Master Service Agreement

This Master Service Agreement (hereinafter “Agreement” or “Enrollment Agreement”) is made and entered into effective as of the %DAY% day of %MONTH%, %YEAR%, by and between AmeriClerkships Medical Society, Inc., a California corporation, (hereinafter “AMS”) and %MEMBERNAME%, at IP Address %IPADDRESS% with confirmation number %CONFNUMBER%, a client (hereinafter “Member”) (AMS and Member are individually referred to herein as “Party” and collectively as the “Parties”).

Recitals

WHEREAS, Member is a pre-health students, current healthcare students, healthcare graduates, or current healthcare workers (individually and collectively referred to herein as “Members”);

WHEREAS, AMS is an independent membership driven entity designed to assist its Members with understanding and navigating the U.S. healthcare system through various consultative and placement services; AMS places its Members within affiliated clinical sites for the purpose of obtaining insured U.S. clinical learning experiences meant to improve knowledge and/or patient communication skills (hereinafter “Clinicals” or “Clinical Blocks”);

WHEREAS, Member and AMS desire to enter into and engage in the Agreement subject to the terms and conditions hereinafter set forth; and

NOW, THEREFORE, for and in consideration of the promises and covenants contained herein, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows:

Scope of Services:  AMS agrees, pursuant to the terms and conditions contained herein, to place Member within affiliated Clinical Blocks. Other AMS services may include, but are not limited to, personal consultation and evidence-based strategy sessions for healthcare college and residency entry, various review and revision of healthcare job related documents, interview preparation, as well as personalized work rehabilitation of former residents and physicians who desire to return to residency and medical practice, if deemed appropriate and applicable by AMS; some of these are services that may vary with different membership levels or different Member categories. Member attests that he/she is over the legal age of 18 at the time of digitally signing this Agreement, and acknowledges that AMS has entered into this binding Agreement only with the individual who digitally signed this Agreement; as such, AMS is under no obligation to discuss the details of a Member’s account or this Agreement with any person other than the individual who has entered into this Agreement. AMS is not a law firm and does not provide any legal advice.

Compliance with Policies and Procedures of AMS & Each Clinical Site: The Member represents, covenants, and agrees that as AMS has agreed to assist with access to various clinical settings, the Member must follow all applicable policies and procedures, which may be specific to each clinical site and state, and it is the Member’s personal responsibility to identify and adhere to these policies and procedures. The Member hereby affirms that all questions regarding the clinical setting have been answered fully and that the Member has read the Frequent Questions page and legal disclaimer on https://acmedical.org/legal, as well as the AMS Commitment to Clarity which is located on https://www.acmedical.org/2017/01/clarity/, all of which are incorporated herein this Agreement by this reference as of the date of this Agreement.

Accredited Education & Approved Sponsorship: For hands-on clinical experiences, the Member warrants and represents that the healthcare school in which he/she is enrolled, or has graduated from, is an accredited institution of higher education recognized by the U.S. Department of Education. For observerships or research experiences, the Member must be employed or sponsored by a pre-approved vendor.  Exceptions to this policy may be made in writing by AMS, and on a case by case basis.

AMS Orientations & Pre-Clinical Quizzes: Member agrees to watch and pass the quizzes associated with the AMS Clinical Orientation Video (YouTube), AMS Health Insurance Portability and Accountability Act (hereinafter “HIPAA”) Orientation Video, Occupational Safety and Health Administration (hereinafter “OSHA”) write-up and quiz, Universal Precautions (hereinafter “UP”) write-up and quiz, as well as passing any other associated Certification Tests prior to the start of his/her first Clinical Block with an AMS affiliated clinical site.  Links to the above will be shared with Members immediately following their AMS enrollment. Failure to pass these tests will delay a becoming Fully Enrolled Certified, which may delay Start Dates and cause the Member to incur expedited processing or schedule change fees.

Compliance & Avoiding the Practice of Medicine Without a License: Each Member is responsible for staying current with the policies and procedures of each applicable state regulatory agency for future practice and licensure, including what each such state constitutes the practice of medicine without a license.  Member agrees not to engage in any practice, act or omission that can be construed as practicing medicine without a license according to the relevant regulations.  As such, please note the following:

1. AMS is a placement agency and a career development firm; in addition to receiving career development services such as document revision and interview preparation, Member has contracted with AMS to be placed with licensed providers who may accept and provide Member with clinical experience in the United States;
2. During AMS Clinical Blocks, Member agrees not to engage in the practice of medicine with or without the use of medication (such as behavioral therapy, or providing a diagnosis, prognosis or interpreting lab data), as defined by relevant state and federal regulatory agencies.  Member must refrain from representing Member as a physician, and Member must not use any title, degree or credential initials, or any other designation that could be construed as defining Member’s role as that of a physician.   Member must not accept any compensation for Member’s activities during any AMS Clinical Block.  Member must not engage in any activity prohibited by relevant state and federal regulatory agencies.  Practicing medicine without a license is strictly prohibited, and may be punishable by criminal and civil law. AMS is not liable for any damages or liability as a result of Member participating in an act or omission that constitutes a prohibited activity;
3. The goals and objectives will vary depending on the type of Clinical Block Member is enrolled in (Student or Observer; https://www.acmedical.org/whattoexpect/), but in all cases patients may mistakenly view Member as their healthcare provider, in addition to their regular physician, if Member fails to accurately address any miscommunications in that regard; therefore it is Member’s duty and obligation to ensure that it is clearly communicated with each patient the Member’s status as a Student or Observer, as authorized by the Member’s AMS enrollment;
4. Member must not practice medicine without a license, with or without the use of medication (such as behavioral therapy, or providing a diagnosis, prognosis or interpreting lab data).  Member must, at all times, be under the DIRECT (seeing and hearing distance) supervision of an AMS assigned supervising physician. It is the Member’s responsibility to inform AMS of a change in supervising attending physician (for whatever reason), so that AMS may take the necessary steps to ensure that this new supervising attending physician will be recognized by AMS, and covered by AMS insurance carriers.
5. Member may not, under any circumstance perform invasive physical exams (such as breast, genital or rectal exams).  Member may not perform any invasive procedures, defined as any procedure, test, therapy or surgery that involves puncturing the skin or muscle or into a vein or artery, such as starting an intravenous line, performing cardiac catheterization, injections, inserting central lines, or any other procedure that may pose a risk to patient;
6. Member may not give or receive payment(s), or gift(s), or services, or favors, or consideration of any kind, or any sort of remuneration to or from a supervising physician, or the clinical site, or anyone associated with the clinical site at any time.
7. PLEASE TAKE NOTICE THAT ANY DEVIATION FROM THE ABOVE OR ANY BREACH OF THIS AGREEMENT WILL NULLIFY A MEMBER’S PROFESSIONAL MEDICAL LIABILITY INSURANCE WITH AMS.

Professional Medical Liability Insurance:  Member acknowledges that he/she is strictly liable for the outcome of any and all actions that may result from any activity which is outside the scope of this Agreement.  Furthermore, Member acknowledges that neither AMS nor its insurance providers or insurance agents or affiliated attending physicians have any liability to provide medical liability coverage for any portion of Clinicals, if it is determined that any of the documents, agreements, or information provided to AMS is anything but the truth, or if it is determined that the Member has deviated from the established policies of AMS, as communicated with each Member by way of the Agreement, its websites or notification emails.  As highlighted above, any Clinical Block that is not authorized by AMS, or a Member’s misrepresentation of their membership status will constitute a breach of contract, and the nullification of medical liability insurance for all unauthorized Clinical Blocks.  In such case, Member will be the sole party responsible for any and all malpractice suits and liabilities arising out of Member participation in such Clinical Block(s), including tail coverage.  If while enrolled with AMS, Member is found to have engaged in any activities that can be construed as the practice of medicine by relevant state and federal regulatory agencies, gives health related advice or interacts with patients without direct supervision of an attending physician, this Agreement, the member’s AMS membership, and any medical malpractice provided by AMS or its agents will be terminated. Insurance deductible fees and tail coverage fees (if any), will be paid by the Member. This insurance will remain in place until such time that AMS stays with the same carrier. 

