UCSD SOM Mentorship Program 2015-2016
Please fill this form in its entirety so we can best match you with a mentor!
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First Name *
Last Name: *
Email Address: *
Phone Number: *
Year In School *
This program is only open to 2nd, 3rd, 4th or 5th year students
Gender *
School *
Ethnicity *
Required
Undergrad Major *
GPA *
Have you been involved with SOM Mentors in the past? *
If you answered yes and want to keep the same mentor, please give their name below.
Member of HMP3 &/or HOPE? *
Do you want to be a physician? *
If no, what do you want to be?
Are you interested in pursuing a joint MD/PhD program (MSTP)?
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Please tell us about your interests in medicine (i.e. Why do you want to become a physician? What are your interests in the health field?) *
Please write 4-7 sentences
Submit
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