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Application for Admission as Special Clinical Student

Eligibility

Postings

Applying for a Posting

Application Form

Documents To Be Submitted By Post

Application Fees

Confirmation of Student Status

Health Screening

Insurance

Other Information

Vaccinations

Changes /Cancellations

Evaluation

Immigration

Accommodation

Available Postings

Documents Required for Elective Application

Ongoing Infection Control Precautionary Measures

Download Application form

 

Instructions for applicants:

  • Ensure that you have read all the information on Admission of Special Clinical Students. Failure to complete your application form properly will delay processing and affect your chances of getting a preferred posting.

  • The completed form should be returned to: The Dean, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597. Tel: (65) 6874 3297 or Fax: (65) 6778 5743

  • For clarification, please email Ms Pushpa at pushpa@nus.edu.sg.

Note: Fields in RED are compulsory, please check them for completeness before submission.


1. Applicant's Particulars

Name:

Gender:

Date of Birth:

/ /

Age:

NRIC/Passport:

Citizenship:

Email:

Phone/Fax:

Postal Address:

Phone/Fax in Singapore:

 

* Compulsory for Singapore applicants

Address in Singapore:

 

* Compulsory for Singapore applicants

Next of kin:

Address/Phone/Fax of next of kin:


2. Background of Medical Education

Name of parent medical school:

Address/phone/fax:

Name of Elective Co-ordinator:

Email of Elective Co-ordinator:

Current year of study:

Year of study at time of elective with us:

Expected date of graduation:

/ /

Briefly indicate clinical experience up to time of proposed elective (Please attach an outline of your medical course):


3. Proposed Elective Positions

Overall period of attendance as a special clinical student (please indicate day, month and year)

From:

/ /

To:

/ /

Weeks:


 

Posting in dept, hospital
(eg. Medicine, SGH)

Please state at least 2 alternative postings in addition to your preferred choice (in order of preference). See * below. You must indicate at least one posting period, please enter one posting.

Duration
(in wks)

From

To

1.

/
/
/
/

2.

/
/
/
/

3.

/
/
/
/

4.

/
/
/
/

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