Welcome New Residents and Fellows!
General Information
As a new resident or fellow at UAB, there are several educational requirements and MANY forms that
you must complete before you begin your employment. If you have completed all required paper
work AND educational testing, you may begin your employment on June 24th or July 1st (determined
by your program). Please review this packet and instructions and complete by May 9, 2014 and
complete education modules in the UAB Faculty & Staff Learning System prior to attending
GME Orientation.

Faculty and Staff Learning System: You will review required education modules in this
system, but you will not have access until approximately May 1st. You will receive an email
form the GME Office when you are able to access the system. Please complete the assigned
modules prior to attending orientation.

Reminder: GME Orientation is all day Wednesday, June 18, 2014 (begins promptly at
7:30 a.m.). Breakfast and registration begins at 7:00 a.m. Location is Margaret
Cameron Spain Auditorium. Make-up date is July 1, 2014. Registration begins at 8 a.m.
Location is the West Pavilion Conference Center, Room E.

Important Information on Employee Benefits
Representatives from the UAB Benefits Department will be at orientation to review UAB
Benefits choices and answer any questions you may have. You will have an opportunity to
sign up for your benefits at orientation.
Detailed information on the benefit choices and the forms that you will complete at orientation
are provided on the GME website. You are encouraged to review this information prior to
attending orientation so that you will have time to review your options and prepare any
questions you may have.

Current Alabama License: If you have more than 18 months of residency training in the
U.S., you are required to have a current Alabama medical license at the beginning of your
training at UAB. This applies to graduates of U.S. Medical Schools as well as graduates of
International Medical Schools. More details are provided about license requirements as well
as the Alabama Controlled Substance Certificate and DEA in the GME Policy Manual.
Note: It is important that the name you list on your Alabama License matches the name you
list on the NPI Registry and your DEA License (if applicable)

Federal DEA License & (form) Request for Fee Exemption – DEA Registration
If you are a PGY-3 or higher and write controlled substance prescriptions, you will need your
own personal Federal DEA license.
Note: If you will utilize your personal DEA number only within the scope of your training
program and will not utilize it for external moonlighting purposes, you are eligible for a
fee exemption for your DEA registration. To request approval for fee exemption, complete and
sign the form “Request for Fee Exemption-DEA Registration” that is provided on the GME
Website. Return the form to the GME Office and we will route to your program for approval.
Note: It is important that the name you list on your DEA License matches the name you list on
the NPI Registry and your Alabama License.
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
BCLS/ACLS: All Residents are required to maintain BCLS and ACLS certification throughout
training. You must submit proof of certification or register for one of the courses offered
during orientation. You cannot begin training without this certification. The course registration
form is available on the GME Website.
For Residents in Pediatrics, they must obtain and maintain certification in PALS (instead of
ACLS). All Surgery residents must also obtain and maintain certification in ATLS (in addition
to BCLS/ACLS). If you need PALS or ATLS training, please contact your Program
Coordinator.

New Employee Physical: The State Health Dept. requires all new employees to have a
physical examination. This is also a Hospital requirement. Please call Employee Health at
205-934-3675 to schedule your exam as soon as possible. You can begin as early as today.
Please note that UAB Medicine has a Tobacco Free Hiring Policy and all employees are
tested for nicotine use as part of the pre-employment drug screen.
More information is located here http://www.uabmedicine.org/careers/tobacco-free-hiringpolicy

Take picture for badge prior to orientation: If at all possible, please have your picture made
for your UAB identification badge before you attend orientation. Beginning on May 12, 2014, if
you have established your Blazer ID, you can visit Human Resources Management Monday
through Friday, 8:30 a.m. to 5:00 p.m. at University of Alabama Hospital, Russell Wing
University Hospital (RWUH), Room 165. The physical address is 1813 6th Avenue South.
Telephone: (205) 934-2097. When you arrive, you will first see a Receptionist that will let you
in the area (the door usually remains locked). Please identify yourself as a new GME
resident/fellow and let her know you are there to have your ID badge picture made. ID badges
will be distributed at orientation.

