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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Underrepresented in Medicine (URiM) Scholarship Opportunity*

Are you interested in applying for our URiM Scholarship?

"Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population."

— Association of American Medical Colleges (AAMC)

To learn more, visit the following link.

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Application Files*

Upload the Following:

Board Scores
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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