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Medical Student PIF Recruitment Survey
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Legal Name (Last, First)
Your answer
Preferred Name
Your answer
Pronouns
Your answer
Age
Your answer
MS year
MS3
MS4
Other (please explain)
Explanation if "other" selected above
Your answer
What is your primary UW site?
Your answer
Contact email
Your answer
What medical specialties are you interested in pursuing at this point in your training?
Your answer
Do you have a primary relative (mother, father, brother, sister) that is a physician?
Choose
Yes (if so please answer below)
No
If your primary relative is a physician what specialty do they or did they practice?
Your answer
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