Credentialing Application

Welcome to the London Health Sciences Centre (LHSC) and St. Joseph's Health Care London (St. Joseph's)!

Please review the sections below to initiate and assist you with the application process.

Before submitting an application for hospital privileges, please ensure that you have received approval from the department Chief aligned to your specialty before proceeding.

Please contact the Professional Staff Human Resources and Credentialing Specialist for questions or further guidance. 

Hospital Appointment Approval Process

All applications for privileges to London Health Sciences Centre (LHSC) and St. Joseph's Health Care London (St. Joseph's) must be reviewed by the City-Wide Credentials Committee (CWCC) and subsequent recommendation to the Joint Medical Advisory Committee (MAC), which must approve the procedural privileges and recommend your appointment(s) to the Boards of Directors for London Health Sciences Centre and St. Joseph's Health Care London.

The approval process generally takes 6-8 weeks. All applications and supporting documents should be submitted at least 8 weeks prior to the anticipated start date. Late submission may result in a delayed start date.

Application for Hospital Privileges - Submission Schedule

Items to be Completed by the Applicant (Physician, Dentist, Midwife)

**All documents must be converted to PDF before sending to Medical Affairs. The hospital is currently removing all Microsoft Word files with a .doc extension from all internal and external emails.

Please complete all requirements listed below:

Credentialing Application Package
  • Email the completed form to @email

Joint Reference Form

Clinical Academics who have already obtained three references as part of the initial interview process would have already completed this step.

  • Email the Joint Reference form directly to your chosen three referees.
  • The standard reference form must be used. Personal reference letters will not be accepted.
  • Request the referee to send the completed confidential reference directly to Medical Affairs at @email.
  • At least one reference must be from an immediate supervisor.
City-Wide Health Screen Form

If you have any question about the health screen requirements, please contact OHSS-MedicalAffairs@lhsc.on.ca

  • All health information is confidential. Please submit the completed Health Review form and supporting health documentation directly to Occupational Health at your primary affiliation:
    • Primary affiliation - St. Joseph's - email to Occupation Health / fax to 519-646-6235
    • Primary affiliation - LHSC - email to Occupational Health / fax: 519-667-6753
  • You will not be able to begin your appointment until you are completely cleared by Occupational Health.
Current Curriculum Vitae

A current Curriculum Vitae (CV) is to be emailed to @email and copy to your department administrative contact.

Certification of Registration to Practice in Ontario
Current Confirmation of Professional Conduct/Letter of Good Standing

For Physician applicants

  • The applicant will need to log into their Member Portal to submit the Certificate of Professional Conduct (CPC) service request. Within the portal, members can monitor the progress of their CPC request and send direct messages to the CPSO. 
  • The CPC can only be requested once the CPSO license becomes active. Due to this, hospital privileges cannot be finalized and approved until after your CPSO licensure effective date. 
  • The CPC needs to be aligned to an Independent or Restricted certificate type (certificates with Postgraduate Education will not be accepted).
  • CPSO may take up to 15 business days to process the CPC once requested
  • Form is to be requested to the attention of:

Medical Affairs
Professional Staff Planning and Credentialing Specialist
London Health Sciences Centre
St. Joseph's Health Care London
P.O. Box 5777, Stn B
Room A2-014
London, ON N6A 4V2
Fax: 519-667-6844

For Dental applicants

  • The Royal College of Dental Surgeons of Ontario (RCDSO) will issue a Letter of Standing to confirm College membership. 
  • The applicant is responsible for requesting the Letter of Standing from RCDSO and forwarding it to Medical Affairs at @email

For Midwifery applicants

  • The College of Midwives of Ontario (CMO) will issue a Letter of Professional Conduct to confirm College membership
  • The applicant is responsible for requesting the Letter of Professional Conduct from CMO and forwarding it to Medical Affairs at @email
Confirmation of Professional Liability Membership Coverage

For Physician applicants

  • Apply for professional liability membership through the CMPA - Canadian Medical Protective Association

  • Membership must be for Ontario

  • CMPA risk code must be in alignment with the Professional Staff work that will be done. Code 12 is aligned to Resident/Clinical Fellows and therefore will need to be updated accordingly for the Professional Staff work.

