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Departmental Internship/Externship/Affiliating School
Contact: Tracie Wildner, Professional Development Advisor
Office: Jacobsen Hall, Room 417
Phone: 315 464-6125
Email: email@example.com (Non-Patient Care Internships)
Individuals requesting an internship/externship at Upstate Medical University are responsible for directly contacting the department where they would like to intern/extern. Please visit our Building Locations and Directions webpage for locations and contact information - click the link next to the building for Map, directions, and building directory and choose the directory tab at the top of the map.
Upon receiving an internship/externship request, the department interested in sponsoring the job shadowing individual will need to verify with the Upstate Contracts Office that an affiliation agreement/contract between the individual's school and Upstate Medical University exists. If an affiliation agreement/contract exists, the individual may intern/extern pursuant to the affiliation agreement. (If there is NOT an affiliation agreement/contract in place, the individual/the individual's school will need to request one through Upstate's Contracts Office.)
The sponsoring department is responsible for initiating the non-employee request within Self Serve (Instructions) and ensuring all required education/forms are completed, health clearance is received, and an ID badge is issued prior to beginning their internship/externship. The sponsoring department is also responsible for entering the completed education into Self Serve Tracker and maintaining all required forms on file within the department. If the department is not able to enter into Self Serve Tracker, a COPY of the completed forms should be sent to OTD, JH Rm 417 or fax 4-4400, for entry.
Required Education/Forms (Return all completed forms to the department/person sponsoring your internship/extrernship)
- Confidentiality Agreement
- HIPAA Privacy Rule Education and Completion Certificate
- Non-Employee Orientation Guide and Completion Certificate
Health Statements (Return completed health form to Employee/Student Health for clearance)
ID BadgeAll requests for non-employee must be submitted electronically via Self Serve AND each request must be reviewed (and cleared or waived of clearance requirement) by Employee Health. Once a request for a non-employee is submitted the manager of the department sponsoring the intern/extern will be instructed via e-mail from Employee Health to advise when the non-employee should report to Employee Health and when he/she is free to visit Payroll for badging. We appreciate your support in our full compliance of this Department of Health requirement.
* Individuals interning/externing a Pediatric In-Patient Child Life Specialist OR in OB/GYN must be at least 18 years of age*