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Rush University Medical Center Department of Orthopaedic Surgery Medical Student Clerkship Application

Thank you for your interest in a clinical rotation in the Department of Orthopaedic Surgery at Rush University Medical Center. As part of the application process, students are asked to complete this online application. Applications are accepted from February 1, 2017 – May 1, 2017. Applications received by March 31 will be notified of the status of their application by April 15th, 2017. Applications received after April 1 will be notified of the status of their application by May 15th, 2017. Applicants who are accepted for a rotation will then be asked to complete the online VSAS application to register for the course with Rush Medical College. VSAS instructions will be provided to those students accepted for a rotation.

Demographic Information

Name*
Email*
Date of Birth*
Telephone*
Address*
Emergency Contact Name*
Emergency Contact Email*
Emergency Contact Telephone*

Premedical & Medical Preparation

Please list all medical school clerkships (e.g. orthopaedic surgery, internal medicine, general surgery) you have completed or are currently enrolled in. Please do not list any orthopaedic surgery rotations you will be completing at outside institutions.

Institution* City, State* Degree Earned* Dates of Attendance*
Name of Orthopaedic Surgery Faculty Advisor
Email of Orthopaedic Surgery Faculty Advisor
Telephone of Orthopaedic Surgery Faculty Advisor

Clinical Rotation Experience

Please list all current and completed clinical clerkships. Please do not list any orthopaedic surgery rotations you will be completing at outside institutions.

No Hospital City Type Of Rotation Date Grade, (If received)
AOA candidate*
USMLE Part 1 Score *
USMLE Part 2 Score
(Please leave blank if you have not taken this test yet)
Current Medical School*
Current Class Year*

Research Experience

Please list any research experiences you have had to date including any current research teams you are a part of.

No Name of Hospital City Faculty Advisor Field of Investigation Dates

Publications*

Please list any published manuscripts you have authored. If you have more than 5 published manuscripts, please list the 5 that you are proudest of or have been most involved in. All additional publications should be listed on your CV.

No Publications

Statement of Interest

Please briefly state your interest in applying for a clerkship rotation in the Department of Orthopaedic Surgery at Rush University Medical Center.*

Clinical Rotation Preference

Please list your preferred rotation dates as well as your service preferences. We do our best to accommodate all requests for both dates as well as service assignments, but cannot guarantee that all first choices will be honored.

Services

Available Rotations

Preference 1:

Adult Reconstruction
Sports Medicine
Spine
Hand
Foot & Ankle
Trauma & Pediatrics
Tumor

Preference 2:

Adult Reconstruction
Sports Medicine
Spine
Hand
Foot & Ankle
Trauma & Pediatrics
Tumor

Preference 3:

Adult Reconstruction
Sports Medicine
Spine
Hand
Foot & Ankle
Trauma & Pediatrics
Tumor
Preferred Date
Preferred Date
Preferred Date

Upload Your CV*

Thank you for applying for a clinical rotation in the Department of Orthopaedic Surgery at Rush University Medical Center. If you have any questions regarding your application or the orthopaedic surgery residency program, please contact our clerkship coordinator, Ms. Phyllis Velez.

Phyllis Velez, C-TAGME
Orthopaedic Residency Program and Sports Medicine Fellowship Coordinator
The Orthopaedic Building
Rush University Medical Center
1611 W. Harrison Street Suite, 201
Chicago, IL 60612

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Department of Orthopaedic Surgery Residency · 1611 W. Harrison Street Suite 201, Chicago IL, 60612

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