Scholarship Application | MD Program | Emergency Medicine

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The Indiana University School of Medicine Department of Emergency Medicine is pleased to offer an Academic Scholarship for Visiting Students available for underrepresented minority visiting students rotating with Indiana University.

Requirements

INSURANCE COVERAGE

Note: The Indiana University School of Medicine does not provide personal health or professional liability insurance coverage to students from other schools. The student will be required to provide his/her own personal health insurance and professional liability while on a senior elective at the Indiana University School of Medicine. If approved, this information will be required for the formal VSAS application.

Name

First * Last *

Address

Street Address * Address Line 2 City * State / Province / Region * ZIP / Postal Code * Country * Phone * Email *

Race * White Black or African American American Indiana or Alaska Native Native Hawaiian or Other Pacific Islander Other Other

Ethnicity * Hispanic or Latino Not Hispanic or Latino

Current Medical School * Date of Graduation * Step 1 Score *

Please enter a number from 200 to 300.

Please check which months you are available to rotate * August September October November

Describe your interest in emergency medicine. *

Please describe in 300 words or less

Describe your interest in this scholarship and rotating at Indiana University School of Medicine *