Complete the Form I-9 online and have your documents reviewed in HR if at all
possible: The Form I-9 is used to verify both the identity and U.S. work eligibility of all
employees. Before you attend GME Orientation, you will be sent (to the email address that
we received for you) a link to complete a portion of the Form I-9 online. You will actually
receive two separate emails during this process: 1) one email will provide your Login Name
and a link to our online Form I-9; 2) a second email with your password for the system. You
will receive an email from the GME Office notifying you that the emails are about to be sent.
This will occur sometime later in April.
Please follow the link and complete Section 1 of the form before you attend GME orientation.
You will be also asked to identify the documents you will use in order to complete the Form I9. A list of the acceptable documents needed is available for review while in the online system.
Please bring these documents with you when you arrive for your GME orientation. A copy of
the Form I-9 and list of acceptable documents are also on the GME Website.
If at all possible, at the time you have your picture made for your UAB identification badge;
you can also bring your documents and have them reviewed by an HR representative.
Beginning on May 12, 2014, you can visit Human Resources Management Monday through
Friday, 8:30 a.m. to 5:00 p.m. at University of Alabama Hospital, Russell Wing University
Hospital (RWUH), Room 165. The physical address is 1813 6th Avenue South. Telephone:
(205) 934-2097. When you arrive, you will first see a Receptionist that will let you in the area
(the door usually remains locked). Please identify yourself as a new GME resident/fellow and
tell her that you need your Form I-9 documents reviewed. This will save you time at GME
Orientation.
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
All educational modules in the UAB Faculty & Staff Learning System (Health Stream)
must be completed before you can attend orientation and begin training. You will not have
access to this system until your Blazer ID has been set up, or approximately May 15, 2014.
An email from the GME Office will be sent to you, when you can log on in the system and complete the
assignments. This education will be due prior to you attending GME Orientation.

Computer training: All residents rotating through the University of Alabama Hospital must
complete training on the IMPACT system. You will be assigned a module to complete in the
Faculty & Staff Learning System. You must complete this education before your physician
dictating number can be activated.

NPI Number (National Provider Identifier)
You will need an NPI number – a standard unique identifier for health care providers (required
by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you do not have
one, please apply for one using the following directions.
Note: It is important that the name you list on your NPI number matches the name you list on
your Alabama License and DEA registration (if applicable).
Below are the steps when applying for an NPI number:
If you need help during the application process or have any questions, please contact Jamie Moody in the GME
Office at 205-934-4793, or jmmoody@uabmc.edu. You can also contact the NPI Enumerator at 1-800-465-3203.
Note: You will be completing the Information Required for Individual Providers and NOT the Information
Required for Organizations
You will be asked the following information when applying for an NPI number online:
Are you a sole proprietor? No
Provider Name: Your name
SSN: You must have a Social Security number to submit an online application for an NPI.
Note: If you do not have a Social Security number, you will have to complete this step after you have your
Social Security number.
Provider Date of Birth: Your birth date
Country of Birth: “U.S.” if you were born in the United States. If you were not born in the U.S., you will be given a
list of the standardized two letter abbreviations for the country in which you were born. You will not be required to
also enter a state or province.
State of Birth: If Country is U.S. – if you were born in the U.S., you will be given a list of the standardized two letter
abbreviations for the state in which you were born.
Provider Gender: Your gender
Mailing Address: 625 19th Street South, Birmingham, AL 35249
Practice Location Address: 625 19th Street South, Birmingham, AL 35249
Practice Phone Number: Your Program’s phone number
Student – Health Care
Taxonomy (Provider Type): 390200000X – STUDENT IN AN ORGANIZED HEALTH CARE
EDUCATION/TRAINING PROGRAM
State License Information: Leave the license field blank
Contact Person Name: Your Name
Contact Person Phone Number: Your Phone Number
E-mail: Your Email
IMPORTANT: When you application is accepted and a number has been issued to you, you will receive your
notification by email. Please retain this notification for the duration of your career as it is the only one you
will receive. Also, please email a copy of the confirmation to the GME Office at GME@uabmc.edu
Click below to begin the registration at the NPPES Registration Site.
https://npiregistry.cms.hhs.gov/NPPESRegistry/NPIRegistryHome.do
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The Affordable Care Act requires physicians or other eligible professionals to be enrolled in
the Medicare/Medicaid Program to order/refer items or services for Medicare/Medicaid
beneficiaries. This section contains information on completing a Medicare Enrollment
Application.

