Resident and Fellow Onboarding Handbook for Programs

Please review the items in the “Before You Begin” section below before proceeding with any MedHub functions.

ADVANCE Current Residents/Fellows (Promotions): Programs are responsible for advancing/promoting residents/fellows continuing in their program and staying within the same Job Profile. Carefully review your residents/fellows selected for advancement/promotion to the next academic year and ensure that the dates are accurate. NOTE: The advancement function is not easily reversible – any fixes will need to be corrected by the GME Office.

ADD New Resident/Fellow Appointments (New)

Add New Trainees Individually (Use the Add New Resident Function)

Add New Trainees in bulk (Batch Import via New Resident Import Task Wizard)

• Use this tool to import new residents/fellows from an Excel file if you prefer a batch import over manually entering individual appointment records. Before you choose this option, please note:
  • May not be used for residents/fellows who have previously trained at UW, as this will result in a duplicate record.
  • All trainee records entered via batch import are automatically assigned the Job Profile 10328. Job profile corrections must be submitted to Appointment Manager in the GME Office.
  • All fields must be completed (for Program abbreviation, refer to the abbreviation list at the far right side of the template).
  • The Citizenship and Medical/Dental School fields are not included in the import wizard and must be added manually in the Resident Management section (Demographics and Education tabs).

Terminating Appointments: Programs will need to terminate appointments in MedHub for residents and fellows departing their program. This includes residents and fellows:

• transferring to another UW GME program (e.g., residency to fellowship)
• moving into a faculty position
• departing UW

Terminations may be submitted within 90 days of the termination date and are not reversible. Programs must defer submitting terminations for any departing resident/fellow whose end date is subject to change.

The GME Office will run a Contract Report of trainees appointed to the program to:

• Facilitate delivery of the RFPA signature pages
• Verify accuracy of Hire data entered in Workday by the department

The report includes the trainee’s program level, stipend rate, start and end dates, and their assigned RFPA signature page template. Approval of this report is required to assign RFPA signature pages and deliver onboarding/continuing packages to incoming residents and fellows. Programs with trainees who will be signing something other than the standard RFPA signature page (e.g., trainee is paid-direct by military) must notify Appointment Manager in advance to ensure that the appropriate signature page is generated.

• Once a program has finished adding and advancing their trainees, they must notify Appointment Manager that the process is complete.
• A Contract Report will be emailed to the program administrator and any other relevant staff for review.
• Program must review the dates, training levels, and other appointment details on the Contract Report for accuracy. This information will populate each resident/fellow’s RFPA signature page.
• If any changes are required, highlight them on the report and email the corrections back to Appointment Manager.
• If the report is correct, send a confirmation email to Appointment Manager.
• Once the Contract Report is approved by programs and the GME Office, the RFPA signature pages will be delivered to current residents and fellows via MedHub, and incoming residents and fellows via the onboarding portal. Signature pages will be generated with the signature of the DIO (Dr. Byron Joyner), and will be electronically signed by the resident/fellow and program director.

Current Residents/Fellows can access the RFPA signature pages in two ways:

1. Email notification: Current Residents/Fellows will receive an automated email from MedHub notifying them that their appointment packets are available for review and signature.  This will include a custom link that will direct them to the signature page in MedHub.
2. MedHub Tasks Box: When already logged in to MedHub, residents/fellows will find a link to the Trainee Applications portal (aka onboarding portal) in the Tasks box on the myHome This will take them to the same page of required documents as the link included in the email referenced in Step 1. This list includes the RFPA, RFPA signature page, and the UW Medicine Privacy and Confidentiality Agreement (PCISA). Any additional documentation required by the GME and the program will also be found here.

Incoming Residents/Fellows: Residents/fellows with new UW appointments will view their signature page and RFPA in the onboarding portal in MedHub, with their other appointment documentation.

Resident/Fellow Signature
When a resident/fellow has reviewed the RFPA and signature page, they will type their full name in the signature block and select the Sign Contract button. Their signature will appear on the RFPA as an electronic signature, with the date it was e-signed.

Program Director Signature
After the resident/fellow has signed the RFPA, the Program Director will see an Unsigned Contracts notification in the Urgent Tasks box on their myHome page, alerting them that they have received signature pages for their review and signature.
The Program Director selects the Unsigned Contracts link to review and electronically sign the RFPAs. These may be reviewed and approved individually, or by batch. After reviewing the RFPA, the Program Director clicks the box in front of the trainee’s name and types their name in the Signature box. Their signature will appear on the RFPA as an electronic signature, with the date that it was electronically signed.

