Breaking Return of Service Contracts (ROS)

[macmed]

..............

[BlackJack]

To break contract you must first have a clause in your contract that states as such. Some contracts have specific no-break clauses. I'd steer clear of these ones because they make you a prisoner to the underserviced area named in the contract should your circumstances make moving there unmanageable.

 

Breaking contract usually entails paying for the cost of the residency plus interest, which generally amounts to a substantial six-figure number. If you are in a lucrative field, then you can reach this number after a few years. Otherwise, the contract will be difficult to break.

[eddo]

To break contract you must first have a clause in your contract that states as such. Some contracts have specific no-break clauses. I'd steer clear of these ones because they make you a prisoner to the underserviced area named in the contract should your circumstances make moving there unmanageable.

 

Things might be different in the military, but in the normal world you can always break a return of service type contract, regardless of whether or not there is a clause in the contract to that effect. There is no such thing as a no-break clause. Even if a contract had one it would not hold up legally. (Source: my father in law who is a lawyer). They cannot force you to work, however they can make you pay a steep financial penalty.

 

But like I said, different legal rules may apply when it is a contract with the military. If you're considering this and want a definite answer you should talk to a lawyer.

[Mourning Cloak]

There's getting out of ROS, and then there's breaking the contract.

 

Most contracts will have an "out" - look for it. Usually it involves, as pointed out above, a substantial repayment (the price of your education + interest). The ROS I am familiar with has an "out" - you pay the money and everyone walks away friends.

 

Breaking the contract, on the other hand, is not friendly. And it is not benign. This is a LEGAL contract you are signing. With the GOVERNMENT. In the ROS I read through, it stated that failing to live up to your end of the agreement (and you could satisfy the contract either by working in the underserviced community or buying yourself an "out") MAY result in the provincial medical association making a request of the College NOT to issue you a certificate of good standing.

 

This doesn't sound like much, but in fact every time you want to apply for a job or even do a locum you need to get a certificate of good standing from the College of Physicians and Surgeons in whatever province you trained/last practiced. Basically, this states that to the best of their knowledge there's no reason why you shouldn't be practicing (e.g. questions of competence, ethics or professionalism).

 

In other words, no certificate of good standing from old province = no licensure in new province = no work. Ever.

 

If you're interested in seeing this in print, check out Clause 10.

 

Obviously, I disagree with eddo above; s/he states that they cannot force you to work, but I submit that they may be able to prevent you from working anywhere in Canada.

 

Don't ask me whether they would invoke this clause. It's pretty lethal stuff (as you can surely see).

 

Advice:

 

Read your contract. Know what it says. Understand what is expected of you. Understand your options. And do NOT PLAN TO BREAK your contact (or your promises).

 

These ROS have existed for decades. I've met people who have exercised an "out" in the contract, but I've never met anyone who just said "screw you" and walked away. Remember, this is a legally binding contract you're signing, and that the government has much better lawyers than you can afford (or are related to).

[eddo]

Obviously, I disagree with eddo above; s/he states that they cannot force you to work, but I submit that they may be able to prevent you from working anywhere in Canada.

 

I don't see why you disagree with me, because we're saying the same thing. I said they cannot force you to work, but they can force you to pay a steep financial penalty. If you refuse to pay the penalty, obviously there will be consequences.

 

The only difference between what we're saying is that I'm saying if they were dumb enough to not include an out in the contract, you could still break it, and the courts would probably make you pay a reasonable financial penalty. So basically it's not relevant if an out is included in the contract, you always have an out. That's what I meant when I said they can't force you to work. Either way the military does include details in their contract about the financial penalties, so it's not relevant, just an interesting legal point.

[Mourning Cloak]

I said they cannot force you to work, but they can force you to pay a steep financial penalty. If you refuse to pay the penalty, obviously there will be consequences.

 

Paying back the cost of your education isn't a penalty. It is simply a buy-out (assuming such outs are allowed by the rules of your contact). If you actually break your contract, a worst case scenario is never, ever being permitted to practice medicine.

 

you could still break it, and the courts would probably make you pay a reasonable financial penalty

 

Yes, you could break it.

 

No, you'd never see the inside of a court room

 

The government isn't going to take you anywhere near the court system.

 

Why not? Because there is typically already a clause in the contract that covers what the government will do if you break the contract. So if you break your contract, they exercise their right as part of the contract you signed. This is their nuclear option. In the contract I referenced, if you break your contract, the worse case scenario could be NEVER being able to be licensed to practice medicine.

 

So basically it's not relevant if an out is included in the contract, you always have an out.

 

Rule #1 of legal contracts: if it's not in the contract, it doesn't exist. If there's no out in the contract, then "outs" don't exist in your universe, never have, never will.

 

Be very careful when you read your contract. Understand what you are signing, and understand what is required of you, because you WILL be required to satisfy the terms of your contract, whatever those may be.