CMS-855O MEDICARE APPLICATION
When you begin your training program, you must be registered as a Medicare provider so that you can order or
refer items or services for Medicare beneficiaries. This applies to all GME residents and fellows.
Here are the steps to register:
1. You must have an NPI number. Your NPI log-in and password will be required to access the Medicare
application system.
Note 1: If you recently registered for your NPI number, it may take up to 7 days for your log-in and password
information to be transferred to the Medicare application system.
Note 2: If you do not have a valid SS #, you will not be able to complete this enrollment step until after you
obtain your SS# and NPI.
Note 3. Your name on this application must match what is listed on the NPI Registry.
2.
You will use the internet-based Provider Enrollment, Chain, and Ownership System (PECOS).
Click here to begin the enrollment process at the PECOS site: https://pecos.cms.hhs.gov/pecos/login.do
3.
First, check to see if you are already registered. If you are registered, you do not have to go any further.
Notes on the Application Process
SECTION 1 - Basic Information
A.
You are registering for the sole purpose of ordering/referring
B.
Licensed intern resident or fellow not employed at any of the above
SECTION 2 - Identifying Information
A.
Complete in full (most of you probably do not have PTAN). Enter NPI number
B.
Complete in full
C.
1. Alabama License information entered here
2. Check box - Certification Not Available – if you do not have an Alabama medical license/ACSC
3. List your personal DEA if you have one
SECTION 3 - Final Adverse Legal Actions – Complete if applicable
SECTION 4 - Medical Subspecialty
A.
Choose only 1
B.
Leave Blank
SECTION 5 - Important Addresses
Business Location: 619 19th Street S., Birmingham, AL 35249
Attention: YOUR NAME
Mailing Address: UAB Hospital, 619 19th Street S., Birmingham, AL 35249
Telephone number: YOUR PHONE
Email: YOUR EMAIL
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SECTION 6 - Contact Person Information
YOUR NAME
Same address as above
Phone: YOUR PHONE
Email: YOUR EMAIL
Relationship - Self
SECTION 7 - Nothing Required
SECTION 8 - Certification and Signature
Be certain to enter your name and date Print and sign - IN BLUE INK
Before you submit your Medicare application electronically, please print a copy and send to
GME.
If you do not have SS #, you will not be able to complete this application until you obtain one.
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The forms you will need can be found on the GME website
http://www.uab.edu/gme