Zero Tolerance Policy:  Members hereby agree that he/she will be professional at all times, and WILL NOT contact any “clinical site or hospital or physician” (or their representatives; affiliated with AMS or not) whom AMS introduces the Member to, unless expressly permitted to do so in writing by AMS. Any and all clinical inquiries, such as request for clinical site processing, start and end details, contact information, changes, orientations, check-in/check-out process, request for clinical evaluations, or any other matter that pertains to a Member’s clinical enrollment must be made directly and solely through AMS. Additionally, Member agrees to abide by confidentiality laws which prohibit the sharing of contact information of any clinical site or hospital or physician (or their representatives; affiliated or not) with any person or entity except for medical residency programs to which the Member is applying to. Member acknowledges this paragraph as his/her FIRST AND FINAL WARNING, even if the Member has already begun their Clinicals with AMS. Member acknowledges that any breach of this Zero Tolerance Policy will be grounds for immediate and permanent dismissal from AMS and its affiliated clinical sites without consideration for a credit or refund.

Infection Control: Member hereby represents and affirms that he/she does not have an infectious disease or a contagious health problem that might or could risk any person’s health at clinical sites. Member agrees to immediately notify his/her supervising physician (“Attending Physician”) and AMS if he/she contracts or becomes aware that he/she has a health problem that might or could put at risk a patient’s or employee’s health.  Member agrees to provide AMS with documentation of negative status for various infectious diseases, which may from time to time be necessary at the discretion of AMS.

Protected Health Information & Patient Confidentiality. Member agrees to comply with the Administrative Simplification provisions of HIPAA of 1996 and regulations issued pursuant thereto.  Member shall not disclose to any third party, except where permitted or required by law or where such disclosure is expressly approved by AMS in writing, any patient or medical record information regarding any patients.  The Member shall comply with all federal and state laws and regulations, and all rules, regulations, and policies of AMS and any applicable clinical site regarding the confidentiality of such information, including, but not limited to, the Health Insurance Portability and Accountability Act (HIPAA) (45 C.F.R. Part 160, et seq.), the Confidentiality of Alcohol and Drug Abuse Patient Records regulations (42 C.F.R. Part 2), and the California Confidentiality of Medical Information Act (California Civil Code section 56 et seq.), as amended from time to time.

1. Uses and Disclosures of Protected Health Information (PHI): Member will not repeat or share confidential (private) patient information as required by related state and federal laws, including patient name, health related information or any patient specific information. Member will only make known this information as allowed by law.  From and after the Privacy Compliance Date, Member shall Use and Disclose PHI only as necessary to perform its obligations under this Agreement as follows:
   1. For the proper management and administration of the Member at each Clinical Block; and/or,
   2. To carry out the legal responsibilities of Member.
2. Failure to Comply with HIPAA Obligations; Opportunity to Cure; Termination: If Member is found to have improperly disclosed PHI, this Agreement and Member’s enrollment with AMS are terminated.

No Independent Arrangement of Clinicals with AMS Clinical Sites:  Member agrees that he/she will not attempt to set up his/her own Clinicals, or direct any individual to arrange clinical rotations, with any Attending Physician with whom AMS has an independent contractor or other contractual relationship with at any time during the duration of the Agreement and for a period of two (2) years from the expiration or earlier termination of the Agreement.  Failure of Member to comply with this section shall constitute a violation of the Zero Tolerance Policy, and constitute automatic and immediate termination of the Agreement, whereupon the Member shall have no further rights hereunder, and AMS shall have no further obligations hereunder, except as expressly provided otherwise herein.

Criminal, Credit & Background Checks:

1. It is a Members’s responsibility to disclose any and all felony and/or misdemeanor charges to AMS prior to his/her enrollment, with or without having been asked to disclose such information by AMS; refunds will not be issued if positive findings identified in background checks, and prevent a Member from being able to start one or all of the Clinical Block(s) he/she has paid for. As such, Member represents and affirms that he/she has not been found guilty or entered a plea of nolo contendre (plea of “No Contest”) to any felony and/or misdemeanor in the past 10 years.
2. Some states have statutes that require background checks on persons who provide care for others or have access to people who receive care. Such laws normally apply to all persons who are employed in the care-giving industry or have formal access to individuals being served by the care-giving industry.  Members are placed in clinical site(s) and therefore may be subject to background checks.  Member authorizes AMS and its affiliates to conduct an investigation of Member’s background including criminal, credit, employment & educational history, irrespective of whether the background check is mandated by the applicable jurisdiction.  This may include acquiring consumer reports from any appropriate agency.  Member agrees to advise AMS of any changes to Member’s criminal record at any time.  Member hereby consents to a random “drug test” before, during & up to 30 days after completion of any Clinical Blocks.  International Members may be asked to provide an official “Police Report” from his/her home country.

Immigration:  Member warrants and represents that he/she will be lawfully residing in the United States at least 2 weeks before the commencement of the Clinical, in accordance with the regulations of the U.S. Citizenship and Immigration Services and Department of Homeland Security.  Member is solely responsible for securing a visa for entry into the U.S. Member’s inability to secure a visa will not be a basis for a refund of any amount paid. However, credits may apply (read Cancellation Policy below). An expiring U.S. immigration status will trigger AMS to withdraw the Member from any and all pending Clinical Block(s) that extend past the date of U.S. visa expiration; AMS Member will be responsible for all rescheduling fees, including possible renewal of an AMS membership, and Member acknowledges that he/she may not be entitled to any credit for any scheduled but incomplete Clinical Blocks.

Accounting Matters/Payment of Fees:

1. The Member agrees to remain current with his/her financial obligations to AMS and established payment plans with AMS at all times.  If a new payment schedule is approved by AMS, the Member will remain in good financial standing and he/she will not experience any interruptions in Clinicals or services provided by AMS, and will remain fully covered by professional medical liability insurance for all AMS authorized Clinical Blocks.  Failure to remain in good financial standing may result in being pulled out of Clinical Blocks, delay or cessation of services, and/or termination of this Agreement and Member’s AMS membership. In a case of breach of this Agreement by a Member, the Member shall be liable for all costs and attorneys’ fees incurred by AMS.  Under no circumstances shall AMS be obligated to revise a payment schedule for any Member.
2. Membership fees are applied towards annual membership packages. It is the responsibility of the Member to take advantage of all associated benefits during the membership period. AMS is under no obligation to provide any membership benefits after the expiration date of a membership.
3. It is a Member’s responsibility to clearly communicate any potential delays in scheduled payment plans as soon as possible in order to maximize the possibility of AMS being able to keep or even change your requests start date(s) AND to minimize incurring potential change fees.
4. The Member hereby authorizes AMS to charge his/her credit card for membership or services or Clinical Block fees that are approved by the Member (digitally, verbally, or in writing). Member hereby agrees to pay all applicable fees and agreed upon monthly payment plans in accordance with Member’s credit card issuer agreement.  Member also agrees that the billing address provided to AMS is valid and that Member is the authorized credit card holder, or has appropriate and legal authorization to use the credit card provided to AMS.  Furthermore, Member hereby agrees to discuss (or cause the credit card holder to discuss) all requests for cancellations or downgrades with AMS in order to secure a resolution and avoid a hostile charge back.  In the event that the credit card on file is different or changed after receiving this form, the above credit card holder will be held liable to pay for any disputes along with a $55 charge-back fee.  This authorization is valid for the duration of Member’s membership with AMS.

Memberships:

1. AMS Memberships typically expire annually, therefore unless a Clinical Block start date delay was caused by AMS or its affiliated Clinical Site, the Member agrees to pay for a new Membership if the end date of any scheduled Clinical Block extends past his/her Membership end date. Membership discounts may only be applied if Membership renewals are coupled with new/additional clinical enrollments. Courtesy (unpaid) Membership extensions do not entitle the Member to any other Membership benefits other than temporary professional liability insurance till the end of the affected Clinical Block.
2. If signing up for 7 or more months of Clinical Blocks, then a 2 year “Certified Fellow Membership” is strongly recommended at the original time of enrollment.
3. Members who enroll at least 9 months in advance of their first scheduled Clinical Block will be entitled to a grace period before AMS starts their membership. For these enrollments, Memberships will start 90 days prior to their first Clinical Block (scheduled at the time of enrollment, and will not change if Clinical Blocks are changed by member in any way).

