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

PIT Holder Report

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Criminal Background Check Information


CBC Website

HSC OP 20 - Criminal Background Checks for Students, Trainees and Residents

Attachment A - Notice to Students/Trainees and Residents

Attachment B - Consent for Release-Hold Harmless Agreement

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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 10/31/09)

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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

Confidential 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

J-1

Checklist Form


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CURRENT RESIDENT


Leave without Pay Form

W-4 (for changes to current information)

Rotation Application

Evaluation Advancement

J-1 Renewal

Address Change*


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


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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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**Residency Completion Certificates Will Not Be Mailed Until

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

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