David Geffen School of Medicine at UCLA Elective Application For Medical Students Attending Approved Schools in the United States and Canada
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UCLA and Affiliated Hospital Addresses
Important Notes

BAKERSFIELD VA SATELLITE 1801 Westwind Dr. Bakersfield, CA 93301	DR. KENNETH KIM'S OFFICE Allergy, Asthma and Respiratory 2600 Redondo Ave. Suite 400 Long Beach, CA 90806	SHRINERS HOSPITAL FOR THE CRIPPLED Dept. of Orthopedic Surgery 3160 Geneva Street Los Angeles, CA  90020
BRENTWOOD VETERANS ADMINISTRATION Department of Psychiatry 11301 Wilshire Blvd. Los Angeles, CA  90073	KING/DREW MEDICAL CENTER (not currently taking applications for visiting student electives)	ROBERT J. SIMON, M.D. 13320 Riverside Drive, #214 Sherman Oaks, CA  91423
CEDARS-SINAI MEDICAL CENTER Department of  ..... 8700 Beverly Boulevard Los Angeles, CA  90048 All Medicine Electives- Attn: Judy Jacobs All OB/Gyn Electives- Attn: Fay Shapiro All Pediatrics Electives- Attn: Esther Tolentino All Surgery Electives- Attn: Sheila Yancy	NORTHRIDGE HOSPITAL Family Practice Center 18406 Roscoe Boulevard Northridge, CA  91325	ST. MARY MEDICAL CENTER - Dept. of Medical Education Attn: Sylvia Perez 1050 Linden Avenue Long Beach, CA  90813
or for Psychiatry Electives CEDARS-SINAI MEDICAL CENTER Department of Psychiatry, Thalians Mental Health Center 8730 Alden Drive, Suite W156 Los Angeles, CA 90048	OLIVE VIEW-UCLA MEDICAL CENTER (OVH) Dept. of ... 14445 Olive View Drive Sylmar, CA  91342	UCLA Center for the Health Sciences David Geffen School of Medicine at UCLA (CHS) Search for Course Chair's Mailing Address, OR Coordinator (See below) All Surgery Electives- Attn: Iris Mau
GOOD SAMARITAN HOSPITAL Attn.:  Dr. Stuart Shear Dept. of Medicine/Dermatology 1245 Wilshire Blvd., #907 Los Angeles, CA  90017	SANTA BARBARA COTTAGE HOSPITAL Attn: Cynthia Stoddard Office of Medical Education PO Box 689 Santa Barbara, CA       93102	or for Psychiatry Electives Resnick Neuropsychiatric Hospital at UCLA (NPI) Attn: Carla Vera Dept. of Psychiatry, C8-238 Semel 740 Westwood Plaza Los Angeles, CA 90095
HARBOR-UCLA MEDICAL CENTER Department of  ..... 1000 W. Carson Street Torrance, CA  90509	SANTA MONICA-UCLA CENTER FOR EAST-WEST MEDICINE 2428 Santa Monica Blvd. Ste. 208 Santa Monica, CA  90404	VENICE FAMILY CLINIC 604 Rose Avenue Venice, CA  90291
KAISER PERMANENTE - SUNSET Center for Medical Education 4733 Sunset Blvd. W. Mezz., 3rd floor Los Angeles, CA  90027	SANTA MONICA-UCLA JOHN WAYNE CANCER INSTITUTE 2200 Santa Monica Blvd. Santa Monica, CA  90404	VENTURA COUNTY GENERAL HOSP. Department of  ..... 3291 Loma Vista Road Ventura, CA  93003
KAISER PERMANENTE - WOODLAND HILLS Department of  ..... 5601 De Soto Avenue Woodland Hills, CA  91365-4084	SANTA MONICA-UCLA LES KELLEY FAMILY HEALH CENTER 1920 Colorado Ave. Santa Monica, CA  90404	WEST LA VA MEDICAL CENTER (WVA) Dept. of  ..... 11301 Wilshire Blvd. Los Angeles, CA  90073
KERN MEDICAL CENTER Department of  ..... 1830 Flower Street Bakersfield, CA  93304	SEPULVEDA V.A. MEDICAL CENTER - SAN FERNANDO VALLEY MEDICAL PROGRAM 16111 Plummer St. Sepulveda, CA  91343

IMPORTANT NOTES

• SEND APPLICATION AND REQUIRED DOCUMENTS DIRECTLY TO THE COURSE CHAIRMAN OF YOUR FIRST CHOICE ELECTIVE, HOWEVER, FINAL ENROLLMENT APPROVAL NOTIFICATION COMES FROM UCLA STUDENT AFFAIRS OFFICE.
• MAXIMUM DURATION LIMIT FOR TOTAL EXTERNSHIPS AT UCLA AND/OR AFFILIATED HOSPITALS MAY NOT EXCEED NINE (9) WEEKS.
• A SEPARATE APPLICATION MUST BE PREPARED FOR EACH CLERKSHIP, SEPARATE FEES AND DOCUMENTS ARE REQUIRED.
• APPLICATION FEES ARE NOT REFUNDABLE ONCE YOUR ELECTIVE HAS BEEN APPROVED.
• FAILURE TO REPORT FOR ANY APPROVED COURSE WITHOUT SUBMITTING WRITTEN NOTICE NOT LESS THAN ONE MONTH PRIOR TO THAT START DATE, WILL RESULT IN AN UNSATISFACTORY EVALUATION SENT TO THE DEAN OF YOUR MEDICAL SCHOOL.
• ALL VISITING STUDENTS WILL BE REQUIRED TO COMPLETE A BRIEF EVALUATION OF ELECTIVE CLERKSHIPS AND SUB-INTERNSHIPS ON TEACHING FACULTY.  STUDENTS WILL RECEIVE AN E-MAIL WITH EVALUATION INSTRUCTIONS AND LINKS TO THE COMPUTERIZED UCLA EVALUATION SYSTEM WHICH PROTECTS ANONYMITY.
• APPLICATIONS MUST BE SUBMITTED TO THE DEPARTMENTS AT LEAST TWO MONTHS PRIOR TO THE START OF THE ELECTIVE.