David Geffen School of Medicine at UCLA Elective Application For Medical Students Attending Approved Schools in the United States and Canada
Adobe Acrobat Reader is required to view and print the Application and Calendar of Weeks. You can download Acrobat at the following website. http://www.adobe.com/products/acrobat/readstep.html

Information is now available now on this site for students attending US and Canadian Medical Schools for the July 2008 - May 2009 Academic Year ONLY

Information for our next academic year (starting July 2009) will be available on this web site after April 1, 2009

To view and print all application materials, including course lists and affiliated hospitals' addresses, click on the above buttons.

To view elective course descriptions, click on these links:

2008-2009 Course Descriptions	Addenda Since Publication (TBA)
Note: Not all courses are available to Visiting Medical Students (Externs)

For elective start dates, match up the week numbers in the course descriptions to the Calendar of Weeks.  'By Arrangement' means to contact the student coordinator (but not until mid-June).

We offer a maximum opportunity for participation of 9 weeks (total) in a wide variety of advanced clinical clerkships at CHS and a number of affiliated hospitals in the greater Los Angeles Area. Our electives are open to fourth-year students only. No core clerkships may be taken by non-UCLA students. 

Mail completed applications and supporting documents to course chairs/coordinators at their Hospital Addresses.

APPLICATION DEADLINE

• Application packets must be submitted to the departments at least two months prior to the start date of the elective. Please mail all required components of the application packet directly to the department where you are applying to do an elective.   A COMPLETE separate application must be prepared for each elective. If you wish to come for only one time period, complete one application packet and list multiple elective choices.  

FEES

• The North American student application fee is $100 per elective. This fee must be paid electronically before your application is submitted by going to the following web site https://www.medstudent.ucla.edu/applications/externs/creditcard5.asp. The application fee is non-refundable once you are approved and enrolled in the elective.
• Once you have completed your payment, please be sure to indicate your Payment Confirmation Number in the space provided on the Part 1 application page.
• Submit one payment per application:
  • If you are applying to do only one elective, with multiple elective choices, submit ONLY one application with ONLY one payment, and send to the first choice department
  • If you are applying for more than one elective (up to a maximum of 3), you must pay separately for each application
  • Each application should have its own Payment Confirmation Number
• DO NOT CLOSE YOUR WEB BROWSER until the Payment Confirmation Number appears on the screen.
• If you have questions about payments, please email Brandon Susselman

LETTER OF RECOMMENDATION / LETTER OF GOOD STANDING

• Letter from a medical school faculty member or home school dean is required.  Please note:  a letter of recommendation from clinical faculty is required for all applications to Harbor-UCLA Medical Center (The letter of good standing does not meet their requirement).

TRANSCRIPT

• Official copy of medical school transcript, indicating successful completion of core clinical clerkships, is required with application.

HEALTH INSURANCE

• You are required to submit evidence of personal health insurance (hospitalization and major medical care) during the time of the proposed clerkship. Health insurance for visitors is mandatory prior to enrollment but is NOT offered through the school.  Proof may be supplied in the form of a photocopy of your health insurance ID card or a letter from the insurance carrier.

HEALTH STATEMENT

• The David Geffen School of Medicine Health Statement must be completed by all applicants and signed by a health care professional. Submitting your immunization records is NOT a substitute for this requirement.

UCLA ID BADGE, PASSPORT STYLE PHOTOGRAPH  (size 2" x 2" on a solid light-colored background)

• As approved participants in electives at UCLA and affiliated hospitals, all visiting students are issued  UCLA ID cards.  Therefore, a separate ID application and photo must be included in each application packet submitted.  All visiting students are required to check in at the Student Affairs Office at UCLA (if doing an elective at UCLA CHS),  the Medical Director's Office at Harbor-UCLA Medical Center (if taking an elective at Harbor), or the respective office at any of the affiliated hospitals to pick up the ID card.  All  ID cards must be returned before an evaluation may be released to your home school. Click here to read BruinCard Terms & Conditions.
  

HIPAA COMPLIANCE CERTIFICATE

• All applicants must show compliance with the Health Insurance Portability and Accountability Act (HIPAA) by enclosing a UCLA Certificate of HIPAA Compliance with the application packet. To obtain the certificate, go to http://www.mednet.ucla.edu/hipaa, apply for a Participant ID, read the policies set forth by HIPAA, take the quiz, and print out the certificate that will appear upon successful completion of the module.  The UCLA module must be completed by all visiting students regardless of training done at one's home school.

HOUSING

• Although the David Geffen School of Medicine at UCLA does not provide housing, our students have been very gracious in their response to inquiries for short-term sublets to visiting students. Once confirmed for an elective, please visit our Visiting Student Sublet Database
  
  http://www.medstudent.ucla.edu/visitingstudents/sublet/

• You may also wish to check the main UCLA Community Housing Office web site: www.cho.ucla.edu

• Or the Daily Bruin: www.dailybruin.ucla.edu/advertising/classifieds/categories/housing/

EVALUATIONS

• Please contact the course chair or elective student coordinator for assistance with the evaluation of the student's performance. Upon request, this will be submitted directly to the student's home school after the completion of the elective.
• All visiting students will be required to complete a brief evaluation of elective clerkships and sub-internships and on teaching faculty. Students will receive an e-mail with evaluation instructions and links to the computerized UCLA evaluation system which protects student anonymity.

ADDITIONAL INFORMATION FOR ELECTIVES AT UCLA CENTER FOR HEALTH SCIENCES (CHS)

• Parking: We regret that students approved for courses at the Center for the Health Sciences (CHS) do not have parking privileges unless the department to which you are assigned is able to make arrangements for you. Please be advised that parking at CHS is $9 per day
• Lockers: We regret that due to space limitations, there are no lockers available to visiting students while on rotation at UCLA CHS. Students are advised to bring only what is required with them to the hospital
• Computer Access: for access to computerized patient information systems, you must go to the Student Affairs Office (12-159 CHS) on the first day of your elective to complete an application, or you can click here and fax the form in one week before your elective begins. Visiting Students are NOT eligible for Bruin Online (BOL) access.
• Pagers: Pagers are only available to visiting students in certain departments. Please check with the department coordinator for availability.

Disclaimer: The David Geffen School of Medicine at UCLA is not responsible for determining whether, or in what way, the UCLA clerkship is to be credited toward the requirements of the home medical school, including credit toward graduation of the student at the home medical school.