Name:  SELECT STUDENT NAME UserID2008 StudentName Ahmad, Naurin Baker, Chad Belangee, Kelli Bridgetts, Catherine Bryant, Richard Burge, Meredith Cady, Benjamin Carrigan, Marc Chabak, Mickey Chastain, Beth Combs, Andrew Conklin, Alissa Davison, Jamie Dean, David Dixon, Nikita Doerr, Christina Eltrevoog, Holly Eubanks, Matthew Gaffigan, Matthew Garrison, Stephen Graba, Sandra Grant-Acquah, Kwesi Grusby, Jennifer Guignon, Mary Hall, Adam Hanson, Matthew Hardwick, Jennifer Harris, Jacqueline Harter, Edward Hillard, Alexia Hoefgen, Holly Hook, Rebecca Ireland, Susan Kigozi, Francis Kinzinger, Robert Knolhoff, Joshua Lafikes, Marla Link, Chad Linn, Sarah Maguire, Kristen McAllister, Robert McCrery, Dennis Mister, Antonio Patel, Pritesh Pegg, Renee Pham, Sapa Pine, Ryan Rapp, Catherine Rathert, Nicholas Redwood, Gwen Rheaume, Patrick Rhee, Susie Rhoades, Patrick Rivera, Christopher Roberts, Jonathan Rojas, Nereida Rommel, Jennee Ross, Jessica Rybak, James Sams, Jacob Sea, Stephanie Slater, Karsten Stams, Victor Stehling, Dustin Tonozzi, Jessica Tubbs, Jeffrey Vandeveer, Janice Veeder, Catherine Waller, Christine Wayman, Rebecca Wemlinger, Amanda Yost, Johnathon zztest                   Advisor:  SELECT ADVISOR NAME Hossam Abdel-Salam, MD Kabiyadi Acharya, MD Thomas Ala, MD Janet Albers, MD Tracy Aldridge, MD Edward J. Alfrey, MD D. Gordan Allan, MD Joan Barenfanger, MD Amber Barnhart, MD Joseph Basler, MD Craig Batterman, MD Gregory Bennett, MD Careyana Brenham, MD Reginald Bulkley, MD Joni Clark, MD David Decker, MD Gary Dunnington, MD Rodger Elble, MD, PhD M. Steven Evans, MD Mark Francis, MD Maureen Francis, MD Stuart Frank, MD Christopher Gleason, MD John E. Godwin, MD Susan Hingle, MD Gary Horowitz, MD Regina Kovach, MD James La Guardia, MD Kathy Lake, MD Scott Long, MD Fritz Lower, MD Tracy Lower, MD Wesley McNeese, MD Tracy Milbrandt, MD Michelle Miner, MD Sumantra Mitra, MD John E. Murphy, MD Dean Naritoku, MD Charles Neal, MD Erica Nelson, MD Robert Pary, MD Matt Peecher, MD Michael Pranzatelli, MD Jacquelyn Quin, MD Don Ramsey, MD David Resch, MD Anna Richie, MD Gary Rull, MD Leonard Rybak, MD, PhD Ross Silverman, JD Ted Sunder, MD Cynthia Thomas, MD Andrew Varney, MD Zeng Wang, MD Elvin Zook, MD

Your Neurology Clerkship rotation has already been selected and other requests will work around that course.  Also, in the spaces below, please note any SPECIFIC TIME REQUIREMENTS, i.e. clerkship deferrals/remediations that you have to make up, Pending Off-Campus dates that you are sure of, Individually-Designed and Research Electives, and Vacations.  Use the Week # and Date guide above to list time requirements in this space.  Do not # these as priorities.

List IN ORDER OF PRIORITY, not chronological order, those catalog electives you wish to take along with the length of time desired in weeks. (See completed example form copied on pink paper.)

Program Selection (Choose One):

Specialty Pathway Choose Pathway Family & Community Medicine Internal Medicine Obstetrics & Gynecology Pediatrics Psychiatry Surgery: General Surgery Surgery: Otolaryngology/Head & Neck Surgery Surgery: Orthopedic Surgery Surgery: Plastic Surgery

Undeclared