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Congratulations for your selection of the Virginia Commonwealth University Health System for your training. The following are requirements for employment and appointment as housestaff members. Please read this information carefully as it will save you time in the long run. All required forms, including the contract previously mailed to you, must be returned to the GME Office in the envelope that was provided no later than Friday, May 2nd . If you have any questions as you complete this process, please call us at (804)828-9783.
Step 1:
The following is a list of forms/documents that need to be completed and returned to the GME Office. Completing these may be done in one of several ways:
- Most of the forms are “fill-ins” and can be completed on-line prior to printing. If you choose this option, we suggest that you print the “All Instructions” document to use as a guideline for completing the forms.
- Or, you may print each form first and complete them by hand using the instructions for each provided below. Just click on the appropriate link for each form to access the guidelines for completion.
When completing the forms:
- Do not fill in ADDRESS on forms unless you have secured housing in the Richmond area. (Exception: You will need to put your current home address on the Investigative Consumer Report Release.) You may return the forms without this information and provide it to the GME Office as soon as it is available.
- NAME used when completing forms should reflect what your legal name will be as of your employment date. (i.e., last name changing due to marriage)
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Step 2:
Return all forms and required documents, using the checklist above, to the GME Office in the pre-paid envelope that was provided to you. Make sure you have signed all documents where required. Remember to place the Employee Health forms into the smaller envelope, and then return with your other forms in the larger envelope.
INSTRUCTIONS AND REQUIREMENTS FOR EMPLOYMENT:
Forms and Documents
Please sign the original contract (mailed to you in the welcome packet) and return it to us with your other forms and documents. Appointments cannot be made without a signed contract and a delay in returning it could prevent timely initiation of your pay.
- Preplacement Drug Testing
VCU Health System is a drug free environment and we do preplacement drug testing. If you are a VCU School of Medicine or Dentistry graduate or will be in the area in April or May, you need to make arrangements as described in the instructions provided in the packet with the Chain of Custody forms. If you are not going to be in Richmond before June, you will need to have your drug testing done in accordance to the general information provided. I would urge you to not put this off. You are not allowed to start work until you are cleared. So please have your screening done (APPOINTMENTS ARE REQUIRED) when you are in town to look for housing or schedule it at your local lab that meets the criteria. Do not wait until you move to Richmond. The other issue about waiting until you arrive in Richmond is that positive results may have to be reported to the Board of Medicine or Dentistry. While we cannot foresee this being an issue, we need you to be fully informed.
- Temporary Training License Applications for Medical and Dental Residents
Virginia State Law requires that, in order to be employed in a Virginia graduate medical/dental education program, interns/residents/fellows possess a temporary training license. Therefore, all required forms must be completed and returned to the GME Office as soon as possible. IT IS YOUR RESPONSIBILITY TO INSURE THAT CONFIRMATION OF YOUR DEGREE (Form B for medical graduates, Form A for dental graduates) IS COMPLETED APPROPRIATELY BY YOUR REGISTRAR AND RETURNED TO US IN A TIMELY MANNER. It is particularly important for May 2008 and June 2008 graduates to insure that your Registrar mails the form immediately following graduation. Note that this form must be completed AFTER your graduation date. Forms stating “will graduate” will not be accepted by the Board and will have to be redone by your Registrar.
If you possess a full, unrestricted Virginia medical/dental license, you need not complete this application. However, please send a copy of the license that shows a valid expiration date. Information regarding application for permanent licensure in Virginia is available from the Virginia State Board of Medicine at (804) 367-4472 or the Virginia State Board of Dentistry at (804) 367-4538 or on-line at for both Boards at http://www.dhp.virginia.gov/.
NO HOUSESTAFF MEMBER WILL BE ALLOWED TO PRACTICE UNLESS HE/SHE IS LICENSED IN VIRGINIA.
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Housestaff members are not required to obtain individual DEA numbers in order to write prescriptions. Rather, you will use the Hospital DEA number of the institution at which you are working plus your 4-digit doctor number.
The NPI is a unique 10-digit identification number for covered health care providers used to identify a health care provider in standard transactions, such as health care claims. As a resident, your NPI will primarily be used to identify you on prescriptions, to order durable medical equipment, in patient medical record systems, and in several other ways. As of the May 23, 2007, the NPI will be the only health care provider identifier that can be used to identify you in standard transactions by covered entities. You will use your NPI throughout your medical career.
Please complete the enclosed form.
- If you currently have an NPI number, provide the information requested as we will update your NPI record related to practice location, licensure, and taxonomy. Consult your previous program/employer for the information if necessary.
- If you do not have an NPI number, provide the information and the GME Office will obtain an NPI number for you.
- Criminal Background Check
A criminal background check, conducted by the Virginia State Police, is a condition of employment. On the Criminal History Record Name Search Form:
- Please complete only the two sections described below (these are highlighted).
- SECTION 1. Fill in your name, current address, sex, race, date/place of birth, and social security number (highlighted areas). You may type, then print the form OR print the form and complete, legibly, by hand.
