Clinical Anesthesiology Interest Group Sign-Up Form

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If you are a Ross student interested in applying anesthesia and are in dedicated, MS3, or MS4, please fill out this form! The goal of this form is to know where AIG members go after the island and how we can best serve you in preparing for Match!

First and Last Name *

RUSM email *

Student ID *

Phone Number *

Feel free to join our WhatsApp! https://chat.whatsapp.com/HGKSwR0wHRFAZSPwVaOILq

Year *

Dedicated (Step 1)

MS3

MS4

Which clinical site are you currently at? *

California

Chicago

Connecticut

Maryland

Miami

Michigan

New York

Ohio

Currently in dedicated study

Have you completed an anesthesia rotation yet? *

Yes

No, but I have one scheduled in the next 3 months

If "yes" or "scheduled", let us know where!

Are you currently a member of the ASA? *

Yes

No (learn how to join here: https://drive.google.com/file/d/15OKmvXPN77wsTVmaKUPQxkcDyIyrJz9J/view?usp=sharing)

Are you planning on attending the ASA annual meeting in 2025? *

Yes

Maybe

What kinds of events would you like AIG to host for clinical students? *

Academic events (Shelf/Step 2 reviews)

Professional (guest speakers, Match info, residency program data, ERAS workshops, etc.)

Casual group events (general study sessions, chats, application support, etc.)

Skills (intubation labs, suturing, simulations, etc.)

Other:

Required

Would you potentially be interested in holding a future leadership position with AIG? *

Yes

Maybe

What kinds of questions do you have for us? (not required)

Submit

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