Sultan Qaboos University College of Medicine & Health Sciences

Medical Internship Program

LEAVE APPLICATION
Full Name: Rotation during which leave is to be taken: Type of Leave: Annual Maternity Other Date Lave Expires: Total No. Days off: Telephone: Date: I.D: Hospital:

Date Leave Begins: Due Date Back to work: Contact Address While on Leave: Signature of Intern:

(1) Approval of Medical Internship Program Office:

Accrued Leave: Leave Applied: Balance: Authorised Signature & Date: Signature: Signature: Date: Date:

Days. Days. Days.

(2) Approval of Hospital Internship Coordinator: (3) Approval of Head of Department

1. All Types of Leaves should be first approved by the Medical Internship Program Office, College of Medicine & Health Sciences.
2. The completed application form should be forwarded to Internship Office immediately on a daily basis.(Fax: +968 24413300, Email: medtcs@squ.edu.om).

3. Interns are entitled to a total of 28 days (including weekend and holidays) annual leave in the Internship Year. 4. Interns may take a maximum of two weeks leave during any one rotation. 5. Interns may not take annual leave during an Elective rotation.