Policies for Change & Cancellations

Change & Cancellation Policy for Clinical Blocks

Clinical Block(s) that Members Approve AND have made a partial or full payment towards, with or without a signed Agreement, are considered “Paid For” and will not be put back on the market for anyone else for enrollment. This is mainly because AMS begins its CB approval processing immediately prior to Member enrollment (start of Membership date), followed by certifying and insuring the enrolled CB immediately after Member enrollment. This also means CBs for other AMS Members are often scheduled back-to-back, therefore most changes will cause some degree of disruption to existing schedules. AS SUCH, MEMBERS AGREE THAT THEY ARE NOT ENTITLED TO ANY REFUND OR CREDITS IN CASE OF CANCELLATIONS OR NO-SHOWS OR CHANGES CAUSED BY THE MEMBER. However we understand that life happens, and unforeseen incidents may disrupt clinical start dates and intended residency timeline, so AMS MAY be able to help you keep or reschedule your upcoming CB estimated Start Date(s), or even make other more significant changes (i.e. changes other than Start Date, such as changes made to Specialty, General Vicinity, Product, Weeks, etc.), but that depends on many factors. By digitally signing this Agreement, AMS Member acknowledges his/her full understanding of how AMS determines if changes requested by its Members are possible or even feasible (as outlined below), and agrees to pay the following corresponding Change Fees prior to AMS working on his/her requested changes, as well as pay any difference in weekly or daily Clinical Site fees (between the previous and new Clinical Site):

• $0: If the Clinical Site (CS) is known to be accommodating to changes in Start Dates, and the requested change will NOT disrupt existing schedules of supervising attending physicians AND other AMS Members.
• $125 Schedule Change Fee: If the change in Start Date will force AmeriClerkships to have to secure approvals from at least 1 other CS in order to minimize disruptions to existing schedules.
• $250 Program Change Fee: If the change in Start Date will disrupt existing schedules, requiring the reprocessing of at least 1 other CB.
• $500 Complete Program Change Fee: For any change that is considered ‘MAJOR’ (i.e. other than Start Date, such as changes made to Specialty, General Vicinity, Product, Weeks, etc.), or other unusual changes or adjustments.
• Unable to Change: In the unusual event that a change proves to be too disruptive, or costly, or not approved by a 3rd party who is party to approving your CB, then AmeriClerkships reserves the right to respectfully decline a Member’s request to change. Also No-shows OR changes made on or after a CB has been final confirmed OR on or after the confirmed start date (day 0) will not be honored, and the Member will be responsible for the entire cost of that CB.

Under extenuating circumstances, such as the unavailability of a Clinical Site or Act of God, Members may be allowed to change their Clinical Site in order to start within a reasonable timeframe (within 4 weeks) from their original estimated Start Date (when available, AND if the situation has not been addressed in this Agreement), and be responsible for any Clinical Site fee differences. Fees are assessed per change, even if subsequent changes are caused by the original change requested by the member (i.e. changing the Start Date on first CB will cause a change to the 2nd CB’s Start Date, hence two change fees will be assessed and paid by the Member). Changes to Clinical Blocks must first be approved by member via MyClinicals, and any change fees must first be paid in order for AMS to begin work on such changes. Therefore Member agrees to make any and all change requests by 1) email, then 2) formulating an amicable possible solution with AMS that fulfills the requested change, then 3) immediately logging into his/her MyClinicals Account at https://myclinicals.acmedical.org page, and approving all changes, and if a Complete Program Change Fee is being assessed, 4) document the requested change by creating a case at acmedial.org/change, and 5) pay the invoice.  Other examples of changes, no-shows, cancellations or downgrades are as follows:

Member acknowledges that changes made to any Clinical Block are destabilizing, and future options may be significantly different than what was first available to the Member at the time of original enrollment (including availabilities for specialties, start dates, locations, Clinical Features, etc.). As such, Member holds AMS harmless and will not request any further changes or ask for credit if he/she is not happy with the availabilities, or the changes that the Member requested to be made in the first place.

Clinical Site Permission Deposit (CSPD)

CSPD is a required deposit for clinical sites which are deemed by AMS to be more challenging than usual to secure for specific Members. By paying this fee, Member is giving AMS 10 business days to confirm the details of a Clinical Block that the Member last approved online. This fee is refundable if AMS is unsuccessful at confirming the details of a Clinical Block on the 11th day in the original form of payment made by the Member.

All Other Non-Clinical Block Products, Services and Memberships for Retail Members

AMS staff will begin rendering services towards paid invoices for NON-Clinical Block products and services (i.e. hourly consultations, document revisions, mock interviews, accent reductions, expedited services, etc.) or memberships almost immediately. Although AMS will work hard to gain the satisfaction of each of its clients, individual outcomes are not guaranteed and therefore, any fee paid in association with any NON-Clinical Block products and services are NON-REFUNDABLE and MAY NOT BE ISSUED A CREDIT.

Cancellation Policy for Wholesale Vendors and Members

Wholesale Vendors and Members are entities with whom AMS has agreements with in order to provide special services for. As such, refund and cancellation policies for such special entities vary greatly from “Retail Clients and Members” stated above, and must refer to their own individual agreements for details.

Cancellation Policy for Conditionally Enrolled Members (such as those needing a US visa)

Members requiring supporting documents at the time of original enrollment, evidencing tentative enrollment into AMS and specific clinical sites are considered “Conditionally Enrolled”, and are required to pay a NON-REFUNDABLE Membership fee, plus $1000, plus 10% of total balance as deposit, plus all applicable courier service fees. These fees are due on day of first invoice, and required prior to to the issuance of a Letter of Enrollment. In case a Member is not granted a visa, or admission towards entry into the United States, or is faced by a rejection of sponsorship or permission to proceed by his/her institution (government, school, hospital, employer), the Member will be required to provide an official visa or institutional rejection letter in order to request to be issued a pro-rated credit to be used towards any AMS products or services.

Members who have not already obtained a U.S. visa must participate in a one-on-one “U.S. Clinical Experience Orientation” session with Dr. Mizani in order to understand the scope of clinical experiences so that there would be no confusion when explaining the purpose of their visit to the United States. If this session is NOT completed prior to the Member becoming Fully Enrolled Certified, the Member will not be eligible for any credits.

Cancellation Policy for Securing a U.S. Medical Residency

A Member may request to be issued a partial AMS credit by providing a signed copy of his/her U.S. medical residency employment contract prior to the start of clinical block(s), and giving AMS full authorization to verify such medical residency contract. Fellowships or research positions, or residencies outside of the continental United States do not count.

AMS Credit Request Form: Member’s Responsibilities

It is the Member’s responsibility to complete the AMS Credit Request Form in order to initiate any of the above requests for downgrade/credit at https://www.acmedical.org/change/.  Member must allow up to 8 weeks (and possibly more under extenuating circumstances, such as dispute resolutions, lost credit cards, closed bank accounts, etc.) for processing.

Credits Issued by AMS (Credit on File)

Any credit issued by AMS will expire 36 months after the original date of issuance of such credit by AMS.  AMS Credit on File can only be applied to AMS memberships, products and services (but not towards change or expedited fees), and only used by the original AMS Member; no cash value. AMS Credit on File may be transferred to a Member’s friend or relative ONLY ONCE, at Member and AMS’ discretion (must be qualified to be enrolled as a Member into AMS), and will be treated similar to anyone new to AMS; AMS credits will be subject to a 10% AMS Credit Processing Fee, as well as other fees associated with the changes that the original transaction was subject to. Credits transferred to a Member’s friend or relative are non-transferrable, and shall not affect the AMS Credit on File expiration date.

The Online Clinical Management System (My Clinicals: https://myclinicals.acmedical.org):

