Synergy

 Synergy (Domestic & International Student Applications)

 The University of Toronto has partnered with Synergy Verified to provide support and clearance for pre-placement requirements for domestic and international student applications. 

Do not submit an application to the AFMC portal unless all prerequisites listed below have been verified by Synergy with a “Pass” status. Portal applications without a Synergy pass status will rejected.

 Domestic Students

As part of a domestic visiting elective application, students must complete the Consent to Disclose Information form providing consent for personal information to be shared with Synergy for the purpose of pre-placement clearance.

To have documents validated, students are required to also book an Electronic Student Permit Checking (ESPC) appointment through Verified.

International Students

As part of an international visiting elective application, students must complete a form providing consent for personal information to be shared with Synergy for the purpose of pre-placement clearance. This form will be sent to those selected from the Random Selection Process. To have documents validated, students are required to book an Electronic Student Permit Checking (ESPC) appointment through Verified.

ESPC Appointment

Once the Consent to Disclose Information form has been completed, students will receive login credentials to register with Synergy. Students will then:

• Upload required documentation for review
• Book ESPC appointment. The service reviews the uploaded documents and provides a status indicating eligibility to apply for an elective.

 Book early: Students are encouraged to book appointments early while getting documentation in place. Do not wait until a week or two before the deadline to book appointments; appointments are not always available at the last minute.

 Book before the deadline: It is recommended that students book appointments prior to the last available date in the event documentation is missing and a follow-up appointment is required.

 Additional fees: If documents are missing or a requirement is not complete, student’s will not be cleared for an elective and will need to book a follow-up appointment for an additional fee.

Student’s do not need to be present on the day of the appointment – this is the date that staff at Synergy Verified will retrieve documents for review. The Verified account status will be updated (pass/fail/pending) once documents have been reviewed and verified by Synergy staff.

Once cleared by Synergy Verified for elective placement, international students may apply on the AFMC portal for an elective.

Did not receive Synergy login credentials?

Please check the spam folder for email with login credentials. Note that the activation link expires within 72 hours. If you have not received the email within 5 business days or if the link has expired, proceed to Synergy’s login page and select “forgot password”. Enter the email address you used for registration. If you continue experiencing issues, please submit a ticket on Synergy’s webpage.

Synergy Pre-Placement Requirement Clearance Information – International Visiting Students

Synergy Pre-Placement Requirement Clearance Information – Domestic Visiting Students

Special Electives

Special Electives for International Students Only

 CVS – Paediatric Cardiovascular Surgery, SickKids Hospital

 International students may apply to the CVS sub-specialty without being selected through the application process below will be rejected; no refunds will be issued.

 Students selected for the CVS program may not apply to other specialties/sub-specialties.

Program

This program offers the opportunity for international students to undertake clinical electives in the Division of Paediatric Cardiovascular Surgery at SickKids. Electives students will actively engage in the treatment of patients with rare or complex congenital malformations, with the opportunity to specialize in paediatric heart surgery. In addition, students will be able to participate in weekly teaching opportunities for the residents and fellows in both cardiac surgery and paediatric cardiology, attend clinical case conferences and daily rounds in both the cardiac ICU and the regular cardiac ward, and join the Adult Congenital Heart programme at UHN. Students will be encouraged to choose a research project in their time with us and contribute to data collection and analysis.

Special Notes

This program will accept up to six international medical students per year, for two to four weeks per student. Elective placements by international students may be undertaken at any time of year, providing they do not in any way conflict with the needs of either University of Toronto, or Canadian undergraduate medical students seeking elective placements.

Application

Interested candidates must submit their CV and Letter of Intent to Dr. Osami Honjo and Amy Huang. Successful applicants will be selected according to the program’s criteria. However, in accordance with the general policies of the University’s Electives Program, students must:

• Be in good academic standing;
• Be enrolled in either the penultimate, or final year of their undergraduate medical degree program at the onset of the proposed elective (i.e. graduating in 2024 or later);
• Be at a school that is recognized by the World Directory of Medical Schools;
• Have completed a paediatric clinical core rotation and any other core rotations required specific to their elective (sub-)specialty;
• Be undertaking the elective as a required part of their clerkship curriculum;
• Review the agreements process and ensure an agreement between their home school and the University has been completed and signed within six weeks of the student’s intended start-date;
• Not participate in the University’s Electives random allocation program within the same academic

Applicants are encouraged to express interest and apply at least one year prior to their desired elective date.

Once selected through the program, the program administrator will notify the University of Toronto Electives office. The Electives Office will contact the student directly with next steps. Students are asked not to apply directly through the AFMC poral prior to direction from the University of Toronto as it may result in additional fees; refunds will not be issued.

Students will be subject to the policies and procedures of the University of Toronto’s Electives Program. The process includes: the payment of all AFMC Portal and University of Toronto application fees; the completion of all required criminal self-disclosure, immunization, health insurance, and medical malpractice insurance documents; the satisfactory verification of the student’s information by their university’s administration; and the acceptable demonstration of English language proficiency.

