GME Data Sheet

Form Name:GME Data Sheet
Completed By:House Officer
Used When:Completed by all incoming House Officers

Contains information needed by LSU GME Office and Hospital GME Offices for federal reimbursement.

Direct Questions To:Yolanda Lundsgaard
Form Link:

Autopopulated for newhires:  Newhire Documents

GME Data Sheet.pdf

Instructions for Completing Form

This form is completed automatically as part of the online Newhire Documents process.  It is included in the Newhire Packet that is submitted to the GME Office.  It is also completed and submitted to the GME office when a House Officer is transferring between programs.

Only the first page of the Data sheet is required for House Officers that Match or are accepted to LSU training programs immediately after graduating from Medical, Osteopathic, and Dental School.

 House Officers that graduated Medical, Osteopathic or Dental School more than 2 months prior to their start/appointment date, must complete both pages of the Data sheet to include a continuous and inclusive list of internships, residencies, fellowships, staff positions, leave of absences, etc. from Medical, Osteopathic and Dental School Graduation through LSU training program start/appointment date. There should NOT be any gaps in dates.

Other Info

A blank 2nd page for the GME Data Sheet may be downloaded here.

Places This Form is Referenced

LSU GME Knowledge Base

Copyright 2020 LSU School of Medicine unless otherwise specified.