Medical Education Elective Rotation Request

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Students interested in rotating at Ascension Genesys Hospital, must fill out this application for a rotation. The UME Manager will contact you after receiving your application. Please contact the specific program manager regarding resident rotations only. Due to the demand for rotations at Ascension Genesys, visiting students are limited to two (2) rotations or eight (8) weeks per Academic year. Rotations scheduled will start beginning January 30, 2023 until April 23, 2023. Elective rotations will not be scheduled or accepted during the audition season. You may submit a request for an elective rotation January 3, 2023 to March 27, 2023. Any applications submitted outside these time lines for rotations will not be processed. Enter Information into the fields below and when completed, press the “Submit ” button. Please note that these fields are mandatory unless noted. This is considered an initial application for enrollment and does not guarantee a rotation. All communication regarding rotations will be done by email only. At the time a student schedules and rotates all attempted Boards must be passed. If this status changes between being scheduled and rotating, the UME Manager must be notified.

Desired Rotation

During audition season (from July to the beginning of December) elective rotations are NOT available: Emergency Medicine, General and Vascular Surgery, Internal Medicine and any IM subs and OB/GYN and Orthopedics.

FIRST CHOICE: SECOND CHOICE: START OF ROTATION (MONTH/DAY):

Note: All rotations start on Mondays unless it's a holiday. Then, the start date will be Tuesday.

HOUSING REQUESTED (IF AVAILABLE): YES NO GENDER MALE FEMALE

Contact Information

NAME: STREET ADDRESS: CITY: STATE: POSTAL CODE: BIRTH MONTH/DAY (MM/DD) EMAIL ADDRESS: TELEPHONE#: DO YOU REQUIRE A VISA? YES NO MEDICAL SCHOOL ANT. GRADUATION DATE MD OR DO? MD DO PREVIOUS ROTATIONS AT GENESYS? YES NO LAST FOUR DIGITS, SSN OR CANADIAN ID IS THERE A GAP IN YOUR MEDICAL EDUCATION? YES NO IF YES, LIST THE LENGTH OF THE GAP: IF YES, PLEASE EXPLAIN THE GAP (OPTIONAL)

Please note that all correspondence will be done by e-mail and will be answered as soon as possible.

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