Print out forms, complete and return in the self-addressed envelope by May 9, 2014 for a
June 24th or July 1st Start Date
 Missing items could delay your start date
Reminders
Comments
2014 Orientation Schedule
June 18, 2014 begins promptly at 7:30 a.m. Registration and
breakfast begin at 7 a.m.
Make up dates is July 1st.
ECFMG Certificate
If you are an IMG, you MUST present a valid ECFMG
certificate to be eligible to work.
Medical Schools Diploma
You must provide a copy of the Medical or Dental school
diploma by July 15, 2014.
Alabama Medical License
If you are a PGY-3 or higher, you must have a current
Alabama medical license and Controlled Substance license (if
applicable) to begin training.
Federal DEA License
If you are a PGY-3 or higher and write controlled substance
prescriptions, you will need your own personal Federal DEA
& (form) Request for Fee Exemption –
license.
DEA Registration
Note: If you will utilize your personal DEA number only within
the scope of your training program and will not utilize it for
external moonlighting purposes, you are eligible for a fee
exemption for your DEA registration. To request approval for
fee exemption, complete and sign the form “Request for Fee
Exemption-DEA Registration.” Return the form to the GME
Office and we will route to your program for approval.
FORMS TO BE PRINTED FROM THE
GME WEBSITE
USMLE Step III/ Licensure/ACSC/DEA
Acknowledgement Form
INSTRUCTIONS
Print. Sign and date.
After you return your “GME Information Form” and your Blazer
ID is set up, you will be receiving two additional emails (they
The Form I-9 is used to verify both the identity will come 24-48 hours apart) from gme@uabmc.edu regarding
and U.S. work eligibility of all employees.
our online Form I-9. The emails will be sent to the email
address that we received for you. Please check your
The Form I-9 is viewable on the GME
junk/spam folder.
Form I-9 and Instructions
website, but you will complete the actual form
electronically.
One email will provide you Login Name and a link to our
online Form I-9. You will receive a second email with your
password for the system. Please follow the link and
complete Section 1 of the form before your attend GME
orientation.
You will be also asked to identify the documents you will use
in order to complete the Form I-9. A list of the acceptable
documents needed is available for review while in the online
system. Please bring these documents with you when you
arrive for your GME orientation.
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IMPACT Policy Acknowledgement Form
& Use of Portable Devices within UABHS
HIPAA Covered Entities
GME Policies and Procedures
Acknowledgement Form
BCLS/ACLS Registration Form
RSVP for GME Orientation
OPR AL Medicaid Application
(Note: Alabama Medicaid only wants
physicians with a valid Alabama license
to order services for Medicaid patients)
If at all possible, please have your original documents (that
you identified) reviewed by an HR representative at the same
time you have your picture taken for your ID badge. That will
save you time at GME Orientation.
Print. Sign and date (1 sheet only).
Print and sign. You can access the GME Policy and
Procedure on the GME website. You will be given a hard copy
of this manual at orientation.
Print and complete. Attach valid BCLS/ACLS/PALS/ATLS
card, if applicable.
Print and complete.
Print and complete form only if you will have an AL license by
July 1, 2014. If you are in the process of obtaining an AL
license, please do not complete.
If you do not have SS #, you will not be able to complete
this application until you obtain one.
Notes on the Application Process
SECTION 1 - Basic Information
List your NPI number
SECTION 2 - Identifying Information
A.
Complete in full
B.
Complete in full. List YOUR ADDRESS
D.
Medical Specialties – choose 1
SECTION 2.2 - Identifying Information – Skip this section
SECTION 3 – Disclosure Information – Answer all questions
SECTION 4 – Contact Person – List YOUR NAME and information
SECTION 5 - Read
SECTION 6 – Sign and date in blue ink
Code of Conduct for Professional
Behavior
Application for Institutional Controlled
Substance Permit (Temporary DEA
Application Form)
Print. Sign and date.
Print and complete this form. The Pharmacy will issue you a
number at orientation, if needed.
In addition, residents/fellows with greater than 18 months of
training must have a personal DEA.
Background Check
Exceptions in these programs only: Pathology and Pathology
subspecialties( does not include Blood Banking/Transfusion
Medicine); Dermatology; Diagnostic Radiology,
Neuroradiology, Vascular Interventional Radiology
Print and complete.
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FORMS TO BE PRINTED FROM THE
GME WEBSITE (continued)
Infectious Disease Questionnaire
INSTRUCTIONS
GME Information Form
Print and fill out completely. Under “home address” – please
list your local address here after July 1st.
ID Badge Application
Print and complete. If at all possible, please have your picture
taken prior to orientation (beginning May 12, 2014).
Print and complete. Parking Cards will be issued at
orientation for most programs.
Parking Application
Request for Fee Exemption – DEA
Registration
Print and complete.
Exceptions are Pediatrics and subspecialties, Dermatology,
and Ophthalmology. You will receive these parking
assignments through your programs. DO NOT COMPLETE
THIS FORM IF YOU ARE IN THESE PROGRAMS.
Complete and return this form only if you are applying for your
person DEA number and will utilize your personal DEA
number only within the scope of your training program and
will not utilize it for external moonlighting purposes. You
are eligible for a fee exemption for your DEA registration.
To request approval for fee exemption, complete and sign the
form “Request for Fee Exemption-DEA Registration.” Return
the form to the GME Office and we will route to your program
for approval.
FORMS THAT ARE IN THIS PACKET
FORM IN YOUR PACKET
INSTRUCTIONS
Scrubs Order Form
Complete and return to GME– don’t forget to
circle coat size. You will be issued scrubs at
orientation. Return to GME
Complete and return to GME– don’t forget to
circle coat size. You will be issued coats at
orientation. Return to GME
Complete. Sign. Return to GME.
Lab Coat Order Form
Malpractice Form
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PLEASE RETURN COPIES OF THE FOLLOWING IN THE SELF ADDRESSED ENVELOPE BY
MAY 9, 2014

