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Office of Graduate Medical Education

GENERAL INFORMATION FOR ALL RESIDENTS

AFFILIATION AGREEMENTS BETWEEN INSTITUTIONS

SUNY Downstate is responsible for the quality of the educational experience and retains authority over the residents’ activities at the affiliated hospitals. Master Affiliation Agreements must exist with all of our major participating institutions and Program Letters of Agreement for each residency program with required rotations is appended to the Master Agreements. For more information, see Affiliated Institutions in Section 1 and Section 3.

BANKING

Chase Bank ATMs (Automated Teller Machines) are located in the lobby of the SUNY Downstate, Basic Science Building near the 430 Clarkson Avenue entrance. Please see Section III for banking services at other affiliate hospitals.

BOOK STORE at SUNY Downstate
http://www.downstate.edu/fsa/bookstore.html

The Faculty Student Association Bookstore stocks reference books at a discounted price. In addition to books, it offers stationery, sundry items, medical instruments, lab coats and jackets, school rings and pins, microscope sale and rentals, drug items, swimming supplies, master locks, batteries, film, rolls of stamps, and casual school clothing items.

Location: First Floor, Room 232, Student Center,
394 Lenox Road
Hours: Monday & Thursday, 9:30 AM- 7PM
Tuesday, Wednesday & Friday, 9:30 AM- 5PM

CERTIFICATES

Each year departing residents receive an official certificate from SUNY Downstate indicating the length and scope of residency training satisfactorily completed in a SUNY Downstate sponsored training program. The certificates are issued at the request of the resident’s training program. A $30 replacement fee will be charged for a duplicate certificate. Certificates are generally only printed two times a year.

CERTIFICATION BY MEDICAL SPECIALTY BOARDS

Medical specialty certification in the United States is a voluntary process. While medical licensure sets the minimum competency requirements to diagnose and treat patients, it is not specialty specific. Board certification—and the Gold Star—demonstrate a physician’s exceptional expertise in a particular specialty and/or subspecialty of medical practice.
The Gold Star signals a board certified physician’s commitment and expertise in consistently achieving superior clinical outcomes in a responsive, patient-focused setting. Patients, physicians, healthcare providers, insurers and quality organizations look for the Gold Star as the best measure of a physician’s knowledge, experience and skills to provide quality healthcare within a given specialty. Residents successfully completing an accredited program are expected to become eligible for and take the Board examination in the specialty in which they trained.


About the Certification Process
Certification by an ABMS Member Board involves a rigorous process of testing and peer evaluation that is designed and administered by specialists in the specific area of medicine. ABMS Member Boards are responsible for setting the standards for quality practice in a particular medical specialty. Individual Member Boards evaluate physician candidates on several fronts, asking questions such as: Has the candidate completed the appropriate residency requirements? Does he or she have an institutional or valid license to practice medicine? If a physician meets these basic admission standards, the Member Board will evaluate the candidate using written and oral examinations. Because specialties differ so widely, the criteria that inform these tests are quite different.
At one time, physicians were awarded certificates that were not time-limited and therefore did not have to be renewed. Later, a program of periodic recertification (every six to 10 years) was initiated to ensure physicians engaged in continuing education and examination to keep current in their specialty. In 2006, ABMS’ 24 Member Boards adopted a new gold standard for re-certification with a continuous ABMS Maintenance of Certification (MOC) program for all specialties. MOC uses evidence-based guidelines and national standards and best practices in combination with customized continuing education so physicians demonstrate their leadership in the national movement for healthcare quality. MOC also requires proof of continuing education and experience in between testing for re-certification.
The approved Member Boards of ABMS certify specialists in more than 145 specialties and subspecialties. The primary function of each of these boards is to evaluate candidates in its primary specialty and subspecialty areas who voluntarily appear for review and to certify those qualified as "diplomates" or "subspecialists" of that board. This is accomplished through a comprehensive process involving educational requirements, professional peer evaluation and examination.

Links to the ABIM and Specialty Board Web Sites are on this page

CONTROLLED SUBSTANCE REGISTRATION
http://deadiversion.usdoj.gov

Drug Enforcement Administration
At the beginning of the residency, each resident is assigned a controlled substance (DEA) suffix for use when writing prescriptions for controlled substances. Each affiliated hospital has its own prefix, and the resident uses his/her own three digit suffixes when writing a controlled substance prescription at any of the affiliated hospitals. The resident keeps his/her suffix for the duration of his residency. This suffix is not for use during moonlighting activities.

Under NYS law, licensed physicians must be registered to prescribe controlled substances. Registration for DEA authorizations may be conducted online at the DEA website or DEA (Drug Enforcement Administration) application forms may be obtained directly from:

Drug Enforcement Administration
555 West 57 Street, Suite 1900
New York, NY 10019-2978
800-882-9539

CHAPLAIN SERVICES

Please see Section on affiliate hospitals for Chaplain Services

CHILD CARE

SUNY Downstate provides child care services for the University community including all SUNY Residents. The Children's Center, located at 440 Lenox Road, is an on-site care center which offers developmentally appropriate early childhood education for children from age 8 weeks to five years. The Center has a sliding fee scale and Center hours are 7:30 a.m. to 5:30 p.m. The director and staff are fully qualified to teach young children. There is a $20 non-refundable application fee to put your name on the waiting list. For more information call the Children’s Center at 718-469-7750, 718-221-6160, 6163, or 6165.

INSTITUTIONAL COMMITTEES

SUNY Downstate as the sponsoring institution provides residents with an opportunity to participate in institutional committees and councils, especially those that relate to their education and to the provision of patient care. Examples include GME Committee and Subcommittees, Internal Review Committees, Quality Assurance Committees, various clinical care committees, etc.

For further information on opportunities to serve on institutional committees contact your Residency Director, Department Chair or the GME Office.


CREDENTIALING DOCUMENTATION

It is SUNY-Downstate Medical Center’s policy, in compliance with the regulations of the New York State Health Codes (Part 405.4) that all residents accepted into SUNY Downstate programs must provide credentialing documentation prior to their appointment as house staff physicians.

Each year all new residents undergo a credentialing appointment process beginning in March and concludes at the end of June. All incoming residents, regardless of pay source, are also required to attend a two-day mandatory orientation. Those who are unable to attend the credentialing appointment process must contact the GME Office at (718) 270-4221.

