UCL MEDICAL SCHOOL
Community based teaching
DEPARTMENT OF PRIMARY
CARE & POPULATION HEALTH
DERMATOLOGY – September 2015 to June 2016
Dermatology placements are for 2 Wednesday mornings per placement
We aim to send students to you in groups of 4 (occasionally we have to ask practices to take an
extra student or two).
Please tick below all the dates you can commit to teaching.
Placement 1
Wednesday 23 Sept a.m.
Wednesday 7 Oct a.m.
Placement 2
Wednesday 21 Oct a.m.
Wednesday 4 Nov a.m.
Placement 3
Wednesday 18 Nov a.m.
Wednesday 2 Dec a.m.
We can commit to teaching both
these mornings
We can commit to teaching both
these mornings
We can commit to teaching both
these mornings
Please  box
Please  box
Please  box
Placement 4
Wednesday 6 Jan a.m.
Wednesday 20 Jan a.m.
Placement 5
Wednesday 3 Feb a.m.
Wednesday 17 Feb a.m.
Placement 6
Wednesday 2 Mar a.m.
Wednesday 16 Mar a.m.
We can commit to teaching both
these mornings
We can commit to teaching both
these mornings
We can commit to teaching both
these mornings
Please  box
Please  box
Please  box
Placement 7
Wednesday 20 Apr a.m.
Wednesday 4 May a.m.
Placement 8
Wednesday 18 May a.m.
Wednesday 1 Jun a.m.
Placement 9
Wednesday 15 Jun a.m.
Wednesday 29 Jun a.m.
We can commit to teaching both
these mornings
We can commit to teaching both
these mornings
We can commit to teaching both
these mornings
Please  box
Please  box
Please  box
We tell the students that the sessions are from 9.30 a.m. to 12.30 p.m.
Please confirm that you are happy with these times:
Yes
No
If not, please indicate times that would suit you:
Name of Practice (please print):
Name(s) of tutor(s) who will be teaching Dermatology:
Signature:
Date:
Please return this form ASAP either by email (s.gerrard@ucl.ac.uk), fax (020 7472 6871) or by post to the address below:
Sandra Gerrard
Dept. of Primary Care & Population Health, UCL Medical School (Royal Free Campus), Rowland Hill Street, London NW3 2PF