Contracts and Pre-Matriculation

Procedure for Completion of Initial Agreement with Physicians

The initial employment contract will cover a resident/fellow over the course of their entire residency or fellowship training. When a resident/fellow is promoted each year, they will receive a contract renewal letter instead of a new contract. SIU obtains electronic signatures through DocuSign for all resident/fellow initial agreements. The contract template, completion directions and routing instructions will be sent electronically to all programs at the appropriate time.

Contract Renewal Letter or Extension of Training Letter

When possible contract renewal letters should be issued by the program four months prior to the end of each resident’s/fellow’s contract for the following year.  However, the minimum timeframe for a renewal letter to be issued is 60 days from the end date.  If a resident's /fellow's training must be extended at any time, an extension letter will be used to extend the training dates. 

Springfield programs

  • The program will maintain the original letter on file, and provide a copy to the resident and the Office of Graduate Medical Education.
  • OGME will send one copy each to the Affiliated Hospitals. 

Affiliate programs

  • The program will maintain the original letter on file, and provide a copy to the resident, OGME, and the employing hospital.

Pre-Employment Requirements for New Residents/Fellows

Prior to beginning training as a new resident or fellow at SIU School of Medicine there are several requirements that must be completed. Each of the items below are a condition of employment and are stated in each contract. The items below MUST be completed before a resident/fellow can start:

  • Pre-Employment Screening by their employing hospital
  • Background check by their employing hospital
  • Employing hospital’s required computer based learning (CBL) courses
  • Completed employment application/documents for their employing hospital
  • Valid visa and/or work authorization documents for their employing hospital
  • Valid Illinois Medical License
  • SIU School of Medicine required CBL courses
  • Signed contract
  • Passing USMLE/COMLEX scores
  • BLS/ACLS/ATLS/PALS/NRP certification (Springfield based residents)

Their employing hospital will send information about employment screening, work authorization documents, background checks, employment forms, benefits information and their online training requirements. 

Pre-employment screening

At the beginning of their appointment the employing hospital will require that a health questionnaire be completed. They must comply with the hospital’s policies concerning tuberculosis screening and immunizations, including COVID, measles, mumps, rubella, hepatitis B, and proof of Chickenpox disease, positive titer or vaccination. This is required at the time of their initial pre-placement screening.

Drug testing

A urine drug screen will be part of the employing hospital's onboarding process. Even though marijuana is legal in Illinois and a number of other states, it remains illegal on a federal level.  The pre-matriculation drug test will include cannabinoids, and "failure" of the test will negate your contract. If an incoming physician is using medical marijuana (or any other controlled substance) under a doctor's supervision, it must be discussed with the employee health nurse before testing. The Physician shall not have the right to request a review of a failed test


All residents and fellows must hold either an Illinois Temporary Medical License or an Illinois Permanent Medical License. First year residents must apply for a temporary license. This process takes approximately 8-12 weeks. Information on how to complete the Illinois license application will be provided to all incoming trainees.

Application for permanent licensure can be made after successfully passing Step 3 and completing 24 months of clinical training, but is not required by SIU School of Medicine or its affiliated hospitals. After securing a permanent license, a physician may apply for a state controlled substance number and federal DEA license if desired. 


All residents at SIU School of Medicine are required to pass Steps I and II of the United States Medical Licensing Exam (USMLE) or Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX) before beginning a PGY1 or PGY2 position. 

Residents transferring from another program to a residency at PGY3 level or higher or any fellowship program at SIU School of Medicine are required to have passed USMLE or COMLEX Step III prior to beginning their training.

Residents must pass USMLE or COMLEX Step III before progression to the PGY 3 year. Assistance in the application process is provided by the Office of Graduate Medical Education. To review this policy in its entirety, go to

Computer based online training

Each incoming resident and fellow is required by their employing hospital, Graduate Medical Education at SIU School of Medicine, and SIU Medicine to complete online training modules. These modules must be successfully completed before starting training. Instructions on accessing these systems and completing these courses will be sent to each incoming resident/fellow. 

The employing hospital will also require completion of online training courses. These are required to meet their Joint Commission requirements. The employing hospital will send you detailed instructions on these courses and how to access them.

Cardio Pulmonary Resuscitation - Springfield based Residents

Springfield Memorial Hospital and HSHS St. John’s Hospital mandate that residents and fellows be certified in Basic Life Support (BLS) and ACLS (PALS for Pediatrics). Both certifications must be maintained throughout their residency regardless of specialty. The hospitals usually offer ACLS classes the week before orientation. It is a pre-requisite to have a current BLS card to take the ACLS (PALS) course. It is the responsibility of the resident/fellow to pay for initial BLS training. The affiliated hospitals have agreed to pay for the initial ACLS (PALS) course and recertification for BLS/ACLS if it is completed at their employing hospital. The training program may also require that you be certified in Neonatal Resuscitation Program (NRP) or Advanced Trauma Life Support (ATLS). 

DEA Numbers

Once a resident/fellow has received their permanent Illinois medical license, they are eligible to apply for an Illinois State Controlled Substance number and a DEA federal drug number. They will have access to the online application upon issuance of their permanent license. 

DEA applications are available at

Residents who have a temporary medical license are provided with a hospital assigned DEA number, which is only valid in the hospital setting for training purposes. That number is a combination of the hospital DEA number and the resident’s dictation number.

NPI Numbers

Once a resident/fellow has obtained a temporary or permanent Illinois license, they need to obtain a National Provider Identifier (NPI) number. The NPI number will remain with the individual throughout their medical career.

Although residents/fellows do not practice as independent practitioners, unless they are moonlighting, with the advent of the EHR, NPI numbers are necessary to allow our hospitals and SIU to arrange the flow of lab results, etc., to residents for review before attendings. This is necessary for them to learn and to assume progressive levels of responsibility.

A listing of residents and their DEA and NPI numbers is distributed to Springfield area pharmacies.

PECOS Registration

Effective June 2016, Medicare has stated that they will only process orders for physicians that are enrolled in their online PECOS system. To enroll, Residents/Staff must have log in and password information that they used to obtain their NPI number. What happens if a resident doesn't get enrolled in PECOS? Worst case scenario is that orders (lab, x-rays, DME, etc) will be rejected and an attending will have to sign off.

IMPACT Registration

Effective April 2017, the state Medicaid program requires that all physicians enroll in the IMPACT system in order to write orders for patients on Illinois Medicaid. Program Coordinators and/or other designated staff have been trained to handle these enrollments.

For instructions on requesting a NPI number or how to register in PECOS/IMPACT, contact the Office of Graduate Medical Education.