Scholarly Concentration (SC) Application CURRENT

Scholarly Concentration (SC) Application

If you plan to apply to multiple concentrations, please submit one form for each concentration for which you would like to be considered.

Please complete this application for consideration to enter the Scholarly Concentration (SC) Program. Submission and acceptance is required PRIOR TO initiation of any scholarly concentration activities. Student eligibility for acceptance into a concentration is determined by the SC specialty Program Director and the Student Promotion and Conduct Committee. To receive a determination of satisfactory completion of the SC specialty program, a student must meet the applicable program requirements distributed with the application solicitation announcement, and includes the submission of scholarly work. Students are encouraged to consult with the relevant SC specialty Program Director in advance of application to learn more about the specialty and requirements. Students may apply to multiple concentrations; however, they may only accept enrollment in one concentration, to ensure quality of involvement and progress toward successful program completion.

Student Information

Choice of Concentration *

If applying to multiple concentrations, list your preferences in order

Name*

First Name

Last Name

Phone*

Email*

Class Year*

Student CV

No File Chosen

File uploads may not work on some mobile devices.

Please submit a copy of your CV. Accepted formats include MS Word and PDF.

In good academic standing?

Yes No

Please Explain

Faculty Mentor Name

First Name

Last Name

Faculty Mentor Contact Information (Phone and Email)

Indicate "pending" if mentor not yet identified

Rational and Background for SC Selection

Please describe your personal, professional or academic experiences which relate to the SC for which you are applying.

Student Goal Statement

Please provide a comprehensive goal statement for your SC experience. This statement should describe your interest in pursuing this specific SC and the outcomes you expect to achieve upon completion. Please include any specific interests or ideas you may have about your participation in this program. (750 word limit)

SCiCE Supplemental Application Form

1. Field(s) of study for your previous undergraduate or graduate work: *

2. Describe any ethics coursework/experience you had before medical school: (Note: no previous experience required) *

3. List you area of interest related to ethics : *

4. Describe what you hope to gain from this experience and why you are interested in pursuing a Scholarly Concentration in clinical ethics: *

5. Briefly describe any relevant previous work or volunteer experience you have had: *

6. Describe a possible project you might like to pursue if you are granted a Scholarly Concentration in clinical ethics, or particular ethical issues that you are interested in learning more about. *