2010 KINGS COUNTY- SUNY DOWNSTATE
DEPARTMENT OF EMERGENCY MEDICINE
MINORITY MEDICAL STUDENT EMERGENCY MEDICINE (MMSEM)
SUMMER FELLOWSHIP PROGRAM
Congratulations! As a medical student you are already making history as part of
the
ever- growing family of minority physicians who continue to make incredible
contributions to the health of our communities both nationally and abroad. At
Kings
County - SUNY Downstate Medical Center, located in the heart of Brooklyn, we are
dedicated not only to our surrounding largely minority and immigrant population,
but
also to ensuring that we produce superb health care providers that will have the
tools and
knowledge to be successful in whatever career path they choose.
We invite you to apply for the second annual Kings County - SUNY Downstate
Minority
Medical Student Emergency Medicine (MMSEM) Summer Fellowship Program. It is
designed to give highly qualified first and second year medical students the
opportunity
to get first-hand clinical experience in one of the busiest emergency
departments in the
country. In an intense 40 hour a week, 6-week program, participants will gain
direct
experience in emergency medicine research, clinical skills such as history
taking,
suturing, splinting, exposure to cutting edge emergency ultrasound and medical
simulation, grant writing, USMLE and residency application preparation, and
mentoring
experience with the most diverse emergency medicine residency program in the
country.
The program is open to under-represented minority first and second year medical
students
in good standing at their respective medical schools. Applicants must include a
CV,
letter from the dean of the medical school stating that you are in good
standing, write a
short essay as well as submit one letter of recommendation. Please see the
attached
application form for details. The program will run from Monday June 7th to
Friday, July
23rd, 2010. All participants will receive free housing in the campus dormitory
as well as
a $2000 stipend. ALL APPLICATIONS MUST BE POSTMARKED BY APRIL 10th,
2010. Acceptance notices will be given by APRIL 30th.
Welcome to the exciting field of Emergency Medicine! We look forward to seeing
you
in Brooklyn!
2010 KINGS COUNTY- SUNY DOWNSTATE
MINORITY MEDICAL STUDENT EMERGENCY MEDICINE (MMSEM)
SUMMER FELLOWSHIP PROGRAM APPLICATION FORM
NAME:_________________________________________________________________
ADDRESS 1: ____________________________________________________________
ADDRESS 2:____________________________________________________________
CITY:________________ STATE:_______________ ZIP:____________________
HOME PHONE NUMBER:_________________________________________________
ALTERNATE PHONE NUMBER:___________________________________________
EMAIL ADDRESS:_______________________________________________________
MEDICAL SCHOOL:_____________________________________________________
YEAR IN MEDICAL SCHOOL:____________________________________________
MEDICAL SCHOOL ADDRESS:___________________________________________
MEDICAL SCHOOL DEANÆS OFFICE PHONE NUMBER:_____________________
UNDERGRADUATE INSTITUTION
ATTENDED:____________________________________________________________
Have you ever been suspended or put on any type of probation, academic or
otherwise in
undergraduate or medical school? _____ If yes, please attach a paragraph
explaining the
circumstances.
Name of person providing letter of recommendation:__________________________
In what capacity have you known this individual? ___________________
LETTER OF RECOMMENDATION WRITER CONTACT INFORMATION:
Address_____________________________________________________
Phone_______________________________________________________
Email______________________________________________________
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2010 KINGS COUNTY- SUNY DOWNSTATE
MINORITY MEDICAL STUDENT EMERGENCY MEDICINE (MMSEM)
SUMMER FELLOWSHIP PROGRAM APPLICATION FORM
APPLICATION REQUIREMENTS:
In addition to the application form, please provide the following:
1. A curriculum vitae.
2. A short (500 words maximum) essay explaining why you are interested in the
program
and specifically emergency medicine, what you hope to gain from the program, and
your
future career goals.
3. One letter from the Academic Dean of your medical school stating that you are
a
student in good standing.
4. One letter of recommendation from a faculty member at your medical school.
The postmark deadline for the letter of recommendation is also APRIL 10TH, 2010.
It is
advised that you give your letter writer a copy of your curriculum vitae as well
as a preaddressed envelope for their convenience.
Applicants will be notified by APRIL 30th, 2010. All applicants will be notified
by email
by this day (please ensure a working email address as this will be the primary
form of
communication).
PLEASE MAIL ALL APPLICATION MATERIALS TO:
SUNY DOWNSTATE MEDICAL CENTER
DEPARTMENT OF EMERGENCY MEDICINE
MMSEM SUMMER FELLOWSHIP PROGRAM
ATTENTION: DR ROBERT GORE
450 CLARKSON AVENUE, BOX 1228
BROOKLYN, NY 11203-2098
Applications may also be emailed to the address below. Send all materials as an
attachment.
Questions can be directed to Dr. Robert Gore, at robert.gore@downstate.edu or
telephone
at 718-245-2975.
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2010 KINGS COUNTY- SUNY DOWNSTATE
MINORITY MEDICAL STUDENT EMERGENCY MEDICINE (MMSEM)
SUMMER FELLOWSHIP PROGRAM APPLICATION FORM
LETTER OF RECOMMENDATION FORM
APPLICANT NAME:______________________________________________________
RECOMMENDER
NAME:_________________________________________________________________
SPECIALTY:____________________________________________________________
ADDRESS:______________________________________________________________
TELEPHONE:___________________________________________________________
EMAIL:_________________________________________________________________
In what capacity and for how long have you known the applicant?
In the space below or on a separate sheet, please describe the applicantÆs
strengths and
weaknesses as well as why you believe this applicant would benefit from this
program.
Please send your completed form to the address below:
SUNY DOWNSTATE MEDICAL CENTER
DEPARTMENT OF EMERGENCY MEDICINE
MEDICAL STUDENT FELLOWSHIP PROGRAM
ATTENTION: DR ROBERT GORE
450 CLARKSON AVENUE, BOX 1228
BROOKLYN, NY 11203-2098
You may also email your completed form to robert.gore@downstate.edu
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