CREDENTIALING OF HOUSE STAFF OFFICERS
IN
ACGME
ACCREDITED
AND
NONACCREDITED PROGRAMS
Revised/Effective:
Reviewed:
Reaffirmed by GMEC:
Supersedes:
Originally adopted:
Approved by:
Web address:
Applies to:
I.
October 22, 2010
October 22, 2010
October 22, 2010
1/15/10
4/13/04
Graduate Medical Education Committee
http://gme.med.nyu.edu/house-staff/gme-policies-and-forms
Residents and Fellows enrolling in ACGME accredited and
non-accredited programs
Preamble
NYULMC is committed to meaningful and enriching educational experiences for its
residents and clinical fellows. This includes assurance that these residents and clinical
fellows have the appropriate credentials to work in a clinical setting and be gainfully
employed while assuring meaningful education, personal health and safety for patients.
The ACGME has established guidelines governing the selection of residents and clinical
fellows enrolled in ACGME approved programs. In addition, the NYS Department of
Health and the affiliate hospitals of NYUSoM have set rules and regulations for House
Staff to be in compliance with these criteria.
II.
Definitions
A. House Staff Officer - a physician who is enrolled in an accredited or non-accredited
NYUSoM Training Program for a clinical specialty or subspecialty this includes all
Residents and Clinical Fellows.
B. NYUSoM Training Program – a specialty or subspecialty graduate training program at
NYUSoM, which may be either an Accredited NYUSoM Training Program or a NonAccredited NYUSoM Training Program.
C. Accredited NYUSoM Training Program - a NYUSoM Training Program that is
accredited by ACGME, ABMS, or any other recognized accrediting agency.
D. ACGME – Accreditation Council for Graduate Medical Education
E. Sponsoring Institution – NYU School of Medicine
F. LCME – Liaison Committee on Medical Education
G. AOA – American Osteopathic Association
H. ECFMG – Educational Commission for Foreign Medical Graduates
I. NRMP – National Resident Match Program
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J. Fifth Pathway Program - A period of supervised clinical training for students who
obtained their premedical education in the United States, received undergraduate
medical undergraduate abroad, and passed Step 1 of the US Medical Licensing
Examination. After these students successfully complete a year of clinical training
sponsored by an LCME-accredited US medical school and pass USMLE Step 2, they
become eligible for an ACGME-accredited residency as an international medical
graduate.
III. Policy
A. Institutional Responsibility to Resident/Fellow Selection
1. The Sponsoring Institution must ensure that its ACGME-accredited programs select from
among eligible applicants on the basis of their preparedness, ability, aptitude, academic
credentials, communication skills, and personal qualities such as motivation and
integrity. ACGME-accredited programs must not discriminate with regard to sex, race,
age, religion, color, national origin, disability, or veteran status.
2. In selecting from among qualified applicants, it is strongly suggested that the Sponsoring
Institution and all of its ACGME-accredited programs participate in an organized
matching program, such as the NRMP, where such is available. This applies to all
residents and fellows transferring in to any NYU training programs.
B. Resident’s/Fellows Responsibilities - The Resident/Fellow is required to comply with all
requirements of each Affiliated Hospital to which she/he is assigned.
1. Credentialing - The Resident/Fellow agrees to comply with each Affiliated Hospital’s
credentials verification and appointments procedure. The Resident will not be permitted
to begin a training program nor to receive any other benefits under this contract without
having met such credentialing requirements, which include:
a. Completion of application for house staff appointment. The Resident/Fellow must
submit all the requested information to the NYU Office of Graduate Medical
Education prior to the Resident/Fellows begin training
b. Proof of graduation from medical school (this includes both Final Transcripts &
Diploma indicating degree
c. ECFMG Certification if the Resident is an International Medical School Graduate;
d. Documentation of identity and right to work, including fingerprinting and background
checks as required by any of the Affiliated Hospitals; and
e. Proof of compliance with NYU’s immunization policy, which is included in the
Resident Handbook.
