QUILLEN COLLEGE OF MEDICINE
OFFICE OF GME INCOMING RESIDENT / FELLOW INCOMING CHECKLIST
Department Responsibilities: (Some may not be applicable to all Programs/Incomings)
______Issue Orientation & Academic Year Contracts
Send Signed Contract to GME Office for DIO Signature
______DS-2019 - Expiration Date & Doc>NI Visa + Send to GME Office
______VISA - Expiration Date & Doc>NI Visa + Send to GME Office
______Upload ERAS Application into NI Files & Notes/ERAS Application
______Distribute Information to Acquire NPI Number - # into NI Basic Info + Send # to VA
______Acquire Copy of Medical School Diploma – Uploaded into NI Education & Check Date
______Verify Required Immunization – Documentation into NI Immunizations –VA TQCVL Form
______Verify Required PALS/ACLS/ATLS, etc. – Dates & Certificates in NI Certification
______Issue, Distribute & Track GLRs – Upload completed to NI F&N/GLR & email copy to VA
______Distribute & Track Wellmont Epic Confidentiality Form – Leave in NI F&N/Onboarding
______Acquire ECFMG Certificate – Effective Date & Certificate Uploaded to NI ECFMG + to
GME Office
______Distribute VA Checklist of Needed Items if appropriate
______Make sure Primary Email Address in NI is ETSU’s email once activated
______Upload any Transfer Documents into NI F&N/Transfer Docs & Notify GME Office
______Make sure all Resident Information is entered into NI, i.e. Credentials, etc.
______ Other Steps required by Programs
Graduate Medical Education Responsibilities:
______ Complete Contract Process – Into NI Contracts/Send Copy to VA Ed Office & Payroll
______ Distribute/Track GME Personal Data Form – Uploaded into NI F&N/HR Documents
______ Distribute/Track Background Check Release, Enter into TrueScreen/Check Clearance
______ Verify GME Resident Handbook Review
______ Collect Copy of Social Security Card – Uploaded into NI F&N/HR Documents to Payroll
______ Enter Incoming into Banner – E# into NI Basic Info
______ Distribute/Track W-4 Form – Uploaded into NI F&N/HR Documents & to Payroll
______Glacier Form (w/appropriate W4) – J-1/EAD Visa Holders – Email will be sent from
Support@on-line-tax.net when SS# and Visa process complete – completed form to
the GME Office. GME will upload into NI F&N GME/HR.
______ Distribute/Track/ Complete I-9 Form & Docs – Uploaded into NI F&N/HR Documents
______ Distribute/Track Direct Deposit Form w/voided Check – Uploaded into NI F&N/HR
& to Payroll
______ Distribute/Track Life, Disability, Dental & Health Insurance Information & Enrollment
– Into NI F&N Insurance Applications & disburse forms/info to providers.
______ Distribute/Track Sick Leave Bank Enrollment for Incomings – Into NI F&N GME/Sick
Leave Bank & to HR
______Distribute Parking Sticker Information and Request Form – Into NI F&N GME HR Docs
& to Parking Services
______Distribute/Track GME Photo Release Form – Into NI F&N GME HR Docs
_______Visa & DS2019 – GME to double check & upload documents into NI if necessary.
2/10/2016 12:37 AM