Signed RFPA Signature Pages
Once a signature page has been electronically signed by the Program Director, the fully executed RFPA signature page will become available in the Training History tab in MedHub. To view the document, select the Signed Contract link in the Contract column of the applicable appointment record.

Monitoring the Status of Signed RFPA Signature Pages
To monitor the status of signed RFPASPs, use the following pathway: MedHub homepage > Site Management > Resident Contracts.

Guidelines for initiating business processes for resident and fellow appointments in Workday are outlined for departments on the Workday section on the Appointments & Credentialing page on the GME website.

UW Appointments Report
Programs will need to provide department HR/payroll staff with the UW Appointments Report from MedHub to initiate hires and make specific job changes in Workday. The report will include the following appointment types:

• New: New to UW
• Promotion: Continuing in program from current AY
• Transfer: Transferring from another UW GME program

Delivery of Onboarding Packages to Trainees

Once Contract Reports are approved, the GME Office will assign UW GME onboarding packages to residents and fellows to be completed via MedHub, concurrently with the RFPA signature page. Once onboarding packages are assigned to trainees, they will receive an automated email from MedHub with instructions and a link for accessing the portal.

The portal includes:

• UW GME onboarding form
• UW Medicine Privacy, Confidentiality, and Information Security Agreement (PCISA)
• Credentialing requirements outlined in the Credentialing Policy, as well as resources for review prior to their appointment.
• Employee Health requirements
• Notification of A-Check Background Check: A-Check is a national background screening company used by UW to screen all employees. Included in the MedHub email is a notification regarding the national background check through A-Check, which must be completed by the resident/fellow within three (3) business days of receipt of their background check request email from A-Check. Residents/fellows must notify Appointment Manager if they will not be able to complete the check immediately after receipt of the email from MedHub.

Note: Incoming trainees do not need a UW NetID to access the MedHub onboarding portal. MedHub usernames for incoming residents and fellows will be setup in MedHub by the GME Office using their UW NetID and UW email address, once issued. New Residents and fellows will be able to log in to their full MedHub profile once NetIDs have been added.

*Please ensure that your incoming trainees are aware of the difference between the following:

1. Having access to the MedHub onboarding portal (sent via email with a unique link)

and

2. Having full access to MedHub with a UW NetID (access granted shortly before MedHub appointment start date)

Basic insurance benefit coverage for eligible residents and fellows begins on the first day of the month following their date of appointment, or on the first day of appointment for those starting on the first of the month, and is effective through the end of the last month of appointment. The Incoming Residents and Fellows page on the GME website provides benefits information for incoming housestaff.

Residents and fellows will receive their benefits enrollment letter in Workday on the day they become benefits eligible and will have 31 days following their eligibility date to enroll in their preferred insurance plan. Additional information can be found on the UW Benefits page.

Programs must notify the GME Office that an individual has been designated as Chief during the appointment process. Chief Residents will hold the title “Resident (10328)” and Chief Fellows will hold the title “Fellow (10439)” in MedHub.

Residents/Fellows will receive a Chief Supplement during the period they are designated as Chief by their program. For more information, refer to the Chief Resident/Fellow Policy.

Residents will be paid a daily rate appropriate to their level of training to attend UW Medicine Orientation activities and for completion of eLearning modules, if the requirements are met prior to commencement of training. Payment will be coordinated by the GME Office.

For programs that require early orientation for their incoming residents and fellows, programs are similarly responsible for paying residents/fellows the daily rate for these orientation days.

Updated 11/15/2023

Residents and fellows who prescribe, order, administer, or handle controlled substances are required to obtain an individual DEA registration. Refer to the GME DEA Registration Policy for information on applying for initial registration and renewal, and for submitting registration updates.

Residents and fellows must apply for their DEA registration as soon as they have been issued a Washington state provider license.

Registrations may be obtained on a fee-exempt basis while training in a UW GME training program.

**In order to qualify for a fee-exempt DEA, trainees must use their institutional work email address and training program mailing address (with Program Box Number) on the DEA application.

