Offer Letter
Penn Medicine Clinician
[Date]
John Doe, M.D.
123 Park Place
Philadelphia, PA. 12345
Dear _____________:
On the basis of our recent discussions, I am pleased to offer you an appointment to the staff of
the University of Pennsylvania as a Penn Medicine Clinician. In this position, your responsibilities will
primarily include [briefly describe] at _______________________ [location]. Note that your clinical,
administrative, and teaching duties may be subject to change, depending on the needs of the (division)
(department).
(If applicable)
Additionally, I will recommend your secondary, academic appointment as Clinical (specify rank)
Professor in the Clinical Track of the Associated Faculty. Your academic appointment, as well as any
subsequent reappointments and/or promotions, are subject to the University of Pennsylvania’s review and
approval process. Members of the Associated Faculty, including the Clinical Track, are not eligible to
acquire tenure.
(Omit the following paragraph if not recommended for a clinical faculty appointment :)
The Faculty Affairs and Professional Development website, www.med.upenn.edu/fapd contains
policies and related information which may be helpful to you. Within our department, (insert name of
faculty coordinator) is the faculty coordinator, (insert name of department coap chair) is the chair of our
department committee on appointments and promotions and (insert name of department education
officer) is the education officer and may also serve as a resource for you.
(Omit the following paragraph if not recommended for a clinical faculty appointment :)
As a member of the Associated Faculty, you must participate in a minimum of 50 hours per year
of active and high quality teaching or equivalent service. [briefly describe any other details]. The
Housestaff and Medical Student Teaching Evaluation Record (HAMSTER) is a substantial online report
of teaching information that will be available to you. It includes recorded teaching activities and
evaluations of faculty by medical students, residents, fellows and masters students in the Perelman
School of Medicine. You are responsible for collecting and submitting any qualitative and quantitative
data for teaching activities not captured in HAMSTER.
In connection with your Penn Medicine appointment, you must also be a member of the Clinical
Practices of the University of Pennsylvania (CPUP). Your execution of the CPUP Member Agreement
(see attached document) is a condition to this offer.
As a full-time University employee and CPUP member, you will be subject to all applicable
University, Penn Medicine and CPUP policies as well as policies applicable to UPHS medical staff.
These policies, which are subject to amendment, from time to time, currently include, though are not
limited to the “Principles of Responsible Conduct” (www.upenn.edu/audit/oacp_principles.htm),
“Conflict of Interest” as described in Faculty Handbook Policy II.E.10
(http://provost.upenn.edu/policies/faculty-handbook), in related policies and procedures at
(http://www.med.upenn.edu/fapd), and the enclosed policies and procedures concerning patent and
tangible research property (http://www.upenn.edu/almanac/volumes/v51/n22/pdf_n22/patent_policy.pdf).
You must read and sign the Participation Agreement included with the Patent Policy.
You will not be authorized to enter into any outside contracts or agreements on behalf of the
University, without formal University approval for which you should apply through me.
This offer is predicated on your not having entered into any type of restrictive covenant or noncompete that could interfere with your performing the services contemplated. The offer is also predicated
on your not having any preexisting or anticipated conflicts of interest with respect to your proposed
position at the University of Pennsylvania. If you believe you may have a restrictive covenant, noncompete or conflict of interest, please contact me immediately to discuss the matter.
Attached you will find a statement regarding your compensation for the period (insert date).
(If applicable)
In support of the University’s sustainability goals and for the convenience of employees, we have
replaced University paper checks with electronic payment options:
 Direct deposit to your bank account (Direct Deposit) and
 The ADP ALINE Card, with courtesy checks, (ALINE Card)1
The ALINE Card is automatically issued to all new employees for purposes of receiving their pay or
reimbursements for travel or other business related expenses. An ALINE Card packet will be sent to you
directly from ADP. The packet will contain both the ALINE Card, which can be used like any debit card,
and courtesy checks, along with instructions on how to use them.
Your acceptance of employment and/or completion of your employment eligibility verification (Form
I-9) constitute consent to the University’s payroll methods, including the use of the ADP Aline Card.
You may choose to elect Direct Deposit at any time. If your Direct Deposit election is processed in time
for your first wage payment, Penn will attempt to prevent ALINE card issuance. If you receive your pay
via Direct Deposit, you do not have to activate the ALINE Card, and you can cancel a previously
activated card at any time.
For more information on both of these options, please visit the following website:
www.finance.upenn.edu/comptroller/payroll/receiving_your_pay.shtml
Position continuation and subsequent renewals will be contingent upon your performing your
duties to the satisfaction of the Division Chief and Department Chair, as well as the financial,
organizational and clinical needs of the department and the Health System. In the event of termination of
your employment as Penn Medicine Clinician, termination of any secondary, academic appointment in
the associated faculty and any staff privileges at all UPHS hospitals and locations will occur
concurrently.