Originals are required and must be presented for the following documents:

1. Original Medical School Diploma, must be in English or accompanied by certified U.S. translation*.

2. Original Official/ Medical School Transcripts, must be in English or accompanied by certified U.S. translation*.

3. Original Proof of citizenship or legal employment status (passport, birth certificate, naturalization papers, alien registration card, H1, J-1 Visa with DS 2019..etc.).

4. Original ECFMG Certificate (or Fifth Pathway Diploma) for all International Medical School Graduates; must be current and valid.

5. Original New York State Medical Limited Permit/License, if applicable - REQUIRED FOR ALL NON-ACCREDITED FELLOWSHIP, DENTAL & CHIEF RESIDENTS (a wavier request may be submitted six (6) months prior by the program director for the Chief Resident.) Waivers will not be granted for financial hardship.

6. Original Social Security Card.

Translations
Any documents not printed in English must be accompanied by an acceptable, original U.S. translation, performed by a qualified translator, which includes all written and printed material on the original translation, performed by the applicant will be accepted only if a qualified translator verifies it.
Each translation must be accompanied by an Affidavit of Accuracy, in which the translator who performed or verified the translations affirms, having read the completed translation, that the entire document has been translated, that nothing has been omitted, and that the translation is true and correct.
An original translation can be returned to the applicant only if a photocopy of the entire translation, including the Affidavit of Accuracy is submitted. Translation and qualifications of translators are reviewed on an individual basis. Examples of qualified translators are:
An Officer or employee of an official translation bureau or agency, which are
usually listed in classified telephone directories.
A Professor or instructor who is teaching the translated language in an accredited college or university in the United States. The type of course being taught must be included in the Affidavit of Accuracy, which must be notarized and on official school stationery.

 

Checklist for Resident/Fellows Credentialing File*

Verify that all required documentation is submitted by marking the appropriate boxes below. Incomplete applications will result in delays.

Original Medical School Diploma (with Original U.S. certified translation, if applicable)

Original Medical School Transcript (with Original U.S. certified translation, if applicable)

Original Proof of citizenship or legal employment status

Original ECFMG Certificate/Fifth Pathway (If Applicable)

Original NYS Medical License/Limited Permit (If Applicable)

Original Social Security Card



Residency Application (available through Onboarding Checklist in New Innovations)

SUH Agreement (available through Onboarding Checklist in New Innovationst)

EHS Physical Clearance (To be done at Pay Source, including Drug Screening)

Release Statement & Questionnaire (available through Onboarding Checklist in New Innovations)

Deans Letter (Must be signed with Original U.S. certified translation, if application)

Two Reference Letters (Must be on letterhead, signed and dated within the year, with Original U.S. certified translation, if applicable)

Prior U.S. Training (If Applicable)

USMLE Steps 1 & 2, 3 (see policy, all three steps required for anyone starting at PGY-3 or above)

ACLS, BCLS, ATLS and PALS (where Applicable)

List of privileges/procedures completed in current program
(for all PGY 2 and higher)

Mandatory Orientation & Pre-employment, Background Check & Drug Screening (Must be done at least two weeks before start date).

* The above items must be on file in the GME Office before July 1.

REAPPOINTMENTS

Residents should report to the GME House Staff Office before the end of May to ensure that the credentialing file is in order. Physicians ID cards will be renewed upon completion of the credentialing review. Continuing house staff physicians are required to have on file an updated health clearance and house staff agreement and visa if applicable.

GUIDELINES TO FOLLOW WHEN APPOINTED TO OR CHANGING PAYROLL

All residents are appointed as Clinical Assistant Instructors at SUNY-Downstate but are salaried by an affiliated hospital. Residents being appointed to the same program for a period of accredited training are expected to remain on the same salary source unless otherwise approved by GMEC (based on request of the Program Director for appropriate circumstances and with agreement by resident. Requests for pay source transfer must specify a reason determined to be valid by GMEC and assures that the resident experiences no interruption in insurance benefits, the resident receives appropriate salary for PGY level and must be accompanied by a letter from the resident assenting to the pay source change.

Most participating institutions require residents on payroll to attend mandatory orientation programs.
Residents appointed to or transferring to SUNY SUH or SUNY IFR are required to attend a mandatory orientation and complete a credentialing review prior to being placed on SUNY payroll. Orientation is generally held on Thursdays and Fridays of the SUNY pay week period. NYS law also requires attendance of all new employees be verified by signing in on the first day of employment.

Failure to attend the mandatory orientation session or to sign-in on day one can result in significant delays in the house staff physicians’ ability to start work, receive salary, be (re-)appointed and/or processed for payroll.

GRADUATING RESIDENTS/FELLOWS

All graduating House Staff Physicians (regardless of pay source) are required to come in to the GME Office (BSB 2-74) no later than June 1 to receive final clearance. They will be required to submit any missing documents, complete an exit questionnaire and property control survey at the time.
Failure to do so can prevent them from receiving their Diplomas and final pay check.
Should you have any questions, please contact the GME House Staff Affairs Office at Ext. 4220.

COUNSELING AND SUPPORT SERVICES

Graduate medical education places increasing responsibilities on residents that require sustained intellectual and physical effort. Programs closely monitor the performance of their residents and are cognizant of stressors. Each SUNY Downstate program provides access to counseling service, and several have psychologists on staff. SUNY Downstate makes an Employee Assistance Program available to all residents. The Department of Psychiatry provides residents from all departments with information about referrals for psychological or psychiatric intervention and treatment. (See Policy and Procedure Section of Handbook). Residents may also contact the GME Office or each pay source participating affiliate for additional information.


DRESS CODE

All residents are expected to present a public image of professionalism and appropriate behavior at all times. Attire must be appropriate for the area in which the resident is working and be acceptable to the professional standards expected of a physician. Personal and patient safety and infection control precautions must also be considered when determining appropriateness of attire. Personal protective devices including masks, gowns (possibly sterile), gloves, and shoe and head coverings may be required in certain circumstances. Such attire must not be worn routinely in public or outside of the health care setting. When wearing scrub attire outside of the operating room, procedure room or special care unit (PACU, MICU, SICU, PICU, CCU, etc.) setting, covering by gown or long lab coat is required. Each participating facility provides laundry serves for scrubs and lab coats that it distributes.

EMPLOYEE ASSISTANCE PROGRAM
http://downstate.edu/eap/
See relevant affiliate pay source in section III or contact the GME Office (718)270-1984 for more information.

