Beth Israel Deaconess Medical Center, Clinical Neurophysiology Fellowship Application

Please complete all fields

Training Year (select one)*

APPLICANT INFORMATION

Degree*

CITIZENSHIP

We accept J1 and H-1B visas. H-1B visas must be in place prior to beginning fellowship.

Citizenship Status*

EDUCATION


Please provide a BRIEF summary of other pertinent education, clinical experience, or research experience not described above. You can provide additional information in your personal statement.


REFERENCES

Please provide the names of three references who will send a letter of recommendation. Letters should be addressed to "Director, Fellowship Program" and must be sent directly by the author by mail or email to: Trudy Pang, MD Beth Israel Deaconess Medical Center 330 Brookline Ave., Baker 5 Boston, MA 02215 tpang@bidmc.harvard.edu

Program Director Letter

Your Residency Program Director should send a letter addressed to "Director, Fellowship Program", stating that she/he anticipates that you will successfully complete your residency program and the expected date of completion. The letter should be sent directly by mail or email to the same address as letters of recommendation. If your program director is one of your references, please add "Program Director" after his/her name above, and ask that the letter of recommendation includes the residency completion information.