Office of Mississippi Physician Workforce Graduate Medical Education Support Statement of Interest

Office of Mississippi Physician Workforce Graduate Medical Education Support Statement of Interest

The Office of Mississippi Physician Workforce (OMPW) was established in 2012 through House Bill 317 and is currently housed within the Mississippi State Department of Health. Its primary mission is to address the state's physician shortage, particularly in primary care, by developing strategies to attract, educate, and retain a well-trained and appropriately distributed physician workforce.

OMPW, with the input of the advisory board, shall have the authority to award financial support, from funds specifically appropriated for that purpose by the Legislature to any hospital or entity with demonstrated commitment and resources to establish and operate an ACGME accredited Family Medicine residency program or other GME program or fellowship.

What is a statement of interest?

A statement of interest is an opportunity for potential applicants to express their facilities need for funding to start-up and/or sustain support for their residency programs. Submission of your statement of interest is the only way to initiate the application process. Once you submit your statement of interest, a OMPW staff member will contact you via email with additional information and guidance on next steps.

Contact Information

Please contact OMPW@msdh.ms.gov or (601) 576-7874 with any questions or technical assistance needs.

Entity Name (Hospital and/or Residency Program)*

Street Address*

City*

Zip Code*

Point of Contact Name*

(Last name, First name)

Point of Contact Title*

Point of Contact Email Address*

Point of Contact Phone Number*

Federal Unique Entity Identifier (UEI)*

Any entity receiving funding from the Mississippi State Department of Health must be registered in SAM.gov. The Unique Entity ID is the 12-character alphanumeric ID assigned to an entity by SAM.gov after the registration process is complete.

Federal Tax ID Number*

Pre-Application Requirements

Attachment 1 Letter of Intent: The Letter of Intent should include a detailed description of the project and purpose for applying for funding for the residency program. To determine program eligibility, the proposed financing structure (proposed budget), and any other terms of the applicant’s proposed project.

Attachment 2 Letter of Good Standing: A Letter of Good Standing refers to a certificate issued by the Mississippi Secretary of State Office verifying that a registered business entity has complied with all requirements for conducting business in the State of Mississippi. To request an official letter, please visit https://www.sos.ms.gov/business-services/order-documents.

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