Visiting Internal Medicine Elective Request

Internal Medicine Resident Visiting Elective Request

Used for Core Internal Medicine Residents in PGY1-3.

Name
Program Level
Level you will be when completing the elective
Academic Year
Planned Elective Dates
Select blocks you are available to participate in an elective. Choose all that apply
Please provide details on the elective options you wish to participate in. We offer a number of electives for visiting residents including, community, POCUS, periop, CTU and more…
Please provide any additional details about your request.