Application for US Clinical Rotation
(Fill out separate forms for each rotation)
Applicant's Name
*
First Name
Last Name
Applicant's Phone/WhatsApp
*
-
Country Code (+)
Phone Number
Applicant's Email
*
example@example.com
Applicant's Medical School Name & Address
*
Street Address, City, State, Country
City, State/Province
State / Province
Zip Code
Applicant's Expected or Completed Month & Year of Graduation
*
e.g., June 2024
Applicant's Expected Year of ERAS Application
*
e.g., September 2027
Clinical Rotation Site: Hospital Name
*
e.g., AdventHealth Florida and Borland Groover Foundation (Copy & Paste from "Availability" Table)
City & State
*
e.g., Port Orange, FL (Copy & Paste from "Availability" Table)
Clinical Experience Type
*
e.g., Gastroenterology (Copy & Paste from "Availability" Table)
Preferred "Month & Year" for Rotation (If the month is not decided, please mention "NOT DECIDED YET - BASED ON USA VISA INTERVIEW")
*
e.g., September 2025 (Write one specific month after discussing availability with the team)
US VISITOR VISA (B1/B2) APPLICANT: Do you need a hospital invitation letter for the US visa interview? (YES or NO, and if YES, then mention the "Month & Year" you would like to have.
*
eg: YES, September 2025
Checklist
*
Valid passport (immediate submission) or US Visa (both must be submitted 1 month prior rotation) (Mandatory)
Proof of medical school enrollment OR degree certificate/transcript (Mandatory)
USMLE exam score report (if taken, otherwise optional)
Recent photo (Mandatory)
Valid health insurance (optional)
HIPAA certificate (Mandatory)
Recent immunization records either vaccination titers or vaccination history signed by physician (with proof of COVID-19 vaccines and Influenza shot) (Mandatory) https://www.aamc.org/media/23441/download
Upload Documents With Clear File Name
*
Browse Files
Cancel
of
My Products
*
prev
next
( X )
Application -
$
800.00
Application + Advance Booking* + LoR Drafting Fee + Self-Paced Clinical Research Program (*Advance booking is conditional upon applying to the same institution within the same calendar year and paying the remaining fees at least 90 days before the rotation start date.)
4 Weeks US Clinical Rotation -
$
1,500.00
Hospital Invitation Letter for the US Visa Interview or Hospital Badge -
$
200.00
A one-time additional $200 fee for a hospital invitation letter for the US visa interview or hospital badge will be applied to the application fee for each rotation, if applicable.
Enter coupon
Apply
Subtotal
$
0.00
Tax
$
0.00
Total
$
0.00
Credit Card
Note: Please specify the rotation details clearly to ensure accurate scheduling, and describe any concerns you may have regarding the rotation.
I have discussed the details of this rotation with the IFMGE team. I have paid the application fees and clinical rotation fees. (Non-refundable)
*
Yes
Signature
*
Submit
Should be Empty: