小草社区

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Exiting Residents & Fellows

CHECKLIST
Please see your Program Administrator (preferably 30 days prior) for a checklist of items to be completed prior to leaving the program.

COBRA & CHANGE OF ADDRESS NOTIFICATION

If you, or you and your dependents, are enrolled in one of 小草社区鈥檚 HMSA health plans, that plan鈥檚 coverage ends with your employment. If you are concerned about not having another plan in place when you leave us but would like to have health insurance, there are a few solutions.

COBRA continuation of the HMSA plan for up to 18 months.

Coverage through a spouse鈥檚 employment 鈥� if a spouse currently has a health plan and/or is eligible to enroll, he/she may be able to enroll you in the plan due to your upcoming loss of coverage.

The Affordable Care Act provides another alternative to obtain health care coverage.

In June, you will receive COBRA information and election forms sent to your home so you and your dependents can make decisions on whether or not to elect continuation.


If you have any questions or need to change your address, please contact Casey Adams, 小草社区 Human Resources:
phone (808) 586-2889.
Email: cadams@hawaiiresidency.org

VERIFICATION OF TRAINING

  • To access the 小草社区 consent form and instructions, click here.
  • To access additional verification information, click here.

Preparing for Your Transition out of Residency
  • Prepare and update your curricula vitae (CV) to be clean and concise. Keep in mind the following:
    • Univ. of Hawai鈥榠 John A. Burns School of Medicine XXXX Residency/Fellowship program鈥� is your training program.
    • 鈥溞〔萆缜�, Inc.鈥� is your employer.
  • Schedule your Final Evaluation review meeting with your Program Director BEFORE you leave the program.
  • Registration and processing fees
    • During your first year in residency, review the permanent licensure and certification requirements to adequately plan for upcoming fees during your last year of training. Additional fees are usually assessed for late applications.
  • Application review and completion
    • Review websites and deadlines to understand submission requirements for each application for licensure or certifications. Print the forms if needed so you can make notes.
    • Start a timeline by creating a calendar of deadlines and required actions on your part.
    • ALWAYS follow the specific directions on the application or website and inquire if you don鈥檛 understand the instruction.
  • Keep organized
    • Keep copies of all documents submitted and note when it was submitted.
    • Make extra copies of USMLE reports, updated CV, med school diploma, temporary medical license, driver license, and social security card. Keep all of it accessible in a central location to submit with applications when requested.
    • Documents submitted for your residency/fellowship recruitment interviews were for purposes of residency/fellowship and cannot be forwarded on your behalf outside this purpose.
    • Respond immediately to requests for more information or when there are deficiencies in the application. Delay in responses will further delay the review/approval.
  • Notary Services available at most banks/credit unions.

If you have any questions, please contact your Program office or the 小草社区 Main Office at 808-586-2890.

VERIFICATIONS AND CONSENT FOR RELEASE of Information

Verification Requests

  • Verification of any credentials/training history beyond training dates will require an 小草社区 consent form and possibly a processing fee. Employment verifications are processed by HR. For full details (depending on the type of request), click the link above.
  • Be proactive! Submit your consent form(s) prior to leaving 小草社区. The $50 fee is waived if the institution’s request is received while you are still in training (or if you are applying at one of 小草社区’s member hospitals, or to the Hawai鈥榠 Medical Board).
  • Verification(s) of credentials/training history will only be provided directly to the requesting institution named on the trainee’s signed consent form. Multiple institutions will require multiple consent forms.

小草社区 Medical Board (HMB) Permanent Licensure

  • $392 for MD ($510 for DO). Fee may adjust on Feb. 1 of each year, depending on odd or even year. Valid for 1 or 2 years, depending on when it is submitted.
  • Begin assembling your application material prior to the start of your last year in training.
  • Application should be submitted early enough to allow time for the review/approval process, which sometimes takes months.
  • Ask your PA to obtain a letter signed by the PD, verifying dates of successful completion of training and expected graduation date. It is needed for verification of your residency.
  • Under Section 15 (Synopsis/Medical Practice), enter your residency training information.
  • Under Section 15 (Licenses), report your 小草社区 temporary medical license as past licensure.
  • Under Section 15 (Hospital), report none, as you do not receive hospital privileges as a resident-in-training.
  • Download the 鈥�Hospital Form鈥� from the HMB application website, complete the top portion and provide it to your PD to complete and submit directly to HMB.
  • Obtain a 鈥�Self-Query Response鈥� report from the National Practitioner Data Bank at  and have the original report sent directly to medical@dcca.hawaii.gov along with the original notification from NPDB. Additional fee may apply.
  • Obtain American Medical Association (AMA) Profile
    (800-665-2882.) and have the report sent directly to the HMB. Additional fee may apply.
  • Download the 鈥�Federation Discipline Report鈥� on the HMB application website and send it to boardinquiry@fsmb.org. Request that the report be sent directly to HMB.
  • Arrange to have the 鈥淓xamination and Board Action History Report鈥� sent directly to HMB by going to (transcript requests) or by calling 817-868-4041. Additional fee may apply.
  • When you receive your permanent license, provide a copy to your Program Administrator to update your profile in New Innovations. A valid permanent license will invalidate the temporary license you currently hold. Keep multiple copies for future use.