For questions about program participation, application, and requirements, contact Amy Huang.

For technical questions regarding the AFMC portal, contact the AFMC Portal Helpdesk.

As of 2024, student document verification will be completed by Synergy. Student application fees have been reduced accordingly.

Health & Safety

CLINICAL WORKPLACE INJURY INFORMATION AND PROCEDURES FOR VISITING ELECTIVES STUDENTS

As part of maintaining your personal safety as well as the safety of our patients, please review the following information which is required reading prior to your arrival.

• HAND HYGIENE
  This module teaches how to perform proper hand hygiene in order to decrease the spread of infections in a healthcare environment.
• PERSONAL PROTECTIVE EQUIPMENT
  Please review the presentation below from the Center for Disease Control. The presentation is meant to be a general overview of Personal Protective Equipment (PPE) use. Equipment will vary from site to site; please ask your preceptor for assistance with your site-specific PPE.
• SHARPS
  The module elaborates on the proper prevention techniques and management of sharps injuries in a healthcare environment.
• WHMIS
  This module teaches about the Workplace Hazardous Materials Information System, what knowledge and actions are required for learners to keep themselves and the workplace safe.
• WORKPLACE VIOLENCE AND HARASSMENT
  This module teaches about recognizing and preventing workplace violence and harassment and the rights and responsibilities of learners and the hospital in maintaining a safe working environment.
• PRIVACY
  This module teaches about the importance of maintaining privacy and confidentiality of patient’s personal health information and ways to do so.

PROCEDURE IN CASE OF INJURY

Should you experience any injury or potential exposure to infectious disease (e.g. needle-stick) while on clinical service for your elective, it is critical that you follow this procedure:

1. FIRST AID FOR INCIDENTS INVOLVING EXPOSURE TO BLOOD BORNE PATHOGENS:
   • Remove any contaminated clothing.
   • Allow wound to bleed freely.
   • Wash the area thoroughly with soap and water.
   • If exposed area involves the eyes, nose, or mouth, flush thoroughly with water.
2. Inform your supervisor of the incident.
3. Ask your supervisor to arrange for sample testing of the source patient if your injury is related to potential exposure to infectious disease. It is important for the supervisor to record the source patient’s full name and identifying number, such as their hospital number, health card number, date of birth, etc.
4. Go immediately to the Occupational Health Unit (or equivalent) if you are in a hospital or other patient care setting with such facilities. If the incident occurs outside business hours or in another clinical setting, of if you encounter any other difficulty in accessing care through the Occupational Health Unit, present at the nearest Emergency Department. Note: A search tool for Emergency Departments is available.
5. Identify yourself clearly as a Medical Student and be prepared to present
   • your hospital identification badge (if applicable)
     AND
   • your provincial health card or University Health Insurance Program (UHIP) card.
6. Request copies of all paperwork (incident reports, etc.) that are completed by the Occupational Health Unit and/or Emergency Department staff.
7. You may be eligible for coverage of costs and losses related to your injury/exposure through
   • your home medical school
     AND/OR
   • your provincial health insurance or UHIP
     AND/OR
   • your private insurance.
     Please communicate directly with them for details of the coverage they may provide and the documentation they require.
8. Please report the incident directly to the Director of Electives at the University of Toronto, Dr. Seetha Radhakrishnan.

EXPOSURE RISK ASSESSMENT and ESTIMATED RISK OF TRANSMISSION

A risk assessment for the provision of post-exposure prophylaxis will initially be conducted by the staff in the Emergency Department or Occupational Health Unit. The type of body fluid and details of the exposure must be documented to determine the significance of the exposure and hence the role of prophylaxis. Many factors contribute to a significant exposure and a higher risk of transmission of a blood borne pathogen, including the type of body fluid involved, the type of injury that occurred, the size of the inoculum, and the attributes of the source patient.

• Students who are a sero non-converter for HBsAg after 2 courses of immunization with Hepatitis B vaccine should have all potential exposures investigated promptly;
• In the event of an exposure to a patient who is known or found to be HBsAg positive, it is advisable that you receive Hepatitis B immune globulin (HBIG) as soon as possible after the exposure (i.e. within 48 hours) and a second dose one month later;
• All our teaching hospitals have bloodborne pathogen protocols in place to manage these situations
• You may contact any of the infection control officers in these hospitals.

Learner Mistreatment

The MD Program places the utmost importance on the safety and well-being of students, including their ability to learn in an environment of professionalism, collegiality, civility and respect.

All members of the MD Program community have a joint responsibility to protect the integrity of the learning environment and a right to appropriate treatment and response when the environment is compromised.