Best Practice for Programs: When entering the DEA number in MedHub, under the “Certifications” tab, ensure that the items entered are alphanumeric, with no spaces. The information listed in this field will flow through PUMA. If there are spaces, the training record will be placed on IAM’s hold report, until the identified issue has been corrected.

Payment of registration fees in error: Residents/fellows who pay for their DEA registration in error will need to request a refund directly from the DEA. Refunds are not guaranteed; it is therefore important that housestaff understand that they should not submit payment for their registrations, unless otherwise required (e.g., for moonlighting).

There is a one-time 8 hour training requirement on the treatment and management of opioid or other substance use disorders for all DEA-registered practitioners. More information can be found on the DEA’s website, here.

Residents and fellows may dictate patient notes in the UW Medicine Epic EHR, using Dragon Medical One (DMO) cloud-based speech recognition. Dragon setup is completed by the resident/fellow.

To setup:

1. 1. Complete UW Medicine Epic training
   2. Follow the UWM Dragon Medical One (DMO) Setup Guide located in the EHR Hub

For more information, please visit our EHR Systems and Training page. 

For enrollment in Electronic Prescribing of Controlled Substances (EPCS), ensure the resident or fellow has a copy of the DEA registration on file in MedHub and their DEA registration information is entered in their profile under the “Certifications” tab.

Required information includes:

• DEA Registration Number
• Effective Date
• Expiration Date
• Fee Status (Fee-exempt or Paid)

When this information is in MedHub, and after an overnight refresh of the system, the resident or fellow can meet with an EPCS Enrollment Coordinator to finalize the EPCS enrollment process.

For more information, please visit UW Medicine’s Electronic Prescribing of Controlled Substances page. UW Medicine credentials required for login.

Employee Identification Numbers (EID) are assigned to new employees during the hire process in Workday. Once residents/fellows have their EID they can select their UW NetID and password.

This is an ACGME requirement. Per GME Director of Accreditation, the milestone evaluation from ACGME ADS does not meet the full requirement. Trainee will need a verification of previous educational experiences and a summative competency-based performance evaluation. Program will be responsible for ensuring the Final Summative Evaluation has been received and reviewed by the Program Director.

Where to save this document online via MedHub:

• For residents and fellows, new to UW and who will onboard during in the spring season: the document can be uploaded under “Final Summative Evaluation” in the “Orientation” tab.
• For residents and fellows who have moved internally (i.e.; between programs at UW): the document can be uploaded in the “Application/Appointment Documents (GME)” folder under the “Forms/Files” tab.

Residents and fellows are required to have an ID badge for each of the training sites in which they rotate. Using the photos submitted to MedHub by trainees during onboarding, the UW GME will request UWMC-Montlake and HMC badges be printed by GME’s orientation date. Trainees must submit photos in the required format by April 30th. The required format of badge photos is communicated via the MedHub onboarding package to all incoming residents and fellows and must be submitted by April 30th for GME to coordinate with the badging offices.

Badge pick up can be done by the individual resident or fellow, or the program can work directly with each badging office to coordinate a bulk pick up.

Residents and fellows should have a photo ID with them when going to get their badge (either new or replacement).

Badge request information for Seattle Children’s Hospital and VAPSHCS will be communicated by the sites to programs as part of the credentialing requirements for those sites.

GME will facilitate the hospital badge printing for new residents and fellows only. Any current trainees who are moving from one program to another (i.e.; residency to fellowship), must have badge updates facilitated by the receiving training program, using the process outlined below.

Note: An active Workday record is required for hospital badges. The Employee ID (EID) number will be printed on the badge, which will be generated after a Workday profile is finalized.

The information below provides guidance for individual hospital badge requests, not facilitated by the GME office. 

The Husky Card is the official identification card for members of the UW community. Husky Cards are used for the following:

• Husky Card Account (on campus debit card)
• U-PASS Program
• PPUP parking at UWMC and HMC
• Prox card access to UWMC and HSB
• On-call meals program reimbursements at UWMC and HMC
• Library Services
• Membership to the Intramural Activities Building (IMA)
• Activities and Entertainment

Husky Cards can be issued once a resident/fellow has an EID with a complete payroll record.  A U.S. state- or federally-issued photo ID (such as a driver’s license or passport) is also required. The ID system is not updated in real time and requires a nightly feed from the employee payroll system. Once residents and fellows have been entered into the payroll system, it will take at least 24 hours for the system to send the update to the ID card database.

