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Health Equity Visiting Clerkship
This will serve as the supplemental application for OHEI Health Equity Visiting Clerkship upon completion of the application for Visiting Student Learning Opportunities (VSLO) and acceptance.
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* Indicates required question
Email
*
Your email
First Name
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Your answer
Last Name
*
Your answer
Institution
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Your answer
How would the Health Equity Visiting Clerkship be beneficial to your development as a physician?
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Your answer
How have you demonstrated a commitment to Health Equity?
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Your answer
In what field will you want a mentor?
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Your answer
Please indicate the racial or ethnic group(s) with which you identify. (Select all that apply.)
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Asian American/Asian
Hispanic/Latino/a
White
African American/Black
Native Hawaiian/Other Pacific Islander
Middle Eastern/North African
Other:
Required
A copy of your responses will be emailed to the address you provided.
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