Transitioning from Training to Practice
Welcome to the next phase of your NHSC journey! Before you graduate, the NHSC will send you timely information and helpful resources to help you identify an NHSC-approved site where you will complete your service commitment. You are encouraged to download and read the NHSC Scholar Orientation and Employment Search Guide, which highlights key deadlines, HPSA requirements, and travel and relocation costs that are covered by NHSC. You will also receive information that will enable you to defer your service commitment until you have completed an approved residency or other postgraduate training.
NHSC- Approved Sites & HPSA Requirements
You must work at an NHSC-approved site that fulfills the minimum Health Professional Shortage Area (HPSA) score for your class year. Please refer to the chart below.
HPSA Score Requirements by Class Year*
|NHSC Scholarship Program
(all disciplines – MD/DO, PA, NP, DDS/DMD, CNM)
*A class year runs October 1 – September 30 and is based on your ‘Available for Service’ date.
Additional information on selecting a site can be found in these helpful resources:
Identifying Job Opportunities
You will have the opportunity to identify open positions located at NHSC-approved sites in high-need areas that are right for you and your family. It is your responsibility to select sites that appeal to you and interview with them. Check out these helpful tools during your site search:
- Health Workforce Connector – includes open positions and information on NHSC-approved sites. You can narrow your search based on location, discipline, specialty, HPSA score, or site name. You should also contact NHSC-approved sites directly to inquire about open positions that might not be listed in the NHSC Jobs Center.
- NHSC Virtual Job Fairs – allow you to experience an interactive recruitment event from the comfort of your own home. Learn about the exciting job opportunities that are available at NHSC-approved sites across the country and interact with NHSC site administrators to gain key insights about populations served, employment benefits, advantages of working with interdisciplinary teams, and the unique communities.
Visiting and Interviewing at NHSC Sites
Once you have identified current NHSC-eligible jobs of interest, contact those sites and work your Regional Advisor to verify the HPSA score. If you are selected for an interview, the NHSC will coordinate and cover up to $1,200 in allowable site visit interview travel costs. Before you interview, check out some of these tip sheets to help you determine what site works for you.
- Choosing an NHSC Site (PDF - 471 KB)
- Finding a Site ... a Community ... a Home (PDF - 332 KB)
- Top 10 Interviewing Tips (PDF - 333 KB)
Once you have received a job offer from an NHSC-approved site where you want to fulfill your service commitment, you must upload the following documents to your Customer Service Portal account:
- Results of Your Final Professional Exam (e.g. USMLE or COMLEX Step/Level 3, PANCE)
- Unrestricted State License in the State that You will Practice (unless it is a Federal Prison, Indian Health Service Site, or an Immigration and Customs Enforcement Site)
- Copy of Your Job Offer Letter
- Copy of Your Acceptance Letter
If you live within 50 miles of your new job location, you are NOT eligible for NHSC-supported relocation services. Once you have accepted a job and submitted all four NHSC required documents, you are ready to actively plan a move to your new location. The NHSC provides assistance for your initial relocation; it does not provide any relocation support for additional transfers, or moves, beyond your first NHSC-approved site.
In the spring of the year of graduation, and each subsequent year of residency training, all physicians and dentists pursuing approved postgraduate training must request deferments to postpone their required NHSC service commitment until they have completed their specialized training. Review the Postgraduate Training Bulletin for additional details.
To request a deferment of service in order to attend a residency program or fellowship, you must submit a deferment request through the Customer Service Portal each year. Those eligible to defer the service obligation (MD, DO, DDS, and DMD students) will receive information on deferment during the last year of medical or dental school and will be notified when the deferment request must be submitted. If you do not submit a Deferment Request each year of residency training or fellowship, you may be considered to be in default of the NHSC service obligation and subject to penalties.
Physicians (MD or DO) must complete a residency training program in one of the primary care specialties:
• Family Practice (3 years )
• Internal Medicine (3 years)
• Pediatrics (3 years)
• Obstetrics-Gynecology (4 years)
• Psychiatry (4 years )
• Internal Medicine/Family Practice (4 years)
• Internal Medicine/Pediatrics (4 years)
New deferments will not be granted for dual residencies other than internal medicine/family practice and internal medicine/pediatrics.
One-year osteopathic internships may be approved for deferment. If you plan to pursue this internship year, please provide a letter from your training program stating that the internship is for one year and is prior to entering residency training. Upon completion of the year internship, osteopathic physicians are required to enter and complete a residency program in one of the approved specialties.
Fellowships may be approved for deferment:
• Child Psychiatry following Psychiatry (2 years)
• Obstetrics/Gynecology following Family Practice (1 year)
• Geriatrics following Family Practice or Internal Medicine (1 year)
The NHSC does not provide financial support (e.g., stipend, training expenses, etc.) while you are in postgraduate training. Physicians will be in default of the NHSC contract and liable to pay penalties if they:
• Do not enter an approved postgraduate training program
• Enter an unapproved postgraduate training program
• Do not complete the approved postgraduate training
NHSC requires all physicians to pass all three parts of the medical licensing examination (USMLE or COMLEX) prior to completing their last year of training, so that service can commence immediately upon completion of approved postgraduate training. It is your responsibility to select a residency program that will adequately prepare you to sit for the USMLE or COMLEX and obtain the appropriate license to practice in the United States. You must notify the NHSC when you have successfully completed all three parts of the medical training examinations.
Dentists are not required to, but may elect to participate in, postgraduate training in:
• General Practice Dentistry (1 year)
• Advanced Education in General Dentistry (1 year)
• General Pediatric Dentistry (2 years)
• Public Health Dentistry (2 years)
If you decide not to participate in postgraduate training, you must begin service as a general practice dentist within 6 months of your graduation from dental school. If you do pursue postgraduate training, you must notify the NHSC in the spring of your final year of dental school and then also submit a Deferment Request.
NHSC will not provide financial support (e.g., stipend, training expenses, board exam fees) while you are in an approved postgraduate dental training program.
Dentists will be in default of the NHSC contract and liable to penalties, if they fail to either begin service as a general dentist at an NHSC-approved site within 6 months of graduation or do not receive an approved deferment for postgraduate training after graduation from dental school.
You are expected to take the appropriate exams at the earliest possible date. The NHSC requires all dentists to pass both parts of the National Board Dental Examination (NBDE Parts 1 and 2) prior to completing their last year of dental school or approved postgraduate training so that service can commence immediately upon completion.
To assure that dentists will have licensure in states with the greatest dental needs, NHSC reserves the right to determine which Regional or State clinical licensing exam you should take and pass prior to your service start date.
When to Notify the NHSC
After the NHSC has approved your deferment request, please notify us via the Customer Service Portal if you:
- Do not obtain a position in the postgraduate training program that the NHSC has approved
- Change your address
- Plan to switch residency programs
- Plan to suspend training for maternity leave or other medical or personal reason