1. INDIAN HEALTH SERVICE www.ihs.gov/scholarship IHS Scholarship Program Health Professions Scholarship Recipient Orientation Deferment and Service Obligation

2. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship IHS Scholarship Program Agenda  Deferment of Your Service Obligation  Fulfilling Your Service Obligation  Breach of Contract and Default  Additional Information

3. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation

4. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Purpose To allow Health Professions scholarship recipients in identified health profession degree programs the opportunity to complete required or optional post-graduate clinical training programs to fulfill the requirements for board certification or licensure.

5. INDIAN HEALTH SERVICE Deferment of Your Service Obligation Eligible Degree Programs Required Training  Medicine  Clinical Psychology  Social Work  Dietetics Optional Training  Dentistry  Nursing  Optometry  Pharmacy http://www.ihs.gov/scholarship

6. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Medicine Eligible Residencies Three-Year Deferment:  Emergency Medicine  Family Practice  General Internal Medicine  General Pediatrics

7. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Medicine Eligible Residencies Four-Year Deferment:  Family Practice/Psychiatry  General Psychiatry  Internal Medicine/Family Practice  Internal Medicine/Pediatrics  Internal Medicine/Psychiatry  Obstetrics/Gynecology

8. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Medicine Eligible Residencies Five-Year Deferment:  Anesthesiology  General Surgery

9. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Clinical Psychology  A training position must be secured within 90 days of graduation.  The maximum deferment period is two years.  State licensing boards require that graduate psychologists practice under the supervision of a licensed clinical psychologist for a specified number of hours (usually 2,000) before they are eligible to take the state exam.

10. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Clinical Psychology  All supervised work must be completed and a license obtained within those two years.  You must complete a PhD or PsyD program and become an independent, licensed clinical psychologist before any service will count toward your service obligation.

11. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Social Work  You must secure a training position within 90 days of graduation.  The maximum deferment period is two years.  State licensing boards require graduate social workers to practice under the supervision of a licensed clinical social worker/psychologist for a specified number of hours (usually 2,000) before they are eligible to take the state exam.

12. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Social Work  You must complete all supervised work and obtain a license within those two years.  You must complete a master’s degree program and become an independent, licensed clinical social worker before any service will count toward your service obligation.

13. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Dietetics  You must secure a training position within 90 days of graduation.  The maximum deferment period is one year.  The American Dietetic Association (ADA) requires dietitians to complete a 900-hour ADA-approved internship under the supervision of an RD before they are able to take the ADA registration exam.

14. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Dietetics  You must complete all supervised work and become a registered dietitian within one year.  You must complete a bachelor’s degree program and become a registered dietitian before any service will count toward your service obligation.

15. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Dentistry  You must secure a training position within 90 days of graduation.  The maximum deferment period is one year.  You must complete a one-year Advanced Education Program in General Dentistry (AEGD) or General Practice Residency (GPR).  Only programs that are fully operational with the ADA CODA accreditation status are permitted.

16. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Nursing  You must secure a training position within 90 days of graduation.  The maximum deferment period is one year.  The training program must emphasize clinical out-patient (OPD), in-patient (IPD) and/or emergency (ERD) nursing skills (example: Montana American Indian Nurse Internship program [MAINI]).

17. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Optometry  You must secure a training position within 90 days of graduation.  The maximum deferment period is one year.  You must enroll in Ocular Disease/Pathology and Primary Care Optometry residency programs only.  Consult the IHS Discipline Chief for Optometry prior to applying to a residency program.

18. INDIAN HEALTH SERVICE http://www.ihs.gov/scholarship Deferment of Your Service Obligation Program Policies — Pharmacy  You must secure a training position within 90 days of graduation.  The maximum deferment period is one year.  You must complete a one-year American Society of Health-System Pharmacists (ASHP) or American Pharmacists Association (APhA) accredited Post-Graduate Year One (PGY 1) Pharmacy Residency Program (Hospital, Community or Managed Care only).

19. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Deferment of Your Service Obligation Required Forms Prior to Training  Request for Approval of Deferment (IHS-856-11) Submit to your IHS Scholarship Program Analyst prior to your final year of academic training. List post-graduate clinical training program(s) to which you will be applying. Receive approval for the program(s) from your IHS Scholarship Program Analyst.

20. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Deferment of Your Service Obligation Required Forms Prior to Training  Notification of Deferment Program (IHS-856-14) Submit by May 31 of your final year of academic training. Notify your analyst of the post-graduate clinical training program in which you have been accepted and intend to begin your training. The Request for Approval of Deferment form, submitted at the beginning of the academic year, must list that clinical training program.

21. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Deferment of Your Service Obligation Required Forms and Documentation During Training  Notification of Deferment Program (IHS-856-14) Submit annually until the approved deferment period is complete.  Letter of Good Standing Submit annually until the approved deferment period is complete. The Director or Coordinator must sign this letter.

22. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation

23. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Program Policies All recipients scheduled to graduate or complete post-graduate clinical training must:  Provide one year of service for each year of scholarship support received, with a two-year minimum service period.  Apply for available job vacancies in their chosen health profession.  Find a position at a facility within 90 days of graduation or completion of training.

24. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Program Policies  Engage in full-time clinical practice 80 hours/two weeks — with a minimum of 64 hours providing direct inpatient or outpatient care.  Spend no more than seven weeks, or 35 workdays, per service year away from the practice.

25. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Eligible Service Sites  Indian Health Service program  Tribal health program  Urban Indian health program

26. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Eligible Service Sites  Private practice: Option for physicians, dentists and clinical psychologists only. Must be in a designated Health Profession Shortage Area (HPSA) in which at least 75% of the patient base from that geographic area are documented members or descendents of federally or state-recognized Tribes. Only available when there are no identified vacancies in an Indian, Tribal or Urban Indian health program. Final approval of this option is at the discretion of the Director, IHS.

27. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Career Paths  Federal civil service  Direct Tribal hire  USPHS Commissioned Corps

28. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Job Search  Begin your job search three to six months prior to graduation or completion of post-graduate clinical training.

29. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Job Search  Submit the following forms and documentation to the ASCs in the IHS Areas where you would like to work at least three months prior to graduation: Optional Application for Federal Employment (Optional Form-612) Preferred Placement (IHS-856-12) Verification of Indian Preference for Employment in the Bureau of Indian Affairs and the Indian Health Service (Form BIA-4432)

30. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Job Search  One month before graduation you must: Send a Notice of Impending Graduation (IHS-856-13) to your IHS Scholarship Program analyst. Follow up with each respective ASC and IHS Discipline Chief regarding available vacancies and application status if you have not yet selected a job. Prepare for licensure, if applicable.

31. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Job Search You must submit the following form if you are unsuccessful in securing employment prior to graduation or completion of post-graduate clinical training.  Placement Update (IHS-856-15) Submit 30, 60 and 90 days after graduation or completion of post-graduate clinical training. Attach documentation of attempts to secure employment (for example, letter of application, interview dates, denial letters, etc.).

32. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Job Search You will be subject to involuntary placement if you do not secure employment after 90 days of graduation or completion of post-graduate clinical training.

33. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Offer of Employment The IHS Scholarship Program must approve your service site and position prior to employment. The service site must submit a written document identifying:  Whether the site is an IHS program, Tribal program, Urban Indian program or private practice.  The clinical position that you will fill.  Whether the clinical position is full time or part time.  If the services you will provide are included in an IHS Contract or Compact under which you will serve authorized patients.

34. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Documentation Requirements — Graduation The following documentation is required upon graduation or completion of post-graduate clinical training:  A copy of your diploma.  An official final transcript stating the degree conferred.  A copy of your license or certificate (if required for employment).

35. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Documentation Requirements — Verification of Employment The following documentation is required to verify your employment status: Civil Service  A copy of your Notification of Personnel Action form (SF-50) from your personnel office reflecting your entrance on duty date.

36. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Documentation Requirements — Verification of Employment Tribal Program  A contract, work agreement or hire letter from the Tribe indicating the start date of employment.

37. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Documentation Requirements — Verification of Employment Commissioned Corps  A copy of your Call-to-Active-Duty notice (CAD).

38. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Documentation Requirements — Verification of Employment Private Practice  A contract, work agreement or hire letter from the facility indicating the: Start date of employment. Position title. Position description. Terms of employment and benefits.

39. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Documentation Requirements — During Your Service Obligation The following documentation is due annually until your service obligation is completed:  Annual Status Report (IHS-856-16)  Combined leave report Your local Human Resources department will provide this report. Note: Private practice clinicians must also provide quarterly reports documenting the practice’s user population of American Indians and Alaska Natives vs. non-Indian and Alaska Native.

40. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Fulfilling Your Service Obligation Other Notifications You are also required to notify the IHS Scholarship Program if there are any interruptions in your service obligation due to:  Maternity leave.  Extended sick leave.  Disability or family-friendly leave.  Outside training exceeding 10 days per a 12-month period.  Breaks in service related to a change of work site.  Any other extended time away from work.

41. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Breach of Contract and Default

42. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Breach of Contract and Default You will be in breach of your IHS Scholarship Contract and placed in default if you:  Pursue an unapproved post-graduate clinical training program.  Fail to serve within the health profession for which you received financial aid.

43. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Breach of Contract and Default Liability Recipients who complete their degree and pursue an unapproved post-graduate clinical training program or fail to serve in their chosen health profession will be liable to:  Repay three times the amount of scholarship funding plus interest.  Repay the scholarship funds plus interest within one year of the default date.

44. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Additional Information

45. INDIAN HEALTH SERVICE www.ihs.gov/scholarship Additional Information For assistance contact: IHS Scholarship Program Analyst — (301) 443-6197 Area Scholarship Coordinator — http://www.ihs.gov/scholarship/ IHS Discipline Chiefs — http://www.ihs.gov/scholarship/ IHS Recruitment Office — (301) 443-2443 For additional information: Visit http://www.ihs.gov/scholarship/ or consult your Student Handbook.