After residency
Requirements for moving from residency to independent practice
Residents should separate the terms of their training appointment from any later employment agreement, then complete the state, payer, insurance, and practice requirements that apply where patients receive care.
DINOMO — Democratized Independent Network of Medical Offices is Ignite Health Partnership’s network for independently owned medical offices. Each office decides whether to use the physician directory, credentialing, payer-contract, revenue-cycle, or MEDFlow services. The office retains its own clinical and business decisions.
Section 01
ACGME training-appointment rule
ACGME-accredited sponsoring institutions and residency programs may not require residents or fellows to sign a non-compete or restrictive covenant for the training appointment.
An ACGME requirement is an accreditation rule, so a sponsoring institution that breaks it faces accreditation consequences, which is not the same as a court treating the contract term as automatically void.
Separate post-training employment agreements and state law may be different. Graduates must also satisfy state licensure, practice-formation, malpractice, Medicare, payer, prescribing, and patient-location requirements.
Section 02
Agreements and patient relationships
Review the signed training documents, moonlighting terms, separate employment offers, confidentiality duties, patient-contact rules, medical-record rules, and state law with qualified counsel. Do not copy or use patient information outside an authorized care or records process.
- Confirm which agreement applies during training and which agreement would apply after graduation.
- Use approved patient communication, consent, and medical-record procedures.
- Do not assume that an ACGME rule decides the validity of a separate employment term.
- Document advice about state restrictive-covenant law and patient-notice requirements.
Section 03
Practice-opening requirements
Build a state-specific checklist for the physician and the office. The required sequence depends on the entity type, specialty, payer model, prescribing activity, and patient locations.
- Obtain unrestricted licenses, controlled-substance registrations, malpractice coverage, and required entity approvals.
- Choose Medicare participation or opt-out status correctly and complete private-payer enrollment when the practice bills insurance.
- Set up documentation, coding, billing, privacy, patient notices, scheduling, call coverage, referrals, and record retention.
- Verify every deadline before advertising an opening date or accepting an appointment.
Official sources
Review the current source documents and obtain professional advice for the physician, patient, employer plan, and practice location.