 

you can always break a return of service type contract

 

This is specifically what I disagree with.

 

I would submit that you can NEVER break a return in service contract (unless you have decided not to practice medicine after all, or are dead; then they would have minimal hold over you).

[eddo]

You are taking what I say out of context and than arguing with it. You responded to my comment about going to court and having to pay a penalty by saying that you would never go to court because the consequences are already outlined in the government's contract. But if you had actually read my post, you would have noticed that i said IF AN OUT IS NOT INCLUDED IN THE CONTRACT you will probably go to court and pay a penalty, so the case of a return of service contract with the government does not apply here and your response makes no sense. If you want to argue, please argue with what I am actually saying.

 

Rule #1 of legal contracts: if it's not in the contract, it doesn't exist.

 

Not true, parts of contracts can be implied and still be legally enforceable.

 

Be very careful when you read your contract. Understand what you are signing, and understand what is required of you, because you WILL be required to satisfy the terms of your contract, whatever those may be.

 

Also not true. There are a myriad of reasons that contracts or parts of contracts would not be legally enforceable, even ones that have been freely signed.

 

Getting back on point, you are correct that it is possible you would not be able to practice medicine. I did not realize this, so thank you for pointing out this very important fact for everyone.

[Renin]

(unless you have decided not to practice medicine after all, or are dead; then they would have minimal hold over you).

 

Yes... I would imagine so

[Mourning Cloak]

i said IF AN OUT IS NOT INCLUDED IN THE CONTRACT you will probably go to court and pay a penalty

 

You're confusing "outs" with "breaking the contract". An "out" is exactly that. It's a way to fulfill the contract without actually practicing in the rural area. It usually involves large amounts of cash.

 

If there are no "outs" in your contract, you either serve your time or break the contract.

 

If you break the contract, then they may choose to enforce their "if you break your contract . . . " clause. This would be the consequences.

 

It's all laid out in black or white in your contract. You can know exactly what will happen step by step just by reading it. There is no reason for the health authority to take you to court. They've already got you all sewed up.

 

Are you talking about trying to sue them?

 

Not true, parts of contracts can be implied and still be legally enforceable.

 

Can you give a concrete, relevant example from a ROS contract? The legal eagles my hubby consulted prior to signing his contract with the hospital kept saying over and over if it wasn't written down in the contract, it never happened, it didn't exist.

 

Tip for med school: if it wasn't written down in the SOAP notes, it didn't happen, either.

 

There are a myriad of reasons that contracts or parts of contracts would not be legally enforceable, even ones that have been freely signed.

 

Asides from insanity or coersion, what are examples of this?

[VanMD]

People have talked about breaking a ROS contract with the province of Ontario. Perhaps on ValueMD rather than on here.

 

There is a penalty and I am not sure exactly what it is.. If I remember right it was paying back your salary plus interest. In BC it is much steeper a penalty.

 

Either way these ROS for Canadians who studied abroad have only been in place for 3 or 4 years now (Not decades, not for Canadians and not in Ontario). In fact IMG who were not Canadian who matched in Ontario before that had ZERO requirements for ROS. One of these smart ass resident told me with a smirk and laughter.

 

I can see that limiting a Canadian's right to practise and work freely where they want may be challenged in the courts. I would not be surprised if this does come up and some people challenge it in the next year or two. It is a contract, I KNOW. BUT there are no alternative options in Canada for Canadian IMGs wanting to return to their country.

 

I for one refuse to be dictated to where I can work, and will most likely chose the US route for residency. Or will challenge it within 8 years.

[TurkandJD]

Mourning Cloak, i think ur 2012 not 2013

[Mourning Cloak]

Deferral x 1 year.

 

(Hope it isn't bad luck)

 

I would not be surprised if this does come up and some people challenge it in the next year or two.

 

Neither would I. Nobody has done it yet, though.

 

PS - It just occurred to me what the downside of that could be. If the health authorities have too many residents reneging on their promises, and don't get anything out of the money they're spending, they'll just stop funding the positions and then those IMG residency spots will disappear.

 

Don't say it won't happen - it has happened in the past. In Saskatchewan, they used to fund ROS contracts for specialists (e.g. they would give poor but clever residents money in exchange for indentured servitude when they were finished), but discontinued them b/c too many specialists just paid them out instead of actually practicing in rural Saskatchewan when they were done.

[VanMD]

Deferral x 1 year.

 

(Hope it isn't bad luck)

 

 

 

Neither would I. Nobody has done it yet, though.

 

PS - It just occurred to me what the downside of that could be. If the health authorities have too many residents reneging on their promises, and don't get anything out of the money they're spending, they'll just stop funding the positions and then those IMG residency spots will disappear.