- SECTION 1A. Sign on “Signature of Person” line. Your signature must be notarized to provide consent for the search to be conducted and to mail the processed search to an individual or authorized agent (if applicable).
- Leave the remainder of the document blank as these sections will be completed by the VCUHS Human Resources Department.
- VCUHS will pay the required fee so do not send a check or fill in credit card information.
- If an item is not disclosed and is subsequently found on a background check, the resident will be eligible for dismissal. Refusal to complete the self-disclosure or to sign consent to conduct a criminal background check will prevent employment with VCUHS.
- Ten Print Fingerprint Card
The 10-print fingerprint card was mailed to you with your contract. Please have your local Human Resources Office, local Police Department, or local fire Department assist you in completing this. It requires official verification. This is required of all new housestaff.
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- Investigative Consumer Report
The Investigative Consumer Report Disclosure and Release are used only to conduct criminal background checks in states (other than Virginia) in which you have lived. Neither a credit nor personal background check is requested. Please complete these two forms, using your current address as your "Home Address" (on this form only), and return them with the other required documents.
Please note: If you have lived in the states listed below during the last 7 years, you will need to contact Melissa Washington immediately -- at (804)628-3647 or via email at mwashington@mcvh-vcu.edu. These states require additional state-specific documents to conduct criminal background checks (state-specific form, copy of photo id, and/or fingerprint card). These states are: Delaware, Georgia, Idaho, New Hampshire, New Mexico, Ohio, Rhode Island, Vermont, West Virginia, and Wyoming.
You will need to provide the Employee Health History/Immunization Record form to your health care provider for completion. In addition, you will need to complete the Medical History form, including the Registration form.
NOTE: To maintain confidentially, the Employee Health forms (4 pages) must be placed in the small envelope addressed to Employee Health. (This envelope was included in the packet containing your contract.) The small envelope then should be included with your other forms in the larger pre-paid return envelope.
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- Supplemental Application Form
The Supplemental Application Form is an internal document specifically designed for housestaff and is required for appointment to the Virginia Commonwealth University Health System Housestaff. All information received becomes part of your confidential employment files in the Human Resources Department. The Housestaff Self-Disclosure and Criminal Background Check Policy is located on our website under “GME Policies” at www.medschool.vcu.edu/gme. We encourage you to make a copy of this completed form for your records. All questions must be answered and the form must be signed and dated. If you answer YES to any questions (other than question #1a), please provide a detailed explanation on a separate sheet of paper. In addition, YES responses to questions #1b and #1d will require documentation from a treating professional.
For credentialing purposes, the Final Reference Form must be completed and returned to the GME office. Please print this form and have it completed by the appropriate official of the institution in which you currently are completing medical school (Registrar), serving as a resident or fellow (Program Director), or practicing (Medical Staff Office). For verifications of education or training, the form must not be completed prior to completion of the program. Returning this form after May 2nd is acceptable. However, it must be returned by Orientation.
- Release of Information Form
Please read and sign the attached Release of Information Form. As indicated, this will be used to verify your education, training, etc. as necessary.
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- Salary and Payroll Information
Paychecks are issued bi-weekly, with payday every other Friday. The 2008 PAY CALENDAR will provide you with the date of your first paycheck, based on your start date. Annual and bi-weekly salaries can be found at www.medschool.vcu.edu/gme/salaryscale.html. To be placed on payroll, you must complete the Personal Data Form, W-4 form, VA-4 form, and I-9 process. Please return these with a Photocopy of your Social Security Card. If you do not have a social security card or number, you are responsible for obtaining one.
- Personal Data Form: Please complete this form.
- Post-Offer Voluntary Self Identification Form: If you have a disability or are a special disabled veteran of the Vietnam era and would like to participate in our affirmative action program, please read the information provided and complete the attached form.
- I-9 : Under the Immigration Reform Act of 1986, employers are required to view original documentation from new employees to verify identity and eligibility for employment. The I-9 form is used for this purpose. Please complete Section 1 only.
- PLEASE READ the instructions for Section 2 carefully to insure that you possess the documents necessary to complete this section.
- RETURN COPIES of the original documents you will present at Orientation with your other forms.
- BRING the original documents with you to Orientation as they must be viewed by the employer.
YOU CANNOT BE PLACED ON PAYROLL UNTIL THE I-9 IS COMPLETED.
- Direct Deposit Authorization : Direct deposit is a condition of employment at VCUHS.
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- Veterans Administration Medical Center Application
The McGuire VAMC welcomes all incoming housestaff. All housestaff (except Emergency Medicine, Pediatrics, and Obstetrics/Gynecology) rotate through our hospital and must complete certain documents PRIOR to performing clinical duties. To expedite your processing on orientation day, please complete the following documents:
- Appointment Letter with signature
- Appointment Affidavit
- Clinical Trainee Information Form
- Application for Residents (VA Form 10-2850b)
If you are an incoming resident who already has a full medical license from another state, please attach a copy to the completed application. It is required for this application.
