Away Elective Request

PURPOSE

To inform GME of an IUSM GME resident's intention to participate in an Away Elective (i.e. in a learning experience at an institution other than IUSM and the affiliated hospital system) and of details relevant to that Away Elective.


ELIGIBILITY

Only IUSM residents in good standing are eligible for participation in an Away Elective. A resident is in good standing with GME when they have completed all tasks and requirements assigned to them via MedHub.


DEADLINE

All Away Elective requests must be submitted at least 90 days prior to the start of the elective.


CONTENTS

All information on this form is required. If you are not sure about any details, connect with your IUSM Program or the program which you intend to visit to obtain that information.


APPROVAL

GME will independently verify request information with resident's IUSM Program Director as well as with the Away Institution.

International Away Electives will be additionally reviewed by IUSM GME Designated Institutional Officer and by IU Center for Global Health before permission to participate in an away elective is granted.


IUSM GME request approval is not a guarantee of an away elective. In addition to the documentation required by IUSM GME as part of the Away Elective Request approval process, onboarding requirements of the Away/Host Institution must also be completed, and within the timeframe requested by the Away/Host Institution.


ADDITIONAL RESOURCES AND HELP

Away Electives page in GME Resource Library

Away Elective Approval Process infographic.

Before You Begin

You are expected to familiarize yourself with the Away Elective Process before you submit a request. Visit the Away Electives page in GME Resource Library and/or the convenient one-page Away Elective Approval Process infographic.



Requester Information

This form should be submitted by an IUSM GME resident who wishes to participate in an Away Elective (i.e. in a learning experience at an institution other than IUSM and the affiliated hospital system).


Alternatively, this form can be submitted by a representative of an IUSM program (Program Coordinator, Program Director, Educational Coordinator, etc.) on behalf of a resident in their program.

Request Submitted By*

Enter your name, email, IUSM program and your role within that program. Keep in mind that the form is to be completed from the perspective of an IUSM resident.


E.g. John Smith, jjjsss@iu.edu, Internal Medicine, Program Coordinator

IUSM Resident Information

Select or enter value
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Enter the projected PGY-level at the start of the away elective.

Select
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Immigration Status*

Away Elective Details

Note: Away Elective Requests must be submitted at least 90 days in advance.

Elective Type*

All International away electives require review and approval of Indiana University Center for Global Health Equity (IUCGHE). IUCGHE might need to schedule an interview with you.

Explain, in as much detail as possible, why you are requesting this elective, and why a similar trianing experience cannot be obtained as part of your current - or another - IUSM GME program.


"Fellowship Audition" is not an acceptable rationale for an away elective.

Explain, in as much detail as possible, what you hope to gain, personally and/or professionally, by participating in the proposed elective.

Source of Funding*

Who will fund this elective? If unsure, obtain this information from your program's director, coordinator, of financial administrator. Source of funding for away electives must match the source of funding for IUSM GME training, unless "Other" is selected.

I.e. grant, own funds, etc.

IUSM Program Contacts

Away Institution Details

E.g. The Johns Hopkins University School of Medicine

E.g. Pediatric Emergency Medicine

E.g. Johns Hopkins Children’s Center; 1800 Orleans Street Baltimore, MD 21287

This is the person at the Away Program with whom you are primarily making arrangements for this away elective and whom GME and/or your IUSM program should contact with any questions regarding your request.

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