Visiting Medical Student Application Form


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Rotations 3rd & 4th Year *AVAILABLE ONLY TO SUNY, AUC and ROSS UNIVERSITY* MEDICAL STUDENTS - 3rd Year Medical Clerkship - 4th Yr Medical Subinternship - Neurology - Primary Care I - Primary Care II - Geriatrics Rotations 3rd & 4th Year *BUT WITH* PREREQUISITES - Allergy & Immunology - Cardiology - Endocrinology & Metabolism - Gastroenterology - Hematology- Oncology & Palliative - Hospital Medicine (Hospitalist) - Infectious Diseases - Nephrology - Pulmonology - Rheumatology Rotations 4th Year Only - Ambulatory/Community Medicine - Critical Care - Geriatrics RETURN TO: Education Section home SIUH home		Visiting Medical Student Application Form Directions for those wishing to apply: Thank you for your interest in pursuing a medical student rotation at Staten Island University Hospital (SIUH). CLICK HERE to open a PDF version of the application. Complete the application. It must be filled out in its entirety. Please answer all items and do not leave any blank spaces. Return the application promptly WITH A PASSPORT PHOTO. We must receive the applications at least eight (8) weeks prior to the start of the course. PLEASE BE SURE TO CHOOSE THE CORRECT RETURN ADDRESS (see below). FOR INPATIENT ELECTIVES / ROTATIONS, RETURN TO: Jeanette Fraticelli Education Office Coordinator Department of Medicine Staten Island University Hospital 475 Seaview Avenue Staten Island, NY 10305 Telephone: (718) 226-6527 Fax: (718) 226-9271 Email: JFraticelli@siuh.edu FOR PRIMARY CARE I/AMBULATORY MEDICINE, RETURN TO: Lorraine LoPrete Manager Department of Medicine Staten Island University Hospital 475 Seaview Avenue Staten Island, NY 10305 Telephone: (718) 226-6158 Fax: (718) 226-1528 Email: Lloprete@siuh.edu RETURN TO: Student Section Home RETURN TO: SIUH Home