- VA National Rules of Behavior for appropriate use
and protection of the information which is used to support Department’s missions and
functions.
- Pharmacy Card: This is required to allow you to write prescriptions through the VA Pharmacy.
- Statement of Commitment
- Police and Security Service Form: If you are requesting a VA parking sticker, you will need to complete this form and bring your current vehicle registration card and current driver’s license.
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In the packet containing your contract, you received the 2008 Housestaff Enrollment Guide and a Housestaff VCUHS Benefits Enrollment Form. Please review these carefully. During Orientation, a presentation will be made to better acquaint you with the benefits that are offered by VCU Health System. It is during that time that enrollment forms will be completed. Benefits representatives will be available to answer your questions and to assist you in completing this process.
For housestaff with a contract start date of July 1, 2008, your insurance coverage will be effective July 1st, provided you have submitted the application within 31 days of your start date. For housestaff with a contract start date of July 2nd or later, your insurance coverage will be effective the 1st day of the month following your start date, provided you have submitted the application within 31 days of your start date.
NOTE: You should make arrangements to continue your current health insurance plan until the effective date of your insurance through VCUHS.
Please do not mail your enrollment form back to us with your other documents. Rather, you should bring it with you to Orientation at which time Benefits staff will review and you will complete.
Please complete the lab coat measurement form carefully, as lab coats will be packaged in advance and ready for issuance during Orientation. Samples of each and size conversion charts can be viewed by clicking on the appropriate link below:
Ladies' Coat Man's Coat
Size Conversion Charts
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Complete and sign the application form if you will need VCU parking.
Parking for medical residents is provided on the D Deck, located on 13th Street near the intersection of Marshall and 13th Streets. Parking for dental residents is provided in the N Deck, located on 10th Street at the intersection of 10th and Leigh Streets.
The monthly rate is $77.26 and will be deducted from your paycheck ($38.63 from 24 bi-weekly paychecks). However, the Health System pays $42.46 of the monthly fee. This payment will be provided to you as an increase in your bi-weekly base salary of $21.23.
At Orientation, all housestaff will be provided with a Long Distance Access code for use in making long distance work-related calls only.
Pagers will be issued to all incoming housestaff through your program.
In accordance with the rules set forth by the VCU Health System, each employee must be issued an identification badge complete with a photograph in order to have 24-hour access to the hospital. Photos will be taken and ID badges issued at Orientation.
All housestaff members are provided a mailbox, either in their clinical department or in the GME Office mailroom. Your box number and location will be provided to you at Orientation.
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Required Training
Federal regulation, the Health Insurance Privacy and Accountability Act (HIPAA), requires that you complete this institution’s privacy education program before you are allowed to access patient health information. Instructions and a unique user logon number were provided to you in the packet containing your contract. This on-line training can be accessed at: www.vcuhealth.org/hipaa.
All housestaff members are required to complete the on-line
Sleep Alertness & Fatigue Education in Residency (SAFER) training.
- Start with the Survey
- Navigate through the Content -- Introduction & Slide Presentation. (NOTE: To return Content Menu, use the BACK button on your browser.)
- Complete the Posttest and Evaluation.
- Print the Certificate. You must print the certificate when presented. If you navigate away from the certificate, you will not be able to return to it.
All housestaff members also are required to complete the on-line Legal Medicine training. There are 8 modules providing an overview of the legal ramifications of practicing medicine in Virginia. Each module has a post-test that must be completed in order to receive credit. No certificate(s) will be provided. However, passing scores will be recorded in your name when submitted.
All incoming interns, residents, and fellows are required to complete a training class to use the clinical information system, CIS/Cerner. You will be scheduled for this class as follows:
- Interns who are VCU graduates have been scheduled to complete training in early May.
- Non-VCU interns have been scheduled to complete training during the week following Orientation.
- PGY 2 & above residents and fellows should contact your training program coordinator to schedule training.
- Point-of-Care Proficiency Testing
Certain residents and fellows are required to complete Point-of-Care Proficiency tests. The number and type are based on your specialty. Please refer to the Program Requirements listing to determine which tests, if any, you are required to take. For each required test, a policy is provided. Once you have reviewed this information, please complete the short quiz and return it with your other forms/documents. A hands-on assessment also will be done at Orientation.
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The VA Medical Center in Richmond Virginia now requires all incoming housestaff to complete computer training PRIOR to receiving their computer access codes. Please refer to the scheduling information for instructions for arranging to complete this training.
- VAMC Cyber Security and Privacy Training
All residents/fellows are required to complete mandatory Cyber Security Awareness and VHA Privacy Policy Training. Please refer to the information above for instructions on accessing these on-line training modules. REMEMBER to print the certificate once you complete each module.
- CHECKLIST for Returning Forms
Please use this checklist to insure you have completed all paperwork as you place it in the envelope to be returned to the GME office.
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