Application procedures for MEL4012 Physician Shadowing

Email questions to mel4012!psychiatry"ufl"edu

Spring 201#

$eadline for Application Postmar% &riday' May #
rd
' 201# (if mailed )ia *"S" mail +y this date'
application will +e accepted , no need to o)ernight-e.press ship/

$ecisions Announced 0y early May )ia email

1ntroduction
Enrollment in MEL4012 is closely controlled +y the 2ollege of Medicine in an effort to protect the
patients of Shands 3ospital at the *ni)ersity of &lorida" Selection of students is +ased on
academic and professional performance in MEL4011 and also the information contained in this
application" 4he num+er of students we can enroll is limited +y the num+er of physicians
a)aila+le to +e shadowed for any gi)en term"
Appro.imately the top 105 of the students who ta%e MEL4011 will ha)e a chance to ta%e
MEL4012" Selection criteria include
6 Must ha)e completed at least one &all and one Spring semester at *& (transfer students
with #0 credit hours may apply after ta%ing MEL4011/
6 Minimum 7PA of #"#
6 A grade of 8A9 in MEL4011

Special note on transportation6 many of the clinics are located outside of Shands!*& and
require students to ha)e a personal means of transportation to tra)el to the location"
Special note on professionalism6 Shadowing a doctor as an undergraduate is a rare opportunity
and will certainly pro)ide you with a great opportunity to learn more a+out different specialties of
medicine" :ith this opportunity comes responsi+ility" ;ou represent not only yourself +ut also
MEL4012 and the *ni)ersity of &lorida" ;ou are e.pected to uphold a high standard of
professionalism in order to ensure this opportunity remains for future students" A portion of your
grade will +e +ased off of how your doctor <udges your professionalism"

1nstructions
;ou will need to compile all of the following information and send it in one finali=ed pac%et to our
physical mailing address" Please use a mailing en)elope large enough so that you do not ha)e
to fold the papers" $o not enclose staples or paperclips so that we may easily shred your
personal information after the semester" Please %eep at least two copies of ALL application
documentation for yourself in addition to the application materials you send in" ;our physician
may as% you to pro)ide a copy of certain parts of your application " Mail all application materials
to

MEL4012 Physicians> Shadowing
P? 0?@ 1001A#
*ni)ersity of &lorida
7aines)ille' &L #2B10601A#


1mportant Cead the final section' 81mportant 4ips for Applying to MEL4012'9 in order to ensure
correct completion and a)oid any delay of re)iew"

$ecisions
?nly completed applications postmar%ed +y the deadline will +e considered" ;our application
will +e inspected to ma%e certain all required materials are present" Applications will then +e
re)iewed in detail and will recei)e a priority score (0 to 100' with 100 +eing the most fa)ora+le
score/" &or a gi)en term' the num+er of a)aila+le slots will +e determined and offers will +e
made to the highest priority scores" MEL4012 will +e offered each &all' Spring' and Summer 2"
All decisions will +e announced )ia email to *&L email address only , if your *&L account is
o)er quota you will not recei)e you decision as well as other important emails"

1f you are not accepted to MEL4012 for the term in which you apply' you are welcome to su+mit
a new application for su+sequent semesters" :e recommend that you consider the Summer 2
term as we traditionally recei)e fewer applications then" 1f you are applying for MEL4012 again
after ha)ing +een turned down pre)iously' please indicate in your application when you applied
+efore and we will ta%e this into consideration"

Application:

