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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.- Two surgery applications at Institution X = 1 form
- One surgery application at Institution X and One surgery application at Institution Y = 2 forms
- One Internal Med application at Institution X and One surgery application at Institution x = 2 forms
Host Institution Application Form
Most Medical School will require completion of their application form or an application via VSAS.- 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. - 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. - 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. 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.
Guidelines and Tips: Click here for additional information discussed at the class meeting (filling out forms, alternate school dates, malpractice coverage, etc.).
Fingerprinting, Background checks, Drug screens, Immunizations, etc.: Click here
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
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
Thomas Doherty
Thomas_W.Doherty@lvhn.org
Neurology
Tom Frontera
afronter@health.usf.edu