Medical Student Visiting Rotation Application

Medical Student Visiting Rotation Application

This application is for rising/current fourth-year medical students who are interested in completing an inpatient medicine rotation with the BMME-Jackson Internal Medicine Residency Program. Please complete the form with your details, upload your photograph and transcript, and provide your exam scores. Any questions can be sent to IMRes.Jackson@bmhcc.org.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical School
Education Dates (entry to expected graduation)
Medical School Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
What field of interest (Internal Medicine, Family Medicine, etc.) are you interested in applying to for Match and why? Any interests in fellowships yet?
Why are you interested in visiting our program?
Hobbies and Interests
USMLE Step 1/COMLEX level 1 Exam – Passed
Please explain why you selected Other
Step 2 CK/COMLEX level 2 Exam Score (if not taken yet, enter 0)
Available Rotation Dates
1
2
3
4
Upload a recent professional photograph

Cancelof
Upload your current transcript

Cancelof
Should be Empty:

Available Rotation Dates