1. Member is solely responsible for tracking his/her Clinical Schedule, messages & account status on My Clinicals.
2. Member affirms that his/her My Clinicals login information has been provided by AMS.
3. Member acknowledges that final confirmation of Clinical Blocks may take an unusually long time to complete, and be finalized just a few days or even hours prior to the estimated Start Date of each Clinical Blocks:
   1. Despite earlier Clinical Block approvals at the time of original Enrollment, such approvals need to be continuously confirmed and subject to enrollment processing and final approvals through various departments and stakeholders (clinics, hospitals, surgical centers, etc.), some of which may not be allowed to be completed till a few days prior to the Member’s actual Clinical Block Estimated Start Date; AND
   2. AMS has agreed to protect the privacy of each Supervising Attending Physician, by not disclosing their identity and contact information till immediately before each Clinical Block’s Confirmed Start Date; AND
   3. Changes can occur with the originally enrolled Clinical Site (too many reason to mention, but some of which include supervising physician’s unavailability; change of hospital policies; new potentially negative information obtained about a Clinical Site; etc.) and therefore, AMS reserves the right to, and Member gives AMS full permission to secure an alternative Clinical Site with similar or upgraded Clinical Features within 50 miles of the “General Vicinity” of the Clinical Site last approved by the Member. The member further agrees to an expanded replacement policy, if he/she is affected by a change made to a PGY1CONNECT™, Verified and Postgraduate Subinternship Clinical Site or Clinical Features that he/she has enrolled in (read “Changes Affecting PGY1CONNECT™, Verified and Postgraduate Subinternship Clinical Site or Clinical Features” section below for details);
   4. Only after the receipt of final confirmations from all stakeholders for each Clinical Block, can AMS complete its own required administrative processing and approvals, so that each Clinical Block can get properly “certified and insured” through AMS and its affiliates/partners/vendors – this process typically takes place on the Thursday and/or Friday afternoons (or 1-5 days) prior to each Start Date.
4. Members who enroll in 2 or more Clinical Blocks acknowledge that the order of such Clinical Block(s) are not guaranteed, and give AMS full consent to switch their order as deemed fit by AMS.
5. The exact specifics of Member’s scheduled Clinical Block(s), also referred to as “Final Confirmation Notification” may be emailed to the Member, and displayed on the Member’s MyClinicals page approximately 72 hours prior to Member’s start date (or possibly earlier, or later, depending on various processing challenges that AMS may face, as mentioned above). Other general information such as cross streets, or tentative zip codes may be released much earlier at the request of the Member, but the Member understands that early releases of information are provided as a courtesy only and are frequently subject to change.  Therefore Member should rely on such preliminary information only at Member’s own risk.
6. AMS acknowledges and agrees to provide any notice required under this Agreement to Member through My Clinicals. Member agrees to accept communications from AMS in that form and manner.  Member acknowledges and agrees to provide any notice required under this Agreement to AMS by email, or by certified mail.
7. Member is expected to start his/her Clinical Blocks as approved and outlined in his/her MyClinicals, or documented in email communication. A Member’s failure to start on the date/time indicated in the final confirmation email may result in adverse action status alert, i.e. a “No Show”, which would be a total loss for that non-showing member for that Clinical Block. In such an event, AMS is under no obligation to reschedule that Clinical Block, but if it does, the Member agrees to pay for all applicable change fees up to and including the total cost of that Clinical Block.
8. Any information provided in advance of this protocol are considered preliminary estimates without warranty, and shall be relied on at Member’s own risk.
9. Member acknowledges that clicking the button to approve changes on his/her MyClinicals Account will approve all changes on all Clinical Blocks displayed.
10. Once again, Member gives AMS their full consent to be placed in another Clinical Site with equal or better clinical features, so long as it is located within fifty (50) miles of the Clinical Site that was originally approved by the Member.
11. AMS is constantly working on confirming Clinical Site details, and Members are frequently asked to log into their MyClinicals page to immediately review and “Approve” any changes made to their Clinical Blocks, or to simply “Check-in”, in case there has been any gap in communication between AMS and the Member. The immediate approval of each Member is imperative to AMS’ ability to final confirm each Clinical Block, since supervising attending physicians are often in short supply, hence any availability must be dealt with extreme urgency so to avoid loss of opportunity. As such, Member agrees to keep a watchful eye on his/her email inbox for any email notification by AMS asking the Member to log into his/her MyClinicals page to review and approve any changes, and Member agrees to review each Clinical Block individually and approve all changes by clicking “Approve My Clinicals” (or reply back to clinicals@acmedical.org with any questions) within 24 hours. Failure to approve Clinical Block changes (or pose questions to clinicals@acmedical.org) within 24 hours can put the original estimated start date and location of Clinical Blocks at risk.
12. Member acknowledges that completion of “Post-clinical Evaluation(s)” is required, and agrees to submit them online in a genuine and honest fashion immediately upon the completion of each Clinical Block. This process takes just minutes, and is the only way that AMS can compile a fair assessment of its Clinical Sites and attending physician for other AMS members to utilize, the same way as others have done in the past for future Members. Therefore by becoming a Member of AMS, you agree to the release of details of any future clinical blocks (i.e.”YOUR CLINICAL CONFIRMATION” email), clinical evaluations, or any document pertaining to clinical placement facilitated by AMS to be withheld until such time that you have submitted genuine and honest “Post-clinical Evaluations” of any and all previous attending physicians and past clinical block(s).

Electronic Communications: Member agrees to provide a valid email address to AMS, and that any communications sent by AMS to that address are to be considered received by Member.  Any notice of any updated contact information of Member must be provided to AMS in the form and manner otherwise acceptable under this Agreement.

Required Documents (https://www.acmedical.org/stepstoclinicals/):

1. Member acknowledges that prior to obtaining Full Enrollment status & authorization to start Clinicals, AMS must receive certain required documents, including but not limited to the executed Agreement.  Member acknowledges & agrees that he/she will not commence Clinicals without becoming Fully Enrolled Certified (FEC).
2. All documents (with the exception of notarized documents) must be uploaded by each Member through a private “Document Upload Portal” link that will be emailed to Members at the time of enrollment. This also applies to instances of required document resubmission.
3. Member’s enrollment with AMS is provisional and conditional until ALL documents are submitted and Member’s initial deposit is received.  Member will be unable to access his/her account unless all documentations have been approved & Member’s status has been changed to Fully Enrolled Certified.
4. In case of duplicate uploaded documents, the latest upload will be deemed as the most up to date for the purposes of processing.
5. Member’s clinical blocks can begin no earlier than 3 weeks from the date of becoming Fully Enrolled Certified, unless signed up for expedited processing and enrollment (unless a Fastart expedited processing is paid for).
6. Unless an extenuating circumstance that has already been discussed and pre-approved by the Chief Clinical Officer at AMS, Letter of Enrollment (LOE) will only be issued only once as an email attachment, and only after a Member has become FEC, has paid any applicable fees, and is in good financial standing with AMS.
7. If AMS agrees to re-issue an LOE at the request of the Member, the Member agrees to pay all associated fees. 
8. Please allow up to 30 days for the processing of LOEs and Letter of Completion (LOC), however expedited processing may be available (additional fees apply).
9. All forms and applications completed and submitted by Member become the sole property of AMS.
10. A Member’s unreasonable delay or refusal or lack of adherence to providing any required document as exactly required by AMS or the Member’s Clinical Site or any healthcare facility, will constitute a breach of contract, and may be grounds for immediate dismissal of Member from AMS and any enrolled Clinical Block without a refund.
11. AMS reserves the right to refuse issuing an AMS signed document on AMS letterhead to any prospective or active AMS Member, at its sole discretion.

Consequences of Insufficient Communication by Member: From time to time, Members do not respond to the multiple attempts made by AMS, or fail to adhere to specific set deadlines (i.e. do not submit all required documents in time to allow AMS sufficient time to complete its enrollment and processing, OR not becoming Fully Enrolled Certified (FEC) prior to their set “Final FEC by Date”, etc.). This also means that AMS will not be able to certify the Member as properly enrolled, meaning that the Member’s Clinical Blocks will not be insured and his/her start dates may be affected. Potential scenarios and outcomes:

1. Member sufficiently responds <21 days prior to their Estimated Start Date, AND AMS is able to maintain the Member’s original Estimated Start Date: Member agrees to pay all service and/or expedited processing fees (ranging from $199 to $500) AND “Approve” any and all changes proposed by AMS on the Member’s My Clinicals page AND submit any documents required by AMS or Clinical Sites within the time allotted by AMS;
2. Member sufficiently responds <21 days prior to their Estimated Start Date, AND AMS is able to renegotiate the rescheduling of the Member’s start date to a later time with that Clinical Site: Member agrees to pay all service and/or expedited processing fees (ranging from $199 to $500) AND “Approve” any and all changes proposed by AMS on the Member’s My Clinicals page AND submit any documents required by AMS or Clinical Sites within the time allotted by AMS;
3. Member sufficiently responds <21 days prior to their Estimated Start Date, however AMS is UNABLE to renegotiate the rescheduling of the Member’s start date to a later time with a Clinical Site: Member acknowledges that he/she will completely forfeit on one or all of the Clinical Block(s) that he/she enrolled in;
4. Member does NOT respond, or his/her response is insufficient: In an effort to help its Member’s not completely lose his/her Clinical Block(s), AMS MAY be able to postpone one or all of that Member’s Clinical Block(s), however this service is not guaranteed and should not be expected. Member gives AMS its full consent to push one or all of his/her Clinical Block(s) to the end of his/her membership, and agrees to “Claim” his/her clinicals on or prior to their “Claim by Date”. Once claimed, Member also agrees to pay all service and/or expedited processing fees (ranging from $199 to $500) AND “Approve” any and all changes proposed by AMS on the Member’s My Clinicals page AND submit any documents required by AMS or Clinical Sites within the time allotted by AMS. If AMS is unable to postpone a Member’s Clinical Block(s), then the Member acknowledges that he/she will completely forfeit on one or all of the affected Clinical Block(s);

Sufficient responses is defined as a response that answers all of AMS questions, and allows for definitive decisions to be made by both AMS and the Member.

