Toho Univeristy Clinical Training Application Form

Clinical Training Application Form
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail

Confirmation Email
Date of Birth

YearMonthDay
Age
Nationality
Institution currently working
Medical school conferred a medical degree
Total length of medical course

Other
Date of graduation

YearMonthDay
Clinical medical training or experiences completed prior to clinical clerkship at Toho University
Preferred elective topics (First choice)
Preferred elective topics (Second choice)
Preferred elective topics (Third choice)
Gender
NO ELECTIVE PROGRAMS ON FOLLOWING HOLIDAYS (July 2026 - March 2027)

July 20, August 11, September 15, September 21-23, October 12, November 3, November 23, December 21-January 1, 2027, January 11, February 11, February 23, March 20
Starting date

YearMonthDay
Last date

YearMonthDay
Total number of weeks

Other
Do you want to stay in University Housing?
Do you need an invitation letter from Toho University Faculty of Medicine for your visa?
Date of medical license issued

DayMonthYear
Is your mother tongue English?
Have you acquired a degree in a program where Japanese or English was the primary language of instruction
The following documents have to be submitted when you submit this application form. Please convert documents and images to PDF except your face photo. Please also note that the maximum size per file should not exceed 1.1 MBytes.
Letter of Recommendation from Hospital

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Required Supporting Documentaion

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On a form specified by TOHO Cancelof
Immunization Record

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On a form specified by TOHO Cancelof
Assessment of chest X-ray

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Image of chest X-ray

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Copy of passport

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Proof of English proficiency

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Only scores of TOEFL, IELTS, or CEFR accepted Cancelof
Face photo

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Taken within 6 months of application dateNo hat (*except for religious reasons)No backgroundFace should be in front of the applicantClear image quality Cancelof
Copy of Medical License

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If not in English, an English translation must be attached. Cancelof
Short CV

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Please include your work experience as well as areas of research you have involved Cancelof
Proof of Immunization against COVID-19

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Three dots required Cancelof
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