2. Licensure - A valid New York State medical license is required (or limited permit if the
Fellow is not eligible for a License. (Note: Failure to take and/or pass USMLE Step 3
does not determine “eligibility.” See Section IV.B.2 of Licensure Policy) if the Fellow is
entering a non-ACGME accredited training program or entering a Fellowship program.
This license must be obtained before training can begin. The Resident agrees to abide
by NYU’s Licensure Policy in addition to the New York State licensure requirements for
physicians in training, which can be found at: http://www.op/nysed.gov. NYU’s policy on
licensure is more restrictive than that of New York State. A full description of NYU
Licensure Policy can be viewed at http://gme.med.nyu.edu/house-staff/gme-policiesand-forms.
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3. Employment – All employment requirements must be satisfied prior to commencement
of training. These include but are not limited to, satisfaction of all pre-employment
employee health requirements, successful completion of all background check
processes, (questionnaires, fingerprinting, etc.), passing a urine toxicology screening
test, and completion of the I-9 (employment eligibility form).
a. Failure to satisfactorily complete the credentialing process nullifies the contract and
is not subject to appeal.
b. All level one aspects of credentialing and employment must be satisfied to obtain,
‘clearance’ to begin training. Within 60 days of beginning training the resident or
fellow must satisfy any remaining level two requirements.
c. Failure to satisfy all the requirements within the 60 day ‘grace’ period will result in the
resident/fellow being placed on an unpaid Leave of Absence (LOA) status until all
requirements are satisfied. The resident/fellow may not work or receive training credit
for anytime during this LOA.
d. Missed training time may result in an extension of the training program in order to
satisfy training requirements, in accordance with the program policy.
4. Eligibility – Applicants with one of the following qualifications are eligible for
appointment to ACGME-accredited programs:
a. Graduates of medical schools in the United States and Canada accredited by the
LCME.
b. Graduates of colleges of osteopathic medicine in the United States accredited by the
AOA.
c. Graduates of medical school outside the United States and Canada who meet one of
the following qualifications:
i. Have received a currently valid certificate from the ECFMG prior to appointment
or
ii. Have completed a Fifth Pathway Program provided by an LCME-accredited
medical school.
5. Appointment – The Office of GME tracks Clinical Year, Post Graduate Year (PGY) and
Payroll Year. A House Staff Officer’s clinical year is the level of training that they are at
in the training program. The PGY Year is the number of years that has passed since the
House Staff Officer has completed Medical School. The Payroll Year refers to the
Stipend level at which the House Staff Officer will be compensated.
6. Reappointment – is dependent upon satisfactory demonstration of clinical competence
and professional standards as determined by verbal and written evaluation by the faculty
and the Office of GME. A House Staff Officer shall be appointed at the appropriate
Payroll Level, which shall be determined as follows:
a. A House Staff Officer who has not completed at least one year of service in an
ACGME approved training program shall be placed at Payroll level 1.
b. A House Staff Officer who has completed one or more years of service in an ACGME
accredited training program shall be placed at the Payroll level which equals the
years of completed training plus one (e.g., a House Staff Officer who has completed
two years of a training program shall be paid as a Payroll level 3 upon appointment).
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c. In the event a House Staff Officer changes their specialty, a maximum of two years
of credit will be allowed. (e.g., a House Staff Officer who has completed four years of
a Pathology training program and has transferred to an Internal Medicine training
program shall be paid as a Payroll level 3).
d. If a House Staff Officer has completed or trained in a non-ACGME training program,
they will be placed at the Payroll level that equals the years completed in an ACGME
accredited training program plus one. Please note: This will include non-ACGME
Research Programs and Extra Year Chiefs in Medicine and Pediatrics.
e. Non-ACGME House Staff Officers may be paid in excess of the House Staff Payroll
Scale, as the circumstance warrants at the discretion of the department.
