• University of Tennessee Medical Center Outside Learner/Observer Experience Registration

  • Thank you for your interest in participating as an Outside Learner/Observer at the University of Tennessee Medical Center. This is an observation only activity. Observation experiences are not available to medical students or medical residents through the UTMC Outside Learner Observer Program. Participants must review the Guidelines for Outside Learner/Observer prior to completing the below documentation. By completing the following information, outside learner/observer attests to being 18 years of age or older with high school diploma or successful GED requesting to participate at the University of Tennessee Medical Center in an educational experience or observership who is not enrolled in a health-related program through an "affiliated" educational institution.

    Note: This form should be completed before beginning the observational or educational experience and with each change of clinical area/sponsor.  If observation is extended or crosses calendar years, you will need to complete separate requests for each observation.  Requests for the upcoming year will be accepted beginning December 15th.

     If you have questions please contact:

    Kelly Rozzell, UHS Compliance Anaylist krozzell@utmck.edu

    Donna Patty, UHS Compliance Specialist dpatty@utmck.edu  

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  • Limit requested observation date to actual approved observance dates approved by the sponsoring care provided. Requests with exended dates may be delayed and require additional approval or require submission of additional Outside Learner/Observer Experience Registration form.  Research assistants and clinical liasions can request up to a maxium of six months.

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  • Vaccinations: We encourage you to be up-to-date with all recommended vaccines before you begin the observational experience. Documentation of the requested vaccines helps to ensure that observers understand our expectations to protect our patients, families and themselves. We reserve the right to request additional documentation regarding vaccination records as needed. Failure to provide documentation will result in delay or unapproved experience.

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  • Declination of influenza vaccine will require approved outside learner/observer to wear a surgical mask during observational experience for the duration of flu season (typically October 1st - March 31st).

  • COVID-19 Vaccinations:

    On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) updated their rule which establishes a COVID-19 vaccine requirement for healthcare workers in 25 states, including Tennessee. The medical center must comply with these regulations under the Medicare health and safety standards known as Conditions of Participation or Conditions for Coverage. We are required to abide by this mandate to participate in Medicare and Medicaid programs.  

    UT Medical Center is required to extend the requirements of this regulation to all students/outside learners who visit the UTMC campus. Please note that being fully vaccinated does not require having a booster shot at this point in time. 

    We are happy to offer it to you free of charge through our vaccine clinic at the link below.

    https://vaccine1.utmedicalcenter.org/

    If you have chosen not to be vaccinated against COVID-19, you can submit an exemption form to see if you are eligible for an approved exemption. These will be reviewed by a committee through a fair and confidential review process protecting health information.


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  • Links to Partner - Covid -19 Vaccination Exemption Requests - Please follow all directions to complete the process correctly to be considered for approval which can take up to 4 weeks. 

    Partner - COVID-19 Vaccination Exemption Request: Medical Exemption This is a two part process with completion of the submission and form (link inbedded) which must be signed and dated by your healthcare provided. On question #5 of the submission, select other and on question #6 identify yourself as UTMC Outside Learner/Observer. 

    Partner Covid-19 Vaccine Exemption Request: Religious/Sincerely Held Spiritual Belief This is a one part process with completion of the submission but additional supportive documentation can be provided. On question #5 of the submission, select other and on question #6 identify yourself as UTMC Outside Learner/Observer. 

     

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  • Documentation of two MMR vaccines required OR positive titers for measles, mumps and rubella.

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  • Hepatitis B vaccination history is required for any observer in patient care areas.

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  • Documentation of three Hepatitis B vaccines required OR positive HbsAB titer.

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  • We cannot accept the history of the chicken pox as an indication of Varicella immunity.

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  • Documentation of two Varicella vaccines required OR positive Varicella titer. We cannot accept the history of the Chickenpox as an indication of immunity.

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  • All submissions must be reviewed for completeness and the requested experience/dates must be confirmed with sponsoring healthcare provider.  Please allow 30 days for review. An email request will be sent to the observer to address any incomplete information. Once all information is complete and confirmation of experience is approved, an email will be sent to observer/sponsoring healthcare provider regarding next steps.

  • Distribution of Form:

    Please print 3 copies of the completed form before clicking submit button.  

     

    • Copy to be maintained in departmental file
    • Copy to Human Resources if identification badge is required
    • Copy to outside learner/observer
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