Medical Student Summer Externship Application – Due May 1st Title of project here Your name and email address here Name of medical school and year here Date submitted here Identify your externship experience. Pick one. ____Family medicine research ____Shadowing a family physician ____Clinic/community project Describe your externship. If research, what question are you answering/researching? If shadowing, whom will you be shadowing and what type of practice is it (urban or rural)? If a clinic/community project, what will you be doing in the clinic/community to improve patient care? Background: For research- or project-based externships, share a brief background on the problem/need that your project will address. Identify your project's purpose and goal/aim. And, share how your project is innovative--how it's different than what's been done before or how it builds on other work? Budget (up to $2,000): Provide a line item budget of how funds will be used. We do not fund travel to conferences and only fund projects that take place in MN. Project Methodology: List step-by-step your project plans. Provide a project timeline from start to finish, include your presentation at the MAFP Innovation & Research Forum meeting in winter. Share how you will evaluate and analyze your work. How will you know if you've met your purpose and goal/aim? Why is this externship important to you? How will it help you in your growth as a family physician? How is your project important to family medicine and/or how does it improve patient health and outcomes? List your family physician mentor and their email. A letter of support from your mentor is required.