  • Proof of membership confirmation must be forwarded to Medical Affairs at @email

For Dental applicants

  • The Royal College of Dental Surgeons of Ontario (RCDSO) will issue a Memorandum of Insurance Coverage to confirm liability coverage.

  • The applicant is responsible for requesting the Memorandum of Liability Insurance Coverage and forwarding it to Medical Affairs at @email

For Midwifery applicants

  • The College of Midwives of Ontario (CMO) will issue a Letter of Malpractice Insurance Coverage to confirm liability coverage.

  • The applicant is responsible for requesting the Letter of Malpractice Insurance Coverage and forwarding it to Medical Affairs at @email.

Membership with the Royal College of Physicians and Surgeons of Canada or College of Family Physicians of Canada

Physicians applying for Professional Staff privileges must be a registered member and maintain membership with one of the following colleges:

Those who hold a CPSO Restricted certificate of registration will not be eligible for membership as noted above, until such time the applicant is eligible to write the required certification exam. 

Privacy and Confidentiality eLearning and Other Required Learning
  • You will receive instructions from the Medical Affairs office on how to complete the Privacy eLearning and agreement.
  • The Privacy eLearning and agreement must be completed in order to receive your hospital Corporate ID and password. 
  • Once Privacy has been completed, your department Chief's office will email your Corporate ID and password details to you, along with additional information relating to the following:
    • Training for the Electronic Health Records Systems (EHR)
    • Access to the ME(MyEducation) system.
      • The ME system is a learning management system that you will use to complete and maintain required eLearning. Required eLearning must be completed prior to the identified due dates within the ME system and must be kept up to date at all times.
      • eLearning is mandated either by legislation or hospital policy. 
      • Completion of the modules is a requirement for continuation of all hospital privileges. Please ensure compliance at all times. 
Review Prior to Submitting the Application Package
Save the Following Links to View Once You Receive Your Hospital Corporate ID and Password
Items to be Completed by the Department Manager of Administration and Finance or Delegate

The following is to be completed by the Department Manager of Administration and Finance or delegate:

Chief Support Form

Submit the completed and signed Chief Support form. To assist with completing this form, please view the following documents located within the "Appointment Categories for Professional Staff" section located by clicking HERE:

  • Professional Staff Categories
  • Departmental Delineation of Procedural Privileges
Submit the Systems Access Request Form
  • The Manager of Administration and Finance (Manager) or delegate will request the corporate ID, hospital email, and Cerner access for incoming Professional Staff.

  • Click HERE for full instruction on how to request and manage systems access.

Disclaimer

LHSC and St. Joseph's respect the privacy and confidentiality of the applicant's personal and professional information. Information provided in the application will be used for determining the applicant’s eligibility as a candidate for appointment.

Upon approval of the applicant's appointment, business address, as well as appointment and privileges information will be shared with the relevant corporate departments in order to facilitate access to corporate resources (for example, Admitting and Information Management). Information may also be shared with the University of Western Ontario, Schulich School of Medicine and Dentistry. Only that information which is required will be shared, including our regional hospital partners in the surrounding London region (Tillsonburg District Memorial Hospital, Alexandra Hospital in Ingersoll, Woodstock General Hospital, Middlesex Hospital Alliance including Strathroy Middlesex General Hospital and Four Counties Health Services, and St. Thomas Elgin General Hospital).

All approved applications will be maintained by the Medical Affairs department for the duration of the appointment with LHSC and St. Joseph's. Upon termination, records will be kept in an archive filing system for 7 years.

Preparing for Your First Day

Click HERE for information on how to prepare for your first day. 

Corporate ID, Hospital Email, Remote Access, System Access, & Training

Click HERE to view information relating to systems access and training.