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    2022 International Visiting Student



     
    Spring 2022 Term
    Date of Birth:
    Date of Birth:
    Present Address:
    Present Address:
    Address of Home Medical School:
    Address of Home Medical School:
    ELECTIVE DEPARTMENT(S) REQUESTED: Please list your departmental preference – e.g.: Anesthesiology, Family Medicine, Internal Medicine. A full list of course offerings can be found here. You will be able to narrow down your course and date/block selection once you have been accepted into the program. 
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    STATEMENT OF VISITING MEDICAL STUDENT –Acceptance of the condition of your visit to UNC CH. “I am aware that acceptance as a Visiting Student carries no implication concerning formal admission to or matriculation at the UNC-CH School of Medicine. I certify that I am a final year medical student in good standing at my home institution and I have completed a criminal background check for my home institution and/or have no criminal violations. I understand that I have to pay a $2500 administrative fee per elective ($2500 per four week time block). Evaluation of my performance while studying at the UNC-CH School of Medicine will be based on the same criteria as those used to judge matriculated students at UNC-CH. I am aware that I must purchase personal health insurance from a US carrier while I am participating in an elective at the UNC-CH School of Medicine; that I must take two short courses at UNC-CH on Tuberculosis and Blood borne Pathogens; and that proof of full compliance with UNC Hospitals’ immunization requirements is a prerequisite for placement in an elective at UNC-CH. I understand that the course MEDI 408 Hematology/ Oncology Consults will not provide Letters of Recommendation for visiting students and students are not to request LORs from MEDI 408 faculty. Instead, after the elective, the Office of Student Affairs will generate a letter based off of the faculty evaluation grade and comments on the student’s behalf.”
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