• Current UW medical students will need to have a new Employee Husky Card issued.
• All incoming residents and fellows must have their Husky Cards in order to sign up for parking and a U-PASS.

The GME will request an ID photo as part of the trainee onboarding requirements in MedHub, and will have Husky Cards made for all incoming trainees who submit their photos in the correct format before April 30th. If they are unable to meet this deadline, they will need to arrange for their own Husky Cards.

Husky Cards can be produced at several locations around campus – a full list of ID Center Locations is available on the Husky Card ID web site. Recommended locations:

• UWMC – Montlake Public Safety Office (room BB-120). Programs may make arrangements in advance to reserve time for their residents/fellows to have their cards made during program orientation.
• Husky Card Office at Odegaard Undergraduate Library (ground floor)

The Immunization and Health Screening Policy for residents and fellows includes requirements for initial appointment and annual immunization requirements. All required immunization documentation for incoming residents/fellows is to be uploaded by individual trainees directly to the onboarding portal in MedHub prior to their appointment start date.  Due to Protected Health Information (PHI) this information should never be sent to programs or the GME. The UWMC-Montlake and HMC Employee Health Offices will review the immunization documentation and respond directly to trainees with any questions via MedHub. UWMC-Montlake EH will send immunization compliance updates to the GME Office and programs starting in mid-May. Please note that the Employee Health staff reviews and checks in these documents via MedHub, and they are not viewable or processed by GME staff. If you have any concerns about health documents that have not been checked in, please contact Employee Health directly. Contact information can be found below:

Residents and fellows are required to complete eLearning modules in the UW Medicine Learning Management System (LMS) both at initial appointment (Phase 1 in June) and mid-year (Phase 2 in October). Refer to the UW Medicine Learning Gateway website for descriptions of required eLearning modules, rollout dates, deadlines, and instructions for opting-in to modules and requesting exemptions, and information on access to completion reports.

All residents and fellows must hold an active Washington state provider license while training in a UW graduate medical education program, and are responsible for submitting their license application during the onboarding process. Residents and fellows are also responsible for complying with any additional licensure requirements while participating in educational experiences outside of UW Medicine and affiliated hospitals. Refer to the State Licensing Policy for more information, including links to application forms and fee schedules.

Residents and fellows are encouraged to apply for one of the licenses listed on the State Licensing Policy. Exceptions to this guidance are IMG fellows training in a non-ACGME training program. These individuals may apply for the limited Fellowship (FE) License, which requires a nomination letter from the Dean.

Departments requiring a nomination letter for an individual applying for the teaching/research (TR) license, must get in touch with the Chief Medical Officer’s office. Contact information for the CMO is listed below:

Angelica Perales
Assistant to the Chief Medical Officer
asjp@uw.edu

Best Practices for Programs:

• When entering the medical license number in the MedHub “Certifications” tab, ensure that the items entered are alphanumeric, with no spaces. The information listed in this field will flow through PUMA, to EPIC. If there are spaces, the training record will be placed on IAM’s hold report, until the identified issue has been corrected.

All residents and fellows are required to be enrolled in the Washington State Medicaid program prior to their appointment start date in order to order, refer, or prescribe for Medicaid patients.

• Enrollment is facilitated by the GME Office.
• An initial batch enrollment request is sent to the Washington State Health Care Authority (HCA) in mid-May for all incoming residents and fellows who have an NPI present in MedHub.
• GME Office will enroll all other residents and fellows in the state’s ProviderOne database as they receive their NPI number.
• Enrollment status is tracked in the Verifications tab in MedHub.

All residents and fellows are required to enroll in Medicare prior to their appointment start date to order/refer certain items and services for Medicare beneficiaries in order for claims to be paid.

• Enrollment in Medicare is completed by residents and fellows through Medicare PECOS (Provider Enrollment, Chain and Ownership System).
• Enrollment instructions for PECOS are included as part of the GME onboarding portal in MedHub. Residents/fellows already enrolled for in PECOS (i.e.; because of previous clinical training or employment) need only to submit confirmation of current enrollment.
• Non-enrolled resident/fellow cannot sign orders or write prescriptions for certain drugs or services. Attendings will be required to sign all orders placed by residents and fellows who are not enrolled in Medicare.
• Enrollment status is tracked in the Verifications tab in MedHub.

