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resident/fellow/rotator requirements
resident/fellow information formmedical and immunization historyconfidentiality statement

All rotations must be arranged directly with the resident coordinator for the appropriate department. Once you have received approval to do a rotation at Advocate Lutheran General Hospital (ALGH), the following three forms must be completed and returned to the approving department a minimum of four weeks prior to the start of your rotation. The completed forms can be returned by fax (refer to table below) or mailed to ALGH, Attn: (refer to table below), 1775 Dempster, Park Ridge, IL 60068. We recommend you follow-up with the appropriate coordinator to ensure your paperwork has been received and is being processed. If your forms are not received a minimum of four weeks prior to your rotation, YOUR START DATE WILL BE DELAYED.

  1. Resident/Fellow Information Form (RFIF) -This form must be completed in its entirety for EVERY rotation scheduled at ALGH.
  2. Medical and Immunization History Form - ALGH needs to have your most current TB information on file at all time. If your school does not provide you with a medical history listing, please fill out this form completely and have it signed by an RN or Physician. You must have an updated TB test every 12 months. If your TB test expires during your rotation, you can renew the test at ALGH. If your TB skin test is positive, proof of a clear chest x-ray or medical clearance is required.
  3. Confidentiality Statement - This statement must accompany the MSIF for EVERY rotation scheduled here at ALGH.

If any of the above mentioned forms are not received in the required time frame, you will NOT BE ALLOWED to start your rotation.

Orientation start times vary for every department. Please contact the appropriate coordinator listed below for the date and start time of your orientation. (Area Code 847).

Department

Location

Coordinator

Fax

Phone Number

 Anesthesiology

 8 South

Eve Gorski

 696.3394

 723.5524

 Internal Medicine

 6 South

Mary Jane Mangan

 723.3390

723.5871

 Ob/Gyne

 4 South

Pamela Newford

 723.1685

723.8404

 Pediatrics

 2 South

Judy Fregetto

 723.2325

 723.5986

 Psychiatry

 8 South

Heather Kempisty

 723.7312

 723.5884

 Surgery

 8 South 

Eve Gorski

 696.3394

 723.5191

The Medical Education Office is located on the 8th floor of the South Pavilion. Should you have any further questions, please contact Jen Enger at phone 847.723.8077, fax 847.696.3389, or e-mail Jennifer.Enger@advocatehealth.com.


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