** Only GME recognized programs (ACGME & Non-ACGME), whose trainees are credentialed as residents/fellows, should execute this contract
Evaluation Forms: (360; summative, annual, faculty, program, resident/fellow)
Elective Form: This form must be completed by the resident/fellow, approved and signed by the program director, and returned to Haidy Nagib in the GME office for review and approval by MMCIP (self-insurance trust) before the elective activity is permitted. 90 days advance notice is required. **If the resident/fellow is on a J1 visa, you must complete the Notification of an Off-Site Rotation form and scan it to Serena Roach at firstname.lastname@example.org for submission and approval from the ECFMG before returning the completed elective form to Haidy. ECFMG approval can take up to 10 business days.
Moonlighting/Extra Sessions Form: This form required to be completed by the resident/fellow, signed by the program director, medical staff services and the self-insurance trust (MMCIP) before the extra session or moonlighting activity can be considered for approval. *For Moonlighting or Extra Sessions NOT on the UMMC campus, please allow 2-4 weeks for approval through MMCIP
Offer Letter Residents/Fellows: A standardized offer letter is required for all applicants that will be enrolled in post-graduate clinical training programs sponsored by the University of Maryland Medical Center.
Resident /Fellow Data File: This file is to be completed by the Program Liaison (e.g., Residency Coordinator, Administrative Assistant, Program Director) to assure that all residents and fellows are appropriately credentialed. The instructions for completing, along with the form are also found in this link.
Tax Forms – Maryland: New residents and fellows will also be asked to provide a completed state tax form order to satisfy the requirements to be added to payroll.
Tax Forms – Federal: New residents and fellows will also be asked to provide a completed federal tax form order to satisfy the requirements to be added to payroll.