1) Personal Information Page (please use the letter format a, b, ci as we have here)
a !ull "ame
b #!I$ %
c #! email (non&#! email is "'( acceptable)
) Previous *+,-.1/ application semesters (If none, write "A If applicable, for
e0ample if 1ou previousl1 applie) for the *+,-.1/ section for 2pring /..3 )uring the !all
of /..4, write 2pring /..3)
e Pro5ecte) gra)uation semester
f ,ocal an) Permanent Phone %
g ,ocal an) Permanent *ailing A))ress
h 6eferences: Please provi)e the name, email an)7or phone % of three a)ult
references unrelate) to 1ou who coul) tell us about 1our professional potential 8e sure
to in)icate 1our relationship with the person
i Please ran9 the following $epartments b1 or)er of sha)owing preference
accor)ingl1 (%1 woul) be 1our first choice, %/ 1our secon) choice, an) so on Please list
from 1 on consecutivel1 so that 1our choices are in )escen)ing or)er, in other wor)s, )o
not leave them in alphabetical or)er) 8e sure to ran9 A,, )epartments liste)


Anesthesiology
2ardiology
ED4 6 Ear Dose E 4hroat
EC 6 Emergency MedicineF
&amily Medicine
7astroenterology
3ematology
1nternal Medicine
Deurology
Deurosurgery
?07;D 6 ?+stetrics E 7ynecology
?ncology
?phthalmology
?rthopedic
?rthopedic Surgery
Pediatrics
PsychiatryFF
Pulmonology
Cadiation ?ncology
Cadiology
Sports Medicine
SurgeryFFF
?ff6site 7eneral PsychiatryFF

FEmergency Coom 0e aware that EC doctors ha)e many shifts on nights and wee%ends"
4hese are often great times for students who are interested +ecause they happen to +e the
most e.citing times to shadow in the EC" Gust ma%e sure that this would +e possi+le for your
schedule"
FF?ff6site 7eneral Psychiatry6

FFSpecial opportunities e.ist in Psychiatry shadowing' including
a/ 4he a+ility to shadow for either one or two semesters
+/ 4he a+ility to do research along with shadowing
c/ :or%ing on a mo+ile clinic
1f you list Psychiatry in your top fi)e' please indicate if any of these options are of interest to you"
Also' please indicate your preference for addiction' child' womens' or general psychiatry"

FFF4here are special requirements in order to request surgery descri+ed +elow" 1f you do not
meet this criteria and still apply to surgery' you will +e dropped to the specialty of our choosing"
a/" Students applying for surgery must find a 4 hour +loc% of time that starts no later than 4pm
on any day of the wee%"
+/" ;ou cannot request a specific surgeon +ut instead will +e matched with whate)er team has
the +est training opportunity +ased on the schedule the student (you/ pro)ides"

2/ 4ranscript of *& 2oursewor% and 7rades with 7PA and MEL courses
a" An unofficial print6out from www "isis "ufl "edu is accepta+le (minimum 7PA of #"# is
required/"
+" Please highlight e)idence that you too% MEL4011 and the grade you recei)ed (a grade of
8A9 is required/" Also highlight your o)erall 7PA"
c" 1f you are currently enrolled in MEL4011' please wait until your grades ha)e +een
a)eraged through Lesson 10 +efore su+mitting your application" Also' please include a printout
of your MEL4011 H1S4A grades through Lesson 10 along with your application (your o)erall raw
a)erage through lesson 10 must +e an 8A9 of I0 or higher/"
d"
#/ 31PAA and 2onfidentiality Statements (please also %eep a copy for yourself and your
physician J 2 e.tra copies/
a" Dote 4hese must +e current for the entire semester 6 this means that the date on these
documents must +e dated within the past A months"

+" Please )isit the *& Pri)acy ?ffice we+site at http -- pri)acy "health "ufl "edu -
i" 2omplete 8Le)el 1 31PAA E Pri)acy 6 7eneral Awareness 4raining9 and include a printout
of your completion certificate"
ii" 2omplete 82onfidentiality Statement &or Annual Cenewal and Dew :or%force Mem+ers9
and include a printout of your completion certificate (select *& 2ollege of Medicine67aines)ille/"
Ma%e sure your signature is )iewa+le on the print6out"