The EAP at SUNY Downstate was initiated in response to the growing demand for a service that could offer all employees a confidential setting in which to discuss personal issues, and to get the necessary help. SUNY Downstate is one of a handful of State facilities to have a full-time EAP Director on staff. All current employees of the SUNY Downstate Medical Center, their immediate families, and the retirees of the SUNY Downstate Medical Center (and their immediate families) are eligible to use the EAP service. In addition, all residents and housestaff of University Hospital, and all residents and housestaff who hold faculty appointments, regardless of assignment, are eligible to use the services of the EAP. Using the EAP is not a condition of employment. It is a voluntary option.

OUR MISSION
Our mission is to provide a comprehensive worksite-based program to assist employees in the prevention, early intervention, and resolution of problems which may impact on job performance. These problems may include (but are not limited to) family, marital, stress, financial, grief, alcohol/drugs, domestic violence, emotional or legal issues.

The goals of the Downstate Employee Assistance Program are:
• To improve the health and well-being of our employees
• To reduce the impact of personal and job-related problems on employee productivity
• To offer supervisory and administrative staff training and information on assisting employees with problems
• To support Downstate policies for maintaining a safe and healthy workplace
• To work closely with the EAP Advisory Committee, and the New York State Employee Assistance Program to serve our employees and maintain good relations with labor and management.

The EAP is a voluntary program, designed to offer a highly professional, confidential source of information and referrals for people with personal problems or concerns. People who use EAP services have everyday problems which have the potential of getting out of hand.
Some of these may include:
• Separation/divorce or being widowed
• Balancing work and family
• Needing elder or child care resources
• Coping with adolescents/children
• Managing stress
• Conflict resolution
• Domestic violence
Of course, the EAP also helps clients with alcohol and other drug problems as well.

SERVICES PROVIDED
Assessment and Referral
We provide confidential information, assessment, and referral services to employees of SUNY DMC, their families, and retirees, who are experiencing personal, family, or work problems that may affect job performance.

Educational Resources
EAP is a good source of information about books, videos, pamphlets, courses, tapes, and other educational materials. We have information on helpful websites, community groups, support groups, self-help groups, and treatment providers in the entire Metropolitan Area.

Supportive Follow-Up
Short-term services may be provided for employees who find themselves in complex, stressful situations. The EAP may also provide supportive assistance to employees returning to work after an extended period of leave for medical mental health and/or substance abuse problems. The EAP can provide support and follow-up for employees during their initial transition back to the workplace.

Consultation with Management

Supervisory Referrals

Informal Referral
Employees may be encouraged by supervisors, union representatives, human resource/labor relations personnel or another services on campus to contact the EAP for assistance due to personal or job performance concerns. Such referral may be made before the situation becomes a formal disciplinary action. This is known as an informal referral.

Formal Referral
There may be situations in which a supervisor identifies, documents, and discusses with an employee a specific issue of behavioral or job performance concerns, and the supervisor makes a recommendation that the employee contact the EAP. This recommendation may be made after counseling the employee concerning job performance issues. This is known as a formal referral. **Supervisors and other personnel are not expected to act in the role of advisor, diagnostician, or confidential counselor. Offering a recommendation to contact the EAP for assistance is good management.**

In either scenario, the decision to contact the EAP and use its services rests entirely with the employee. In the case of a formal referral, depending upon the circumstances (i.e. whether the employee is the subject of a formal disciplinary procedure, or has entered into a settlement agreement), the employee may incur consequences for not making such contact with the EAP.

Issues discussed by any employee with the EAP staff, whether that employee was formally or informally referred to the EAP, will NOT be shared with anyone without the express written permission of the employee. Supervisors are NOT entitled to information concerning an employees discussions with the EAP staff. In certain cases, a supervisor may be informed that an employee has made contact, or has kept an appointment with EAP staff, but NO FURTHER INFORMATION will be shared.

Information and Consultation
Supervisors and management may seek resources and ideas about how to resolve workplace problems. Topics cover stress, interpersonal conflict, communication skills, team building, and substance abuse education.

Education and Training
The EAP serves as a clearinghouse of resources on mental health and wellness. Our mission is to help employees maintain a healthy balance between work and family responsibilities, while remaining productive and creative. The EAP is available to any campus department or service to offer training and workshops on topics of interest.

Critical Incident Stress Debriefing
EAP professionals and others on campus can offer support and guidance when a work group is affected by a critical incident in or outside of the workplace. A critical incident is defined as a sudden, unexpected, stressful event such as an accident or injury, the death of a co-worker, an act of violence, or a disaster. The event may occur in the workplace, or outside. CISD is a technique used in helping individuals cope with abnormal situations that may produce a strong emotional reaction. CISD helps employees by allowing them to discuss the event(s) in a safe environment, listening to what happened and how it has affected the staff, and helping them understand what they can expect in the healing process.

Drug-Free/Smoke-Free Workplace
The EAP may offer consultation with management concerning policies and procedures that are instrumental in helping employees and the institution comply with mandates for maintaining a drug-free workplace. The EAP also provides information, support, and assistance to employees who wish to quit smoking, through referrals, support groups, and smoking-cessation programs

Lorraine Brooks, Director of the Employee Assistance Program, is a Certified Employee Assistance Professional (CEAP), Credentialed Tobacco Addiction Counselor (CTAC), and an Alcohol and Substance Abuse Counselor (ASAC). She has received specialized training in Critical Incident Stress Intervention, Grief Counseling, and prevention of trauma and violence in the workplace. She holds additional certification from the U.S. Department of Transportation as a Substance Abuse Professional under the Federal Omnibus Transportation Employee Testing Act of 1991.
She is a member of the Employee Assistance Professionals Association (EAPA) (where she serves as Chair of the Diversity Committee and Co-Chair of the Women’s Issues Committee for the Long Island Chapter); Employee Assistance Society of North America; National Association of Alcoholism and Drug Addiction Counselors; and the New York Federation of Alcoholism Counselors. She holds a faculty appointment at Brooklyn College, and serves as a private consultant to small businesses establishing drug-free workplace policies


EMPLOYMENT ELIGIBILITY VERIFICATION

In compliance with Federal regulations SUNY Downstate must verify documentation of the identity and employment eligibility of all employees. All residents are required to complete and sign the INS Form 1-9.

