Thank you for your interest in applying for staff membership and privileges at Chandler Regional Medical Center (CRMC) and/or Mercy Gilbert Medical Center (MGMC).  Please indicate on the enclosed Pre-Application whether you will be applying at Chandler Regional Medical Center or Mercy Gilbert Medical Center, or both. 

The following are pre-requisites for receiving an application for Medical Staff appointment:

1. Current unrestricted license to practice medicine in Arizona and a current unrestricted DEA.
2. Actively engaged in a clinical practice at least 6 of the past 12 months (residency/fellowship or private practice).
3. Actively practiced in a hospital for at least two of the past five years (full-time clinical residency/fellowship is equivalent).
4. Board certified OR an "active board candidate" for less than 7 years after completion of residency, in the specialty for which privileges are sought (must be a board approved by the American Board of Medical Specialties, the American Osteopathic Association, or American Board of Podiatric Surgery), or have completed at least one year of a hospital based residency approved by the American Dental Association for dentists.  Please be aware that these are the minimum qualifications for staff appointment, and individual departments may have more stringent requirements.
5. Professional liability insurance in the minimum amount of $1,000,000/$3,000,000 with a carrier acceptable to the Board of Directors (i.e. financial rating:  AM Best - B+ or better and Standard and Poors - BBB or better).
6. Residence and office location sufficiently close to the hospital(s) to provide continuous patient care.

Please complete the enclosed Pre-Application Questionnaire & Intended Practice Plan in its entirety and return it with copies of all required documents within 20 days.  After review of the form, we will notify you in writing whether you meet the minimum qualifications and if so, you will be provided with an application.  If you do not meet the qualifications, you will be so advised and given the opportunity to provide additional information.  Upon receipt of a completed application (including any supplemental information requested), the investigation and review of your application will include at least the following:

1. Verification of all information provided on the application.
2. Evaluation of at least three references from physicians who are familiar with your current skills and competence.
3. Review of information from your malpractice insurance carriers regarding claims, suits and settlements.
4. Evaluation of information from other hospitals and health care facilities with which you are now or have been affiliated.
5. A query to the National Practitioner Data Bank and the Federation of State Medical Boards.
6. If deemed appropriate, an interview with the Credentials Committee or the Chairman of the Department in which you request privileges.

If I can be of assistance or if you have any questions regarding the application process, please don't hesitate to contact me at 480-728-7160.

Sincerely,

Leilani Wilson, CPCS
Supervisor, Credentials Verification Office
Medical Staff Services
Mercy Gilbert Medical Center/Chandler Regional Hospital
leilani.wilson@chw.edu