4/ 1mmuni=ation Cecords (please also %eep a copy for yourself and your physician J 2 e.tra
copies/

a" Please include a copy of the following 4 immuni=ation records

i" MMC (measles' mumps' ru+ella with appropriate +oosters/

ii" 2urrent PP$-4u+erculosis 4est (within the last A months/6 copy of test results with date
ta%en and read
1" HEC; 1MP?C4AD4 , Students historically lea)e this out of their application" 2all *&
student health to schedule a PP$ s%in test , it ta%es at least two days to get the result" 4he
date must +e within the past A months to +e current AD$ M*S4 S4A4E DE7A41HE
2" 1MP?C4AD4 , 1f you ha)e a positi)e reading on your PP$ s%in test' you will need to get a
chest .6ray and su+mit the radiologist>s report"

iii" Haricella (2hic%en Po./6 date and year of infection or immuni=ation
1" 1MP?C4AD4 6 ;ou need to pro)ide documentation of the date-year of chic%en po.
infection ?C date of )aricella )accine ?C documentation showing positi)e titer" 1f you had the
chic%en po.' most pediatricians indicate that on your immuni=ation forms' howe)er' if it is not
then <ust state the year you had the disease"
2" +ssa1s an) resume (appro.imately one page each' single6spaced/
a" Please include a statement about 1our e0perience in *+,-.11' how you heard a+out
MEL4012' why you wish to ta%e it' and what are your current career goals"
+" Please include a resume detailing your pre)ious e.periences wor%ing in a clinic'
shadowing a physician' )olunteering' doing research' and any other form of employment
demonstrating responsi+ility"
c" American patients' particularly the poor and elderly' are importing prescription drugs from
2anada +ecause they cost less" As a result' this ta%es +usiness away from American
companies and their employees" 2onsider this 3ow would you ad)ise the *S 2ongress when
considering how to regulate this acti)ityK 0e sure to consider +oth the )iewpoints of the patient
(and their families/ and physician as well as the American drug companies and its employees
(and their families/" Please approach this essay as you would any other MEL4011 essay'
include at least two references"


1mportant 4ips for Applying to MEL4012
&ailure to complete the application fully and properly will delay your application consideration"
4he following are common pro+lems that delay an applicant>s acceptance"

1" All decisions will +e announced )ia email to *&L email address only" Please ma%e sure
that your *&L email account is not o)er quota (i"e" full/ so that you will recei)e the decision
email"

2" Leep 4:? E@4CA personal 2?P1ES of all parts of your application' particularly 31PAA'
2onfidentiality Statement' and 1mmuni=ations (PP$ completed within the last A months/" 4his is
important as your documentation may additionally need to +e su+mitted to certain departments
when you shadow"

#" 31PPA and 2onfidentiality Statement must +e S17DE$ and dated :1431D 43E LAS4 A
M?D43S" 1f you already ha)e one that is older than A months +ut less than one year old you
still need to redo the training and update your certification"

4" ;ou must include a copy of the following 4 immuni=ation records
i" MMC (measles' mumps' ru+ella/ copy of immuni=ation record with date and year of
inoculation

ii" 2urrent PP$-4u+erculosis 4est (:1431D 43E LAS4 A M?D43S/6 copy of test results with
date ta%en and read
1" 1MP?C4AD4 , Students historically lea)e this out of their application" 2all *& student
health to schedule a PP$ s%in test" 4he date must +e MA; 200A ?C LA4EC (within the past A
months/ AD$ M*S4 S4A4E A DE7A41HE CEA$1D7"
2" 1MP?C4AD4 , 1f you ha)e a positi)e reading on your PP$ s%in test' you will need to get a
chest .6ray and su+mit the radiologist>s report"
#"
iii" Haricella (2hic%en Po./ 6 year of infection or immuni=ation or positi)e titer
1MP?C4AD4 6 ;ou need to pro)ide documentation of the date-year of chic%en po. infection ?C
date of )aricella )accine ?C documentation showing positi)e titer" 1f you had the disease and
your physician does not ha)e documentation' write the year you had the disease"