Congratulations on your provisional acceptance into the graduate medical education training program at Loyola University Medical Center and Loyola University Health System. To be considered for temporary licensure in Illinois, the following forms and supporting documents must be submitted to your training program administraors office as soon as possible, but no later than April 7,2008 to be assured of a timely start to your training program.

Loyola University Medical Center
c/o [Enter your training program name here]

2160 S. First Avenue

Maywood, IL 60153

Failure to submit the required documentation in a
timely fashion will delay the start of your training.

Licensure

Every trainee must have a valid and current license to practice in the state of Illinois. The GME Office and your specific program coordinators will make every attempt to assist you through the application process, it is your responsibility to make sure your license is always current. You may not start your training program until you have secured your Illinois license.

Please note that all allophathic and osteopathic licenses for all State of Illinois physicians are expiring this year. Timeliness of submission is essential.

Residents

Application for Temporary Medical Licensure for US Grads

Application for Temporary Medical Licensure for International Medical Grads

Application for Temporary Podiatric Licensure

Application for Temporary Dental Licensure

Applications for temporary licensure and requisite fees should be forwarded to your training program administration office as soon as possible. Temporary licenses are governed by LUMC and covers only the practice of medicine within the realm of your training at LUMC. If you need further information regarding temporary licensure, it is also available on the Illinois Department of Financial & Professional Regulation website at http://www.idfpr.com/dpr/WHO/med.asp. Please select the appropriate discipline from the dropdown list provided. The GME Office will file your application with the state on your behalf. It is imperative that you complete the application for licensure immediately as it may take a minimum of 8 weeks to process an application once it is received in Springfield.

You cannot begin your training program until
you are licensed in the State of Illinois.

Fellows

Application for Permanent Medical Licensure: 41kb

Applicants for accredited and non-accredited fellowship programs must have the requisite education and certification to secure a full and unrestricted permanent license in the State of Illinois including, but not limited to, documentation of successful completion of USMLE parts I, II and III. Submission of documentation for permanent licensure is the sole responsibility of the fellow. If you need further information or instructions, please go to the website for the Illinois Department of Financial & Professional Regulation at http://www.idfpr.com/dpr/default.asp. You are also encouraged to click on the “Licensure” link on the menu bar on the left.

Fellows must be in possession of their permanent
license prior to beginning their training.

Graduate Medical Education Agreement

Three copies of your LUMC Graduate Medical Education Agreement will be mailed to you at the address you provide on your application. Please sign and return all three copies of your Agreement to your training program administration office. One fully executed copy will be forwarded to you when all appropriate signatures have been secured.

LUMC Graduate Medical Education Application

The LUMC GME Application must be current on the date of commencement of your program. Any application completed on or before February 1, 2008 is invalid. Please include a passport size photo with your application. Click Here: 94kb

Consent and Release Form

Please print, review, sign and return. Click Here: 23kb

Conflict of Interest Statement

Please print, review, sign and return. Click Here: 37kb

Safety/HIPAA Exam:

Please click the following links to 2008 Loyola Healthbeat Annual Education Newsletter and Test sheet. You need only print out the answer sheet itself which is found on pages 9 to 11 of the document. Please return your answer sheet with the rest of your documentation to your training program administrative office.Click Here

Housestaff Handbook and Attestation of Receipt

The 2008-2009 Housestaff Handbook is linked for your review. Click Here: 393kb The Housestaff Handbook is also available electronically on the LUMC Intranet site and will be accessible there after you begin your training program. Please print, sign and date the attestation of acknowledgement of the Handbook and return with the rest of your documentation to your training program adminstrative office. Click Here

User ID Request

Please print out and complete the linked form and submit to your training program administrative office. Click Here

I-9 Form

You must complete an I-9 form and provide supporting documents to prove eligibility for employment in the United States. Please print out the form and complete the top part in black ink. Please bring the form and appropriate supporting documents when you report for orientation. The acceptable documents are found on the third page of the I-9 application document. Click Here

Transferees

If you are transferring to Loyola from another training program, you will need to have your current program director complete the Transfer Resident Evaluation Summary form and return it to your training program administrative office, 2160 S. 1^st Avenue,Maywood IL 60153. Click Here: 52kb