INTRODUCTION

 

Welcome to The University of Oklahoma College of Medicine - Tulsa!  We are pleased you chose to continue your medical education in our residency program, and we are confident your experiences with us will prove to be mutually satisfying.

 

You are obligated to be familiar with and abide by the policies and regulations presented in this handbook. This handbook is not intended to create any contractual rights in favor of the resident or the university. The State of Oklahoma and the University of Oklahoma are at-will employers.  An employment relationship may be terminated at the will of the employee as well as by the employer.  While policies and procedures have been established to provide guidance for university administrators and residents, the policies herein shall not be construed to limit or abrogate the rights of the University of Oklahoma or its residents under the employment-at-will relationship.

 

 

VERY IMPORTANT

 

All resident physicians new to The University of Oklahoma College of Medicine - Tulsa (OUCM-T) must contact the Resident and Student Affairs Office immediately upon arrival in Tulsa and before reporting to a hospital or performing any official duties.  Resident physicians cannot participate in patient care experiences until their professional liability insurance is in effect and a special license or a full medical license has been issued by the Oklahoma State Board of Medical Licensure & Supervision or the Oklahoma State Board of Osteopathic Examiners.

 

The statements, terms and provisions contained in the Resident Handbook are subject to change at any time by the Board of Regents and/or the administration of The University of Oklahoma, which expressly reserves the right to make any changes or to establish new policies, rules and regulations from time to time as it deems necessary and proper.  The establishment of new policies, rules and regulations will be expressly for the purpose of improving the quality of the resident's experience in his or her training program.

 

Residents will be paid as indicated in the OUCM-T residency agreement (contract).  Any salary increase approved by the Tulsa Medical Education Foundation (TMEF) effective after the date of the contract will be automatically reflected in paychecks without reissue of the contract.

 

While the University expects to receive the full funds necessary to support the budget, it reserves at all times the right to institute budget reduction actions in accordance with state law, including changes in salaries and/or fringe benefits.

 

 

DEFINITION OF TERMS

 

Residents

Residents are M.D. or D.O. (graduate) physicians holding appointments to Emergency Medicine, Family Practice, Family Practice – Rural, Internal Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry, Surgery, or the combined Family Practice/Psychiatry and Internal Medicine/Pediatrics or the Sports Medicine fellowship graduate medical education programs at OUCM-T.

 

Program Directors

       Program Directors are full-time faculty members at OUCM-T with the responsibility for graduate medical education at OUCM-T.

 

Residency Appointments

 

Eligibility Criteria:

Applicants for graduate medical education programs sponsored by the University of Oklahoma College of Medicine and its clinical departments are eligible for appointment if they meet one of the following qualifications:

 

Graduates of medical schools in the United States and Canada accredited by the Liaison Committee on Medical Education (LCME) who have passed the United States Medical Licensing Examination (USMLE) Step 1 and Step 2-CK and Step 2-CS examinations in 3 or fewer attempts per step.

 

Graduates of colleges of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA) who have passed COMLEX-USA Level 1 and Level 2 and Level 2-PE examinations in 3 or fewer attempts per step.

 

 

Graduates of medical schools outside the United States and Canada who meet each of the following qualifications:

 

a.     Hold a currently valid standard certificate from the Educational Commission for Foreign Medical Graduates (ECFMG), the requirements for which include passing Step 1, Step 2-CK and Step 2-CS of the USMLE in 3 or fewer attempts per step.

 

b.   Are citizens of the United States or hold either a J-1 Visa or a permanent immigrant Visa (“green card”).  Applicants holding an H1-B Visa will be considered only under extraordinary circumstances and only on the approval of the Associate Dean for Academic Services.

 

c.    Hold a currently valid Social Security Number as evidenced by an official Social Security Card.

 

 

Note:  Foreign nationals who are graduates of medical schools in the United States and Canada are not considered foreign medical graduates and do not require ECFMG sponsorship.  They must have a Social Security Number.

 

 

Selection Criteria

 

First-year (PGY1) appointments offered to U.S. graduating seniors will be selected through an organized matching program, known as the National Resident Matching Program (NRMP).  All residency programs require applicants to apply through the Electronic Residency Application Service (ERAS).  First-year residency positions offered to candidates other than U.S. graduating seniors will also be selected through the NRMP except in special circumstances in compliance with NRMP’s policies.

