Escolar Documentos
Profissional Documentos
Cultura Documentos
Estgios
Verifique a lista de estgios em:
http://www.medcatalog.harvard.edu/Subjec
tAreas.aspx
Verifique a lista do perodo dos estgios
e da submisso de documentos:
http://ecommons.med.harvard.edu/ec_res/
2E6B3361-4442-4369-9CD793CED745AFC4/2015-2016_Calendar.pdf
Perodo do estgio
1 a 3 meses (Outubro a
Dezembro de 2015)
08 a 12 de junho de 2015
1 a 3 meses (Janeiro a
Maro de 2016)
03 a 07 de agosto de 2015
1. REQUISITOS
1.1. Para participar, o candidato deve atender aos seguintes requisitos
a) Ser aluno de graduao FMUSP do 6 ano de Medicina no momento do intercmbio;
b) Ter desempenho acadmico de excelncia;
c) Ser fluente em lngua inglesa e apresentar TOEFL com nota superior a 100.
d) Estar apto a completar a candidatura e a apresentar os documentos exigidos pela
Harvard Medical School aps a seleo (http://ecommons.med.harvard.edu/org.asp?exclerk ).
1.2. Por critrio de equidade, ser dada prioridade a alunos que no tenham participado de
intercmbio acadmico.
2. INSCRIO (PR-SELEO)
2.1. A pr-seleo ser feita pela CRInt e Comisso de Graduao mediante a apresentao dos
seguintes documentos:
a) Ficha de inscrio;
b) Histrico Escolar;
c) Currculo Lattes;
c) TOEFL;
2.2. O aluno poder cursar de 1 a 3 estgios, mas na ficha de inscrio ele dever fazer uma
lista indicando vrias possibilidades em ordem de prioridade.
2.3. As inscries sero recebidas pessoalmente na CRInt-FM (Av. Dr. Arnaldo, 455 - sala 1345
Faculdade de Medicina da Universidade de So Paulo Comisso de Relaes Internacionais Av.Dr. Arnaldo, 455 1 andar sala: 1345
CEP:01246-903 - So Paulo - SP Brasil Tel: (+55 11) 3061-8720 www.fm.usp.br/crintenglish crint@diretoria.fm.usp.br
3. BENEFCIOS
3.1. Os selecionados podero usufruir da:
a) Iseno de taxas acadmicas;
b) Todas as demais despesas (passagem area, hospedagem e demais gastos) so de inteira
responsabilidade do aluno FMUSP. Mais informaes sobre Moradia e Transporte podem
ser encontradas no site da Universidade;
c) Possibilidade de solicitar um auxlio financeiro pelo fundo para intercmbio da FMUSP.
4. DISPOSIES FINAIS
4.1 Aps o final do estgio o aluno poder solicitar o aproveitamento de crdito das disciplinas
cursadas, mediante anlise da Comisso de Graduao.
4.2. Esta chamada poder sofrer atualizaes ou ser cancelada a qualquer momento. Por favor,
consulte a pgina da CRInt para verificar se houve retificao.
4.3. A CRInt est disposio para sanar as dvidas bem como auxiliar os alunos durante o
processo de inscries.
Faculdade de Medicina da Universidade de So Paulo Comisso de Relaes Internacionais Av.Dr. Arnaldo, 455 1 andar sala: 1345
CEP:01246-903 - So Paulo - SP Brasil Tel: (+55 11) 3061-8720 www.fm.usp.br/crintenglish crint@diretoria.fm.usp.br
Ficha de inscrio
Chamada _______/2015
Universidade ________________
Perodo em que deseja realizar o estgio: ______________________
Opes de Estgio (indicar em ordem de prioridade indicar ao menos 3):
1
4
7
2
5
8
3
6
9
Dados pessoais
Nome completo:
1.
Email:
Telefone:
N USP:
Ano acadmico em curso:
) 3, (
) 4, (
) 5, (
) 6
(
(
) no
) no
(
(
) no
Nmero de reprovaes:
J realizou intercmbio acadmico?
O intercmbio foi realizado com bolsa?
Informaes sobre Currculo Lattes
3.
4.
Participao em Liga
Participou de liga?
) no
) sim
) no
) se sim, qual?
) no
(
(
(
) Captulo de livro
) Texto completo em anais de congresso
) Artigo em jornais ou revistas de difuso
) no
Se sim, quais?
Se sim, quantos semestres?
5.
) se sim, quantos?
Faculdade de Medicina da Universidade de So Paulo Comisso de Relaes Internacionais Av.Dr. Arnaldo, 455 1 andar sala: 1345
CEP:01246-903 - So Paulo - SP Brasil Tel: (+55 11) 3061-8720 www.fm.usp.br/crintenglish crint@diretoria.fm.usp.br
HMSExchangeClerkProgramChecklist
PLEASEPRINTCAREFULLY
LastName
First
EmailAddress
Birthdate(mm/dd/yy)
Middle
HMSExchangeClerkProgramChecklist
HMSDeanorRegistrarVerificationForm
OfficialLetterofSupportonyourschool'sletterhead
OriginalOfficialTranscripts
HMSImmunizationFormHMSformmustbefilledoutinitsentiretyandsignedbyahealth
professional.Homeschoolformscannotbesubstituted.
