The Graduate Medical Education (GME) Clearance Card Checklist lists all the required documents and forms for residents, which are also listed below. Follow the links to complete the necessary forms and view the Inova training documents.
*Please note: The GME forms can now be completed electronically! Simply download and save each form, select the 'Add Text' option under 'Sign' to complete the form. Once you have completed the form, select the 'Place Signature' option under 'Sign' to sign the form*
Please email all required forms to GME Credentialing or fax form to 703-776-7850 if you are unable to complete the forms electronically. If you have any questions, contact the GME office at 703-776-2626.
To Be Provided by Resident And/Or Institution
- Copy of Complete Academic Year Rotation Schedule (must include institution name, resident/fellow first and last name, PGY levels, name of rotation being completed and location of rotation)
- Copy of application to the program (ERAS or other military residents-PCS orders)
- Copy of CV complete with listing of participation in current residency/fellowship program
- Copy of Resident Agreement/Resident Contract
- Copy of Virginia Medical Training License
- Copy of ECFMG (if applicable)
- Copy of NPI Number Verification
To Be Completed by Resident
- GME Clearance Card Form
- Employee Statement of Commitment to Safety and Error Prevention (AIDET)
- Confidentiality and Non-Disclosure Agreement for Physicians
- Medical Records Completion Statement for Residents
- Patient Armband Alert System
- Infection Prevention Quiz
- Patient Safety and Quality Quiz
- Influenza Vaccine Verification (October 1 – March 31)
- ORP Provider Application/Registration Confirmation via the Medicaid ORP Provider Application Website
- PMP Registration Confirmation via the PMP Data Center (Instructions on Completing PMP Registration)
- Language Services Resident Competency Quiz
- VCU Mistreatment Policy Quiz
- On-line Epic Training Verification (On-line Epic training will be assigned by the GME Office once the GME Clearance process has been completed.)