LAMA Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Country Code
-
Area Code
Phone Number
Citizenship
*
Please Select
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominica
Dominican Republic
East Timor (Timor-Leste)
Ecuador
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Fiji
Finland
France
Gabon
The Gambia
Georgia
Germany
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Macedonia
Norway
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Romania
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Slovakia
Slovenia
Solomon Islands
Somalia
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Academic status
*
Please Select
Student
Graduate
Resident
University
*
Please Select
American University of Beirut (AUB)
Beirut Arab University (BAU)
University of Balamand (UOB)
Lebanese University (LU)
Université Saint-Esprit de Kaslik (USEK)
Université Saint-Joseph de Beyrouth (USJ)
Lebanese American University (LAU)
Saint George University of Beirut (SGUB)
Other
If your university is not listed please type it here
Graduation date
*
-
Day
-
Month
Year
Date
Services
*
Clinical Rotation (LORs)
USMLE Step1
USMLE Step2 CK
Road to Residency
Research
Visa Assistance
Housing Assistance
How many rotations (LORs) needed?
*
Please Select
1
2
3
4
5
6
Rotation 1
*
Please Select
IM
FM
Surgery
Peds
Psych
OBGYN
Cardio
GI
ID
ER
Radio
Orthopedics
Neurology
Other
Rotation 1 type:
*
Onsite
Online
If other Please specify
Rotation 1 duration (per weeks)
*
Please Select
2
3
4
6
8
12
Rotation 1 start date
*
-
Day
-
Month
Year
Date
Rotation 2
*
Please Select
IM
FM
Surgery
Peds
Psych
OBGYN
Cardio
GI
ID
ER
Radio
Orthopedics
Neurology
Other
Rotation 2 type:
*
Onsite
Online
If other Please specify
Rotation 2 duration (per weeks)
*
Please Select
2
3
4
6
8
12
Rotation 2 start date
*
-
Day
-
Month
Year
Date
Rotation 3
*
Please Select
IM
FM
Surgery
Peds
Psych
OBGYN
Cardio
GI
ID
ER
Radio
Orthopedics
Neurology
Other
Rotation 3 type:
*
Onsite
Online
If other Please specify
Rotation 3 duration (per weeks)
*
Please Select
2
3
4
6
8
12
Rotation 3 start date
*
-
Day
-
Month
Year
Date
Rotation 4
*
Please Select
IM
FM
Surgery
Peds
Psych
OBGYN
Cardio
GI
ID
ER
Radio
Orthopedics
Neurology
Other
Rotation 4 type:
*
Onsite
Online
If other Please specify
Rotation 4 duration (per weeks)
*
Please Select
2
3
4
6
8
12
Rotation 4 start date
*
-
Day
-
Month
Year
Date
Rotation 5
*
Please Select
IM
FM
Surgery
Peds
Psych
OBGYN
Cardio
GI
ID
ER
Radio
Orthopedics
Neurology
Other
Rotation 5 type:
*
Onsite
Online
If other Please specify
Rotation 5 duration (per weeks)
*
Please Select
2
3
4
6
8
12
Rotation 5 start date
*
-
Day
-
Month
Year
Date
Rotation 6
*
Please Select
IM
FM
Surgery
Peds
Psych
OBGYN
Cardio
GI
ID
ER
Radio
Orthopedics
Neurology
Other
Rotation 6 type:
*
Onsite
Online
If other Please specify
Rotation 6 duration (per weeks)
*
Please Select
2
3
4
6
8
12
Rotation 6 start date
*
-
Day
-
Month
Year
Date
USMLE Step1 Date
*
-
Month
-
Day
Year
Date
USMLE Step1 duration (per weeks)
*
Please Select
6
24
USMLE Step2 CK Date
*
-
Month
-
Day
Year
Date
USMLE Step2 CK duration (per weeks)
*
Please Select
6
24
Housing start date
*
-
Month
-
Day
Year
Date
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