Useful links:

• To enroll: PECOS enrollment
• To search for an active enrollment: PECOS enrollment registry

Programs must notify the GME Office regarding any resident/fellow name changes. Programs are further responsible for making sure all appropriate entities are notified, medical center badging offices, IAM, and UWMC and HMC Transcription. Legal name changes must also be updated in Workday. Residents and fellows must notify the Washington State Department of Health (email request to medical.commission@wmc.wa.gov with supporting documentation, e.g. marriage certificate) and the DEA (via online form) of any name change in order for new licenses and registrations to be issued.

Other databases to consider updating:

• ACGME WebADS
• NPI
• PECOS

All residents and fellows are required to have an NPI number prior to their appointment start date and in order to enroll in Medicaid and Medicare. This is a required field in the UW GME Onboarding Form in MedHub. NPI Enrollment instructions are included in the Onboarding Portal in MedHub. Residents and fellows must update the National Plan and Provider Enumeration System (NPPES) with any changes to their provider information (e.g., new medical license number, change in taxonomy code, or change in address) within 30 days of the effective date of the change. Provider information must be current while training in a UW GME program.

Useful links

• NPPES website
• NPPES NPI Registry database

Orientation for incoming residents and fellows who are new to the University of Washington is organized through the GME Office and includes a days-long orientation to UW Medicine and completion of required EHR training. There will be 1 GME orientation, held virtually, on June 21, 2023 for all residents and fellows, to include:

• R1s starting in June
• Residents and fellows starting July 1 or later
• Fellows based at Seattle Children’s Hospital
• Fellows starting August 1

Information about Orientation is posted on the Incoming Residents and Fellows page on the GME website. Residents/fellow who miss their designated orientation date(s) may attend an alternate orientation session.

Programs are responsible for submitting pager requests to UW Medicine Teleservices for residents and fellows rotating at UWMC and HMC.

• Submit the Pager Request Form: Complete a UW School of Medicine GME Resident and Fellow Pager Request Form (available on the GME website) and email it to uwmcpagers@uw.edu.
• Program Contact/Budget Coordinator: The program contact is the person who approves pager charges and provides pager service updates (includes lost pagers). If this program contact differs from the budget coordinator, please provide their contact information.  The budget coordinator will be added to a listserv that generates monthly invoices for reconciliation.
• UW Medicine Teleservices will return Pager Request Forms with assigned pager numbers and capcodes to programs. Pager charges will begin on the activation date indicated on the form.
• Pagers will be activated at 10 a.m. on the date listed on the Request Form. If pagers need to be activated prior to 10 a.m., be sure to request activation for an earlier time.
• Spok will label the pagers with the following information: Resident Name, Pager #, and “If found call (Please list your program’s contact phone number)”
• UW Medicine Teleservices will notify the designated Program Contact when pagers are available for pickup in UWMC-ML room NE165. Programs based at HMC may request to pick up pagers at HMC Teleservices, room BEC-22.
• Pager instruction manuals can be found at http://www.spok.com/resources/paging-user-guides-faqs
• Voicemail: Voicemail is optional and you must designate “yes or no” on the Request Form.  The voicemail function is an additional $1 per month.  For those ordering voicemail, temporary passcodes are the last four digits of each pager’s cap code.  Please have the users choose their own passcodes when they set up their voicemail to prevent any voicemail resets during future equipment swaps. The voicemail guide can be found at http://cloud.spok.com/UG-AMER-Voice-Mail-Instructions.pdf.
• Rotation Schedules: Programs will be responsible for sending their rotation schedules to the paging offices and/or on-call coordinators at the various institutions. Please email schedules to: uwmcpagers@uw.edu

• Transferring Pager Charges: Programs with residents/fellows transitioning from another UW training program must email uwmcpagers@uw.edu and provide the following information:
• Residents/fellows name
• Pager number
• Current budget number
• New budget number
• Program Start Date *Date new budget number goes into effect for new pager charges

• Returning Pagers: Programs must return pagers to UW Medicine Teleservices, Room NE165, or HMC Teleservices, Room BEC-22, for their residents/fellows departing UW. You will receive an emailed receipt from Teleservices.  You will need to provide both your email and your budget coordinator’s email.
• Each pager returned must be labeled with the following information:
• Pager Number
• User Name
• Program Name
• Program Budget #
• Program Budget coordinator name and email
• If a Resident leaves and does not turn in their pager, the monthly fees will continue to be charged to the budget until the pager is returned or deemed lost. If the pager is lost, a $120 fee will be charged to the budget at the time of disconnect. Notify UW Medicine Teleservices at uwmcpagers@uw.edu if a pager is lost.