Inaddition,thefollowingdocumentationmustaccompanytheHMSImmunizationForm;
CopyofLabReportpostingapositiveMeaslesserologytest.
CopyofLabReportpostingapositiveMumpsserologytest.
CopyofLabReportpostingapositiveRubellaserologytest.
CopyofLabReportpostingapositiveHepatitisBserologytest.
CopyofLabReportpostingapositiveVaricellaserologytestordocumentationofvaccination.
CopyofLabReportforclearChestXRay requiredforallBCGVaccinations
PersonalHealthInsurance(maybeprovidedafterplacement)
Ifproofisindicatedindean'sletter,pleasehighlight.
ProfessionalLiability/Malpractice(maybeprovidedafterplacement)
Ifproofisindicatedindean'sletter,pleasehighlight.
CORIFormonlythetopportionneedstofiledoutandsigned.
ApplicationFee
InternationalStudentsOnly:EnglishInterview
PhoneinterviewsareconductedonTuesdayandThursdayfrom10am2pmEST.
InternationalStudentsOnly:TOEFLScoreReport
IunderstandthatalltheabovematerialsmustbetogetherinONEpacket,otherwisemy
applicationwillbeconsideredincompleteandcanresultinmynotbeingscheduled.
Initial
IacknowledgethatIamcurrentlyenrolledandmyLASTyearofMedicalSchool,graduating
within12monthsofplacement.
Initial
Signature:
Date:
____________
____________
YES
NO
YES
NO
Student has taken and passed Step 1 of the USMLE (U.S. and Canadian
Students only)
Student will be covered by personal health insurance while away
YES
NO (explain if NO)
YES
NO
YES
NO
YES
NO
YES
YES
NO
NO
YES
Date taken:
_______________
Score:
_______________
NO
HARVARDMEDICALSCHOOLEXCHANGECLERKCERTIFICATEOFIMMUNIZATION
StudentName:____________________________________DateofBirth:________________________
ThefollowinginformationMUSTbecompletedandsignedbytheapplicantshealthcarefacility.Pleasecheck
thefollowingimmunizationsthathavebeencompletedbytheabovenamedstudent.Theseimmunizations
arerequiredforparticipationinclerkshipsatHarvardMedicalSchoolanditsaffiliatedhospitals.
PleaserefertotheImmunizationInstructionsonourwebsiteorthefollowingformfordetails.
1.APOSTITIVESEROLOGICALTESTFORIMMUNITYTO
MEASLES,RUBELLAANDMUMPS.AHISTORYOF
DISEASEISNOTACCEPTABLE.ACOPYOFTHE
LABORATORYREPORTMUSTBEATTACHED
PositiveMEASLEStiter:_______________
Month/day/year
PositiveRUBELLAtiter:_______________
Month/day/year
OPTIONAL:DATESOFIMMUNIZATIONWILLNOT
SUBSTITUTEFORTHESEROLOGY.
PositiveMUMPStiter:_______________
Month/day/year
MMR#1____________MMR#2_____________
Month/day/yearMonth/day/year
IFNEEDED:MMR#3_____________
Month/day/year
2.TETANUSDIPHTHERIAPERTUSSISTdap
Tdap:_____________
Month/day/year
Seriescomplete
3.HEPATITISBIMMUNIZATION.ACOPYOFTHE
POSITIVEHEPATITISBSURFACEANTIBODYTITERMUST
#1____________#2____________#3_____________
BEATTACHED.
Month/day/yearMonth/day/yearMonth/day/year
4.TUBERCULOSISSCREENING&CHESTXRAY
Nonewtestrequiredif:
Typeanddate:______________________________
(a) HistoryofchildhoodBCGvaccinationor
#mminduration:____________________________
(b)PriorPPD,QFTorTspottestconsistentwith
Result:
latentTB
negative
Typeanddate:______________________________
consistentwithlatentTB
#mminduration:____________________________
Antibiotictherapyanddates:__________________
IfconsistentwithlatentTB,recorddateofchestX
DateofchestXray(attachreport)REQUIRED
rayandattachreport:_________________
_____________________________
Recordantibiotictherapy,iftaken,anddates:
______________________________________
5.PROOFOFCHICKENPOX(VARICELLA)IMMUNITY.
PositiveVaricellatiter:____________________
Month/day/year
either:a.APOSTIVESEROLOGICALTESTFOR
IMMUNITY(PLEASEATTACHREPORT)or orVaccination:#1_____________#2_____________
Month/day/yearMonth/day/year
b.DOCUMENTATIONOFVACCINATION
Signature:_____________________________________________Date:_________________
M.D.,R.N.,orSchoolOfficial
Month/day/year
Name:(PleasePrint)____________________________________ Title______________________
NameofSchool:______________________________________________________________________
Address:________________________________________Phone:()_________________________
HarvardMedicalSchool
GuidelinesforImmunizationCompliance
Yourhealthandthehealthofourpatientsisourprimaryconcern.Pleasereviewthefollowing
informationcarefullyinordertobeeligiblefortheExchangeClerkProgram.HMSstrictlyadheresto
theseimmunizationguidelineswhichmayexceedCDCrecommendations.