 

Allopathic (M.D.) applicants for first-year positions must have passed Step 1 and Step 2-CK and Step 2-CS of the United States Medical Licensing Examination (USMLE) in 3 or fewer attempts per step.  Osteopathic (D.O.) applicants must have passed Level 1 and Level 2 and Level 2-PE of the COMLEX-USA examination.  Individuals who do not meet these requirements will not be considered for first-year residency appointments.

 

Appointments for second-year and above levels are made in accordance with the policies established by each program in compliance with the standards of the Accreditation Council for Graduate Medical Education (ACGME), its Residency Review Committees (RRC), and the requirements of the respective American specialty certification boards.

 

The PGY level of the initial appointment is determined in part by the amount of previously completed graduate medical education that is acceptable for credit by the specialty board of the training program to which the resident is appointed.  Whenever there is uncertainty in this regard, the applicant shall obtain from the specialty board a written appraisal of previous training and a statement of additional training requirements that must be met to qualify the resident for certification by that board.

 

All residents with the M.D. degree must have passed Step 3 of the USMLE examination by the end of their second year (PGY2) of residency training.  All residents with the D.O. degree must pass Level 3 of the COMLEX-USA examination and be licensed by the Oklahoma State Board of Osteopathic Examiners before proceeding beyond the first year of residency.  Any resident who fails to pass the requisite examinations as stipulated above will be terminated from his/her residency program at the end of the applicable resident year.

 

An individual considered initially for any clinical training position at the PGY2 or above level must have passed all licensure examination steps and be capable of being licensed by either the allopathic or osteopathic licensing boards of the State of Oklahoma or already possess such license.

 

Residency appointments for graduates of International Medical Schools (IMGs) may be offered only to those individuals who meet all requirements of federal and state laws applicable to such appointments including visa requirements.  They must hold a currently valid standard certificate from the ECMFG.  Foreign physicians admitted to the United States for graduate medical education training under the authority of the University of Oklahoma College of Medicine – Tulsa must hold either a J-1 Visa, under the sponsorship of the ECFMG, or a permanent immigrant visa (“green card”) or a H1-B Visa under extraordinary circumstances with approval of the Associate Dean for Academic Services.  All residents regardless of medical school or country of origin must hold a currently valid Social Security Number as evidenced by an official Social Security Card.

 

It is the responsibility of the applicant to complete all ECFMG requirements and visa requirements before appointment to a residency position and/or before beginning residency training.

 

Residents are appointed for a period of one year (or as specified in the individual contract) but in any event not beyond June 30th.  Renewal of the appointment is contingent upon satisfactory performance and is not automatic.  Intention by either party not to renew the appointment should be accompanied by notification in writing within the time specified by the Residency Program Director and as indicated on the residency agreement (contract).

 

Each resident and fellow offered an appointment is expected to read, sign, and abide by the residency agreement (contract).

 

In general, the level of resident pay will coincide with the level of appointment.  It will be left to the discretion of the Residency Program Director to recognize prior training within the same specialty by contracting and arranging for payment at a level above the level of appointment.

 

Each resident or fellow offered an appointment must prove to be eligible for professional liability insurance coverage by the carrier contracted by the University of Oklahoma College of Medicine.  The contract offered to any resident or fellow who is ultimately denied coverage by the University of Oklahoma College of Medicine professional liability insurance carrier will be null and void.

 

 

Not withstanding the above provisions, appointments are subject to the provisions of the Administrative Academic Actions chapter of this Handbook.


ADMINISTRATIVE PROCEDURES

AND RESPONSIBILITIES

 

New Resident Procedures

 

The following administrative procedures must be initiated and/or completed prior to assuming any duties as a resident at OUCM-T.  All procedures will be discussed during the mandatory orientation.

 

Issuance of contract

 

Malpractice insurance application

 

Medical, dental and other insurance forms

 

W-4, loyalty oath and other employment-related forms

 

Professional membership applications

 

Personal information form

 

Issuance of pager equipment

 

Name tag and OUCM-T picture identification card

 

Parking decals for OUCM-T campus and hospitals

 

Application for special training license

 

State licensure application (PGY2 and above)

 

BNDD/DEA registration (PGY2 and above)

 

Graduates of medical schools in countries other than the United States, Territories of the United States, or Canada must submit a notarized copy of their valid ECFMG certificate.

