TTUHSC School of Medicine
Graduate Medical Education

Program Coordinators

***ATTENTION***
IMPORTANT INFORMATION REGARDING
GME MEDICARE FUNDING
*READTHIS*




Duties of PIT Holders     Criminal Background Check    DEA and DPS Certificates    Interview     Match     Checkout



Helpful Links for Coordinators


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Duties of Physician in Training (PIT) Permit Holders to Report


Guidelines


Criminal Background Check Information


CBC Website



Institutional Permits


Use these numbers and Resident's or Fellow's three digit extension


Institutional DEA Certificate (expires 11/30/11)

Institutional DPS Certificate (expires 10/31/10)

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Important Documents

INTERVIEW Prospective Candidates/New Residents List of Items Needed for US and IMG Grads


Resident Credentials Checklist

Acknowledgment of GME P & P’s

Addendum to ERAS

CBC Notice (Attachment A)

Clinical Clerkship Affidavit

Confirmation of ECFMG Certification

Prospective Candidate List – For IMG’s Only

Prospective Resident List – For US Grads Only

Substantial Equivalence List


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MATCH


Welcome Letter

W-4

Authorization of Release

Confidentiality Statement

Crime Victim Election Form

Letter regarding CBC

Direct Deposit Form

HR Bio Form

I-9 Form

Name Tag Request

PLI Form

Standards of Conduct

Suppression of Information Form

TB Questionnaire

Immunization Form

Checklist Form

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CURRENT RESIDENT


Leave without Pay Form

W-4 (for changes to current information)

Evaluation Advancement

Address Change*


*Important – Resident must also change address in Webraider Portal to ensure that Payroll and Human Resources have the most current information.*



CHECKOUT


Check List

Confidential Confirmation & Reference Form

Clearance Form

Program Graduate Information - must have address to mail residency certificate

PLI Form (resignation)

TMB Change of Address Form

DEA Change of Address Form (Must be done online)

DPS Change of Address Form

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Other Forms

Resident Credentialing Verification Form



**Residency Completion Certificates Will Not Be Mailed Until

All Required Check-Out Documents Are Turned Into GME**