Senior Fellow/Acting Instructor appointment process for Urology sub-specialty fellows in the following programs:

• Andrology
• Endourology
• Genitourinary Reconstructive Trauma & Reconstruction
• Pediatric Urology (second year)
• Urologic Oncology

Medical Staff Appointment/Credentialing

The Office of Medical Staff Appointments (OMSA) will contact you via email with a link to an online application and their required forms. Their email address is omsa@uw.edu. Please review the sample Washington Practitioner Application Form (WPA-2011.doc), which is a standard form used by all healthcare organizations in Washington State. Use this form as a reference to prepare for the online application.

Please note although your practice may be based at other hospitals, your medical staff appointment will include the UW Medical Center. OMSA manages the credentialing for both UW Medical Center and Harborview Medical Center and it is regular practice for them to credential our faculty for all organizations at the same time.

Academic/Faculty Appointment

Please upload the following documents:

1. UW School of Medicine Format for Curriculum Vitae
2. University Biography Form
3. Personal Data Form
4. Washington State Patrol Form
5. UW Criminal Conviction and Civil Finding History Self-Disclosure Questionnaire
6. UWP Member Practice Agreement

In addition, please enter the contact information for your letter writers to request the confidential letters of recomendation . They can be the same individuals who wrote letters during the application process.