GRADUATE MEDICAL EDUCATION COMMITTEE (SUNY DOWNSTATE)

The GMEC and the GMEC Chair are appointed by the Dean of the Medical School from among clinical departments’ chairs and program directors. Membership also includes the Clinical Associate Deans from the principal affiliated hospitals (Kings County Hospital, University Hospital Brooklyn, Veterans Administration Hospital, Long Island College Hospital, and Staten Island University Hospital). A peer elected GMEC sub-committee of residents designates five resident representatives for appointment by the Dean to the GMEC. See Section 1 for details.

GRADUATE MEDICAL EDUCATION RESIDENTS SUB-COMMITTEE

The Resident Subcommittee serves as a forum for communication and exchange of information, and provides input to the GMEC on resident issues and concerns. The committee is comprised of residents from each department that have been elected by their peers to represent their department. Meetings are scheduled on the same day as the GMEC, usually the third Wednesday of the month from 12:30 to 1:30 pm. Contact the GME Office at (718) 270-4188 for further information and meeting location. See Section 1 for details.

HEALTH STATUS VERIFICATION REQUIREMENTS

The New York State Health Code (405.3) requires hospitals to verify the health status of all hospital personnel who have contact with patients on an annual basis. New residents are given a physical free of charge by the hospital employing the resident. For returning residents, there is an annual health status reassessment (update) which includes a review of health history and immunizations, and placement and reading of PPD.

HOUSING

Housing Options
The Office of Residential Life and Services at SUNY Downstate Medical Center maintains two residential facilities for full-time students. Faculty and staff may request short- and long-term housing leases when space is available.
Application for faculty and staff housing is available on-line at:

Transient Guest Application

Each facility is located on the Downstate Medical Center Campus, and has 200 standard and apartment style units available for occupancy. For additional information on residence hall living, please visit our website at http://sls.downstate.edu/residential_life. Faculty and staff may request short term contacts for housing during the months of May-July. Year-long contacts may be requested and are approved upon availability.

Faculty and staff wishing to live off-campus that are unfamiliar with the borough of Brooklyn and its neighborhoods should go to the Brooklyn-on-line website at www.brooklynonline.com. The Office of Residential Life also has a listing of off-campus apartments, which have been submitted for posting by private landlords. This listing may be requested in-person at the Office of Residential Life and Services Front Desk.

The office of Residential Life and Services is located at 811 New York Avenue on the first floor of the residence halls. You may contact the office directly at 718-270-1466 or by email at residentiallife@downstate.edu.

Students and Residents are urged to begin their search for off-campus accommodation early, well before the beginning of the academic year.

See your appropriate salary source affiliate institution in Section IV for more options.

IDENTIFICATION BADGES
http://www.downstate.edu/police/downstatecard.html

All Residents irrespective of salary source are required to carry a SUNY-DOWNSTATE Identification Badge. This badge allows you to utilize the University’s Medical Library as well as other campus facilities and identifies you as an officer of the State University of New York..

To obtain a SUNY-DOWNSTATE picture I.D residents must call the GME Office, (718) 270-4221, Monday - Friday 9:00 AM to 5:00 pm. The GME Office will verify that the residents’ credentials are up to date, after which a letter will be provided for issuance of an ID. ID cards are issued to residents only if their credentialing file is complete.
ID Cards are issued by ID Card Office: 825 New York Avenue, Rm1-105B
(ground floor of dormitory building entered through gate on Lenox Road).
ID Office hours are: Monday – Friday, 10:00am – 4:00pm.
Lost Cards can be replaced for a fee of $20.00. Residents must go the Bursar’s office, obtain a receipt, then report to the GME Office. Fore more information call (718) 270-4600.

INFECTION CONTROL TRAINING

New York State law requires that all health care professionals are trained in infection control and barrier precautions, and maintain current certification. Training is conducted by affiliate hospitals generally as part of new employee orientation.

JURY DUTY

The laws of New York State have changed (1/1/97) and residents can no longer be excused from serving on a jury. The resident must report for service and at the appropriate time petition to the judge to be excused. Postponement of jury duty for a time when it is more mutually convenient for the resident and the program can also be arranged usually without difficulty.


LICENSURE
Information on Medical Licensure in New York State
http://www.op.nysed.gov

Any physician who is employed as a resident in a public hospital (provided such practice is limited to such hospital and is under the supervision of a licensed physician) may practice medicine within the state without a license. (N.Y. State Education Law Title 8, Article 131, Section 6526). However, all fellows in unapproved programs must be licensed or have a limited permit (Hospital Assn. of NY State 12/16/85).

Although a license is not required of residents, we recommend that residents obtain a New York State License as soon as they are qualified.

Medical Licensure Information
Any use of the title "Physician" or practice of medicine within New York State requires licensure. To be licensed as a physician in New York State you must: be of good moral character; be at least 21 years of age; meet education, examination and experience requirements;
be a United States citizen or an alien lawfully admitted for permanent residence in the United States (Permanent Resident Card/INS I-551 Status/"Green Card").

To download the application :

NYS Application for Licensure

Licensure Fee: $735
(personal check or money order payable to the New York State Education Department)

Mail your application and fee to:
NYS Education Department
Office of the Professions
P.O. Box 22063
Albany, NY 12201

General Requirements
A. Education Requirements
To satisfy the education requirements for licensure as a physician, you must present evidence of:
1. Pre-professional Education: Satisfactory completion of 60 semester hours of college study from a New York State registered program or the equivalent as determined by the New York State Education Department.
2. Graduating from a Registered or Accredited Medical Program or Graduating from a Non-accredited Medical Program
3. Child Abuse Training
Graduates of New York State Medical Schools are exempt.
Non New York State Medical School Graduates can complete an online course at www.nurse.com . “Course 60012d: Identifying and Reporting Child Abuse and Maltreatment in New York.” The course is located under the section titled New York Requirements for Professionals Licensure. The fee is $25. All other applicants must submit a certificate of completion from an approved provider or file a claim of exemption before a New York State license can be issued.
4. Infection Control Training
Graduates of New York State Medical Schools are exempt.
Non New York State Medical School Graduates can complete an online course at www.nurse.com . “Course 60010f: NY Mandated Infection Control for Healthcare Professionals.” The course is located under the section titled New York Requirements for Professionals Licensure. The fee is $30. Alternatives can be found at www.NYSNA.org or www.MSSNY.org.