As a Penn Medicine Clinician, you will be eligible to participate in the generous benefits
package offered by the University of Pennsylvania. After your arrival, a benefits packet will be mailed to
you by the Penn Benefits Center. If you have any questions about this packet, you should contact the
1
While the University’s’ options for receiving payments are designed to take advantage of the benefits of electronic methods, the ADP ALINE
Card with courtesy checks option enables payees to write and cash checks for the entire amount due to them. This functionally is equivalent to a
‘check only’ process but has the added benefits of being able to the use the debit card, electronic bill payment, and/or write checks for different
amounts. If you prefer the ALINE Card but require assistance in completing a written check due to an accommodation for a disability or other
reason, please contact the Disbursement Office- Payroll (215-898-6301 or payroll@exchange.upenn.edu).
Benefits Center at 1-888-736-6236. You should also arrange to meet with (insert name of department
administrator and title) who can be reached at (insert phone number).
In addition, you may be eligible to participate in the Clinical Practices of the University of
Pennsylvania benefits, which currently include supplemental life insurance and long-term disability. If
you have any benefits issues you wish to discuss while you are considering this offer, you should contact
a Senior Benefits Specialist at CPUP or (insert other CPUP contact).
Both the University and CPUP must retain the right to modify or rescind any portion of their
fringe benefits packages at any time. You will be eligible for benefits according to the terms of
applicable plans, as they may exist from time to time.
The following must be completed prior to providing patient care at any one of the University of
Pennsylvania Health System (UPHS) facilities. The Pennsylvania medical licensure and a DEA(s)
registered in the State of Pennsylvania may take anywhere from three to four months to obtain, so please
allow adequate time for processing. Please go to the website below and apply for your license
immediately. Once the license is granted, you will then need to follow up with the state-specific DEA as
described below.
While your paperwork for licensure and DEA are being processed, (insert name of Medical
Affairs Coordinator) will submit an application request for your credentials, privileges and health plan
enrollment (as applicable) at one or more of the UPHS facilities. Once your application request has been
submitted, reviewed and processed by the Office of Medical Affairs, you will receive a letter from the
Application Team with instructions on the next steps in the process. In order to ensure that your
credentialing, privileging and enrollment are completed in time for you to provide patient care by your
requested start date, it is imperative that you follow the instructions, respond to requests, and supply the
required documentation in a timely manner. It is crucial that the correct contact information is given to
your Department Coordinator so you receive the mailed materials without incident. Some of the
documents/information you will be asked to supply are:
•
Copy of medical school diploma (required for Medicare enrollment)
•
Medical license numbers for Pennsylvania and/or New Jersey (as applicable to your UPHS
practice), and DEA and CDS numbers, if applicable.
•
Pennsylvania medical license application
(http://www.portal.state.pa.us/portal/server.pt/community/state_board_of_medicine/12512/licensure_info
rmation/599413#forms)
•
State-specific DEA registration - The Pennsylvania Department of Health, Managed Care
Division, requires that you hold a current DEA registration with a Pennsylvania address on it if you
practice in that state (with the exception of Pathologists and Non-Interventional Radiologists). If you
currently hold a DEA in another state, once you have a Pennsylvania medical license you should
immediately either:
o
Apply for an additional DEA registration number for the state in which you will be
practicing (Pennsylvania/New Jersey) as soon as you have a medical license in that state
(https://www.deadiversion.usdoj.gov/webforms/jsp/regapps/common/newAppLogin.jsp) or
o
Transfer the address on your DEA current registration to the state in which you will be
practicing (Pennsylvania/New Jersey)
(https://www.deadiversion.usdoj.gov/webforms/jsp/regapps/common/updateLogin.jsp)
•
Copy of Social Security card or W-2 form. (Required for Pennsylvania Medicaid
enrollment)
•
National Provider Identifier (NPI) Number
If applicable insert the following:
(FOR FOREIGN CANDIDATES) This offer is contingent upon your having authorization to
work and it is your responsibility to ensure that you are in compliance with U.S. Citizenship and
Immigration Services (USCIS) policies. Please contact the University’s International Student and
Scholar Services (ISSS) office at 215-898-4661 or online at http://global.upenn.edu/isss immediately
so that any visa issues may be addressed before you join us. Appointment and payroll documentation
cannot be processed until you have presented ISSS approval.
If you agree with the terms of this offer, please sign below and return the signed offer to me by
[insert date]. Also return the signed CPUP Member Agreement and Patent Policy Participation
Agreement. Presuming arrangements through the Perelman School of Medicine and University proceed
as we expect, your Penn Medicine Clinician position will have an effective start date of [insert date].
Please respond promptly to any requests for information or documentation in order that your appointment
and participation in benefits programs proceed as planned.
I have enjoyed our discussions and I look forward to the contributions you will make as an
integral part of the University of Pennsylvania Health System.
Sincerely,
___________________________
Chair of Department
I accept this offer as outlined above:
___________________________
Date
cc:
___________________________
Name of Candidate
Signature
Department BA
Attachments:
Patent Policy and Participation Agreement
CPUP Member Agreement