4th Year Visiting Application: Family Medicine

4th Year Visiting Application: Family Medicine

This application is for our Family Medicine 4th-year rotation. Please visit our website to view the application for the other rotations offered in Internal Medicine, OBGYN, Surgery, and Psychiatry.

4th Year Verification*

Will you be in your 4th year at the time of elective?

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First Name*

Last Name*

Email*

Phone Number*

University*

University Contact Email

Please provide an email address for a contact at your school, should we need to move forward with an affiliate agreement.

U.S. Citizen

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Dates*

Please select the blocks that you are available to rotate. We go by UNC's block schedule and students are expected to complete all 4 weeks. If you select 'other', you will be added to a waitlist if there is availability to offer a different schedule. More dates will be added as they come available.

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Rotation Preference*

Please select all rotations that you are interested in. Depending on which residency programs approve your application, you will be given a chance to select your top preference.

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Supplemental Scholarship Opportunity*

Are you interested in applying for our Supplemental Rotation Scholarship?

The Supplemental Rotation Scholarship is designed to provide financial support to students who demonstrate the greatest need, helping to offset travel expenses associated with completing an away rotation.

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Application Files*

Upload the Following:

Board Scores - USMLE/COMLEX Step 1 is required.
CV/Resume
Letter of Recommendation
Personal Statement
Transcript

Failure to upload all requested items will result in your application being denied.

*If you do not have access to your LoR, please have it emailed directly to jasmine.wood@mahec.net.

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