The purpose of this Protocol is to articulate procedures for University of Toronto and visiting elective medical students to disclose/report mistreatment that they have experienced or witnessed. This Protocol is informed and governed by the University of Toronto, Faculty of Medicine, regulatory body and government statements, policies, protocols, codes and standards listed in Appendix A. This Protocol does not supersede powers and procedures set out in other policies of the University, the Faculty of Medicine or hospitals. Where an existing University or Faculty policy applies, the procedure described in that document will be followed. Likewise, if a University or Faculty office or a clinical institution has jurisdiction in a given situation, its authority will be respected.

• What is Mistreatment?
• Distinction Between Discussing, Disclosing and Reporting
• How Do I Disclose or Report
• Who to Contact
• Additional Information

Travel &
Accommodation

FINANCIAL ASSISTANCE

Health Force Ontario Clerkship Travel Program (For Ontario medical students only; to be confirmed for 2022/2023)

VISA AND IMMIGRATION MEDICAL EXAMINATION (APPLICABLE TO NON-CANADIANS Visiting Canada)

• International students must meet the entry requirements to enter Canada for their visiting elective
• Contact the embassy/consulate in your country for more information regarding Canadian pre-entrance requirements for medical electives
• Non-Canadian residents are required by Canadian Immigration regulation to undergo a medical examination before entering Canada
• The medical examination must be done by a physician on Canada’s list of designated medical practitioners
• Arrange to have this examination carried out at least four months prior to your elective starting date to ensure that the report will be available in time
• The Immigration medical examination cannot be obtained after arrival in Canada. See Citizenship and Immigration Canada for specific information
• Follow this link to find out if you need an Electronic Travel Authorization (eTA) or visitor Visa.

Evaluations and Assessment

Evaluation: Within 15 days of the end of the elective, it is the students’ responsibility to complete the University of Toronto Learner Assessment of Clinical Teaching (LACT) Form to minimize bias and increase data reliability.

 Assessment: Visiting students are responsible for providing their preceptor with an elective assessment form from their home university. If students do not receive the completed form from their primary preceptor within 2 weeks of the elective end date (noted above), they must inform the University of Toronto’s Electives Office (medicine.electives@utoronto.ca) with the student’s preceptor information. The Elective’s Office will then follow-up with the preceptor and department to ensure completion of the assessment. Students must also complete the University of Toronto, MD Program, Visiting Elective Assessment Attestation Form attesting that their evaluation form has been completed. 

CANCELLATION POLICY AND PROFESSIONALISM

• In the AFMC Capacity-Based Model, students are not permitted to cancel an accepted elective placement. If there are mitigating circumstances, students must contact their home schools for permission to cancel an elective placement with a visiting school. The home school’s Elective Office must notify the University of Toronto Electives Office that an elective placement has been approved for cancellation.
• Should a confirmed/accepted elective be cancelled by the University of Toronto (via site or preceptor) due to unforeseen circumstances, a student must notify their home school, as well as the University of Toronto Electives Office. Should the student wish, all attempts will be made by University of Toronto Electives Office to find a reasonable alternative for the selected elective period, however the office cannot guarantee that a replacement elective placement can be confirmed depending on capacity.
• Non-compliance with these cancellation policies are considered unprofessional and written notification will be sent to a student’s home Elective Director (Elective Coordinator copied).
• Students are expected to follow the code of conduct for the University of Toronto and its affiliated sites.

Visiting Electives Absences

The national minimum number of days for an elective is ten. The experiential nature of medical training and electives requires students to participate to the fullest extent. Students should appreciate the important role they play in patient care, their commitment to their preceptor, their own learning and consider their peers who may have not acquired the opportunity.

For planned absences, absences that arise due to known or anticipated circumstances, that fall within a student’s scheduled elective dates: 

• Follow their home school policy for requesting a planned absence (i.e.: emailing the request to the home elective office or appropriate department) AND copy the UofT Electives Office on correspondence medicine.electives@utoronto.ca
• Submit an absence request to their preceptor AND copy the UofT Electives Office on correspondence medicine.electives@utoronto.ca
• Recognize that each circumstance will be handled on a case-by-case basis 
• Notification of a planned absence should be submitted as soon as possible, with a minimum of 6-weeks prior to the elective start date

For unplanned absences, absences that arise due to unforeseen and often emergent circumstances (i.e.: illness), that fall within a student’s scheduled elective dates, students must: 

• Follow their home school policy for requesting an unplanned absence (i.e.: emailing the request to the home elective office or appropriate department) AND copy the UofT Electives Office on correspondence medicine.electives@utoronto.ca
• Notify your preceptor and site administrator as soon as possible AND copy the UofT Electives Office on correspondence medicine.electives@utoronto.ca
• Recognize that each circumstance will be handled on a case-by-case basis 
• Endeavour to provide the earliest possible notice

COVID-19

ELECTIVE CANCELLATIONS DUE TO COVID-19 or OTHER PUBLIC HEALTH CONCERNS

Should the situation with COVID-19, or other public health concerns, change at any point in time, the University of Toronto reserves the right to cancel electives.

We understand the concern these disruptions may cause, and we ask that students regularly check the AFMC Student Portal for any updates.