Clinical Block Start Dates Postponed to End of Membership: This is a measure taken and implemented by AMS (typically due to a Member’s insufficient response), in order to not completely cancel an at-risk Clinical Block enrollment. If this occurs, all AMS can assure a Members of at this stage is that it will do its best to accommodate a new postponed start date, specialty and total weeks when that Member contacts AMS; no other guarantees or promises can be made. When ready, the Member will be required to email AMS by no later than a predetermined claim by date, and AMS will let each Member know their options, and nationwide locations available at that time. Also when ready, Members will be required to log into their account at myclinicals.acmedical.org and approve all changes. Members will most likely have accrued unpaid fees (i.e. expired memberships, or Schedule or Program Change Fees), or may incur additional fees if the future clinical site selected is more expensive than the one he/she originally enrolled in. All fees will be discussed with Members and they must be paid in order for AMS to secure their Clinical Blocks. There will most likely be additional required documents requested when AMS hears back from the Member, and Member agrees to provide them promptly. AMS has no further obligations to service a Member if he/she does not agree to the above OR if he/she fails to meet ANY of the following requirements by 60 days prior to the predetermined claim by date:

1. Contact us in writing to claim their postponed Clinical Block(s)
2. Finalize their enrollment by becoming Fully Enrolled Certified (FEC)
3. Pay all necessary fees
4. Approve all changes online

Again, Members agree that if he/she does not meet the above requirements, or does not utilize the Clinical Block that they paid for within their initial Membership period, then their Clinical Block(s) will be marked as “Withdrawn/Dropped” and they will completely lose one or all of their Clinical Blocks. Other restrictions may apply, which will be discussed with Members when they respond back to AMS.

Nature of Insured Clinicals: Member hereby acknowledges and fully accepts the following:

