Nationwide Children's Hospital: GME Application - Nationwide Children's Hospital
Welcome to the GME Application & Certification form

Purpose of this form 
Programs sending residents to Nationwide Children's Hospital must submit a Graduate Medical Education application and certification form for each resident requesting a rotation. Please follow the instructions below and complete the form. If you have questions, please contact Elizabeth Nortz.

What you will need prior to starting 
  • Personal information: Name, address, phone, pager, email address, birth date, etc.
  • Graduation information: Month, year, institution, degree
  • If known: NPI, DEA, Ohio Medical License
  • Post graduate training history: Dates, specialty, institution
  • International graduates: ECFMG certificate (you will need to attach this to an email later, as a Word or PDF document)

Timeout Feature - IMPORTANT! 
This form has a 20 minute timeout. This means that if 20 minutes pass without clicking a button, you will be timed out and lose your information.

Form Security 
This form is secured in the following methods:
  • SSL encryption: The data from your application is transmitted encrypted to our server.
  • Data encryption: Certain fields such as your Social Security Number are further encrypted prior to being saved in the database.
  • Firewall: Your information from this application is removed daily to a database behind our firewall. Encrypted fields remain encrypted.

GME Application 

Please access our GME application using one of the supported web browsers: Mozilla Firefox or Google Chrome. You may not be able to submit your application using Internet Explorer.

If you have questions, please contact Elizabeth Nortz.

Start the application

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000