All Forms listed on above (pages 6-8)

Current Alabama Medical or Dental License (PGY3 and above)

DEA Certificate (your own personal) – if your program writes prescriptions for controlled substances

Alabama Controlled Substance Certificate –PGY3 and above - if your program writes prescriptions for
controlled substances

ECFMG Certificate – only if applicable

Medical or Dental School Diploma – If you have not received your diploma, you can skip and send
when received. Please send by July 15, 2014 at the latest. You can bring a copy to orientation if you
have it.

Curriculum Vitae

Social Security Card – copy

USMLE Step 2 – we need both CK and CS scores if you have passed (if you are an MD)

COMLEX Step 2 - we need both PE and CE scores if you have passed (if you are a DO)

Step 3 (USMLE or COMLEX) – required for PGY3s or higher, please send if you have it and you are a
PGY2 and have passed

Current Certifications - If you are currently certified in BCLS, ACLS, ATLS or PALS, please send us a
copy of the card
Please feel free to call the GME Office at 205-934-4793 if you have any questions.
GME is open Monday – Friday from 8:00 a.m. through 5:00 p.m. (CST). Our office is located in
UAB Hospital, Jefferson Tower Room J136, Birmingham, Alabama 35249.
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POLICES AND MISC. INFORMATION YOU ARE REQUIRED TO REVIEW PRIOR TO ATTENDING
ORIENTATION
POLICIES AND MISC. INFORMATION TO
REVIEW ON THE GME WEBSITE
All must be reviewed in order to attend
orientation and begin training
COMMENTS
AY 2015 GME Policy and Procedure Manual
You will receive a copy at orientation.
Oracle Self Service Applications (Instructions)
Gives employees access to view and change
personal information in the Administrative
Systems, view pay slips and manage direct
deposit account.
Lister Hill Library Information
YOU WILL NOT HAVE ACCESS TO THIS
SYSTEM UNTIL AFTER ORIENTATION.
You will complete a form at Orientation that
allows you to have access to the library
Physician Resource Center
UAB Health System Personal Appearance
Uniform & Hygiene
Social Media Policy
Consent to Photograph, Video, or Audio
Record
UASOM Honor Code
UASOM Technical Standards
UASOM Student Code of Professional
Conduct
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FACULTY & STAFF LEARNING SYSTEM
INSTRUCTIONS FOR REVIEWING EDUCATION MODULES REQUIRED PRIOR TO ATTENDING
ORIENTATION
EDUCATION MODULES TO REVIEW
All must be completed in order to attend
orientation and begin training
IN THE UAB FACULTY & STAFF LEARNING
SYSTEM
https://www.healthstream.com/HLC/uabhs
Note: Please disregard the instructions on the signin page that says “for UAB Medical West ONLY.”
Instructions are on the GME Website and a
copy is also in this packet
Your user id and password is your Blazer ID
(for both).
Confidentiality Agreement
Rules of Behavior for UABHS Information
Systems
HIPAA Privacy and Security
2014 Environment of Care
2014 Patient Safety Clinical Competency
2014 Joint Commission Medical Staff
Preparedness
2014 Corporate Compliance/HIPAA
Sleep Loss, Fatigue and Medical Training
AIDET Training
CERT Modules (Creating Effective Resident
Teachers) – you will be assigned two modules
ICD -10 Modules
IMPACT (computer system) Module
Please feel free to call the GME Office at 205-934-4793 if you have any questions.
GME is open Monday – Friday from 8:00 a.m. through 5:00 p.m. (CST). Our office is located in
UAB Hospital, Jefferson Tower Room J136, Birmingham, Alabama 35249.
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