Checklist for Incoming House Staff
Review the list below and make sure you have completed or taken the appropriate steps to complete all the requirements listed. If not, please complete prior to orientation. In order to complete each form, locate and select the Submit/Finish button. The department number is 500090. Print the Confirmation Sheet and send with your package.
Sign and return Residency Training Agreement (Contract)
Deadline: 30 days prior to the start of your residency program.
Complete and return Residency Training License Application
http://www.ncmedboard.org/licensing/license_application/category/resident_training_license/, including fingerprint cards. The cost is $138 payable only by credit card.
Deadline: 30 days prior to the start of your residency program.
Please notify the House Staff Office if you are applying for a full N. C. license
Background Information
The North Carolina Medical Board, as part of their licensure process, requires a complete criminal background check on all applicants. The release form for your signature is included with the application that you will print from the "Residency Training License" section of the webpage.
You will need to obtain 2 sets of fingerprints. Cards for the fingerprints will be included in the package being mailed to you containing your contract. The fingerprint cards need to be returned with the license application. Important: These fingerprints must be completed by a professional, i.e. Security Office at your institution, local Police Department or Sheriff Department. It is imperative that you do not attempt to do your own prints. Only ink imprints are permitted. Electronic and digital imprints are prohibited.
In addition to the background check required by the Medical Board, Wake Forest Baptist Medical Center obtains their own background check on all new employees. To expedite a safe background check, please email
nfriel@wakehealth.edu. You will receive a return email that requires you to submit a release form showing your personal identifying information.
Please note: If you lived in any of the states listed on the form additional information and/or additional finger prints may be required
Deadline: 30 days prior to the start of your residency program.
Submit House Staff Information Sheet. This chronological information must be complete with all prior training and an explanation of any gaps.
Deadline: Within 90 days prior to the start of your residency program.
Complete the Demographic Form for Employee Health Services and send to ehftdesk@wakehealth.edu. Make appointment for initial screening - 716-4801. Print Immunization Form and compile records to provide to Employee Health. Deadline is 30 days prior to the start of your residency program.
Required American Heart Association Courses. All incoming residents and fellows must successfully complete BLS and one or more advanced AHA courses (ACLS, PALS, NRP) depending upon your specialty. All staff must register or verify current AHA course status by clicking this link: http://www.wakehealth.edu/Life-Support-Education/Classes/Incoming-House-Officers.htm or log on to www.wakehealth.edu/lse and select the "Incoming House Officers" link.
This section is currently under review. Please do not complete at this time (1/28/2013). Complete the Electronic Medical Recordsonline education videos prior to class. After viewing the videos, if you feel you require additional training in a classroom setting, please RSVP to sholling@wfubmc.edu.
Review Online Medical Records Resident Orientation Manual , then print, sign and return page 4.
Deadline: 30 days prior to the start of your residency program.
Complete and submit NCBH Bloodborne Pathogen Education/Infection Control Annual Training after arrival.
Review the Confidentiality of Information Policy. Then, review, sign and submit Confidentiality Agreement. Deadline: 30 days prior to the start of your residency program.
Complete and return Payroll Direct Deposit Form.
Deadline: 30 days prior to the start of your residency program.
Complete Federal and NC State Withholding Tax prior to beginning training.
Foreign Medical Graduates – ECFMG Sponsorship.
Deadline to begin process: 30 days prior to the start of your residency program.
Prior to arrival,review Death Certificates/Autopsy Reports at this link, http://www.wakehealth.edu/hs_videos/15me/15me.html., and complete the test at https://www.wakehealth.edu/schoolOfMedicine/schoolOfMedicineFrm.aspx?ekfrm=35512.
2013 Incoming House Officers should not complete the current Common Curriculum. A new web based program, Introduction to the Practice of Medicine will be instituted on July 1, 2013. Introduction to the Practice of Medicine Notification
We look forward to your arrival. Please contact the House Staff Office with any questions or concerns.