1. Member is hiring AMS to place them in Clinical Site(s) that practice a specific specialty, and carry a certain “Clinical Feature” (i.e. amount of inpatient vs. outpatient, or Verified or not), on/about an estimated Start Date; no other placement guarantees are made.
2. Member acknowledges and agrees that Start Date(s) and/or location(s)/General Vicinities are estimated and desired, and that they are milestones that AMS is being hired to work towards fulfilling to the best of its abilities by working with physicians and hospitals who function as independent contractors (i.e. not AMS employees or owned facilities), hence the final Start Date(s) and/or location(s)/General Vicinities may change based on factors that are outside AMS control, such as hospital processing delays, supervising physician or clinical site unavailability, contract negotiations or cancellations, emergencies, etc. Therefore in case of a change, AMS will provide the Member with the next closest and earliest available Clinical Site Options List with up to 3 options for the Member to select from and approve, and the Member agrees to fully cooperate with AMS by selecting from one of the provided options. Additionally the Member agrees to hold AMS harmless for any costs incurred as a result of a change, or accepting the alternative options provided to the Member by AMS.
3. It is always the intention of AMS to provide well-rounded experiences for our Members including both inpatient and outpatient exposures, as well as to rare opportunities to certain high profile clinical sites in order to improve chances for residency placement. However in doing so, Member acknowledges and accepts the risk that there may be certain challenges that AMS may not be able to overcome (i.e. Member not being able to communicate with patients in their language, or not feeling comfortable within certain neighborhoods or unfamiliar situations, or with the patients that their assigned supervising attending physician treats, or personality conflicts between the Member and any attending physician, etc.) and as such, the overall experiences may be different than what was originally intended during and Members agree to be fully cooperative with any such challenges. Furthermore each Member agrees to abide by and assist AMS in overcoming any known or unknown challenges, restrictions, hospital and/or clinical site policies, as well as state regulations whenever the need arises, including any additional fees required to remain in compliance with non-AMS entities.
4. Members enroll in Clinical Blocks (CB) at any particular Clinical Site (CS). Our Clinical Sites are categorized by what AMS Members can expect at those sites (known as Clinical Features) in a Core (family medicine, internal medicine, obstetrics & gynecology, pediatrics, general surgery and psychiatry) or Premium (all other) specialties. “Community Healthcare Experience” (CHE) means a clinical experience that takes place in an outpatient/ambulatory clinic, and inpatient exposure is unlikely. “Hospital” means any facility that a patient may be admitted to stay overnight (typically >24 hours). A “Teaching Hospital” means any facility that is listed in acgme.org and/or opportunities.osteopathic.org, or serves as a clinical clerkship training site for medical students attending U.S. medical schools.“Hospital Guarantee” (HG) means the opportunity to enter a hospital for various reasons (i.e. rounds, didactics, visiting admitted patients, surgeries, pre or post-op, etc.) between 1-49% of the duration of an individual CB, whereas “Inpatient” (IP) means 50-99% of the duration of an individual CB, and “Hospitalist” (HOSP) means nearly all inpatient (99-100%). Opportunity to enter a hospital is highly dependent on an AMS Member’s ability to get to that hospital on time, and when his/her supervising attending physician is at that facility, which means it can occur 24 hours/day, 7 days/week, 365 days/year; this also means personal transportation is strongly recommended (and usage of public transportation is highly discouraged). Please note that inpatient experiences are observerships (shadowing), unless expressly stated otherwise by AMS. “Verified” (V) means members will be processed at an affiliated institution (i.e. hospital, long term care facility, behavioral health center, etc.), hence Verified CS are rare and may require up to 90 days of processing time for each CB.
5. “Postgraduate Subinternships” (PGSI) are clinical opportunities sanctioned by a Graduate Medical Education (GME) department, and AMS PGSI Members are required to attend the teaching hospital didactics/conferences with other Residents, Fellows and residency program associates (including Program Directors).
6. “Program Directors” (PD) are individual U.S. licensed physicians who oversee an entire residency program; Clinical Features with the designation “PD” will enable the AMS Member to become a part of that PD’s team (one or several teams at various locations) of resident/fellows, may ultimately be evaluated by that PD (or his/her designee), and may be to solicit a performance based letter of recommendation from that PD (naturally the a physician reserves the right to agree or deny a request to recommend, but if agreed, an LOR written by a PD is a highly desired asset when a Member is compiling his/her residency application for U.S. medical residency programs).
7. Please note that by enrolling in a CB with rare Clinical Features (i.e. PD, VERIFIED, PGSI, HOSP, IP), AMS Member acknowledges that he/she may be assigned to a team instead of an individual physician, hence the absence of the originally assigned physician does not mean that the AMS Member was unsupervised, or that any portion of that CB needs to be repeated without having to pay the weekly fees for that CB. 
8. Physician supervisors, especially high level supervisors (i.e. PDs, GME Directors, Chief Medical Officers, etc.) have a heavy workload and typically supervise multiple teams simultaneously (in person and remotely), therefore such supervisors may not always be available for direct interactions with AMS Member. Additionally physicians can be pulled away from their practice unannounced (for various reasons, this is medicine after-all), causing the AMS Member to not get the 1-on-1 time that they desired with their supervising physician. If a physician is absent for any period of time during a CB, then the physician or resident who he/she designates (Designee) will become automatically in charge, serving as the primary supervisor of AMS Member until the originally assigned supervising physician returns. This Designee is also responsible for reporting back to the originally assigned physician about the performance of AMS Member(s) during his/her absence, the same way the Designee will do for any other medical student who has been assigned to rotate with the originally assigned physician. Therefore all Clinical Blocks are guaranteed for the service of placement, and not a specific attending.
9. Although AMS makes constant active attempts to identify any planned vacations or time-offs, supervising physicians are not employees of AMS, hence AMS may not be aware of such absences. If this occurs, the AMS Member has the right to continue with the Designee (no need to contact AMS), otherwise the AMS Member must IMMEDIATELY contact AMS (within 1 hour of knowing that the physician will be away) to discuss options, which typically include granting of an AMS Member’s request to extend his/her CB by the amount of time that the supervising physician was/will be absent for. However this extension may only be considered to be granted if: 1) the supervising physician agrees, 2) the affected AMS Member notifies AMS of the physician’s absence prior to the physician’s return to his/her practice, and 3) the AMS Member is prepared to immediately STOP his/her CB until such time that the supervising physician returns; otherwise the AMS Member foregoes any rights to have AMS reconsider his/her request for any extension. The maximum time that will be considered for an extension to be granted is the number of days from when the AMS Member notifies AMS of the physicians’ absence, to the day that the physician returns.
10. At PGY1CONNECT™ clinical sites, attending physicians are affiliated with teaching hospitals where AMS Member or Alumni have self reported to have secured residency interviews at or Matched into, across the United States. MEMBER ACKNOWLEDGES AND AGREES THAT THAT SELF REPORTED INTERVIEWS & MATCHES MAY NOT HAVE BEEN ADDITIONALLY VERIFIED BY AMS, AND THERE MAY NOT BE A FEASIBLE WAY TO CONDUCT SUCH VERIFICATION. FURTHERMORE MEMBER ACKNOWLEDGES AND AGREES THAT THERE ARE NO GUARANTEES THAT THE EXPERIENCES REPORTED BY PAST AMS MEMBERS AND ALUMNI MAY BE THE SAME FOR FUTURE MEMBERS, AND INDIVIDUAL OUTCOMES MAY VARY. For purposes of clarity, Member acknowledges that by enrolling in a PGY1CONNECT™ Clinical Site, he/she will: 1) Be placed with attending physicians who are affiliated with teaching hospitals where AMS members have self-reported to have secured residency interviews or Match(es), and 2) Be provided with the opportunity to earn the trust of supervising physician(s) at PGY1CONNECT™ Clinical Sites in order to gain their support while applying to residency. Member acknowledges that PGY1CONNECT™ Clinical Sites will NOT: 1) Guarantee him/her residency interview(s), or a Match, and 2) Be as effective without the benefits of an AMS Certified Membership, and 3) Be a good fit for residency candidates who exhibit signs of unprofessionalism or entitlement, i.e. act overly aggressive/pushy or put their residency-entry needs ahead of patients or attending physicians. Although there are no guarantees that the experiences of past Members will be duplicated at PGY1CONNECT™ Clinical Sites, AMS has determined the major contributors to former AMS member success at PGY1CONNECT™ Clinical Sites to be: 1) The impression left on their supervising attending physicians; 2) Ensuring residency applicant competitiveness through USMLE performance, professional career coaching, including interview preparation and performance; 3) The deep relationship between AMS and PGY1CONNECT™ attending physicians; 4) Other factors unique to each former AMS member and/or teaching hospital. Therefore although individual outcomes may vary, it is our belief that the combination of 1) Successful completion of multiple PGY1CONNECT™ clinical blocks, AND 2) Full utilization of AMS Certified Membership, AND 3) Following AMS expert advice, may significantly improve future Member odds of securing residency interview(s), and ultimately “Matching” into their program of choice.
11. With the exception of enrolling in an AMS products and service that contain the word “Guarantee” (such as HOSPITAL GUARANTEE VERIFIED or TEACHING HOSPITAL GUARANTEE VERIFIED, for which specific rules and regulations apply), Member is not entering into this Agreement with AMS to be assigned to supervising teaching Attending Physicians with hospital privileges, but in outpatient settings. Depending on Attending Physician’s hospital privileges and individual hospital/residency policy, Member may or may not gain hospital exposure and have the opportunity to observe inpatient settings alongside Member’s supervising Attending Physician.
12. Although AMS takes every reasonable precaution to deliver the products and services that Members enroll in, AMS has no choice but to rely on various non-AMS employees and/or independent contractors to carry out certain aspects of AMS products and service that contain the word “Guarantee” (such as a physician providing the Member an opportunity to accompany him/her to hospitals in “Hospital Guarantee” clinical blocks, or medical staff office personnel completing a medical student’s hospital processing paperwork for “Teaching Hospital Guarantee Verified” clinical blocks), and as such, some portion of the “Guaranteed” services may not be fulfilled. If the Member or AMS suspects that this has happened, the Member agrees to fully cooperate with AMS and any of its representatives to isolate the error and/or omission and/or oversight, and if error and/or omission and/or oversight is/are identified, AMS will issue the Member a refund after adjusting the price level of the affected product and/or services to the most relevant applicable product and/or service which best resembles the actual product and/or services that the Member received. For example, if it is concluded by AMS that a Member enrolled in a “Teaching Hospital Guarantee” clinical block, and who also expressed his/her 24 hours/day availability to meet the supervising physician at his/her affiliated hospital, was never offered the opportunity to visit a hospital by that supervising physician, then the Member agrees to complete an online downgrade form, which will trigger AMS to downgrade the clinical product from “Teaching Hospital Guarantee” (1-49% opportunity to visit a teaching hospital) to “Community Healthcare Experience” (100% outpatient), and the difference in cost will be refunded to the Member in the original method of payment within 60 days of such finding; however if AMS investigation reveals that the supervising physician in this “Teaching Hospital Guarantee” asked the Member (even once) to meet him/her at the hospital and the Member did not for personal reasons (lack of transportation, or inconvenience due to being late at night or during the weekends, missing the call, etc.), then AMS services have been provided and the Member will not be owed any refund(s).
13. Although AMS makes its best effort to assign Member to clinical sites and supervising physicians whom the Member has no previous exposure to, this may not always be the case.  In the case that a Member is placed with clinical site(s) or supervising physician(s) whom the Member knows or rotated within the past, Member agrees that AMS has met its contractual obligations so long as any Affiliated Attending Physician agrees to supervise the Member for the purpose of completing Clinicals within 50 miles of the “General Vicinity” of the Clinical Site last approved by the Member, except for PGY1CONNECT™, Verified and Postgraduate Subinternship Clinical Sites and Clinical Features, whose replacement may be much more challenging (please read “Changes Affecting PGY1CONNECT™, Verified and Postgraduate Subinternship Clinical Site or Clinical Features” below).
14. It is the Member’s responsibility to fully disclose any requirements or requests IN WRITING (i.e. specific physicians that they are unwilling to go to, or specific cases that their medical school requires them to be exposed to, etc.) prior to signing this Agreement, so that AMS can evaluate if it can fulfill such requirements or requests. Therefore a Member’s refusal or unwillingness to a begin his/her clinicals at the Clinical Site that AMS has assigned them to, on the Final Confirmed Start Date, without WRITTEN documentation of them notifying AMS of their requirement that a Clinical Site may now be contradicting, will be deemed as a No Show without any further cause for action required by AMS, or credits issued to the Member.
15. Changes Affecting PGY1CONNECT™, Verified and Postgraduate Subinternship Clinical Site or Clinical Features: Both the Member and AMS acknowledge and agree that due to the rarity and extremely unique benefits of PGY1CONNECT™, Verified and Postgraduate Subinternship Clinical Sites and Clinical Features, replacing any Clinical Sites affected by change (i.e. due to, but not limited by, contract cancellation, supervising physician becoming unavailable, state policy changes, medical school policy changes, or any other reason) may or may not be possible within 50 miles of the “General Vicinity” of the last approved PGY1CONNECT™, Verified or Postgraduate Subinternship Clinical Site(s), at or around the original estimated start date. In acknowledgment of this inconvenience, both AMS and the Member hereby agree to the following resolution: 1) Member agrees to relocate to the next closest PGY1CONNECT™, Verified or Postgraduate Subinternship Clinical Site (based on what was originally enrolled in) with a physician who is at least board certified in the original specialty selected by the Member, located anywhere in the United States, OR 2) Member will accept a $750 AMS credit AND agrees for AMS to automatically re-enroll him/her with the nearest U.S. licensed supervising physician who is at least board certified in the original specialty selected by the Member.
16. By approving their Clinical Block(s) in a Postgraduate Subinternships (PGSI) Clinical Site, Member 1) Is willing and able to legally reside in the United States by at least 1 week prior to desired start date, AND 2) Can communicate fluently in English, AND 3) Has personal transportation (not rely on public transportation), AND 4) Will be available 24/7 (no time off or holidays; 100% mandatory attendance unless arranged with supervisors; expect to be present ~12 hours/day + calls + early mornings & weekend patient rounds when available), AND 5) Can document minimum 4 weeks of clinical experience in any country where English is their primary language, within the last 5 years (AMS type clinicals experience preferred), AND 6) Will attend an online AMS PGSI Orientation with the AMS Chief Clinical Officer (typically biweekly; additional fees apply if Member is unable to attend any of the pre-scheduled online time slots, and requires a private 30 minute session for this orientation); AND 7) Can document a flu shot (during the flue season) and a physical exam within 12 months of the last day of scheduled clinicals, in addition to regular AMS required documents for enrollment.
17. Members who have not already obtained a U.S. visa must participate in a one-on-one “U.S. Clinical Experience Orientation” session(typically biweekly; additional fees apply if Member is unable to attend any of the pre-scheduled online time slots, and requires a private 30 minute session for this orientation) with AMS in order to understand the scope of their clinical experiences.
18. Transportation consideration is a must for all AMS clinical sites; having access to a personal vehicle or ride-share (i.e. Uber or Lyft) will allow members to take advantage of a variety of opportunities that may arise at other affiliated clinical sites. Due to the unreliability of public transportation in the area during non-peak hours, a personal vehicle is the recommended method of transportation for this clinical site. Please note that a Member’s inability to secure his/her transportation will not be considered as valid excuse for any delays, or request for change.
19. Hospital names, attending physician status and zip code may change often, therefore a Member is encouraged to log into his/her “MyClinicals” account for up to date details, or email clinicals@acmedical.org.
20. The Clinical Feature a Member agrees to last on their MyClinicals (time stamped with IP address) supersedes all other Clinic Feature requests and approvals.
21. 24+ hours/week is typically considered full-time under this Agreement, however it is the Member’s ultimate obligation to identify and maximize upon each clinical opportunity so that he/she may gain a full-time experience.
22. Amount of inpatient exposure is directly related to the Clinical Features of the site in which Member has enrolled, and the Member’s availability and ability to get to the hospital on time. The extent of inpatient exposure will vary from one specialty to another, and depends on the supervising physician’s varying inpatient census, as well as the policies of each affiliated hospitals.  As such the same clinical site may have a widely varying inpatient exposure.
23. It is the responsibility of the Member to be available to accommodate the schedule of the supervising attending physician, and not the other way around. Every attending physician’s requirement for the Member’s time will differ, may vary, and cannot be predicted ahead of time.  Members must ensure that they will have no other obligations which could interfere with his/her clinical schedule.  Member must immediately inform NCC of any unexpected circumstances which affect his/her availability, and result in an absence, whether planned or unplanned.  Absences, whether planned or unplanned, will not result in any credit of fees paid for any Clinical Block.
24. AMS MAKES NO WRITTEN OR IMPLIED GUARANTEES OR WARRANTIES THAT MEMBER WILL OBTAIN A RESIDENCY, OR LETTER(S) OF RECOMMENDATION, OR RESIDENCY INTERVIEWS, OR OTHER POSITION AS A RESULT OF ENTERING INTO THIS AGREEMENT, OR BECOMING A MEMBER OF AMS, OR PARTICIPATING IN CLINICALS WITH AMS.

