Please complete the following VEPSUM Fellowship Form. The items marked with asterisk (*) are required.


Introduction

Thank you for your interest in VEPSUM!

Sponsored by the Icahn School of Medicine at Mount Sinai's Center for Multicultural and Community Affairs, VEPSUM Fellowship offers four-week electives at The Mount Sinai Hospital to a limited number of qualified 4th-year medical students who attend United States accredited medical schools, and who are from groups underrepresented in medicine.

For the purposes of this program, groups underrepresented in medicine are defined as Hispanic (Mexican, Chicano, or Mainland Puerto Rican), Other Hispanic (Cuban, Dominican, or other), Black/African-American (not of Hispanic origin), Native American or Asian Pacific Islander. VEPSUM Fellowship is designed to increase diversity in the house staff and subsequently the faculty of the Icahn School of Medicine at Mount Sinai and its affiliated institutions, by helping talented minority medical students gain access to electives in our programs.

The total number of accepted VEPSUM students is contingent upon available funding and placement capacity. VEPSUM is a competitive program and placements will not be offered to all applicants.

All supplemental materials must be uploaded OR emailed to VEPSUM@mssm.edu.

Please refer to our website for further information: Icahn.mssm.edu/vepsum

Eligibility Information

*1. Do you attend an AAMC-accredited Medical Degree (allopathic) medical school? *2. Do you attend a non-US-based medical school, or are you currently enrolled in orgraduated from a non-US medical school?

VEPSUM Application

*3. Legal Name *4. Preferred Name
*5. Name of Medical School *6. School Mailing Address
*7. School City *8. School State
*9. School Zipcode

*10. Permanent Address *11. Permanent City
*12. Permanent State *13. Permanent Zipcode
* 14. Phone (preferred) * 15. Date of Birth (M/D/Y)
* 16. Preferred E-mail *17. Citizenship Status
*18. I am currently a If you are on scholarly leave, please explain
*19. Gender *20. What is your ethnicity
*21. What is your race *22. Elective Choice: In what specialty would you like to attend an elective

23. ELECTIVE DATE RANKING: Please complete your preferences for elective time frames below. Please provide suggested time frames for your preferred elective choices, to take place between the months of August and October of your 4th year of medical school. (for example, acceptable formats include: "the month of October" or "from August 15 - September 15th") Please also list your suggested dates in order or preference:

*First Choice
Second Choice Third Choice

*24. Housing: Will you require housing

25. APPLICATION AGREEMENT: In order to COMPLETE my VEPSUM application, I agree to send the following application materials. I understand that my application will be considered INCOMPLETE and will not be reviewed if these materials are not sent. I acknowledge that under no circumstances will paper application materials be accepted.
Please note: You have the option of uploading materials with this form OR emailing them to vepsum@mssm.edu.

*I understand and agree to upload or send the materials to vepsum@mssm.edu with my NAME in the email SUBJECT line

Required Application Materials

Please submit the following materials:
  • Application
Please upload or send via email attachment to VEPSUM@mssm.edu with the applicant’s full name in the subject line:
  • CV/Resume
  • Unofficial medical school transcript (Please note that students must have completed their required core clerkships before starting the program. A completed transcript with grades from these clerkships is necessary for a complete application)
  • USMLE Step 1 score and USMLE Step 2 scores if available
  • One letter of recommendation from a Dean at your home institution
  • One letter of recommendation from a faculty member at your home institution who is in the specialty to which you are applying for in VEPSUM
  • Recent Photo
If accepted into VEPSUM, students will need to apply through the Visiting Student Application Service (VSAS) system. This should be done only AFTER they have been notified by VEPSUM of their acceptance. VEPSUM will not cover any fees associated with the VSAS process or preelective clearance such as specific medical screenings or clearance required for eligibility to rotate as a visiting student.

Please note: If you are applying to VEPSUM, do not contact the clinical departments or the Office of Student Affairs to coordinate the desired elective.

E-mail all of the above application materials to vepsum@mssm.edu

Applications that are sent only through the Visiting Student Application Service and not through the above procedure will not be considered for allocated funding or elective placements available through VEPSUM. We look forward to receiving your application.

PROGRAM CONTACT INFORMATION

APPLICATION STATUS QUESTIONS:
Sherria McDowell, MPH
Program Manager
Email: Sherria.McDowell@mssm.edu
Center for Multicultural & Community Affairs

QUESTIONS ABOUT ELECTIVE SELECTION AND PLACEMENT
Gary C. Butts, MD
Senior Associate Dean for Diversity Programs, Policy, and Community Affairs
Director, Center for Multicultural and Community Affairs
Email: gary.butts@mssm.edu

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