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How to Comply with Students to Service Loan Repayment Program Service Requirements

National Health Service Corps (NHSC) Students to Service Loan Repayment Program (S2S LRP) awardees commit to serving three years of full-time clinical practice at one or more NHSC-approved sites in a Health Professional Shortage Area (HPSA) of greatest need.

Below is an overview of your service commitment requirements. We expect you to review the complete, detailed information in the S2S LRP Application and Program Guidance (PDF – 604 KB).

Service Commitment

Your S2S LRP contract becomes effective on the date the Secretary of Health and Human Services (or their designee) countersigns it.

Your service commitment at an NHSC-approved site begins after you have completed medical or dental school and any approved postgraduate training.

Before making changes to your service status (e.g., transfers, medical suspension, maternity leave, or half-time conversion) you must seek prior approval from the NHSC. Submit requests through the BHW Customer Service Portal.

If you are a dental clinician, and you do not pursue postgraduate training, we expect you to begin service within six months following completion of your Doctor of Dental Surgery (D.D.S.) or Doctor of Medicine in Dentistry (D.M.D.) degree program.

When do you begin receiving credit for your service?

Credit for service toward your service commitment only begins after you do all of the following:

  • Successfully complete an NHSC-approved primary care postgraduate training program (only for Doctors of Medicine (M.D.) and Doctors of Osteopathic Medicine (D.O.));
  • Obtain a full, permanent, unrestricted license to practice medicine or dentistry.
    • You must have a license in the state where you intend to practice.
    • If you are serving as a federal employee, federal contractor, or employee of a tribal health program, you can be licensed in any state; and
  • Begin full-time or half-time clinical practice at an NHSC-approved site.

Note: Any time you serve at the site prior to the contract going into effect will not count towards your service commitment.

When does your service commitment end?

Your last day of service will occur three years from the date you started.

We may adjust your end date in certain circumstances (e.g. we grant you a waiver for absences beyond the approved seven weeks per service year).

Service Hours

You must work a specified minimum number of hours per week full-time or half-time. That work must be within the profession for which you applied, and we awarded you via the S2S LRP contract, at your NHSC-approved service site(s).

Full-Time Clinical Practice

We define full-time as at least 40 hours/week, for a minimum of 45 weeks each service year.

  • You may compress the 40 hours/week into no fewer than four days/week.
    • No more than 12 hours of work in any 24-hour period.
  • You must spend a minimum of 32 hours/week providing patient care.
  • You do not receive service credit for any hours you work over the required 40 hours/week.
  • Additional rules apply based on discipline and practice location.

Full-Time Clinical Practice Activities

  • Clinical-related administrative, management or other activities
    Count no more than eight hours toward the minimum 40 hours/week for these activities.
  • Teaching activities
    Count no more than eight hours toward the minimum 40 hours/week for teaching activities.

Note: There are additional full-time clinical practice requirements by discipline. Review them in the S2S LRP Application and Program Guidance (PDF – 604 KB).

Half-Time Clinical Practice

We define half-time as 20-39 hours/week, for a minimum of 45 weeks each service year.

  • You may compress the minimum 20 hours/week into no fewer than two days/week.
    • No more than 12 hours of work in any 24-hour period.
  • You must spend a minimum of 16 hours/week providing patient care.
  • You do not receive service credit for any hours you work over the required 20 hours/week.
  • Additional rules apply based on discipline and practice location.

Half-Time Clinical Practice Activities

  • Clinical-related administrative, management or other activities
    Count no more than four hours toward the minimum 20 hours/week for these activities.
  • Teaching activities
    Count no more than four hours toward the minimum 20 hours/week for teaching activities.

Note: There are additional half-time clinical practice requirements by discipline. Review them in the S2S LRP Application and Program Guidance (PDF – 604 KB).

Can you switch to half-time service?

When you sign the S2S LRP contract, you agree to serve full-time.

However, at the Secretary of Health and Human Services (HHS)’s discretion, and with written consent from your NHSC site, you may receive a waiver that allows you to complete your service commitment through half-time service.

If you receive a waiver of the full-time service requirement, you must agree to provide six years of half-time clinical practice at one or more NHSC sites.

How do we verify your service hours?

If you have completed your training and are practicing at an NHSC-approved site:

  • Every six months, we verify that you fulfilled your service commitment by meeting clinical practice requirements.
  • We do this through the Service Verification (ISV) form. You complete and sign it, then send to your site administrator to sign and submit it through the BHW Customer Service Portal.

Note While we do alert you about the ISV submission, it is your responsibility to ensure that your site administrator submits it on time.

Watch our presentation: In-Service Verifications (ISVs)

Taking Temporary and Permanent Leave

We provide an overview of our policies around taking temporary leave (e.g. vacation/sick leave or maternity/paternity leave) and permanent leave.