 

Don't say it won't happen - it has happened in the past. In Saskatchewan, they used to fund ROS contracts for specialists (e.g. they would give poor but clever residents money in exchange for indentured servitude when they were finished), but discontinued them b/c too many specialists just paid them out instead of actually practicing in rural Saskatchewan when they were done.

 

Nope. I have not heard of anyone doing that yet, but on SDN there was talk of it. Recall the main reason for the parallel match for IMG is not because the people in charge got warm and loving with IMGs, it is because they were taken to court and challenged.

 

The funding for those spots are not going to waste cause there is a shortage of physicians and someone has to fill the spots (in the city or rural locations). Canadian med schools don't produce enough doctors to meet the requirements.

 

I would love to work in rural or northern Canada, I just don't want to be FORCED into giving 6 years of my life after 6 years of residency. My rights in Canada are no difference than anyone else's right. In fact since I am paying for my own medical education, no government funding my medical schooling, the gov/prov should have zero say in what I want to do or where I want to work. In Quebec if you graduate from their medical school and decide to practise in the city after graduating/residency you get payed less. That is fair since they are funding your education.

 

There was an article in CMAJ, last year or so, about how Canada should reimburse countries where we are recruiting health care professionals (nurses, pharmacists, doctors) to come work here. Well guess what? Canada should reimbursing Canadians who pay out of their own pocket (private loans) and later come back to practise here.

 

The administration is not bending over backwards for me because they have IMG spots. I can care less since I can do training in the US and do one year less of IM and still get a license to work in Ontario and possibly other provinces. But what are the chances of me returning to Canada and not just staying in the USA.

 

DID YOU KNOW? that there are a number of people from other countries that come to do residency in Canada and take up space from Canadian citizens. These are people who are sponsored by their gov and they are cash cows for our hospitals/universities. So the gov of Saudi or Libya pays so much for there MDs to come here and do residency and then these people go back to their countries to work. What is a better investment. Training these people or training your own Canadians that went to undergrad with you and simply didn't make it into Canadian med schools.

[Mourning Cloak]

The funding for those spots are not going to waste cause there is a shortage of physicians and someone has to fill the spots (in the city or rural locations).

 

If I were the CEO of the health region who shelled out 300K to "buy" a FP for two years of indebted servitude, and then at the end of the two years he didn't show up, even if I got the money back I would be seriously choked. And if it happened two or three times in a row, why would the CEO go on funding a positions for "doctors" who never show up?

 

That's what I mean by it going to waste. Athabasca health region doesn't want to spend its time training doctors for Vancouver or Calgary.

 

I would love to work in rural or northern Canada, I just don't want to be FORCED into giving 6 years of my life after 6 years of residency.

That's totally your decision. It's important that people say to themselves, "Can I go along with this ROS contract, or is it going to drive me batty?" If you choose Door #2, then it's important not to sign on the dotted line.

 

My rights in Canada are no difference than anyone else's right.

 

That's correct, in the sense that none of us have any rights. I don't have a right to a residency position, and neither do you. There's no promise out there anywhere for any Canadian grads (except maybe the U of M and the francophone Quebec schools); the only reason the government has (thus far) kept pace with increasing med school admissions is because, as you pointed out, an unemployed Canadian med school grad is a waste of tax payer's money.

 

So, the Canadian trained medical student becomes an financial obligation. And that's the only reason that most Canadian med school grads get residency positions. Since the IMG costs the government money . . . well, you can see where this is going.

 

There was an article in CMAJ, last year or so, about how Canada should reimburse countries where we are recruiting health care professionals (nurses, pharmacists, doctors) to come work here.

And once you're a US-trained physician, they'll want to recruit you, too.

 

I can care less since I can do training in the US and do one year less of IM and still get a license to work in Ontario and possibly other provinces.

Then do it. Don't drive yourself crazy. Do what is best for you.

 

DID YOU KNOW? that there are a number of people from other countries that come to do residency in Canada and take up space from Canadian citizens.

No they don't. Those residents who are funded by their government are add-ons. They come because, as you mention, they are funded by their governments. If they don't come, nobody pays for the residency spot, and it ceases to exist. They don't take any spots away from Canadian grads.

 

they are cash cows for our hospitals/universities.

I won't argue this point - this is probably correct.

 

The problem is that there is a limited amount of money to fund residency positions. It's getting worse every year because, as you know, the government has ramped up admissions to medical school phenomenally.

 

It costs between $300-500K dollars to train a resident. The provincial governments undertake the ordeal because, as you pointed out, tax dollars have already been pumped into getting the Canadian-trained resident to this point.

 

But, unfortunately for the IMGs, it's cheaper (and faster!) to hire a US-trained, fully-qualified Canadian physician than to spend five years training a Canadian IMG to do, eventually, the same job. So right now you have the short end of the stick, but once you're finished residency in the US you will have a big advantage over the IMGs who come after.

[VanMD]

COOL. We posted we had fun.