 

Proof of compliance with the Immigration Reform and Control Act of 1986.  This law provides for an employment eligibility verification system designed to prevent the employment of unauthorized aliens.  Upon accepting employment, law requires all new employees to document their legal employability and personal identity.  Documentation and completion of the employment eligibility form, proving employability and personal identity must, by law, be furnished and verified before or on the contractual commencement date of employment.  A resident who fails to provide the required documentation cannot work.

 

Completion of all required training in HIPAA, Coding, and Resident Time-Tracking.

 

Resident Physician Responsibilities

 

Specific duties and responsibilities of the resident will be outlined by the individual Program Directors.  The resident is responsible to his or her Program Director for performance in all phases of training. 

 

Residents appointed to training programs at OUCM-T are expected to:

 

Develop a personal program of self-study and

professional growth with guidance from the Residency Program Director and Faculty.

 

Be aware of and abide by all University of Oklahoma policies and procedures.

 

Participate in safe, effective and compassionate patient care under supervision, commensurate with his or her level of advancement and responsibility.

 

Participate fully in the educational activities of his or her residency program and, as required, assume responsibility for teaching and supervising other residents and students.  Program Directors will provide residents with guidelines for required participation and attendance for educational activities such as conferences, rounds, seminars, and ambulatory rotations.

 

Fulfill the requirements of the residency program.

 

Participate in institutional programs and activities involving medical staff.

 

Adhere to established practices, procedures, and policies of the institutions, and affiliated hospitals.  For example, excessively delinquent hospital medical records may result in suspension of hospital privileges of the resident, as well as the resident’s attending physician, which will result in the resident’s suspension from the OUCM-T residency training program in all affiliated hospitals until the records are completed.  Suspended time will be “dead” time; that is, time without pay and time not counted toward completion of training that must be made up before a certification of completion will be issued.

 

Foster the principles of medical ethics and participate in peer review.

 

Participate in institutional committees and councils; especially those that relate to patient care review activities.

 

Apply cost containment measures appropriately in the provision of patient care.

 

Agree not to engage in any outside employment or professional activities, which interfere with obligations to the training program.

 

Exhibit conduct consistent with the dignity of the medical profession at all times.  Social and personal matters should be conducted at appropriate times and places apart from professional practice.  Residents are representatives of OUCM-T in their professional relationships with patients and their relatives, colleagues, hospital personnel and the public.

 

Address all physicians and hospital personnel by their last names in the presence of patients.

 

Understand that residents do not have administrative control over nurses or employees.  Hospital and clinic personnel will do their best to provide good care for patients, and residents should be courteous and helpful to them.  When nurses or employees apparently fail to discharge their duties and the welfare of the patient is affected directly, the resident should report the matter promptly to his or her attending physician.

 

 

Medical Ethical Responsibilities

 

The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient.  As a member of this profession, a resident must recognize responsibility not only to patients, but also to society, to other health professionals, and to self.  The following principles adopted by the American Medical Association are not laws, but standards of conduct that define the essentials of honorable behavior for the physician.

 

A physician shall be dedicated to providing competent medical service with compassion and respect for human dignity.

 

A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.

 

A physician shall respect the law and also recognize a responsibility to seek changes in those requirements, which are contrary to the best interests of the patients.

 

A physician shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law.

 

A physician shall continue to study, apply and advance scientific knowledge, make relevant information available to patients, colleagues and the public, obtain consultation, and use the talents of other health professionals when indicated.

 

A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical services.

 

A physician shall recognize a responsibility to participate in activities contributing to an improved community.

 

 

Patient Relationships

 

The attitude of the resident toward patients should be kind and sympathetic.  Patients accepting care should never be allowed to feel that the professional relationship between them and the resident is altered by their economic status.

 

Residents are legally and morally bound to keep medical information regarding patients strictly confidential.  Patients and their medical conditions should not be discussed in public either inside or outside of the hospitals.  Inquiries regarding the medical condition of patients by news media should be referred to the patient information desk, Nursing Service Office or to the Hospital Administrator.

 

 

Medical Records

 

Properly maintained and completed medical records are of the utmost importance in caring for patients and also serve as a basis for some clinical investigative work.  Therefore, great emphasis is placed on the preparation, maintenance, and preservation of medical records in the hospitals and clinics. 

