1. Medical Student Summer Externship Program Application
The Full Title of Project Here
Your name and address here Name of medical school here Date submitted here
Describe your summer externship project. Is it a research or non-research project? Non-research projects include shadowing a family physician or assisting a family physician on a patient, community, or clinic project. Discuss your interest in this project.
Project Methodology:
(What question are you trying to answer by doing this project? List step-by-step tasks, project design, project timeline, etc. How you will implement the project? What will you measure to know if it is successful?
Insert your high res
photo here
About You
Why is this project important? How is it different from what others have done before? How will it enhance your role as a future family physician?
List your Family Physician Mentor, Funders, Partners, etc.
A letter of support from your mentor is required with your application.
Total Project Budget (up to $2,000):
(Supplies, equipment, IRB approval, incentive gift cards, professional services, patient recruitment, personnel time, travel, etc.)