Page Comparison

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1. Externship Application
   These forms are available on the Forms page. The student must complete all requested information in Part I, which includes the signature of the sponsoring USF Department Director (below), and submit the form to the Registrar's Office for approval. You must complete one form per site/specialty, e.g.

   1. Two surgery applications at Institution X = 1 form
   2. One surgery application at Institution X and One surgery application at Institution Y = 2 forms
   3. One Internal Med application at Institution X and One surgery application at Institution x = 2 forms

2. Host Institution Application Form

   Most Medical School will require completion of their application form or an application via VSAS.
3. Proof of Emergency Medical Insurance (if applicable)
   Students traveling internationally must contact USF Medicine International (http://health.usf.edu/medicine/ia/travel_guidelines.htm) and are required to complete the international travel registration process and purchase the University’s travel medical and evacuation insurance.
4. Communication
   Students away from campus on externships are required to keep the Registrar's Office informed of their exact whereabouts so they can be located in the event of an emergency.
5. Non University Externships: This type of program should be arranged between the USF Departmental Chairperson and the Chief of the hospital service (who in turn is responsible for obtaining any further approval required by the hospital governing body). The USF College of Medicine Application for Externship Course must be completed.
   Under unique circumstances tutorial experience with clinicians in practice may be arranged through the Departmental Chairperson and the Dean of the College of Medicine.

6. Externship Evaluation: All externships require a written evaluation of the student's performance at the conclusion of such elective periods. This evaluation must be submitted to the Registrar's Office for processing. Students should take an evaluation form with them to the externship. It is the student's responsibility to ensure that the Registrar's Office receives an evaluation form from the host institution.

7. Guidelines and Tips: Click here for additional information discussed at the class meeting (filling out forms, alternate school dates, malpractice coverage, etc.).

8. Fingerprinting, Background checks, Drug screens, Immunizations, etc.: Click here

   1. 1. Year 3 Clerkship Dates 2015-2016: Core and SELECT

         Department	Signatory (Dept Director)	Email	Coordinator	Email	Signatory LVHN	Email
         Anesthesiology	UME Dean/Stu Aff Dean	kzwygart@health.usf.edu	Meghan Connery	mconner1@health.usf.edu	Thomas McLoughlin	Thomas.McLoughlin@lvhn.org
         Dermatology	Nishit Patel	npatel1@health.usf.edu	Kandi Smith	ksmith3@health.usf.edu
         Emergency Medicine	Kevin O'Brien	kobrien@health.usf.edu	Barbara Pearce	bpearce@health.usf.edu	Charles Worrilow	Charles.Worrilow@lvhn.org
         Family Medicine	Eduardo Gonzalez	egonzale@health.usf.edu	Linda Giordano	lgiordan@health.usf.edu	Veronica Brohm	Veronica_M.Brohm@lvhn.org
         Internal Medicine	Kevin O'Brien	kobrien@health.usf.edu	Barbara Pearce	bpearce@health.usf.edu	James Ross	James.Ross@lvhn.org
         Neurology	Clifton Gooch	cgooch@health.usf.edu	Julie Gordon	jgordon@health.usf.edu	Jay Varrato	Jay.Varrato@lvhn.org
         Neurosurgery	Fernando Vale	fvale@health.usf.edu	Twyla Sumpter	tsumpter@health.usf.edu
         ObGyn	James Mayer	jmayer@health.usf.edu	Kimberly Freer	kfreer@health.usf.edu	Christina Black	christina_m.black@lvhn.org
         Ophthalmology	Carla Bourne	cbourne@health.usf.edu	Stacy DeRaps	sparkerd@health.usf.edu
         Orthopaedics

   David Leffers

   2. 1. Hassan Mir

   dleffers@health

   3. 1. hmir@floridaortho.

   usf.edu

   4. 1. com	Ann Joyce	ajoyce@health.usf.edu
         Otolaryngology	Thomas McCaffrey	tmccaffr@health.usf.edu	Michelle Burnham	mburnham@health.usf.edu
         Pathology	Anne Champeaux	achampea@health.usf.edu	Sally Lamar	slamar@health.usf.edu
         Pediatrics	Ronald Sutsko	rsutsko@health.usf.edu	Meaghan Reyes	mereyes@health.usf.edu	Melissa Brannen	melissa_l.brannen@lvhn.org
         Psychiatry	Saundra Stock	sstock@health.usf.edu	Kris McGill	kmcgill@health.usf.edu	Edward Norris	Edward.Norris@lvhn.org
         Radiation-Oncology	Thomas Dilling	Thomas.Dilling@moffitt.org	Angie Courtney	Angie.Courtney@moffitt.org
         Radiology	Todd Hazelton	thazelto@health.usf.edu

   Candice Kunkle

   5. 1. Tracy Colley

   ckunkle1@health

   6. 1. tcolley@health.usf.edu
         Surgery	Ashley Hodes	ahodes@health.usf.edu	Heather Borgman	hborgman@health.usf.edu	Joseph Stirparo	Joseph_J.Stirparo@lvhn.org