VCMC Medical Student Externship Application

Personal Information

Medical School Performance

Have you ever failed or need to remediate a medical school course? If so, please explain below. *
Have you ever failed the USMLE Step 1 or COMLEX Part 1? If so, please explain below. *
Have you ever taken a leave of absence from medical school? If so, please explain below. *

Rotation Preferences

Requested Dates for Externship
Rotations begin on a Monday (or Tuesday if Monday is a holiday) and end 2, 3 or 4 weeks later on a Friday.

Please rank your preference for which rotation you would like to do (1-most, 7-least). Four-week externships are divided into 2 two-week rotations. We try to accommodate your preferences as much as possible.

Additional Information

Are you planning to match in Family Medicine? *
Are you planning to apply to our program? *

Do you need help finding a place to stay during your externship?

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