Health Workforce Innovations in Response to the COVID Pandemic
Cardiovascular Trainee Redeployment
There is a need to increase health workforce capacity, especially in areas that are the most affected by COVID-
19 (ICU, ERs).
Trainees have a unique position within the healthcare system, serving the dual roles of “learner” and
“employee”. Trainees are typically employed by the regional health authority or provincial ministry of health.
Under exceptional circumstances of clinical need, postgraduate trainees may be asked to be redeployed to
services such as hospital emergency rooms, intensive care units, or medicine wards.
Redeployment is an opportunity for cardiovascular trainees to stand in solidarity with other frontline health
workers in caring for patients, and trainees are eager to contribute. Many residents and subspecialty fellows
are already certified by the RCPSC and hold independent practice licenses in areas of emerging clinical need.
We recommend that:
1. There should be transparency and consultation with trainees in the redeployment process. Redeployment
needs may evolve during the pandemic, and ultimately, should reflect a balance between trainee suitability and
2. Trainees should be redeployed to areas of current clinical need which are most in line with their educational
goals. This is balanced with the needs of the healthcare system.
3. Trainees who are asked to move from their training specialty to work in an area in which they have already
achieved RCPSC competency and hold independent licensing should receive responsibilities that are
commensurate with their existing certification and maximize their skillsets.
4. In some cases where trainees take on duties that are not normally part of their training program, it may be
reasonable for them to receive remuneration. This is particularly relevant in scenarios where trainees hold
applicable independent licensure. This issue should be examined in honest, bilateral discussions between
trainees and programs. Normal local practices occurring prior to the pandemics, including positions (e.g.
Clinical Associate, Junior Attending, House Medical Officer, etc.) and compensation models (e.g. billings,
stipends) may serve as a useful guide to select appropriate models.
5. Trainee redeployment should largely remain voluntary, and redeployment plans should be individualized for
each program. There are also various individual circumstances where trainees may feel inadequately ready for
redeployment, and such situations should be considered on a case-by-case basis. Redeployment of trainees in
their final stages of training should not interfere with their ability to complete the requirements of their
6. In exceptional cases where trainees are redeployed to areas significantly outside of their field of training
(e.g. pediatric trainees being redeployed to adult services and vice versa), they should be adequately
supported and supervised.
7. Trainees with specific health needs (e.g. immunocompromised status, pregnancy) should have their
individual needs taken into consideration.
Fast-track internationally educated health personnel
Rapid upskilling/reskilling existing and available workers (eg. laid off)
Alternative deployments for health workers whose normal duties are temporarily suspended
Physicians - Specialists
Clinical cardiology, cardiac surgery and cardiac subspecialty training programs, as well as graduate and post-
graduate research trainees, have all been affected by restrictions during the pandemic. We are experiencing a
marked decrease in acute cardiac patient volumes and elective procedures as well reductions in research and
educational activity. The majority of outpatient clinics and elective rotations have been postponed. Research,
educational events, and conferences have been delayed or cancelled.