Applying for Staff Membership and Privileges
Thank you for your interest in applying for staff membership and privileges at Chandler Regional and/or Mercy Gilbert Medical Center. Below are the minimum qualifications:
- Current unrestricted license to practice medicine in Arizona and a current unrestricted DEA.
- Actively engaged in a clinical practice at least six of the past 12 months (residency/fellowship or private practice).
- Actively practiced in a hospital for at least two of the past five years (full-time clinical residency/fellowship is equivalent)
- Board certified or be eligible to enter the certification examination system in accordance with the training and/or experience requirements defined by the applicable certifying board. The certifying board must be one of the following:
The physician must achieve board certification within seven years of completing residency/fellowship training, unless otherwise required by the Medical Staff. Departments requiring board certification in under seven years include Anesthesia (4), Cardiovascular (5), Emergency Medicine (3), and Surgery (5).
- Member board of the American Board of Medical Specialties (ABMS)
- Member board of the American Osteopathic Association
- The American Board of Podiatric Surgery
- The American Board of Oral & Maxillofacial Surgery
- Certification by the Royal College of Physicians and Surgeons of Canada will be accepted in the following circumstances:
(a) The applicable ABMS specialty board recognizes the Canadian post-graduate training as equivalent to the ACGME post-graduate training (i.e. the ABMS specialty board accepts Canadian trained physicians for entrance into the ABMS certification exam process).
(b) Medical Staff has approved acceptance of Canadian boards for department members. Such board status (eligible or certified) must be in the primary specialty for which privileges are sought (sub-specialty certification requirements will be determined at the department level).
- 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).
- Residence and office location sufficiently close to the hospital(s) to provide continuous patient care.
- Verification of all information provided on the application.
- Evaluation of at least three references from physicians who are familiar with your current skills and competence.
- Review of information from your malpractice insurance carriers regarding claims, suits and settlements.
- Evaluation of information from other hospitals and health care facilities with which you are now or have been affiliated.
- A query to the National Practitioner Data Bank.
- Information regarding Medicare/Medicaid or other governmental payor program sanctions or OIG exclusions.
- If deemed appropriate, an interview with the Credentials Committee or the Chairman of the Department in which you request privileges.
Please complete the Initial Application and return it with all required documents within 30 days. Upon review, we'll notify you in writing whether you meet the minimum qualifications. 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:
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) 728-7162.
Guadalupe Mendoza, CPCS, CPMSM
Manager, Credentials Verification Office
DHAzCVO / Medical Staff Services
Chandler Regional and Mercy Gilbert Medical Centers
Please note: We do not recommend that you send sensitive information via email.