CLERKSHIP APPLICATION: IN HIS IMAGE FAMILY MEDICINE RESIDENCY
Clerkships are available for current MSIV or OMSIV students who attend US medical schools. At this time we are unable to offer rotations for IMGs.
Full Name *
Address
Phone number
Email Address *
Requested Clerkship beginning and ending dates (We accept students Aug-Jan. Other months are allowed upon a case by case exception) *
Medical school name with city/state *
Expected graduation month/year *
Your score(s) on each Step of the boards you’ve completed and number of attempts needed to pass (we accept both USMLE and COMLEX scores) *
How did you hear about In His Image
Describe your background, aspirations and why you are applying to In His Image
Area of Medical Interest (mark all that apply)
Do you plan to apply to In His Image for the upcoming MATCH (2021)?
Briefly describe your spiritual journey
Name of your current place of worship
Name and phone number of a leader at your worship center who could give us a recommendation about you
Submit
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