| Name _________________________________________________________
DOB ______/______/______ |
Mailing
Address: ____________________________________________________
|
City____________________________________ State __________
|
| Zip Code ____________________ |
Social Security # _______ - _______ - _______
|
Present Phone (______) ________ - ___________ |
Permanent Phone (______) ________ - ___________ |
E-mail Address: ___________________________ |
|
|
Elective 1st choice ____________
Rotation* |
Dates requested ______/______/______ to ______/______/______ |
|
|
Elective
2nd choice ____________
Rotation* |
Dates requested ______/______/______ to ______/______/______ |
(*Rotation is a minimum of 2 weeks and
maximum of 4 weeks.) |
1. Are you requesting housing? ______ |
2. Are you applying to
DCH Residency Program?
______ |
3. Will you be applying to a Pediatrics Residency Program?
______ |
|
MEDICAL EDUCATION
Medical School: ____________________________________________________________________________
Address: _________________________________________________________________________________
Month/Year of (anticipated) graduation ___________________________________________________________
Requirements of consideration of an elective rotation
for fourth year medical students include:
- A letter of good standing from the Dean of your medical school
stating you are currently enrolled in medical school training.
- An evaluation form from your medical school to be completed
at the end of your elective rotation.
- Proof of medical liability and personal health insurance. Driscoll
Children’s Hospital does not provide insurance coverage
of any kind for students, including malpractice insurance.
- Proof of immunizations against rubeola, mumps, rubella, varicella,
polio,diphtheria-tetanus and hepatitis B in accordance with CDC
guidelines. Additionally, a PPD for tuberculosis screening should
have been completed within the past 12 months. If there is a positive
conversation, results of a chest X-ray and appropriate follow-up
and treatment should be provided.
- A recent photograph.
- Documentation of HIPPA training and universal precautions training
by your medical school.
Please note that housing
is provided, but on a first-come, first-served basis for currently
available DCH student housing . Otherwise, housing will be
the responsibility of the student requesting the elective.
Meals and parking will be provided at no cost to the student. |
Current electives offered include:
Individuals desiring a 4th year elective should
submit a completed application to the address listed:
Medical Student Coordinator
Driscoll Children’s Hospital, 3533 South Alameda Corpus
Christi, TX 78411
Phone: (361) 694-4069/1-800-299-0303 x4069 Fax: (361) 694-5466
Student’s Signature ______________________________________________
Date ______ / ______ / ______
Print Name______________________________________________
Welcome to Driscoll Children’s
Hospital. We hope you will find your experience here a pleasant
and rewarding one. Our primary commitment at Driscoll Children’s
Hospital is to place you in a learning environment in which you
can be exposed to pediatric issues and problems. You will interact
with patients/patient’s family, primary care physicians, teaching
attendings, house staff, nursing staff, and other ancillary services.
Students have the opportunity to participate in the clinical activities
of both general and subspeciality inpatient services but the emphasis
in all services is placed on basic issues and common illness. We
encourage students to develop independent learning skills and demonstrate
enthusiasm, self-motivation, and willingness to work as a part of
a team. This is crucial for the care of our children at Driscoll
Children’s Hospital.
You will have one-on-one mentoring with attendings and exposure
to multiple attendings. At times the senior residents will be your
instructors on this rotation. It is a diverse experience depending
on the floor you work.
We expect that you will be responsible for your own behavior. You
should be aware that if you exhibit disinterest and lack of participation,
comments from people around you and on your team reflecting this
behavior would likely appear on your evaluation. Conversely eagerness,
self-motivation, and active participation will equally be reflected.
We would like to know if you are having problems on the clerkship
so that we can intervene and improve the situation. We wish you
well during the time with us.
Enjoy, play with children, and learn from the children but watch
out because they may just steal your heart.
- ID BADGES: Identification
badges will be provided at the beginning of each rotation
during orientation. Badges are to be worn at all times while
on Driscoll Children's Hospital campus.
- SCRUB SUITS:
Each student will receive a scrub suit at no extra cost
which they are required to return at the end of their rotation.
- LAUNDRY: DCH laundry
can be used for washing coats and scrub suits only at no
cost. Students are responsible for picking up their scrubs.
Each student is responsible for their scrubs if scrubs are
lost in the laundry area.
- ON CALL ACCOMMODATION:
Accommodations in the hospital will be provided for the
on call medical student at the resident quarters located
on the 4th floor.
- EXCUSED ABSENCES:
Students must notify the Chief Resident or Medical Student
Coordinator of absences. A note explaining the absence must
be submitted to Medical Student Coordinator within 24 hours
of return.
- MEDICAL LIBRARY:
The medical library is located on the 3rd floor in the Medical
Education department. The library is open Monday through
Friday from 9 AM to 5 PM. A librarian is available during
these hours for special needs such as help on med. line
search for survey medical topics. There is 24-hour access
to the library. There are computers available in the library
with Internet access. PLEASE BE AWARE
THAT ALL INTERNET ACTIVITY INCLUDING DOWNLOADS AND WEB SITE
VISITS ARE MONITORED.
- MEALS: Meals are
provided to all students. This includes weekday and weekends.
Meals are served in the cafeteria which is located in the
Basement (Lower Level) at the following times:
| B/F=
6:30 AM to 9:00 AM |
LUNCH= 11:30 AM to
2:30 PM |
DINNER= 5:00 PM to
6:30 PM |
- PARKING: Students
are allowed to park their cars in the physician/resident
parking lot at no extra cost. This parking is located by
the covered parking area at the hospital (near Medical Records
entrance).
|
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