B. Credential Verification
To ensure authenticity of credentials, the New York State Education Department's Office of the Professions requires that your qualifications for licensure be verified independently.
1. You may have your Registrar's office forward a completed Certification of Professional Education (Form 2) which documents that you have satisfactorily completed all requirements for your degree mailed to:
The New York State Education Department
Office of the Professions
Division of Professional Licensing Services
Medicine Unit
89 Washington Avenue
Albany, NY 12234-1000
OR
2. You may have the Federation Credential Verification Service (FCVS) collect and forward your credentials to the New York State Education Department. The website: www.fsmb.org/fcvs_physician.html. The base fee is $295.
*IMPORTANT NOTE: Effective December 1, 2002, all graduates of medical education programs that are not LCME or AOA accredited or registered by New York State will be required to use the Federation Credentials Verification Service (FCVS).

C. Examination Requirements
The current examinations required for licensure as a physician in New York State are either:
1. Step 1, Step 2, and Step 3 of the United States Medical Licensing Examination (USMLE). The USMLE website is: www.fsmb.org.
OR
2. Part I, Part II, and Part III of the examinations of the National Board of Osteopathic Medical Examiners (NBOME). The NBOME website is: www.nbome.org

Requirements for USMLE Step 3
To register for USMLE Step 3 in New York you must have also applied for your medical license. You may also register for USMLE Step 3 in other states.


LIFE SUPPORT TRAINING

Basic Cardiac Life Support (BCLS)
All house staff must be currently certified in Basic Cardiac Life Support (BCLS) prior to beginning a residency program, and the BCLS certification must be on file in the respective department. Classes for certification are scheduled through the Department of Emergency Medicine. Contact Neida Bonilla at (718) 245-4797.

Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) classes for certification are also scheduled through the Department of Emergency Medicine. Contact Neida Bonilla at 718-245-4797

Advanced Trauma Life Support (ATLS)
Advance Cardiac Trauma Life Support is conducted through departmental orientation. Residents who require these skills will be trained for certification.

Please contact your program director/administrator for additional information.

 

STUDENT LOAN DEFERMENTS

Residents should bring loan deferment forms to the Office for Graduate Medical Education for certification. It is the resident's responsibility to request deferment forms from his/her lender. The resident should have completed and signed his/her portion of the form by the time he/she brings it to the Office for GME, and included the lender's address. The GME Office will complete the verification portion of the form, send the original to the lending institution, and place a copy in the resident's file.


THE MEDICAL RESEARCH LIBRARY OF BROOKLYN
http://library.downstate.edu/

Library Hours
Fall and Winter Terms:
Monday –Thursday 8:30 am to 12 midnight
Friday 8:30 am to 9:00 pm
Saturday 9:00 am to 9:00 pm
Sunday 12 noon to 12 midnight
Summer Term
Monday –Thursday 8:30 am to 12 midnight
Friday 8:30 am to 5:00 pm
Saturday 9:00 am to 5:00 pm
Sunday 12 noon to 12 midnight

Note: Library and LRC services, including borrowing and returning of materials, must be concluded one-half hour before posted hours of closing.

Contact numbers: 718-270-xxxx
Access Services 7401
Reference/Information 7405
Learning Resource Center 7423
Collection Management 7450
Interlibrary Loan 7440, 7442
Archives 7460
Photocopy Services 7443
Administration 7410

Getting Help in Using the Library
Staff is on duty in the Access Services area during library hours. Reference Librarians are on duty from 9:00 am - 7:00 pm Mon-Thurs and 9:00 am -5:00 pm on Friday. They are also available for consultation by appointment on weekdays. They will help you with any problems you may have in using the Library services, including the online library catalog, database workstations, and the many reference books and indexes the Library has in its collection. You may also choose to do the Library Self-Tour on Kiosk #2 on the first floor.
PLEASE NOTE: You must have your SUNY ID visible whenever you are using the Library. SUNY ID’s are not transferable. Call: Reference Center voicemail 270-7401.

Borrowing Books, Journals, Reserves
To borrow Library materials register at the Access Services area with your ID card Books may be kept for three weeks and renewed once. Journals may not circulate for the first thirty days after being received by the library. After thirty days, they may be taken out for four hours only. Journals cannot renew. The latest editions of core textbooks are kept on Reserve at Access Services and may be borrowed for two hours for use in the Library only. Likewise, Special Reserve materials are placed in Access Services by instructors for use by Downstate students only. Reserve items may not be taken out of the Library Call 270-7401.
Some course materials are available electronically over the library’s homepage (library.downstate.edu). Usernames and passwords are required and are assigned by the instructor. The library does not issue these.
Finding the Library’s Holdings
The catalog of the Library’s holding is now contained in the Online Public Access Catalog (OPAC). The Library’s monographs (Books), audiovisual materials and journals are listed in the OPAC along with information indicating the availability of the materials and where to find them. The Serials List on the home page gives print holdings and electronic access options of serial titles. Some titles require usernames and passwords which may be obtained from the Access Services Desk or the Reference Center. The Library’s Web page also contains a complete listing of journals currently received (titles only, however) and whether the journal is available in electronic format. Call: 270-7401.

Databases for Journal Literature
The database workstations have the following: OVID (medline, PsychINFO, Cinahl, Aidsline, Cancerlit, Healthstar, Best Evidence, and Cochrane Database of Systematic Reviews), PubMed, Clinical Evidence, Cochrane Collaboration, Dialog@Carl, Elsevier ScienceDirect, FirstSearch, Harrison’s Online, Health Reference Center, InfoTrac, Internet Grateful Med, Lexis-Nexis, MD Consult, Merck Manual Online, netLibrary, New York Health Connection, Scientific American Medicine Online, and Wiley Interscience. We currently have access to over 700 full-text electronic journals. Help getting started is available from the Access Services Desk and the Reference Center. Classes on searching are held on a regular basis. Registration forms and class schedules may be printed from Kiosk #1 located on the first floor of the Library. Class schedules may also be printed from the Web page. A $25 security deposit check is required for class registrations. The librarians also offer, by appointment, consultations and training on searching. Online instruction is available from the Library’s web page. Call 270-7433.

Fee Based Searches
In addition to the above the Reference department can access additional databases through commercial vendors. All meditated searches are done for a fee. Inquire at the Reference Center. Call: 270-7405

Library Web Page
The Library web page provides access to all web-based services, including OPAC, Ovid and electronic resources. The URL address is http://library.downstate.edu.

