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School*:

Country Location of Your Medical School*:

This is the medical school I have attended / I am attending*:

Status*:

USMLE Scores:

Type of Rotation*: (Type of rotation you are looking for)

Please list the specialties you are most interested in*:
(You may select up to 3)
Allergy & ImmunologyAnesthesiologyColon & Rectal SurgeryDermatologyEmergency MedicineFamily MedicineInternal MedicineInternal Medicine (Cardiology)Internal Medicine (Nephrology)Internal Medicine (Oncology)Internal Medicine (Pulmonology)Internal Medicine (Rheumatology)Internal Medicine (Other)NeurologyObstetrics & Gynecology (Ob/Gyn)OphthalmologyOrthopaedicsOtolaryngology (ENT)PathologyPediatricsPhysical Medicine & RehabilitationPlastic SurgeryPsychiatryRadiologySleep MedicineSurgeryUrologyOtherI would be willing to consider many specialties

Your Desired Locations*:
(You may select up to 10 areas of interest)
I am okay in a smaller city, as long as the doctor is excellentIt is important to me to be in a large cityI have no strong preference in terms of the locationI prefer the East CoastI prefer the West CoastI prefer the SouthI prefer MidwestNew York CityWashington DCLos AngelesBostonPhoenixChicagoHoustonPhiladelphiaDallasAustinIndianapolisCharlotteDetroitDenverBaltimoreAtlantaMiamiClevelandNew OrleansOther (indicate below)

If you chose "Other," please indicate your location of interest not listed:

When would you like to do the rotation?*:
(Please check all that apply as soon as possible)
October 2017November 2017December 2017January 2018February 2018March 2018April 2018May 2018June 2018July 2018August 2018Other

Do you already have a visa?*:

How did you find out about MEDFORUM internships?*:



Upload Required Documents: (CV, Academic Transcript, passport copies, recommendation letters, graduation certificates, Immunization Certificates, USMLE scores)

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Fees: I understand that MEDFORUM is a professional consulting service that can charge fees for providing assistance for professional services* Yes

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