C. Office of GME Responsibilities – The Office of GME will track the submission of all
documents and completion of all processes to obtain the status of clearance and satisfaction
of all credentialing items.
A full list of all requirements follows below:
Required Documents for All Trainees
NYU Resident/Fellow Application Form
HHC Application for Residency
BHC House Staff Application
Original Medical/Dental School diploma
Original final Medical/Dental School Transcript with Seal and
4th Year Grades (must indicate ''Degree conferred'')
Letter of Recommendation #1 (dated six months prior to the
start date) from a doctor who supervised clinical work of
applicant during that time.
Letter of Recommendation #1 (dated six months prior to the
start date) from a doctor who supervised clinical work of
applicant during that time.
Current Curriculum Vitae (Must be updated within six
months of start date)
Dean's Letter from Medical/Dental Degree-Granting Institution
OR if Dean’s Letter has not been issued (some FMGs), a
statement indicating this must be submitted.
Signed NYU House Staff Contract
License is Required for all Fellows (trainees in accredited
and non accredited subspecialty training programs)
NYS License (U.S. and Naturalized Citizens & Permanent
Residents)
NYS Registration
NYS Limited Permit (Oral Surgery and Non-Citizens only)
USLME Step 3 Requirements (for all Residents entering in
final year of Residency)
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NYS License (U.S. and Naturalized Citizens & Permanent
Residents)
Scope of Practice for Fellows in Non-ACGME training programs
International Medical School Graduates (IMGs)
Requirement
Original, Valid Educational Commission for Foreign Medical
Graduates (ECFMG) Certificate or Fifth Pathway Certificate
Requirement for Residents Who Have Had Previous
Training in the U.S.
Original Certificate(s) of Training or Letter(s) from Program
Director(s) certifying successful completion of all accredited
training.
NYULMC Human Resources Requirements
NYU Application for Employment (House Staff/Faculty
Questionnaire)
NYUHC I-9 Form (with appropriate original forms of ID)
New Hire Sheet
Successful completion of Background check
Successful completion of NYS Child Abuse Registry (SCR
Form) background check (for House Staff Officers with
prolonged contact with pediatric patients)
Tisch Hospital W-4
Tisch Hospital IT – 2104
Addendum Letter (rubella vaccine)
Confidentiality Agreement
Patent Agreement
Drug Free Workplace Attestation Form
Tisch Hospital Benefits
Visa Requirements
DS 2019 with valid coverage period (on a J Visa)
I-94 with "Duration of Stay" stamp (on any visa)
NYUHC I-9 Form and Taxation Analysis Form (Finalize these
forms at the Immigration office) (on any visa)
I 797 Form (on an H1 or O Visa)
NYULMC Employee Health Requirements
Physical Exam within the Past Year
Proof of Immunity to Rubella and Rubeola (Addendum Letter)
Proof of Varicella (Chicken Pox) Immunity
Tuberculosis Screening #1
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Tuberculosis Screening #2
Tuberculosis Fit Test (health assessment)
Proof of Hepatitis B Immunity
Proof of Mumps Immunity
Respirator FIT Testing
Bellevue Hospital Requirements
Bellevue Hospital W-4 Form
Physician Agreement
Bellevue Hospital I-9 Form
Personal Data Form (PDF)
Visi Card (Buff/folded)
NYC HHC Employment Application
BHC Fingerprinting
Electronic Fingerprinting/Payroll Deduction Authorization Form
BHC Benefits Enrollment Form
BHC Benefits Waiver Form
BHC TDA Enrollment Form
BHC Deferred Compensation Forms
BHC Direct Deposit Form
BH Appointment Form
BH Employment History Card (Yellow Card)
Infection Control Certificate
Proof of Identity (and copy of visa, if applicable)
405 Attestation
Toxicology Screening Results
Miscellaneous Requirements (online training modules)
Orientation
NYU Code of Conduct
Bellevue HIPAA
Bellevue Corporate Compliance
Veteran's Administration Hospital Requirements
VA Packet
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