Library Electronic Help Desk
he Library maintains a Computer Help Desk for patrons experiencing problems accessing Library Systems via the World Wide Web or vocally via the Local Area Network or connecting to the Library E-mail System. Patrons can leave a voice mail message which will be answered within 24 hours. Voicemail: 270-7448

Getting Materials from Other Libraries
The Interlibrary Loan (ILL) Department may obtain material currently unavailable here from another library. The average turnaround time for an ILL request is approximately 5 business days. Materials may be requested and picked up at the ILL Office, Rm. 123 from 9-5, Monday through Friday, and in Access Services during weekends and evening hours. An interactive online ILL request Form is available from the Library’s Web page: choose “Library Services”, then “Interlibrary Loan”, and then click on the online request form. Please check the Library online catalog to be certain that the item is not already in our collection. Call 270-7442 or 7440

Making Photocopies
A number of photocopy machines, operated by the Faculty-Student Association, are available on the first floor and on the second floor (Level 2). Copies are 14 cents each with a coy card, or 25 cents otherwise. Problems with the machines or requests for copy cards should be referred to the photocopy attendant in Room 112 on the first floor. Call: 270-7443

Photocopy Service
A fee based copy service is available for items in the Library’s holdings. There is a 24 hour turnaround Monday through Friday. Submit requests to the Photocopy Office on the first floor, Room 112 for more information. Cal: 270-7443.

Remote Access to Library
You can access Library services from your home or office via dial-in (phone), or the Library’s web page if you have an Internet provider. Access to Library services via the Campus network will depend on your location within SUNY Downstate. Remote access fro the journal literature databases and the online catalog (OPAC) are available to all current faculty, students and staff of SUNY Downstate. There is no charge for this service apart from the telephone call if dialing in. Inquire at Access Services for more information. Call Voicemail: 270-7405 Proxy server validation is required for licensed resources.

Media and Computing Resources
The Alumni Association Learning Resource Center (LRC) supports the computer-based educational and training programs at Downstate and provides access to media and computing resources including health sciences and curriculum-based courseware, general applications software, E-mail and Internet. Facilities include: computer training rooms, multi-purpose media room, 24-hour open access computer room, and small group viewing rooms. Computer printing is fee-based.

Borrowing LRC Materials
To request LRC materials, Library registration with a SUNY Downstate ID is required. SUNY teaching faculty may borrow most programs to be used on the SUNY-Downstate campus for two days. LRC RESERVE materials may be borrowed for two hours use in the LRC only. The LRC makes only selected programs from its collection available for home use. The LRC is located on Floor B, the lower level of; the library. Call: 270-7423

Circulation Period and Fine Structure
If you borrow:           The circulation period is:                   The fine is:
Books                             3 weeks                                 .50 per day
Serials (current-30 days)    None
Serials (31 days & over)    4 Hours                                5.00 an hour
Reserves                         2 Hours                                2.00 an hour

Group Study Rooms
Those patrons with a valid, current SUNY Downstate ID may use any of the three group study rooms on the second floor upon presentation of a SUNY ID at the Access Services Desk. These rooms are booked through the library systems so registration with the library is required. Rooms may be booked up to 24 hours in advance for periods of up to two hours per group and are not available to anyone who is studying alone.

Before using a room, the key must be picked up at the Access Service Desk at which time the room is charged to the patron and a print-our of the transaction, which gives the time the patron has use of the room, is generated. This print-out is given to the patron, along with the Kay, who must be returned to the Access Services Desk no later than the time indicated on the printout, and/or one-half hour before closing, whichever occurs first, and the room booking is charged from the patron’s record. The rooms are available for booking during regular Library hours.

Frequently Asked Questions about Network Access
How do I log in?
Logging into a network account consists of two steps:
<entering your login (sometimes called “user”) name
<entering your password
Usernames are usually assigned during orientation. Please see information services or your departments’ computer specialist attached to your school/ program/ department about your username. The library does not assign usernames.

MEDICAL ILLUSTRATIONS UNIT
http://www.downstate.edu/bc

SUNY Downstate HSEB 3rd floor, room 312,
Phone (718) 270- 7550, Fax (718) 270-7549
Office is open 9 am - 5 pm (closed 12:30pm-1:30pm), Monday through Friday, except holidays.

The Department of Biomedical Communications supports faculty and staff communications efforts for teaching, research and patient care by combining creative talent with advanced communications technologies. Service includes professional consultation, design, art, and photography, imaging and video production in a wide variety of print, projection and electronic media. We also provide distance education and telemedicine services via satellite and videoconferencing systems.
We can provide virtually any kind of medical or scientific illustration in black & white or color for publication or projection media. All illustration projects are researched carefully, in order to be medically accurate. Pencil sketches are prepared and reviewed with client prior to beginning furnished rendering. Some of the finest medical illustrations in the nation are being produced in our department.
Please call for free consultation and estimate. Our staff will help you determine the most effective instructional materials for your presentation. We provide instructional design guidance through workshops on design and presentation, media selection, distance education and computer graphic software.

NAME CHANGE

Residents must notify the GME Office as soon as possible within 30 days of a name change. In order to officially change a name, original legal documentation must be submitted to the GME Office along with two forms of employment eligibility and any supporting legal documentation. A fee will be levied for new certificates that are issued as a result of a requested name change.

NAME STAMP AND PRESCRIBER ID (NPI Numbers)

Unique identifier numbers issued through KCHC and the GME Office are used for the following:
• To identify the prescribers for hand written orders to pharmacy. Without active numbers that must be used to access CPOE (computerized physician order entry), Eclipsys, residents will not be able to enter orders. These numbers are absolute identifiers.
• The last 3 digits of the GME number must be written on all ambulatory prescriptions for controlled substances in the field titled suffix
• Residents must stamp all ambulatory prescriptions with their name and GME/SMS #.

According to New York State Law, each physician writing a prescription must have his name stamped in ink under his signature. A stamp is provided for each resident by the Office for Graduate Medical Education upon entry into the SUNY-Downstate residency program. If a resident loses his/her name stamp, they must report it immediately to the GME Office and with the KCHC police located on the first floor of the B-Building and replace it at his/her own expense Please note that the replacement stamp must have the letter “A” following the number.

ORIENTATION

Orientation is held annually in June and all incoming residents and fellows must attend irrespective of assigned pay source. Continuing residents coming onto the state payroll for the first time are also required to attend. In addition to several required educational sessions, residents placed on SUNY or KCHC will also sign up for their benefits.

