Application for US Clinical Rotation
(Fill out separate forms for each rotation)
Name
*
First Name
Last Name
Phone/WhatsApp
*
-
Country Code (+)
Phone Number
Email
*
example@example.com
Medical School Name & Address
*
Street Address, City, State, Country
City, State/Province
State / Province
Zip Code
Expected or Completed Month & Year of Graduation
*
(September 2024)
Clinical Experience Type (Copy & Paste from "Availability" Table)
*
https://ifmge.org/us-externships-observerships/
City & State (Copy & Paste from "Availability" Table)
*
https://ifmge.org/us-externships-observerships/
Clinical Rotation Site: Hospital Name (Copy & Paste from "Availability" Table)
*
https://ifmge.org/us-externships-observerships/
Month Preference (Write one specific month after discussing availability with Team)
*
(If the month is not decided, please mention "NOT DECIDED YET". The applicant must decide and pay full payment 90 days in advance.)
Do you need an invitation letter for a US visa interview?
*
(YES or NO, and if Yes then mention the "Month" would you like to have. eg: YES, September)
Checklist
*
Valid passport (immediate submission) or USA Visa (both must be submitted 1 month prior rotation)
Proof of medical school enrollment/degree certificate/transcript
USMLE exam score report (if any)
Recent photo
Valid health insurance (optional)
HIPAA certificate
Recent immunization records either vaccination titers or vaccination history signed by physician (with proof of COVID-19 vaccines and Influenza shot)
COVID-19 RTPCR test results at least 72 hours prior to the start date or date of arrival (Optional)
Upload Documents With Clear File Name
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Application -
$
750.00
Application + Advance Booking* + Self-Paced Clinical Research Program + LoR Drafting Fee (*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.)
Visa or Invitation Letter or Hospital Badge -
$
150.00
A one-time additional $150 fee for a visa or invitation letter or hospital badge will be applied to the application fee for each rotation, if applicable.
Baylor St. Luke’s Medical Center, Houston, TX - Internal Medicine (Externship) -
$
1,500.00
Internal Medicine
Garnet Health Medical Center and New York Cancer & Blood Specialists (NBCBS), Middletown, NY - Hematology & Oncology (Externship/Elective) -
$
1,500.00
Internal Medicine
Houston Methodist Hospital and HCA Houston Healthcare Medical Center , Houston, TX - Cardiology (Clinical + Interventional) (Externship/Elective) -
$
1,500.00
Internal Medicine
Houston Methodist Hospital, Houston, TX - Hematology & Oncology (Externship/Elective) -
$
1,500.00
Internal Medicine
Hospital Audition Rotation, NJ - Internal Medicine (Externship) -
$
3,000.00
Internal Medicine
HCA Houston Healthcare Clear Lake and Houston Heart Care, Webster, TX - Cardiology + Internal Medicine (Clinical + Interventional) (Externship/Elective)
$
1,500.00
Internal Medicine
HCA Houston Healthcare Clear Lake, Webster and Clear Lake Medical Group, Webster, TX - Internal Medicine (Externship) -
$
1,500.00
Internal Medicine
HMH JFK University Medical Center, NJ - Internal Medicine & Infectious Disease (Internal Medicine & Infectious Disease (Externship/Elective) -
$
1,500.00
Internal Medicine
Insight Hospital & Medical Center Chicago, Chicago, IL - Hematology & Oncology (Externship/Elective) -
$
1,500.00
Internal Medicine
Interfaith Medical Center and New York University Langone Health, Brooklyn, NY - Cardiology (Clinical + Interventional) (Externship/Elective) -
$
1,500.00
Internal Medicine
MedStar Health, Baltimore, MD - Internal Medicine (Externship) -
$
1,500.00
Internal Medicine
Montefiore St Lukes Cornwall Hospital And Horizon Family Medical Group, New Windsor, NY - Cardiology & Internal Medicine (Externship/Elective) -
$
1,500.00
Internal Medicine
Saint Louis University School of Medicine, SLUCare Physician Group, SSM Health, and OSF Healthcare, St. Louis, MO - Cardiology (Clinical + Peripheral Interventional) (Externship/Elective) -
