| Form Name: | GME Program Exit Packet |
|---|---|
| Also Known As: | Post Program Completion Packet |
| Completed By: | Program Coordinator |
| Used When: | Final closeout of departing resident. |
| Purpose: | Provides GME office with the final necessary information and ensures accurate files are kept for the resident. |
| Direct Questions To: | Ashley Walker |
| Form Link: | Exit Packet Checklist |
Instructions for Completing Form
This packet is to be completed for each House Officer not continuing with the program (ex. graduating, transferring, and terminating) and sent to the GME office by July 31 with the checklist. (Scans can be sent to acomea@lsuhsc.edu) NOTE: If a resident is OFF CYCLE, please send the packet to the GME office within 30 days of departure
Other Info
The following items should be included in the packet (or check off the checklist to indicate they were completed):
- Updated GME Data Sheet (Must include all training/jobs/LOA from Medical School thru Residency/fellow training including training completed or leaving if not completed.)
- Duty Hour Compliance Report showing up to date completion
- Procedure log summary (if applicable, Summary listing)
- Core Curriculum completion summary report
- Beeper returned to Program Office
- Copy of diploma
- Summative Evaluation Template
- GME Verification Letter
- Copy of Personal Data Change Form (original should be sent directly to Human Resources). If no address change, put NA on the form and include in packet.
- Copy of updated CV
- Copy of completed UMCNO Exit Packet
- Verify the resident’s file is complete and organized according to the House Officer Portfolio Checklist
Places This Form is Referenced
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Post Program Completion Packet (Terms and Abbreviations) — Provides the GME office with final necessary information to ensure accurate files are kept on former residents.
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Summative Evaluation (Terms and Abbreviations)
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Summative Letter Template (Forms & Documents)
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GME Program Exit Packet (Forms & Documents)