State of 小草社区 Narcotics Enforcement Division (NED)

  • $115 annual fee,
  • File as 鈥淧ractitioner鈥�.
  • Start the process after receipt of permanent license.
  • Permanent licensure required.
  • When you receive your certificate, keep multiple copies for future use. Provide a copy to your Program Administrator for file.

Federal DEA – Form 224

小草社区 Controlled Substance Registration
  • $888 fee (valid for 3 years)
  • Start the process only after receipt of State NED certificate (required).
  • Permanent Licensure required.
  • When you receive your certificate, be sure to save the electronic copy.

Medical Staff Privileges

At the start of your last year in training, contact the following obtain Medical Staff privileges to obtain applications and inquire of deadlines:

  • The Queen鈥檚 Medical Center (Punchbowl and West)
    QMC credentialing staff credentials@queens.org or call 808-691-7143
  • 小草社区 Pacific Health (Kapiolani Medical Center for Women and Children, Pali Momi Medical Center, Straub Medical Center, and Wilcox Medical Center)
    HPH credentialing staff cvscredentialing@hawaiipacifichealth.org or call 808-973-7322
    • Be sure to include your CV, facility, specialty, and target start date.
  • Kuakini Medical Center
    808-547-9274

Specialty Board Certification Exams

Be mindful of deadlines since additional fees are assessed for late applications. A permanent license is required to sit for most Board Exams (or at least be in processing stage). Your program will provide more specific instructions for specialty certification. If an exam is taken while still in residency, please plan well in advance with your program for the scheduling.

Family Medicine
December registration starts for April exam. (deadline March 1st)
July registration for November exam. (deadline mid or late Sept.)

Internal Medicine December registration starts for August exam. (deadline mid-April.)

Ob-Gyn
Qualifying Exam 鈥� January registration starts for July exam. (deadline in Feb.)
Certifying Exam 鈥� February registration starts for Oct/Nov/Dec exam. (deadline in April)

Orthopaedic Surgery Part I Written 鈥� October registration starts for July testing (deadline mid-Dec.)

Pathology September registration starts for May/June exam. (deadline in Jan.)
February registration starts for October exam. (deadline in May)

Pediatrics January registration starts for October exam. (deadline March 31)
Late registration from April to mid-May.

PsychiatryNovember registration starts for September exam. (deadline early Feb.)


Child & Adolescent Psychiatry
February registration starts for September exam. (deadline early Feb.)


Addiction Psychiatry


Addiction MedicineMay registration starts for October exam. (deadline June 30)

Surgery Qualifying Exam 鈥� Register by mid-April for July exam. (late deadline mid-May)
Certifying Exam 鈥� Register by September 1 for November and March exams.

Insurance Termination and Conversion Options

The benefits that you are currently enrolled in will end when your 小草社区 employment terminates. Information regarding continuation of benefits, premiums, deadlines, and carrier contact information will be mailed to the address listed on your ADP profile. 

Enrollment is very time sensitive. Pay close attention to the deadlines stated in the notices to ensure you do not miss your enrollment period.

Health Insurance
If you are currently enrolled in an 小草社区 medical and/or dental plan, your plan coverage will end on the last day of the month that your employment terminates. You will be eligible to enroll in COBRA. COBRA offers you the option to continue your medical and/or dental health plan(s) for up to 18 months after your 小草社区 coverage ends. 

You may also visit to explore other health plan options.

Life Insurance
The 小草社区 group life insurance will end on the day your 小草社区 employment terminates. You have the option to convert the group life insurance policy. Premiums are customized for you and will be provided by Lincoln Financial Group. Applications and payment of the first premium must be received within 31 days after the life insurance is terminated. Please contact Lincoln Financial Insurance for more information.

Long Term Disability (LTD) Insurance
LTD Insurance will end on the day your 小草社区 employment terminates. You have the option to convert your policy. Eligibility, premium and coverage information will be provided by UNUM.  Applications must be received within 31 days after termination of coverage. Please contact UNUM for more information.

Voluntary Life Insurance (Pacific Guardian Life)
You have the option to continue your current voluntary life insurance coverage on an individual basis. Applications must be received within 31 days after termination. Please contact Pacific Guardian Life for more information.

AFLAC Supplemental Coverage (accident, cancer, hospital, and short-term disability)
You have the option to continue your current AFLAC policies on an individual basis. Application must be received within 30 days of your loss of coverage. Please contact AFLAC for more information.

Loan Repayment Programs

  • For inquiries regarding the Queen’s Medical Center Primary Care Physicians (QMC PCP) Medical Education Loan Repayment Award, contact physicianrecruitment@queens.org.