$
1,500.00
Internal Medicine
University of Texas Health Science Center Houston, Memorial Hermann Health System, and McGovern Medical School, Houston, TX - Pulmonary Critical Care & Interventional Pulmonology (Externship/Elective) -
$
3,000.00
Internal Medicine (2 Months)
University of Texas MD Anderson Cancer Center, Houston, TX - Hematology & Oncology (Externship/Elective) -
$
1,500.00
Internal Medicine
Advent Health Florida and Borland Groover Foundation, Orlando, FL - Gastroenterology (Externship/Elective) -
$
1,500.00
Internal Medicine
University of Texas MD Anderson Cancer Center, Houston, TX - Hematology & Oncology (Tele-rotation) -
$
1,000.00
Internal Medicine
Internship Bootcamp Program - Internal Medicine - Tele-rotation (Education) -
$
1,000.00
Internal Medicine
Garnet Health Medical Center and Middletown Medical Center, Middletown, NY - Family Medicine (Externship) -
$
1,500.00
Family Medicine
Jackson Park Hospital, Chicago, IL - Family Medicine (Externship) -
$
1,500.00
Family Medicine
Internship Bootcamp Program, Houston - Family Medicine -
$
1,000.00
Family Medicine
CHI St. Luke’s Health and Kindred Hospital, Sugar Land, TX - Neurology and Sleep Medicine (Externship/Elective) -
$
1,500.00
Neurology
HCA Houston Healthcare Pearland and Clear Lake, and PAM Health Rehabilitation Hospital of Clear Lake - Pearland, TX - Neurology and Neurocritical Care (Externship/Elective) -
$
1,500.00
Neurology
Medical University of South Carolina (MUSC) Downtown Center, Columbia, SC - Neurology, Stroke, and Child Neurology (Externship/Elective) -
$
1,500.00
Neurology
Neurology and Epilepsy Specialists and Sunrise Children’s Hospital Outpatient Practice Group, Las Vegas, NV, Neurology, Epilepsy, and Child Neurology (Externship/Elective) -
$
1,500.00
Neurology
Saint Francis Health System, Tulsa, OK - Interventional Neurology and Stroke (Externship/Elective) -
$
1,500.00
Neurology
South Shore Hospital, Chicago, IL - Neurology (Externship/Elective) -
$
1,500.00
Neurology
TBA: EEG, EMG, and Neuroimaging Bootcamp Program - Adult and Child Neurology - Tele-rotation (Education) -
$
1,000.00
Neurology
Manhattan Wellness Psychiatry, New York, NY - Psychiatry (Externship) -
$
1,500.00
Psychiatry
Quannet Health, White Plains, NY - Psychiatry (Externship) -
$
1,500.00
Psychiatry
Neurology and Epilepsy Specialists and Sunrise Children’s Hospital Outpatient Practice Group, Las Vegas, NV - Child Neurology (Externship/Elective) -
$
1,500.00
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Mount Kisco, NY - Tele-rotation (Education) - Anatomical & Surgical Pathology -
$
1,500.00
Pathology
Interfaith Medical Center and New York University Langone Health, Brooklyn, NY - Radiology - Interventional Cardiology and Cardiac Imaging (Externship/Elective) -
$
1,500.00
Radiology
Saint Francis Health System, Tulsa, OK - Radiology - Interventional Neuroradiology (Externship/Elective) -
$
1,500.00
Radiology
University of Texas Health Science Center Houston, Memorial Hermann Health System, and McGovern Medical School, Houston, TX - Radiology - Interventional Pulmonology (Externship/Elective) -
$
3,000.00
Radiology (2 Months)
TBA: Radiology Bootcamp Program - Radiology - Tele-rotation (Education) -
$
1,000.00
Radiology
Saint Francis Health System, Tulsa, OK - Endovascular Neurosurgery - (Externship/Elective) -
$
1,500.00
Surgery
University of Texas Health Science Center Houston, Memorial Hermann Health System, and McGovern Medical School, Houston, TX - Interventional Pulmonology – Surgical Subspecialty Rotation (Externship/Elective) -
$
3,000.00
Surgery (2 Months)
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Total
$
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Credit Card
I have discussed the details of this rotation with IFMGE Team. I have paid the application fees and clinical rotation fees. (Non-refundable)
*
Yes
Signature
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