• Internal staff paging directory at UWMC/HMC: UWMC and HMC have internal paging directories that are available to users, which can be requested on the UW School of Medicine GME Resident and Fellow Pager Request Form. If a resident or fellow was not added during the initial onboarding period, but would like to be, please provide the following phone numbers to trainees interested in using this service.
  • UWMC operator: (206) 598-3300
  • UWMC paging operator: (206) 598-6190
  • UWMC On-Call coordinator: (206) 598-6050
  • HMC operator/paging: (206) 744-3000

Questions or comments: Please contact the GME Office.

Incoming residents/fellows will complete the following steps in Workday as part of their onboarding to the University of Washington:

• UW NetID setup
• Form I-9: Section 1 will be completed in Workday, remaining sections will be completed by department I-9 Coordinator.  Must be completed within 3 business days of first day of employment.  See Complete Form I-9 user guide for details.
• Form W-4 completion
• Direct Deposit setup
• Home and Campus Address Updates: Residents/fellows must update their home address information once in Seattle and prior to their employment start date. Benefits and taxes are linked to the zip code in Workday.

The Residency and Fellowship Position Appointment (RFPA) outlines the terms and conditions of resident and fellow appointments to a University of Washington training program, including the established educational and clinical practices, policies, and procedures in all sites to which residents and fellows are assigned. This agreement is available on the GME website.

• The RFPA signature pages are generated via MedHub. Appointment information on the signature page (program, appointment dates, level, and stipend) is populated with the training history information reflected in MedHub.
• Signature pages will be generated with the signature of the DIO (Dr. Byron Joyner) and will be electronically signed by the resident/fellow and program director. Once all parties have signed, the contract is approved in MedHub and will be viewable by the program.
• A finalized copy of the RFPA signature page can be found under the “Training History” tab for each trainee.

The online UW Directory is the primary location for viewing public contact information for UW employees and staff. Personal Information maintained in Workday will be reflected in the UW Directory.

Programs that require their residents or fellows to wear a physician white coat may provide these at the beginning of training. These may be ordered through MediCleanse or through a preferred vendor, directly by the training program.

A UW Medicine account enables access to the main clinical applications used at UW Medicine, including AMC domain and EpicCare, and is required to enroll residents/fellows for eLearning modules in the UW Medicine Learning Management System (LMS). The user’s UW Medicine Account Login is the same as their UW NetID; however the passwords may be different. Clinical applications at other sites (Seattle Children’s Hospital, VAPSHCS) may require a different account login and password.

Program Administrators who do not have a UW NetID and are unable to submit UW Medicine Account requests should contact their Department HR team in order to be setup with a limited access UW NetID.

You must have a signed UW Medicine Privacy, Confidentiality and Information Security Agreement (PCISA) from a resident/fellow on file in MedHub before they can receive their UW Medicine Account login and password. Residents and fellows will sign the PCISA electronically as an onboarding requirement in the MedHub onboarding portal.

Before IAM can create a UW Medicine Account, residents and fellows must have all of these elements present:

• • A profile in MedHub (with DOB, MedStaffID #, appointment start & end dates)
  • An active payroll record in Workday (with EID #, SSN, & DOB)

Note about continuing, transferring, or terminating residents and fellows: If information is up to date in MedHub, IAM will update/transfer/deactivate the accounts. No additional action is needed by Program Administrators, but feel free to contact the IAM team with questions or concerns.

Programs considering applicants who may require visa sponsorship must be familiar with the UW GME Visa Policy prior to extending an offer or ranking an applicant. Any consideration of H-1B sponsorship must be approved by the GME Office and ISO/Academic HR prior to ranking or offering a position to an applicant. Programs are responsible for notifying the GME Office once they have matched/received acceptance of an offer from a candidate who will require visa sponsorship. Please review the Visas page on the GME website for additional guidelines and resources.