1. Measles,MumpsandRubella
a. HMSrequirespositiveIgGresultsasproofofimmunityforeachdisease.
b. Acopyofthelabreportmustbeattachedforeachtiterresult.
c. BoostersorIgMresultsDONOTsubstituteforapositiveIgGresult.
d. PleasenotethatHMSdoesnotacceptnegativeorequivocaltiterresults,evenwith
arecentbooster.
e. IfyouhavenegativeIgGresults,tobeeligiblefortheExchangeClerkProgramyou
willneedtobeestablishedasanonconverter.
i. HMSrequiresthatthestudentmusthaveanegativereadingposted8weeks
froma3rdboostervaccinationandprovidethefollowingdocumentation:
1. Recordeddatesforall3MMRvaccinations.
2. Labreportwithnegativeresultposted8weeksfrom3rdbooster.
3. Letterfromprimarycarephysiciandeclaringnonconverterstatus.
f. Donotsubmitapplicationwhilewaitingforpendingresults.Allimmunizations
mustbecompleteattimeofapplication.
2. Tetanus,DiphtheriaandPertussisBooster
a. Tdapboostermustbeadministeredwithinthelast10years
b. Tdapboostermustalsocovertheentiretimeofrequestedperiodofstudy.
i. Forexample,ifyourequestApril,MayandJunethenyourTdapbooster
shouldexpirenoearlierthanJuly.
3. HepatitisB
a. Visitingmedicalstudentswillneedtocompletethe3partHepatitisBseriesbefore
rotatingatHMS(incompleteseriesinformationisforHMSstudentsONLY)
i. PleasesubmitlaboratoryreportconfirmingpresenceoftiterforHepatitisB
antibody(HBSAb)
ii. HMSdoesnotacceptnegativeorequivocalresults.Pleaseseeabovefor
moredetailsregardingtiters.
4. TuberculosisScreeningandChestXRays(ONEofthefollowingisrequired)
a. Documentationof2stepTBtesting;#1withinyearofstartdate,#2within3months
ofstartdate.
b. ForindividualsknowtobeTBskintestpositive,documentationofachestxray
reportwhichrulesouractivetuberculosiswithin2yearsofyourfullrotationdates.
c. DocumentationofnegativeQFTorTspot;ifpositiveQFTorTspot,then
documentationofachestxrayreportwhichrulesouractivetuberculosiswithin2
yearsofyourfullrotationdates.
d. Achestxraywithin2yearsofyourfullrotationdatesisrequiredforALLstudents
whohaveahistoryofchildhoodBCGvaccination.Pleasefilloutthepertinent
informationintheleftboxoftheCertificateofImmunizationform.
5. Varicella
a. Ifyouhaveahistoryofchickenpoxinfection(varicella),thenyouwillneedtosubmit
alaboratoryreportconfirmingpositiveIgGresults
b. Ifyouhavecompletedthe2partvaricellavaccinationseries,pleaserecorded
vaccinationdates.YoudonotneedtosubmitIgGorIgMifseriescomplete.
HUMSR
$
First Name
Middle Name
________________________________________________________________________________________________
Applicants Maiden Name (NA, if not applicable)
Place of Birth
Date of Birth (DD/MM/YYYY)
________________________________________
Social Security Number (NA, if not applicable)
________________________________________
ID Theft Index PIN (NA, if not applicable)
________________________________________
Mothers Maiden Name
Current Address: _____________________________________________________________________________
Former Address: _____________________________________________________________________________
Sex: M or F
Weight: ________
HarvardMedicalSchoolClinicalRotationDates&ApplicationDeadlines
20152016
TUITION
permonth
DEADLINEto
submitonline
application
ROTATION
MONTH
ROTATIONDATES
JUNE
June1June28
$4,500
February28th
April1st
JULY
June29July26
$4,500
March31th
May1st
RECESS
July27August2
AUGUST
August3August30
$4,500
April30th
June1st
SEPTEMBER
August31September27
$4,625
May31st
July1st
OCTOBER
September28October25
$4,625
June30st
August1st
NOVEMBER
October26November22
$4,625
July31st
September1st
DECEMBER
November23December20
$4,625
August31st
RECESS
December21January3
JANUARY
January4January31
$4,625
FEBRUARY
February1February28
$4,625
MARCH
February29March27
$4,625
RECESS
March28April3
APRIL
April4May1
$4,625
December31st
MAY
May2May29
$4,625
January31st
DEADLINEtosubmit
materials
October1st
September30th November1st
October31st
December1st
November30th January1st
February1st
March1st
IMPORTANTNOTES:
Tuitionfortheclerkshipprogramissubjecttochangeannually.StudentsatUS/Canadianmedicalschoolspaytuitionatyour
owninstitution.
FINALdatetoapplyforthismonth.ApplicationsreceivedAFTERthisdeadlinewillNOTbeprocessed.
ParticipatinginrotationsduringaRECESSbreakisnotpossible.HarvardMedicalSchoolcannotcertifyanyworkcompleted
overarecessbreak.