Form Name: | Visiting House Officer Checklist |
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Completed By: | Coordinator and Visiting House Officer |
Used When: | When a House Officer from another institution wants to rotate through an LSU residency or fellowship program |
Purpose: | To collect all required documents to credential the visiting house officer at hospitals |
Direct Questions To: | GME Office Staff |
Form Link: | Visiting House Officer Checklist |
Instructions for Completing Form
Request for Visiting House Officers to rotate through an LSU program should be submitted to the GME office no less than three months in advance.
Once the Department Chairman, Program Director, and Visiting House Officer have signed the letter, it is sent, with the copies of the other documents, to the the GME Office, 2020 Gravier St., 6th floor, Suite 602 to obtain the signature of the Director of Medical Education. After all parties have signed, the GME Office will return the original letter to the Program. A copy of the letter should be given to the Visiting House Officer. All paperwork will then be submitted to the training facility.
Visiting House Officer Check List
A letter from the Program (See Sample Letter), to the visiting House Officer, which must include the following:
- Name and Address of visiting House Officer.
- Start date and end date of visit.
- Paragraph stating what the training will include (for example: seeing patients in clinic and/or on various services; participating in Surgery; attending various academic conferences), along with the name of all hospitals the visiting House Officer will be rotating to during the visit.
- Paragraph stating that there is no remuneration or stipend offered and that all costs incurred, including transportation, all living expenses and mandatory health insurance is the visiting House Officer’s responsibility.
- Approval of rotation with signature line for Department Chairman, Program Director, Director of Graduate Medical Education and visiting resident.
Valid Louisiana permit/license to practice medicine in Louisiana before beginning the short-term training as a visiting House Officer, a permit/license to practice medicine in Louisiana is required. House Officers that do not have a Louisiana permit/license to practice medicine, must contact the Louisiana State Board of Medical Examiners at (504) 568-6820 to obtain a temporary permit/license to practice medicine in Louisiana. This can be a lengthy process, possibly a few months, and should be done as early as possible. Permit/license is to be attached to the letter.
Data Sheet for Visiting Residents and FellowsHouse Officer is responsible for completing this form and returning it to the Program Coordinator.
Copy of ECFMG Certificate (only required for foreign medical graduates)
UMCNO Appointment Packet Required if the Visiting House Officer will participate in patient care activities at the hospital.
EPIC Training Contact Cheryl Usher with LCMC's EPIC training team
Proof of Immunizations Visiting House Officer should fill out the worksheet and submit the supporting documents needed.
Proof of HIPPA training
.
Proof of Malpractice Insurance malpractice insurance can be purchased through LAMMICO or other provider of your choice.
COVID Vaccination Proof (photo of vaccination card acceptable) * or Completed LSUHSC Vaccination Exemption Form* This information will be kept and tracked in the GME office only. Private health information will not be shared with the hospital(s).
Places This Form is Referenced
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UMCNO Meal Card Tracking (Forms & Documents)
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LCMC Visiting House Officer Packet (Forms & Documents)
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UMCNO Learner Code of Conduct (Forms & Documents)
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Visiting House Officer Checklist (Forms & Documents)
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LSBME Permit Renewal Spreadsheet (Forms & Documents)
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LSBME Letter of Commitment PGY 2 (Forms & Documents)
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LSBME Letter of Commitment - PGY 1 (Forms & Documents)
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Incoming House Officer Checklist (Forms & Documents)
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Paperwork Submission Timeline (Forms & Documents)
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EQuIP Participation Outline (Forms & Documents)
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Summative Letter Template (Forms & Documents)
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Request for Authorization to Serve Alcohol (Forms & Documents)
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DIO Transfer Approval Packet (Forms & Documents)
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Data Sheet for Visiting Residents and Fellows (Forms & Documents)
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Mask Fit Test Medical Form (Forms & Documents)