June 1, 2010

Commissioning Start December 27, 2010

Video Conferencing start February 15, 2011

Required Substantial Performance March 15, 2011

Projected UofT Move-in Completion May 15, 2011 to July 2, 2011

505 Consumers Road Suite 300 Toronto, ON M2J 4V8 Tel: (416) 222-7691 Fax: (416) 222-0485

University of Toronto Mississauga Health Sciences Complex

Project Update – April 1,2010

Current status: The construction activities to date consist mainly of completing the basement and backfilling works as well as pouring Level 1 to Level 4 slabs. The contractor is currently preparing for pouring Level 5 slab (roof slab). The penthouse erection and framing is scheduled to start by April 20th. Main shop drawings were approved and the mock-ups for curtain wall and cladding have been reviewed. The major equipments and fixtures are scheduled to be delivered to site prior to end of August 2010. As of April 1st, the percentage complete for the main activities are tabulated below:

Activity Percentage Complete Mobilization / Stakeout 100%

Site Protection and Sediment Control 100% Excavation and Backfill 97%

Waterproofing 100% Site Services 90%

Concrete Structure 85% Structural Steel 10%

Prepared by: Maher Traboulsi, Site Project Manager, PMX Inc. April 01, 2010