Clinical Authorization Letter (CAL): AMS Member acknowledges that prior to the start of any student or resident type clinical rotation, AMS may request information regarding the named visiting student/resident (“Student”) clinical rotations/externships (“Rotation”) as well as the medical college/residency’s (“Medical Institution” or “Institution”) requirements for U.S. Rotations in the form of a CAL. This CAL must be completed by both the Student and an official at the sponsoring Medical Institution, unless a Student waives his/her rights (“Optional” within CAL). The purpose of a CAL is to ensure that: 1) AMS places Students in Rotations in accordance with an AMS approved CAL, and 2) Both Students & Medical Institutions know that several U.S. jurisdictions have limitations placed on visiting rotations by Students attending non-U.S. accredited Medical Institutions, and 3) Both Students & Medical Institutions are notified of their sole responsibility to remain in compliance with State Medical Board (SMB) rules & regulations for clerkships and future medical licensure, and 4) AMS will use a completed CAL to issue a Letter of Enrollment to Students, which outlines the nature, locations, specialties, facilities and dates of Student Rotations, and 5) The Student is responsible to remain in compliance with his/her school policies, and 5) The Student is responsible for sharing the AMS Letter of Enrollment with his/her Medical Institution for permissions or credits, and to allow the Medical Institution to obtain any necessary permissions from individual SMB (since SMBs will only work with Students or Medical Institution for school approvals & Clinical authorizations, and not AMS). AMS Member further acknowledges that he/she has been directed to visit acmedical.org/resources for help & more details. Option to Waive Right on CAL: In exchange for streamlining enrollment into AMS and its affiliated clinical sites, a Student may waive his/her right to Medical Institution completing a CAL. By doing so, the Student agrees to take full responsibility for 1) Selecting & approving Rotations through AMS, and 2) Securing any documents, signatures or verifications needed for or from my Rotations (i.e. clinical evaluations, state medical licensure applications, clerkship verifications by any entity, or other), and 3) Any outcome as a result of waiving his/her rights. Student also acknowledges that he/she shall fully defend, indemnify and hold harmless his/her Medical Institution and AMS from any and all claims, lawsuits, demands, causes of action, liability, loss, damages and/or injury, or any kind whatsoever (including without limitation all claims for monetary loss, property damage, equitable relief, personal injury or wrongful death). This indemnification applies to and includes, without limitation, the payment of all penalties, fines, judgments, awards, decrees, attorneys’ fees, related costs or expenses, and any reimbursements to Medical Institution and AMS for all legal fees, expenses and costs incurred by it. In case of a dispute or discrepancy: Student/Member is responsible to ensure that all the details on his/her CAL match the details of his/her Clinical Blocks within his/her https://myclinicals.acmedical.org/myclinicals account login page.

Professionalism & Dress Codes: Members hereby agree to be a professional and appropriate at all times, and by entering into this Agreement agrees to the following requirements: 1) Member must NOT engage in any activity that would jeopardize the relationship that AMS has established with each supervising physician, hospital, residency program, from the beginning to end of their AMS Membership. 2) Member agrees to accept feedback (positive or negative), communicate professionally at all times, and treat everyone (i.e. AMS employees, physicians, clinical site employees, hospitals staff, etc.) with respect. 3) Member agrees to strictly adhere to any and all policies outlined in this Agreement, the AMS Clinical Orientation, and any other policies and orientations specific to each clinical site. 4) Member agrees to be in professional at all times: a “SHORT” white lab coat with an AMS insignia patch (suggested) over professional dress (or scrubs, if acceptable by the clinical site) is acceptable; low rise scrub pants and rolling down the waistband of scrub pants is prohibited; hair should be clean, neatly trimmed, and contained in such a manner that it does not risk coming in contact with the patient or visitors. 5) Member should dress in the same manner as those who provide direct patient care, as specified by OSHA standards.  6) At all times Members must wear socks or stockings and shoes with impermeable enclosed toes. Shoes are constructed of an impervious, non-absorbent material, clean and in good repair.  Shoes are to be closed toed, in good repair and no canvas shoes or flip flops. If Member’s clothing or uniform becomes contaminated with blood, body fluids, or hazardous chemicals, Member must exchange soiled clothing for scrubs, per Safety policy SA 60-10.02 Handling Contaminated Clothing. 7) Cologne/aftershave/perfume are not allowed in patient care areas.  8) Fingernails must be kept clean, well-cared for, and no longer than 1/4 inch from fingertip in length. 9) Artificial and long natural fingernails are not permitted.  The definition of artificial fingernails includes, but is not limited to, acrylic nails, all overlays, tips, bondings, extensions, tapes, inlays, and wraps; nail jewelry is not permitted; nail polish, if worn, must be well maintained; chipped nail polish is not allowed.  10) Clothing needs to be clean and not wrinkled.  Undergarments should not show.  Chest should not show, even when leaning or bending over.  No jeans/western cut pants, sweatshirts, and shirts of underwear type, see-through clothing, sleeveless shirts or any clothing which exposes a bare midriff, back, chest or underwear. Skirts must be knee length or longer. 11) Appearance must be clean and neat. 12) The Picture ID issued by the facility (if processed through the Security or Medical Staff Office, when applicable) is to be worn above the waist and in clear view when in clinical agencies. The following are NOT allowed:

1. Faded, torn, ripped or frayed clothing; Midriff or off-the-shoulder shirts, sweaters, or dresses;
2. Tight, sheer, or revealing clothing;
3. Clothing with advertisements, sayings, or logos, with the exception of AMS-approved apparel when worn as part of the uniform;
4. Spaghetti strap or strapless shirts or dresses;
5. Denim jeans, shorts or sports attire;
6. Hats, caps, bandanas, plastic hair bags/shower caps (particularly worn within buildings) unless for medical conditions or safety purposes or established religious customs;
7. Visible body piercing/jewelry except for ears;
8. Visible tattooing on face, neck, arms or hands; tattoos larger than 1 inch in size that are graphic/disturbing, e.g., displaying violence, drugs, sex, alcohol, tobacco products.

