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Clinical Electives Program
Clinical Electives Program Application
OMB No. 0925-0299
Expiration Date 8/31/2009
Respondent Burden
Instructions: Before you begin, you may want to review some  helpful hints on using electronic forms and a statement about  privacy. After you fill out the application form below, press the [Preview] button at the bottom of this page to review your application for accuracy. Press the [Submit] button to save your data and complete the application process.


Eligibility Requirements for the NIH Clinical Electives Program

In order to be eligible to apply for a clinical elective at the NIH, you must meet the following requirements:
  1. You must be a U.S. citizen, resident alien, or a foreign citizen entering the U.S. on a B1 visa.
  2. You must be in good standing in your medical or dental school.
  3. You must enter all of your medical school grades as Pass/Fail or by a letter grade.
  4. You must have your school's approval to participate and one of the reference letters submitted in your application must be from your Dean of Student Affairs (or equivalent) and state the Dean's title and mailing address.
  5. If you are currently enrolled in or attending a school that is not 1) an LCME-accredited medical school in the United States or Canada, or 2) an accredited school of osteopathic medicine in the United States, or 3) a CODA/ADA-accredited dental school in the United States, then you must provide evidence of proficiency in communication skills either in the form of a TOEFL score or a documented passing grade on the USMLE Step 2 Clinical Skills Exam. For the TOEFL examination, the minimally acceptable scores are as follows:
               a) minimum total score of 560 on the paper-based test
               b) minimum total score of 220 on the computer-based test
               c) minimum total score of 86 on the iBT with a minimal score of 26 on the speaking subsection.
  6. You must have completed all of your core courses in surgery, internal medicine, ob-gyn, pediatrics, and psychiatry prior to review of your application. You must provide written documentation of a negative Mantoux test (intermediate strength PPD) within three months prior to your arrival at the NIH or, for individuals with a positive Mantoux test, a chest X-ray report within the past 12 months.
  7. You must provide written documentation of a diphtheria/tetanus booster within the past 10 years.
  8. You must provide written documentation of recent immunization with Rubeola vaccine.
  9. You must provide written documentation of recent immunization with Varicella vaccine.
  10. You are strongly encouraged to have begun or completed your Hepatitis B vaccine.
In addition, your school must provide the following:
  1. Professional liability insurance coverage of $1,000,000 individual/$3,000,000 in the aggregate, in U.S. dollars) that would cover you on your elective in the U.S. By signing the NIH/School agreement, the school confirms they provide this coverage. If you have met all other requirements listed above, you can purchase sufficient professional liability coverage if your school cannot provide it.
     
  2. Personal health coverage for you during your elective at the NIH. By signing the NIH/School agreement, the school confirms they provide this coverage. If you have met all other requirements listed above, you can purchase sufficient personal health coverage if your school cannot provide it.
Note: Applicants who cannot meet all of the above eligibility requirements will not be considered for an NIH Clinical Elective. Medical students from U.S. and Canadian LCME schools, Dental students from CODA/ADA-accredited schools, and Osteopathic students from AOA schools will be given priority consideration for electives. Graduates of medical, dental, or osteopathic schools are ineligible to apply.


Application Tips:

Applications for the Clinical Electives Program are received electronically. The following tips are intended to assist students in completing the online application:

  • Please review the Frequently Asked Questions before completing the fields in the online application
  • Be sure that you have the accurate e-mail addresses of the Dean of Student Affairs and your faculty reference
  • Proofread your application thoroughly for accuracy and completeness
  • Participants in the Clinical Electives Program are normally expected to start a rotation on the first Monday of the month (unless it is a federal holiday)
Required Field Indicates a required field!
 
1. Personal Information
Name:
  Required Field

/  Required Field  (mm/dd)
 Required Field   Format: user@server.com 
To obtain a free e-mail address, click here
 
 Required Field
 Required Field
State:  Required Field  Candidates from the international community should enter NA in this field
Permanent Zip Code/Postal Code:  Required Field
Country/Region:
Permanent Home Phone:  Required Field  Format: (999) 999-9999
Citizenship Status:  Required Field
If Permanent Resident:
Country of Citizenship Alien Registration No.
 
2. Academic Information
School Name:  Required Field
Student's Address at School:  Required Field
City:  Required Field
State:  Required Field  (DC for Washington D.C.) 
Zip Code/Postal Code:  Required Field
Country/Region: Required Field
Student's Telephone Number at School:  Required Field  Format: (999) 999-9999
Year at Current Level:  Required Field
Current Cumulative GPA: Required Field
School Grading Scale: Required Field
  Note: If you select 'Other', please explain in Section 3, Coursework and Grades. Be sure to describe your school's grading scale and your current cumulative average relative to that scale.
Year Degree Expected:  Required Field
 
3. Cover Letter Include your research interests, career goals, and reasons for applying for training at the NIH. (Max. 15,000 characters)
Required Field
 
4. CV/Resume You may copy and paste your curriculum vitae into this space. Minor reformatting may be necessary. Include education, relevant research experience, scientific publications, honors and awards, etc. (Max. 15,000 characters)
 Required Field
 
5. Coursework and Grades:
Include coursework currently in progress. (Max. 15,000 characters)(Medical and dental school grades only)
Course Title Grade
------------------------------- ---------------
Required Field
 
6. References
Reference 1 (Name, Address, Phone, Email):
Please provide contact information for the Dean of Student Affairs, who must approve your participation in the Clinical Electives Program.
Name:
 Required Field
First
 MI
 Last
 Address:   Required Field
 Phone:  Required Field
 E-mail:  Required Field Format: user@server.com
Once your application is complete, an e-mail will be automatically sent to this reference requesting an approval to participate in the elective program.
 
Reference 2 (Name, Address, Phone, Email):
A letter of recommendation is required from a member of the medical or dental school faculty.
Name:
 Required Field
First
 MI
 Last
 Address:   Required Field
 Phone:  Required Field
 E-mail:  Required Field Format: user@server.com
Once your application is complete, an e-mail will be automatically sent to this reference requesting an online letter of recommendation.
 

  1. If you apply for multiple electives with the same start date, you will be limited to only one acceptance
  2. If you apply for multiple electives with different start dates, you may be accepted for several different rotations
  3. If you apply for a research tutorial, you must specify the research area in which you have an interest
  • Note: Your official transcript should be sent to:

    Coordinator, Clinical Electives Program
    Office of Intramural Training and Education
    National Institutes of Health
    Building 10, Room 1N-248A
    10 Center Drive, MSC 1158
    Bethesda, MD 20892-1158
 
7. Electives
First Choice
Elective:   Start:  
 
Second Choice
Elective:   Start:  
 
Third Choice
Elective:   Start:  
 
 
Notice to all applicants:
Students are advised to ensure that all application information is accurate. False or inaccurate information contained in this application may be grounds for denying your candidacy or removing you from the program.
 
 
 
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