Non- BCM Rotation Form - Residents/Fellows

Please download the elective rotation checklist & supporting documents packet here (the supporting documents has instructions on Castle Branch & TMB permit should you need it).

Do NOT sign within the hyperlink.

If coming from outside the state of Texas, please email patricia.perez@bcm.edu to receive the TMB spreadsheet.

**Note that it is you and your PCs responsibility to make sure the BCM PC and PD are aware of this rotation ahead of time and have approved this rotation**

You must submit your elective rotation forms at least 30 business days prior to rotation start date.

GME DOES NOT ALLOW ANYTHING BUT US CITIZENS, PERMANENT RESIDENTS, OR J-1 VISA HOLDERS THAT ARE ALREADY IN THE US.

** IF a J1 visa holder, you will need to have your TPL Advisor fill out your ISO form: J1 Visa Status

**IF a permanent resident, you can fill this form out: Permanent Resident Status

*this is for any J1 visa holders or permanent residents

 
 
 

Trainee's date of birth

 
mm/dd/yyyy
 
 

Be specific. Example: Pediatric GI

 

Be specific. Example: Pediatric GI

 
 
 
 
mm/dd/yyyy
 
 
mm/dd/yyyy
 
 

Please remember - we only accept J1 visa holder or permanenet residents who are currenly in the USA for their residency or fellowship training.

 

If yes, please upload a formal letter, from your supervisor, stating you have previously done a background check/drug screening and have proof of liability coverage.

 

Include City, State, & Zip Code

 
 
 

Please tell us the name, phone number, & relationship to trainee

 
 
 

Please let us know your home program PC's information! If you can, please also add the BCM PC that will work with you during your rotation. *Ask your home program PC if you're unsure who to add as the contact.

Helpful tip: not Patricia Perez, she is the rotation GME point of contact.

 
 

You will see, below, that there is a section to upload all required documents (up to 10 separate files).

**Please submit all documents at once. You cannot resubmit or edit. IF you are just missing the PLA or the TMB Permit (if outside the state of Texas) it is okay to submit everything else - we will add the PLA and/or TMB Permit on the back end once received.

  1. BCM Liability Form & BCM Privacy Document (this form is in the elective packet embedded in the description of this elective application
  2. Proof (an approval email) from BCM PC/PD that this rotation has been approved **
  3. Proof of Professional Liability Coverage *if military personnel, a formal letter, from your superior, stating you have this is sufficient*
  4. Castle Branch Background Check/Drug Screening (instructions are in the elective packet embedded in the description of this elective application) *if from an affiliated hospital or military personnel, a letter from the program stating this has been completed before is sufficient*
  5. Copy of current TMB license or permit
  6. Copy of most up to date ACLS, ATLS, or PALS from either the American Heart Association or American Red Cross
  7. Proof of HIPAA Training, from your institution
  8. Complete Immunization Records with most up to date Flu Shot, this is a must
  9. Fully Executed Program Letter of Agreement - needs to be uploaded each time - ask your program for this

**NOTE: The BCM Badging Office makes any trainee coming in (that doesn't already have a BCM badge) to pay a fee of $20, paid in cash. This is not something they let us waive, so let your programs know. BCM Badging Information

Drop your files here