No Legal Advice: AMS is an independent entity designed to assist its Members with understanding and navigating the U.S. healthcare system by providing the services described above.  AMS does not provide legal advice and will not be held responsible for decisions made by Members based on the services provided by AMS, as inadvertent errors can occur.  Additionally, AMS may refer its Members to other entities, agencies or attorneys during this process, but this does not constitute a guarantee of the services that other entities, agencies or attorneys may provide.  Members agree that AMS assumes no liability for any damages resulting from Memberships or services provided to Members, or for any referrals made, and that AMS is not guaranteeing any specific outcome(s).  Members further understand and agree that AMS is not a law firm or broker, nor does AMS provide any legal or brokerage services.  Although many topics may be discussed with Members, AMS is not offering any legal advice whatsoever, and Members are always encouraged to seek the advice of an attorney before and during their pursuit of healthcare education, as well as securing a career in U.S. healthcare.

General Release:  As material part consideration for this Agreement, Member hereby voluntarily releases and hold harmless AMS and its shareholders, officers, directors, other Members, representatives, agents, assignees and employees (the “AMS Indemnities”) from any and all liability for and from any and all claims, disputes, allegations, complaints, arbitrations, demands and cause of actions by the Member, his/her heirs, agents or assignees, a third, party, or the clinical site, related to this Agreement, or in the case a Member now or hereafter becomes infected with any sort of disease(s), gets injured, suffers a loss or damages, or death arising out of, or incident to, his/her presence or participation in clinical settings, or declination of vaccination, or lack of immunity to any and all sorts of disease(s), or inability to secure interviews or placements in graduate healthcare schools or residency programs.

Copyright & Model Release: Member hereby grants the AMS Indemnities the irrevocable and unrestricted right to use and publish photographs or videos or audio of the Member, or statements made by the Member, in which the Member may be included, for editorial, trade, advertising and any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same. Member hereby releases AMS and its legal representatives and assignees from all claims and liability relating to said photographs or videos or audio of the Member, or statements made by the Member, or uses thereof.

Indemnification:  Member agrees to defend and indemnify AMS Indemnities and hold AMS Indemnities harmless from all claims, actions, losses, liability, and demands, causes of actions, including reasonable attorney’s fees that may be realized due to Member’s acts, omission, negligence, gross negligence, willful misconduct, or violation of this Agreement.

Services that are Outside the Scope of this Agreement: Additional products and services may be added to this Agreement only through amendment, addenda, attachments, exhibits, pricing attachments, a statement or scope of work, r service level agreements in which various aspects of the work or project to be completed is described (hereinafter “Attachments”).  Such Attachments must be counter signed by both Parties of this Agreement to be effective, and will be treated as “Exhibit(s)” to this Agreement upon such countersignatures.

At-Risk Members, Breach of Agreement, Dismissal: With the Member agreeing to enroll with AMS and to be permitted to enter any U.S. healthcare facility comes the responsibility professionalism and a willingness to abide by all policies as set forth by AMS, individual physicians at their clinical sites, hospitals, local, state and federal entities. Violation of such policies, such as HIPAA or the unlicensed practice of medicine or trespassing (i.e. visiting a hospital prior to confirmed start date), may be punishable by both civil and criminal penalties and therefore by signing this Agreement and becoming a Member of AMS, Member agree to not deviate from the content of this Agreement. Furthermore, AMS Chief Clinical Officer reserves the right to identify “At-risk Members” any cause for concern(s), and the Member agrees to fully cooperate and address each and every cause for concern until such time that in his/her sole professional opinion, the AMS Chief Clinical Officer feels satisfied that the Member has addressed all causes for concern. Such causes for concern may include (but not limited to) any Member’s actions that may pose even the slightest risk to a patient’s well being (at any time, even prior to the start of a Clinical Block), or a Member being accused of combativeness, unprofessionalism, tardiness, falsification, plagiarism, lack of cooperation, inappropriate behavior, fraud, trespassing, practicing medicine without a license, not following directions, sexual misconduct, HIPAA violations, inappropriate or unprofessional communication, theft, any “demand” for an alternative course of action to any item that has been discussed in and agreed to in this Agreement, or any breach of this Agreement. If after reasonable steps the concerns of the AMS Chief Clinical Officer have not been fully resolved and/or satisfied, then AMS’ reserves the right to delay or withdraw or dismiss a Member from any upcoming Clinical Block and/or AMS all together, at which point there will be no refunds or credit issued to such Member.  Although rare, events that may lead to expulsion from a clinical site, or positive Urine Drug Screen results, or falsification of documents will be dealt with individually, and assessed for credit (if any) according to the overall situation at hand. However in most cases, dismissal from a Clinical Site by a U.S. licensed physician that is supported by the dismissing physician’s reason(s) for a Member’s dismissal in writing, is a non-creditable event and considered a total loss for the Member.

Entire Agreement/Non-Reliance: This Agreement AND any additional Attachments AND any future updated Agreements signed contain the entire agreement and understanding of the Parties with respect to the subject matter of this Agreement, and supersedes and cancels all previous and contemporaneous written and oral agreements, understandings and negotiations with respect thereto. The Member agrees to sign any updates to this Agreement, either in part or as a whole new Agreement. Each party further agrees that it has not relied on additional oral or written promises, statements, or assertions not contained herein in executing this Agreement. 

Assignments: Member hereby covenants & agrees that he/she may not assign his/her rights or obligations under this Agreement, either in whole or in part, and that any and all such attempts by Member to assign his/her rights under the Agreement shall be void. AMS may assign its rights and obligations under this Agreement without consenting Member.

Venue & Applicable Law:  This Agreement is negotiated and entered into in, and shall be governed by, and construed in accordance with, the laws of the State of California, without giving effect to principles of conflicts of law and without application of choice of law principles.  The parties to this Agreement hereby submit to the non-exclusive jurisdiction of the State and Federal Courts of the State of California, County of Orange, and each party waives personal service of any and all process upon it and consents that all such service of process be made by registered mail directed to its representative address located at https://www.acmedical.org/contact/, and service so made shall have be deemed to be completed five days after the same shall have been deposited in the U.S. mails, postage prepaid.  Each party hereto waives any objection based on forum non conveniens, and any objection to venue of any action instituted hereunder, and consents to the granting of such legal or equitable relief as is deemed appropriate by the court or arbitrator.  Nothing in this Section shall affect the right of the parties to this Agreement to serve legal process in any other manner permitted by law, or affect the right of any of the parties to bring any action or proceeding in the courts or any applicable arbitrations of any other jurisdiction.

Jury Trial Waiver & Agreement to Mediate:  Each of the parties hereto hereby irrevocably and unconditionally waives, to the extent permitted by applicable law, any right it may have to trial by jury in any legal action or proceeding relating directly or indirectly to this Agreement or any other document or instrument related hereto and for any counterclaim therein.  In the event a dispute arising out of or relating to this Agreement shall arise between the parties hereto, and the parties are unable to resolve the matter amongst themselves, the parties hereto agree to participate in at least (4) hours of private mediation.  Mediation shall be administered in the County of Orange, State of California, by a sole mediator.  If the parties are unable to mutually select a mediator, AMS shall nominate three potential mediators, and Member shall select one mediator from such group. All decisions made by a mediator are final and enforceable.  Each party agrees to share equally in mediation costs.  The failure of either party to comply with this mediation provision shall bar the noncompliant party from recovery of attorneys’ fees and costs as otherwise provided for in this contract.

Severability, Counterparts, Electronic/Digital Signatures: If any provision hereof is determined to be invalid, illegal, or unenforceable in whole or in part, neither the validity of the remaining part of such provision nor the validity of any other provision of this Agreement shall in any way be affected thereby. If this Agreement executed in counterparts, each is hereby declared to be an original; all, however, shall constitute but one and the same amendment.  In any action or proceeding, any photographic, photostatic, or other copy of this Amendment may be introduced into evidence without foundation. The parties agree to accept a digital image (including but not limited to an image in the form of a PDF, JPEG, GIF file, or other e-signature) of this Amendment, if applicable, reflecting the execution of one or both of the parties, as a true and correct original. An electronic/digital signature is enforceable as is an “ink-signature” (ESIGN Act of 2000); IP addresses are recorded for every online transaction (CB reservation, approvals, change request, etc.).

Binding Agreement, Electronic/Digital Signature and IP Address Tracking: This Agreement is binding on and shall inure to the benefit of the parties hereto, their respective heirs, successors and assigns. Member hereby agrees that he/she has read and understood the policies set forth by this Agreement; and the Member will start begin the AMS membership and clinical enrollment process by electronically signing this Agreement below; and the Member will submit all required documents as outlined in https://www.acmedical.org/stepstoclinicals/ by no later than 7 days of electrically signing this Agreement.  The Member certifies that all information and documents provided to AMS are nothing but the truth, are accurate and complete.