Medical Student Research Application
Please complete the form and send a copy of your CV in PDF format to s5gutierrez@ucsd.edu.
Email address *
Demographic Information
Name
Address
Phone Number
Best time to contact?
Year in Medical School
Name of Medical School
Interest and availability
Dates available
Format as: MM/DD/YYYY to MM/DD/YYYY
Which Faculty you are most interested in working with. Please explain why you interested working with this faculty member.
What kind of research are you interested in? Please elaborate as to why this research is of interest to you. Include information on what you have done already in that particular area of interest.
This information will help us direct you to the most appropriate faculty members to consider your request.
Did you hear or find on our website a current project that drew you to contact us. Please explain.
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Your CV and contact information will be emailed to the faculty you selected. It will not be stored on the website in any form.
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