Externship Application for Elective Rotations

Application Process

Directions: Please be sure to thoroughly read and complete every section of this application. Do not submit this application to University Hospitals Parma Medical Center until all of the listed application materials have been secured for submission. Once you have all of the application materials, please submit your application via this webpage. Incomplete applications will not be processed.

Acting Internships are reserved for students that intend to apply to a UH Parma Medical Center Internal Medicine residency program. Acting Internships are limited, please submit your request early. Applications must be received a minimum of 60 days prior to your requested rotation date. If your application is accepted, you will be responsible to return all additional paperwork sent with your acceptance letter no later than 30 days prior to your start date. Failure to meet this deadline will result in your acceptance being revoked.

Elective rotations will be considered once all Acting Internships slots have been scheduled and filled.

Rotations may be 2 or 4 weeks (preferred) in duration.

Applications will begin to be reviewed on February 1st. All applications will be evaluated in the order in which they are received. You will be notified within 2 weeks of your submission of our decision. All acceptance letters will be sent via email to the address provided on your application. Please allow a minimum of 10 business days before contacting the program for a response.

Once your completed application is approved and you are notified by UH Parma Medical Education Department, you will have 1 week to accept the rotation. Once accepted, the dropping of the rotation should only be done in extreme circumstances. If such circumstances should occur, please contact Sarah.Majkrzak@Uhhospitals.org.

First Name:*

Middle Initial:

Last Name:*

Address:*

City:*

State:*

Zip :*

Phone:*

Email:*

Medical School Name:*

City:*

State:*

Degree:*

Anticipated Graduation Date:*

I have rotated previously at UH Parma

Locations and dates of previous UH Parma rotation:

This is my FIRST UH Parma rotation

First Choice Specialty:*

Start Dates:*

End Dates:*

Rotation Type:*

Second Choice Specialty:

Start Dates:

End Dates:

Rotation Type:

Upload application materials (filename MUST include your name or application will not be processed):

Should you accept a rotation offer, University Hospitals Parma Medical Center requires a letter of good standing, proof of malpractice and health insurance, and verification of current immunizations be sent directly from your school official. This information must be on file no later than four (4) weeks prior to the start of the rotation(s). We reserve the right to cancel your rotation if this information is not received.

I understand that UH Parma Medical Center assumes no liability for any medical costs incurred by me while I am participating in an elective at UH Parma Medical Center. I agree to notify UH Parma Medical Center at least 30 days in advance if I am unable to take this elective. I understand that confirmation of acceptance into any elective cannot be given until UH Parma Medical Center has notified me.

At this time we are unable to accept medical students outside of the United States.

The items listed below must be submitted along with this application. Please send as one PDF and include your last name in the filename. Incomplete applications will not be processed.

Copy of USMLE or COMLEX Step 1 score report (Please note, the minimum test store required for a rotation is established by each program.)
Copy of USMLE Step 2CK or COMLEX Step 2CE score report (if not available, please indicate date of exam)
Copy of COMLEX or USMLE transcripts showing all exam attempts (for NBOME, this can be found on the "My Account" page)
Unofficial transcript from your medical school
Copy of current (i.e. unexpired) ACLS card
Letter of good standing from school
Current CV

Your Signature:*

Date:*

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