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Eligibility Requirements

I. Purpose of Policy

The purpose of this policy is the expectation that the Dartmouth-Hitchcock (D-H) Graduate Medical Education Office (GME) maintain written policies on the recruitment of residents and fellows as per the Institutional Requirements set forth by the Accreditation Council for Graduate Medical Education (ACGME).

II. Policy Scope

This policy applies to all ACGME-accredited graduate medical education programs at D-H.

III. Definitions

Resident: Any physician in an accredited graduate medical education program, including interns, residents, and fellows.


Fifth Pathway: An academic year of supervised clinical education provided by an LCMEaccredited medical school to students who meet the following conditions: (1) have completed, in an accredited college or university in the United States, undergraduate premedical education of the quality acceptable for matriculation in an accredited United States medical school; (2) have studied at a medical school outside the United States and Canada but listed in the World Health Organization Directory of Medical Schools; (3) have completed all of the formal requirements of the foreign medical school except internship and/or social service; (4) have attained a score satisfactory to the sponsoring medical school on a screening examination; and (5) have passed either the Foreign Medical Graduate Examination in the Medical Sciences, Parts I and II of the examination of the National Board of Medical Examiners (NBME), or Steps 1 and 2 of the United States Medical Licensing Examination (USMLE).


CanMEDS: A medical education framework developed by the Royal College of Physicians and Surgeons of Canada that emphasizes the essential competencies of a physician.


COMLEX: Comprehensive Osteopathic Medical Licensing Exam.


FLEX: Federation Licensing Examination.


NBOE: National Board of Osteopathic Medical Examiners.


LMCC: The Medical Council of Canada Examination.


MCCQE: Medical Council of Canada Qualifying Examination.

IV. Policy Statement

  1. General Eligibility: Applicants must meet one of the following qualifications to be eligible for appointment to ACGME-accredited residency and fellowship programs at D-H:
    • Graduates of medical schools in the United States and Canada accredited by the Liaison Committee on Medical Education (LCME) and successful completion of any pre-requisite accredited training specified by ACGME Residency Review Committees (RRC).
    • Graduates of colleges of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA) and successful completion of any pre-requisite accredited training specified by ACGME RRC’s.
    • Graduates of medical schools outside the United States and Canada who meet one of the following qualifications:
    • Hold a currently valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) prior to appointment; or,
    • Hold a full and unrestricted license to practice medicine in a US licensing jurisdiction in which they are training; and
    • Successful completion of any pre-requisite accredited training specified by ACGME RRC’s.
    • Graduates of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school and successful completion of any prerequisite accredited training.
    • For individuals who are not US citizens or permanent residents, J-1, F-1 OPT, or H-1B transfer are the sponsored Visa categories.

  2. Fellowship Eligibility: Applicants must meet the following qualifications to be eligible for appointment to ACGME-accredited fellowship programs at D-H:
    • All required clinical education for entry into ACGME-accredited fellowship programs must be completed in an ACGME-accredited core residency program, or in a Royal College of Physicians and Surgeons of Canada (RCPSC)-accredited or College of Family Physicians Canada (CFPC)-accredited core residency program located in Canada.
    • Fellowship programs must receive verification of each entering fellow’s level of competency in the required field using ACGME or CanMEDS Milestones assessments from the core residency program.
    • With the approval of the Associate Dean for Graduate Medical Education, an ACGMEaccredited fellowship program may accept an exceptionally qualified applicant, who does not satisfy the eligibility requirements listed above, but who does meet all of the following additional qualifications and conditions:
      • Assessment by the program director and fellowship selection committee of the applicant’s suitability to enter the program, based on prior training and review of the summative evaluations of training in the core specialty; and
      • Review and approval of the applicant’s exceptional qualifications by the GMEC; and
      • Satisfactory completion of the United States medical Licensing Examination (USMLE) Steps 1, 2, and 3; and
      • For an international graduate, verification of ECFMG certification; and
      • Applicants accepted by this exception must complete fellowship Milestones evaluation (for the purposes of establishment of baseline performance by the Clinical Competency Committee), conducted by the receiving fellowship program within six (6) weeks of matriculation.

        Note: Approval of fellowship applicants who do not meet normal eligibility requirements will be rare.

  3. Requirements After Match: Upon matching with a D-H program, applicants must meet all of the following requirements:
    • Consent to a criminal background check.
    • Pass a pre-employment drug screening.
    • Meet eligibility requirements to obtain and maintain a training license in the State of New Hampshire which requires demonstration of passing scores on one of the following sets of examinations:
      • USMLE Steps 1 and 2 Clinical Knowledge (CK), Clinical Skills (CS)
      • COMLEX Level 1 and 2 Cognitive Evaluation (CE), Performance Evaluation (PE)
      • NBME Parts 1 and 2
      • FLEX Parts I and II
      • NBOE Parts I and II
      • LMCC
    • Foreign medical graduates must also supply proof of ECFMG certification.
    • All fellowship applicants must demonstrate a passing score on USMLE Step 3 or COMLEX Level 3 prior to the scheduled start of their fellowship. Canadian nationals may substitute documentation of successful passing scores on LMCC/MCCQE examinations in lieu of USMLE Step 3 or COMLEX Level 3.
    • Non-citizens must have Permanent Resident Status, current Employment Authorization Card or be eligible to obtain the appropriate visa as outlined in the D-H Graduate Medical Education Visa Policy no later than the date of hire.
    • Applicant must be fully competent in written and oral English.

V. References

New Hampshire Board of Medicine: https://www.nh.gov/medicine/

Royal College of Physicians and Surgeons of Canada: http://www.royalcollege.ca/portal/page/portal/rc/public


D-H Policy ID: 11294

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