Page Title | Texas Tech University Health Sciences Center

Page Title

LINKS

 

 FORMS

House Staff Credentials Checklist

Acknowledgment of GME P & P's

Addendum to ERAS

Clinical Clerkship Affidavit (for IMG's only)

Prospective Resident List (for US Grads only)

Prospective Candidate List (for IMG's only)

ECFMG Confirmation Authorization

Previous Training Verification

2019-2020 GME Program Agreement 

Criminal Background Check

HSC OP 10.20, Criminal Background Checks for Students, Residents, and Trainees

Attachment A - Notice to Students/Trainees and Residents

Attachment C - Consent for Release of Information - Hold Harmless Agreement for Residents/Fellows

CBC Website

House Staff Clearance Form

Confidential Confirmation and Reference Form

Evaluation Advancement Form

Verification of Graduate Medical Education and Training

Program Graduate Information

PLI Online Portal

Change of Address Form

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

The following items will need to be submitted to residency program coordinator before you will be considered for an elective rotation:

  • Rotator Elective Application

  • Sports Medicine Fellowship requires additional documentation. See here.

  • Current Curriculum Vitae

  • Notarized or certified copy of medical school diploma

  • Final medical school transcripts (Notarized or certified)

  • House Staff Guidelines Acknowledgment - Coordinator will obtain when you arrive

  • ECFMG Certificate (if applicable)

  • Texas Medical Board Licensure/Permit & Certification - Rotator Permit/Current Texas PIT (Physician in Training)/Texas license, DEA certificate

  • Malpractice form - If outside TTUHSC, provide coversheet from your institution. If outside country, you will be required to obtain your own malpractice insurance.

  • Signed PLA (Program Letter of Agreement) - Coordinator will initiate once approval has been obtained from program director

Steps to admitting residents from programs outside of Texas Tech University HSC to rotate through TTUHSC residency programs:

  • Contact program you wish to rotate with to check on potential dates.

  • Download application here or ask program coordinator to email or mail.

  • Complete application and return to program coordinator along with any additional needed documentation.

Final decision remains with the Program Director though the Office of Graduate Medical Education will verify the applicant's competency.

Please note: Rotation will not begin until all documentation has been received.