Thank you for your interest in our Emergency Medicine Program at The University of Texas Southwestern Medical Center at Dallas.

For the senior elective information, please go to link for Student Affairs on the Visiting Students Information/Instructions page where you will find the course description, dates, registration form, and several other forms to be printed, filled in, and returned to the address at the bottom of the page.

Course:  Acute Emergency Medicine PMH (SUR1616)

APPLICATION PROCESS

In addition to the forms required by Student Affairs, the Emergency Medicine Education Office requires the following documents and/or information:

1.  Requested dates* in order of preference:  1)____________________________  2)_____________________

2.  Have you completed the required Surgery and Medicine courses at your medical school?    Yes    No

3.  Anticipated Training Specialty: _______________________

4.  An original medical school transcript including explanation of grading system.

5.  USMLE Step 1 Score Sheet or COMLEX Score Sheet

6.  Recent photograph of applicant

7.  Copy of driver's license (for hospital security badge purposes)

Please print, fill in, and return all required forms and documents to:

Ms. Annette Strange
Emergency Medicine Student Program Coordinator
UT Southwestern Medical Center at Dallas
5323 Harry Hines Boulevard
Dallas TX 75390-8579

Email:   annette.strange@utsouthwestern.edu
Office:  214-590-1355
Fax:     214-590-4079