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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
              
            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
        2.  
          1. Shereena Farrington
            sfarring@health.usf.edu
            Jay Varrato
            Jay.Varrato@lvhn.org
            Neurosurgery
            Fernando Vale
            fvale@health.usf.edu
            Kelly Thompson
            kpthompson@health.usf.edu
              
            ObGyn
            James Mayer
            jmayer@health.usf.edu
            Atheer Naif
             anaif1@health.usf.edu
            Christina Black
            christina_m.black@lvhn.org
            Ophthalmology
            Brian Madow
            bmadow@health.usf.edu
            Stacy DeRaps
            sparkerd@health.usf.edu
              
            Orthopaedics
            Hassan Mir
            hmir@floridaortho.com
            Ann Joyce
            ajoyce@health.usf.edu
              
            Otolaryngology
            Thomas McCaffrey
            tmccaffr@health.usf.edu
            Allisha Azard
            allisha@health.usf.edu
              
            Pathology
            Anne Champeaux
            achampea@health.usf.edu
            Michelle Burnham
            mburnham@health.usf.edu
              
            Pediatrics
            Nathan Brinn
            nabrinn@health.usf.edu
            Kelly Paulina
            kpaulina@health.usf.edu
            Melissa Brannen
            melissa_l.brannen@lvhn.org
            Psychiatry
            Saundra Stock
            sstock@health.usf.edu
            Pat Crump
            pcrump@health.usf.edu 
            Katherine Martin
            Katherine_B.Martin@lvhn.org
            Radiation-Oncology
            Thomas Dilling
            Thomas.Dilling@moffitt.org
            Angie Courtney
            Angie.Courtney@moffitt.org
              
            Radiology
            Todd Hazelton
            thazelto@health.usf.edu
            Tracy Colley
            tcolley@health.usf.edu
              
            Surgery 
            Ashley Hodes
            ahodes@health.usf.edu
            Heather Borgman
            hborgman@health.usf.edu
            Joseph Stirparo
            Joseph_J.Stirparo@lvhn.org