Get Pa Application For Pediatric Hospital Epidemiology And Outcomes Research Training Program

Completing the PA Application for the Pediatric Hospital Epidemiology and Outcomes Research Training Program is a crucial step in advancing your medical career. This guide provides clear and concise instructions to help you navigate the online application process effectively.

Follow the steps to complete your application with ease.

1. Click ‘Get Form’ button to access the application form and open it for editing.
2. Begin by providing your full name, including any relevant medical degrees such as M.D., D.O., etc. Make sure to fill this out accurately.
3. Indicate your desired appointment by checking the appropriate box: Clinical Fellow, Research Fellow, or Other. Be specific in your selection.
4. Fill in your current address, including city, state, zip code, and country. Make sure the contact details provided are correct.
5. Provide your telephone number, pager number, and email address for further communication. Include a fax number if applicable.
6. Complete the permanent address section, ensuring it matches officially recognized documentation.
7. List your place of birth and date of birth. Additionally, indicate your current marital status.
8. Specify your citizenship status and provide your Social Security number for identification purposes.
9. Attach copies of your U.S. unrestricted medical license and graduate medical training license, including the respective states and license numbers.
10. Detail any licensing exams you have passed, along with the exam scores. Ensure copies are attached.
11. For international medical graduates, provide your ECFMG Certificate number and specify your visa type if required.
12. Complete the sections related to your premedical education, medical education, and hospital training. Include institution names, dates, and degrees obtained.
13. Describe any postgraduate education or special training that has not been included in previous sections.
14. Fill in the board certification section with relevant details, including year, specialty, and issuing country.
15. Add any additional information that may support your application, such as publications or extracurricular activities.
16. List at least four references who can provide letters of recommendation. Ensure that these references are aware that letters should be sent separately.
17. Sign and date the application at the designated section. This confirms that all information is accurate.
18. Finally, save your changes, and consider downloading or printing a copy for your records. Return the completed application to the designated contact.

Complete your application online today to take the next step in your professional journey.