 

Specific rules concerning medical records vary with the different hospitals and clinics.  General rules apply to all hospitals and clinics and they are as follows:

 

Preservation of Medical Records

 

1.     No medical record may be removed from the files without a proper sign-out of the record to show where it has been taken and who is responsible for it.

 

2.     If a medical record, subsequent to its removal from the files, is transferred from one person to another, it is the responsibility of the person to whom the record is charged to notify the appropriate Medical Records Department.

 

3.     Medical records must not be taken from the hospitals or clinics.

 

4.     Medical records of patients previously treated are available to residents for approved education or research purposes.

 

Preparation and Maintenance of Medical Records

 

1.     A complete history and physical examination shall be written or dictated within 24 hours after admission of each patient, or within the guidelines determined by each hospital’s medical staff executive committee and by the office of Clinical Affairs.

 

2.     Adequate, up-to-date progress notes should accurately reflect the patient’s hospital/clinic course.

 

3.     Residents must date and sign each entry made in the clinical record.

 

4.     When it is known that a patient is to be discharged, all residents responsible for the preparation of items in the record must attempt to complete those items before the patient leaves the hospital.

 

5.     The service discharging the patient is responsible for the summary of the patient’s entire hospitalization in dictated form.

 

6.     Residents on duty in an emergency department should complete the medical record immediately after a patient is treated.  Emergency department records are needed by many.  The record must not be taken elsewhere; if copies are needed, photocopies will be prepared.

 

7.     At regular intervals, the Medical Records Committees of the hospitals and clinics will review medical record delinquencies, including those of residents.  Serious deficiencies will be reported to the appropriate Program Director for administrative action.  (see Academic Administrative Actions) 

 

 

Confidentiality of Medical Records

 

Residents are cautioned that medical records are confidential.  The use and disclosure of the health information contained in a medical record are restricted by the regulations (Privacy Regulations) promulgated pursuant to the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

 

Residents must comply with the University’s Privacy Policies and Procedures (Privacy Policies) implementing the Privacy Regulations.  Failure to comply with the Privacy Policies will result in corrective action, including the possibility of termination.

 

Residents must make reasonable efforts to safeguard medical information.  For example, residents should not discuss particular patients in public and should not leave medical records in places where unauthorized persons could access them.

 

Residents must use extreme caution when storing health information on portable devices.

 

Residents must comply with any policies developed by the University related to security of health information.

 

 

Dress Code

 

Professional appearance and demeanor are a demonstration of self-respect, respect for the patient and the profession.  This appearance and demeanor should be maintained at all times by faculty, residents and medical students.  Individual departments should inform residents of standards unique to that department.  Individual institutions may have additional dress code requirements of which all residents should be aware.

 

Hair should be kept well groomed and neat.  Men may wear mustaches and beards that are neatly trimmed.

 

A clean clinical jacket, suit, or sport coat, with nametag is to be worn at all times, while on duty.

 

Clothing should be clean and in good repair.  Blue jeans, shorts, t-shirts, hats, and exercise clothing are unac-ceptable.

 

Shoes should be clean and neat.

 

 

Nametags

 

Resident physicians are required to wear The University of Oklahoma nametags in all patient care settings.  The nametag will identify the resident as a resident physician and is issued by the Resident and Student Affairs Office during orientation.

 

In the event a resident’s nametag is lost, the Resident and Student Affairs Office should be contacted to arrange for a replacement.

 

Identification Cards

 

1.     The University of Oklahoma photo identification cards are made during resident orientation.  The card, which should be carried with the resident at all times, provides a source of identification in hospitals, the community, and on campus.  The card will enable residents to gain admission to athletic events and other University of Oklahoma functions.

 

2.     Residents completing and/or leaving OUCM-T are required to return the ID card to their residency program.

 

 

Parking Decals

 

1.     Hospitals will issue parking permits as appropriate.

 

 

Resident Mailing Address

 

Residents, as a group, receive the largest volume of mail on this campus.  Complete and accurate mailing addresses ensure that the mailroom is able to sort and deliver mail on a timely basis.  Please provide the complete mailing address to all of your correspondents as shown below.

 

       Your Full Name

       Department of _______________

       4502 East 41st Street

       Tulsa OK 74135-2512

 

 

Health Screening