Unless otherwise stated, all items are to be completed and returned 30 days before your start date. Some tasks take longer than others.
We encourage you to start as soon as possible.
For your convenience, we are including [this printable checklist] for tracking. This is for your use only and does not need to be returned to Wake Forest Baptist Medical Center.
A. First Things First (1 ONLINE FORM)
Fill out the New House Staff Information Form Online. This provides us with a chronology of your prior training and gives you the opportunity to explain any training gaps.
Note: The New House Staff Information Form must be submitted 90 days before your start date.
B. From Your Information Packet (3 DOCUMENTS)
The following items are included in your Contract Packet. Please complete these items as instructed and return to the House Staff Office in the envelope provided.
- Residency Training Agreement/Contract
- Scrub Agreement Form
- Fingerprint Cards
Note: House Staff Department number is 500090
C. Resident Training License (RTL) (ONLINE & MAIL)
Complete the online Resident Training License (RTL) Application (North Carolina Medical Board). Follow the NC Board RTL Checklist to help with the process to obtain your RTL. The cost is $138 payable by credit card only.
Mail the required GME documents, listed on the RTL checklist to the GME Office.
Note: This process takes time and you must receive your RTL before you may begin training.
Upper-level Residents and Fellows (1 E-MAIL)
Please notify the House Staff Office if you are applying for a Full N.C. License. Please start early, this process takes time: North Carolina Medical Board. Once you receive your Full License, please email a copy to the House Staff Office: firstname.lastname@example.org.
D. WFBMC Background Check (1 E-MAIL)
Please email Nadine Friel in Human Resources at email@example.com to request the form. She will send you a release form from Investigative Associates Inc. showing your personal identifying information.
Return the completed form to her via e-mail.
E. Mail Documents (5 DOCUMENTS)
Return these documents to the House Staff Office via mail.
F. Employee Health (1 PHONE CALL/5 DOCUMENTS)
Schedule your initial health screening: 336-716-4801.
Note: A drug screen is part of this process. Drug screens may only be conducted within 90 days of your start date. Consider this when scheduling your appointment.
Complete the following documents and email them to Employee Health Front Desk: firstname.lastname@example.org.
Note: House Staff Department number is 500090.
Note: If you are using an Apple Device, you must use Adobe Reader and not Apple Preview when opening. Apple Preview documents cannot be read properly by Adobe.
G. I-9 Verification of Employment Eligibility (1 IN-PERSON VISIT)
You will be required to have your I-9 (Verification of Employment eligibility in the United States) completed prior to orientation. You must present supporting documentation in person for verification and you will fill out the I-9 form at that time. Your documents must be original and not expired: Review acceptable documents.
You will need to go to the Human Resources Office, Fourth Floor, Piedmont Plaza One. [Campus Map]
H. NPI # (1 ONLINE FORM)
All House Staff are required to have a documented NPI before commencing work.
Secure numbers at: https://nppes.cms.hhs.gov/NPPES/Welcome.do. Please follow the Step by Step Instructions.
- If you do not have a full NC Medical License, you cannot
enter a specialty taxonomy code. Applicants who are applying for an NPI
under a Residency Training License must use the student taxonomy code
- Select "individual" rather than "institution".
- List your home address and phone number as your contact information.
Once completed, email the form to the House Staff Office: email@example.com.
I. American Heart Association Courses (1 ONLINE FORM)
All incoming residents and fellows must obtain a current American Heart Association BLS card for one or more advanced AHA Courses (ACLS, PALS, NRP) depending on your specialty. Current BLS is required even if you already hold a current ACLS, PALS or NRP card.
Note: You must still complete the registration form even if you do not plan on attending our courses.
Register or verify AHA course status with Life Support Education.
These requirements must be completed PRIOR to your orientation and must be current through at least July 2015 or you will not be granted clinical privileges.
J. Special Circumstances
The items below will not apply to everyone.
Foreign Medical Graduates (1 DOCUMENT)
Please email a copy of your ECFMG certificate to the House Staff Office: firstname.lastname@example.org .
VISA Participants must send a copy of their DS 2019 form to the House Staff
Office. For more Information contact J-1 VISA Exchange Visitor Program.
DEA - Drug Enforcement Authority (1 DOCUMENT)
When entering a residency training program and obtaining a residency training license, the institution will issue you a DEA number to use within the parameters of your training program.
If you obtain a Full North Carolina Licensure and plan to use that license to “Moonlight”, you must apply for and obtain your own DEA number.
You may obtain an application for a DEA number at online. If you obtain your own DEA number, please email the information to the House Staff Office email@example.com.