PARKING
http://www.downstate.edu/police/parking.html

Parking Office Manager: Mikhail Fishman
Office: 825 New York Avenue, 1st floor (access through gate on Lenox Road)
Hours. 9:00 AM to 4:00 PM, Monday to Friday
Phone: (718) 270-3163

Parking at the Health Science Center is extremely limited. Available parking has been divided as fairly as possible among the many groups who utilize the Center. Key card parking is available to employees on a seniority basis by employee category of faculty and staff. Employees seeking parking privileges should visit the Parking Office to sign up for the waiting list.
The Health Science Center Foundation operates a parking lot (not State owned) on Parkside Avenue and there is a separate sign up and waiting list. A limited number of pre-paid daily parking tickets available. Applications are available at the Faculty Student Association Office, Room 203 in the Student Center for the Foundation lot. Valet parking is available in front of the entrance to UHB at 445 Lenox Road for $10 per day paid on dropping off the car.
KCHC is in the process of constructing a large indoor parking facility with ample capacity. This structure should be available for resident access in the very near future. Meanwhile, outdoor lot parking is available at Kings County for a monthly fee. Please visit the Parking Office just past the lobby entrance to KCHC B-building on the ground floor for more information.
For additional parking information, please see affiliate pay source in Section III.


PROCEDURES FOR PRIVILEGING

It is SUNY Downstate policy; in compliance with the NYS DOH Hospital Code 405 Regulations, that all residents be formally privileged in order to perform treatments/procedures without direct attending physician supervision. A Fact Sheet for Privileging and Credentialing is included in the Appendix for your information. Additionally, your ABMS board or the specialty Review Committee of the ACGME may require you to log your cases and procedures on the ACGME’s webADS case log system or other case log systems.

SUNY Downstate has a web-based Residency Management System (New Innovations) designed to maintain information on residents physicians privileging and credentialing. The system documents treatments/procedures performed by each resident under the supervision of a qualified physician as defined by the NYS 405 regulations.

1. Authorized Supervisors
The Department Chairmen will provide the GME Office with a list of the names of those physicians authorized to be supervisors in accordance with New York State law and GME policy. It will be the responsibility of the resident or medical student to ensure that appropriate supervision, as defined in the Public Health Law, is available before performing any treatments/ procedures for which supervision is required.

2. Supervision by
Residents who may serve as supervisors under the provisions of the New York State Health Code will be coded as supervisory personnel, in the database system upon the request of their individual departments. Specifically, only those residents beyond their third year of training (greater or equal to PGY 4), or in their last year of training in a particular specialty, will be eligible to serve as supervisors of other junior residents or students. A resident cannot supervise himself/herself. A supervising resident can only supervise other residents in procedures for which they have been privileged to perform.

Rosters for attending physicians and residents with supervisory responsibilities will be reviewed at the beginning of every program year by the department chairmen/chiefs of service/program directors. Any revisions will be made at that time for the upcoming program year, or by request of the department chairman.

3. Verification of Treatments/Procedures
On an annual basis, department Chairmen/Chiefs of Service/Program Directors will review the listing of treatments/procedures, define which procedures residents and medical students may perform under general supervision, and make revisions as necessary. This listing of procedures along with the procedure codes are listed in the procedure logger module of the RMS(New Innovations).

4. Required Minimum Number of Treatments/Procedures
The number of times required for a treatment/procedure to be performed before privileges are granted is determined by the chairman/program director of the department which would require written and/or electronic (New Innovations) confirmation by appropriately designated faculty.

5. Access to Privileges Information
Privileges awarded to individual residents as well as lists of all residents privileged to perform a procedure are available on the RMS (New Innovations) and can be accessed as needed by supervisors, nurses, departments and affiliates as follows:

6. Advanced Level Privileging
Residents entering our programs at advanced levels who have been privileged for procedures at another institution may be privileged at SUNY for those procedures by the Program Director after reviewing and approving the privileging documents from the other institution. If the advanced resident has not been privileged by another institution, the Program Director has the right to modify that resident’s procedure credentialing process after reviewing the nature of that resident’s prior training and clinical experience. Though the manner in which the advanced resident is privileged may be different than a resident entering at the first year level, it will still be necessary for the Program Director to maintain on file any internal or external documentation of the privileging process for that resident and to provide the resident with a letter stating that they have been privileged for performing procedures. A copy of that letter must be sent to the Office for Graduate Medical Education. (See Policy on Procedure Privileging for Advanced Residents and Subspecialty Fellows).


PUBLIC SAFETY
http://www.downstate.edu/police/department.html
(See affiliate hospitals for more information)

University Police/Public Safety Department at SUNY Downstate maintains a pro-active approach toward reduction and suppression of crime on campus. University Police maintains a close and cooperative working relationship with HHC KCHC Hospital Police and with the New York Police Department. If you have any concerns about your safety or that of anyone else, please contact University Police, your Program Director and the GME office immediately.

SUNY Safety Director: Thomas Dugan, Room A1-339 UH, Box 1201
SUNY Police/Public Safety: 718-270-2626 (anytime). Office: hospital lobby, 445 Lenox Rd
Kings County Hospital Police: 718 245-4300 (anytime) Office B-Building, ground floor
New York Police Department: 911 (anytime)
GME Office: 718-270-1984 (non-urgent matters during regular business hours)

University Police/Public Safety Department staff patrols the campus 24 hours a day, seven days a week. At SUNY Downstate Campus Officers are assigned to:
- entrances in each building
- patrol each building
- booths and/or video monitoring cameras located in areas of high pedestrian traffic
- radio-equipped motor vehicles that regularly patrol the area
The perimeter of Kings County Hospital and all of its facilities is patrolled regularly by NYCHHC Police.

Identification/Facility Access: There are systems in place that are designed to ensure that persons entering the Downstate are authorized. Faculty, staff and students are required to display Downstate identification cards when entering the Downstate and to prominently display it at all times while on campus. Visitors are issued temporary visitor passes.

Phones/Alarms: There is a network of emergency telephones (red) conveniently located throughout the Downstate campus. In addition, there is also a network of panic alarms located at various places, including the corridors, laboratories, rest rooms and on-call rooms. Both the "red" phones and panic alarms are linked directly with the Public Safety Department and are monitored 24 hours a day to ensure a quick response to all emergencies.

Shuttle/ Escort Service: Starts at 5am from 224 Clarkson Ave on an on call basis until 2pm. After which it's on scheduled runs starting at 2pm from 445 and 395 Lenox Rd entrances every 15 minutes stopping at the Winthrop Street Subway(#2 &5 trains), 711, 710, Parkside Avenue, the Benificial Lot(404 Winthrop Street) and 760 Parkside Ave. It then proceeds to 323 Clarkson Ave (Parking Garage), 224 Clarkson Ave(Parking Lot), and then down Nostrand Ave to Church Ave and continues to do so until 10:45pm. At 10:45pm there is a pickup from Church and Nostrand Ave. After that it's on an on call basis with the exception of two more pickup locations at 11:45 from the KCH D building and ER location. After that the service is on an on call basis until 5am the next morning at 5am! {Phone (718) 270-2626)}

Property Protection: Do not leave valuables unsecured. Keep your office, desk, locker and car doors locked when unattended. This is a precaution against intruders and thieves. Use available procedures for protecting patient property and valuables. Downstate cannot be responsible for lost or stolen articles. Report all thefts or other crimes immediately to Campus Public Safety. No unauthorized tradesmen, solicitors or loiterers are permitted on Health Science Center property. Report any unfamiliar or suspicious persons or activities to Public Safety immediately.

Interagency Relationship: The staff of the Public Safety Department has established and maintains clear and continuous channels of communication with local law enforcement agencies.

Closed Circuit Television System: A CCTV system monitoring the interior and exterior of the Downstate campus is monitored 24 hours a day by the University Police/Public Safety Department.

Perimeter Lighting: Additional high intensity lighting has been installed on exterior areas of the campus in addition to that already provided by the City of New York.

Safe Corridors: University Police and Public Safety have identified these safe zones and residents are encouraged to utilize them when walking to and from the campus: Lenox Road, Clarkson Avenue, 34th and 35th street, Parkside Avenue and part of Winthrop Avenue.

KCHC Hospital Police: Kings County Hospital Police, a division of the NYPD, is responsible for securing and supporting all areas of their facility and the perimeter. KCHC and UHB Police work collaboratively to ensure safety of the entire campus area.

Incident Reports: Call Public Safety Office 270-2626 to report incidents relating to criminal actions and other emergencies on campus.

Resident Responsibilities: We emphasize that isolation can occur almost anywhere on campus depending on such circumstances as the time of day, day of the week, building, etc. A few common sense rules to avoid isolation are:
- Reduce or eliminate opportunities that make you a target
- Increase awareness in all places and travel in areas you are most comfortable
- Walk and travel in groups and in busy areas.
- Trust your instincts regardless of feeling embarrassed and use caution
- Prepare your daily schedule with safety in mind
-use Public Safety escort and shuttle service
- be aware that Public Safety monitors its telephone switchboard (extension 2626) 24 hours a day and that red telephones have direct contact with Public Safety without dialing
- be aware that Public Safety has emergency alarm buttons throughout University Hospital, Basic Science Building, Student Center and dormitories which, if activated, Public Safety staff are dispatched to investigate.


STUDENT CENTER
http://sls.downstate.edu/student_center

The Student Center is the hub of social, recreational, and athletic activities for the campus community. The building contains meeting rooms, athletic/exercise facilities, lounges and a darkroom. Additionally the Student Center is the home of the Theatre Ticket Service.

Membership
Faculty, staff and alumni of Downstate may obtain a membership for an annual fee. Spouses and/or children of faculty, staff, and alumni may be included for an additional fee. Additional information on membership policies is available at the reception desk.

Athletic/Exercise Facilities
Included are a gymnasium, swimming pool, two squash courts, an outdoor tennis court, sauna, and whirlpool bath. An array of exercise equipment is available in the weight room including stair machines, treadmills, exercise bicycles, free weights, and a multi-station machine.

RESIDENT SUPPORT, BENEFITS, AND CONDITIONS OF EMPLOYMENT

All residents in SUNY Downstate sponsored residency program are provided with appropriate financial support and benefits. Compensation of residents and distribution of resources for the support of education is monitored by and carried out with the advice of the GMEC.

Financial Support: All residents are provided with a stipend that is based upon the PGY level of training in their current residency program. The stipend amount is stated in the residency contract.

Applicants: Applicants for all programs must be informed in writing of the terms and conditions of employment and benefits by the Program Director.

Contracts: All residents are provided with a written agreement outlining the terms and conditions of their appointment and the implementation of these terms and conditions are monitored by the GMEC. Residents must adhere to the established practices, procedures, and policies of the hospital that salaries them.

Hospital and Health Insurance
All residents receive hospital and major medical insurance. The cost of coverage is dependent upon the plan chosen and whether individual or family coverage is selected

Professional Liability Insurance
All residents hold the title of “Clinical Assistant Instructor” and are indemnified in accordance with the provisions of the New York State Public Officers Law while at SUNY-Downstate facilities. Please contact the Risk Management Department for further information.

Institutions affiliated with SUNY-Downstate shall defend, indemnify and hold harmless medical residents and fellows who hold the SUNY faculty title of “Clinical Assistant Instructor” and rotate to the Affiliate as part of their training in integrated clinical programs, in connection with any and all claims, suits, actions, proceedings, expenses, including reasonable attorney’s fees, costs, liability, loss or damage arising out of the residents’ activities at the Affiliate.

Rotations to unaffiliated sites: Prior approval by the GME Committee is required to assure professional liability coverage under provisions of the New York State Public Officers Law for rotations to unaffiliated sites, including private office locations.

SUNY-Downstate shall defend and indemnify, in accordance with the provisions of the New York State Public Officers Law, those residents who hold the SUNY faculty title of “Clinical Assistant Instructor” and are on the payroll of the Affiliate while they are on rotation to SUNY-Brooklyn facilities as part of their training in integrated clinical programs in connection with any and all claims, suits and actions arising out of the residents’ activities at SUNY-Downstate.

Disability Insurance
All residents receive group disability insurance

Other insurance benefits for residents and their families
All residents receive life insurance, prescription plan, vision care as well as dental insurance. The specific details of the benefits coverage may vary according to pay source.

Living quarters, meals, and laundry services
These accommodations are determined by the individual hospitals to which residents rotate and by which the residents are employed. All participating sites have available meal and snack services. Appropriate on call facilities for residents are provided and maintained by each participating institution. Lab coats are provided by the resident’s pay source facility. Scrub attire is provided by participating hospitals as appropriate and needed.