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Metro Health

Careers at Metro Health

Residency and Fellowship Application

Your Information
Name:
Email Address:
Residency / Fellowship Beginning
Date:
Present Address
Address:
City:
State:
Zip Code:
Phone Number:
Permanent Address
Address:
City:
State:
Zip Code:
Phone Number:
Pre-Osteopathic College or University
Name and Address of
College or University		Years AttendedDegree
Osteopathic Education
Name and Address of
Medical School		Years AttendedDegree
How did you hear about Metro?
  • Hospital Days
  • AOA opportunities directory
  • Other Students/Graduates
  • Did a Rotation at METRO
  • Other: Specify
Internship Location
Hospital:
Address:
City:
State:
Zip:
Dates of Internship:
Application For:
  • Residency
  • Fellowship
Residency Specialty:
Fellowship Speciality:
State Licensed in:
Have you served as a Resident in any other Hospital?
  • Yes
  • No
Hospital:
Residency Location
Hospital:
Address:
City:
State:
Zip:
Dates of Residency:
BCLS / ACLS
Do you have a BCLS?
  • Yes
  • No
If yes, expiration date:
Do you have an ACLS?
  • Yes
  • No
If yes, expiration date:
Are you a certified ACLS instructor?
  • Yes
  • No
If yes, expiration date:
Some Questions
References

Please list the names and addresses of at least three references below and have each reference mail a letter of recommendation directly to the Director of Medical Education.

First Reference
Name:
Organization:
Address:
City:
State:
Zip Code:
Second Reference
Name:
Organization:
Address:
City:
State:
Zip Code:
Third Reference
Name:
Organization:
Address:
City:
State:
Zip Code:

Please have the following sent to the Director of Medical Education:

  • A current CV.
  • Have the Dean of your medical school forward a copy of your completed professional transcript (credentials).
  • Intern Applicants: Have Dean of Student Affairs send a letter of recommendation.
  • Residency Applicants: Have the Director of Medical Education of your internship program send a letter of recommendation.
  • Fellowship Applicants: Have the Director of Medical Education or your residency director send a letter of recommendation.
  • A copy of your NBOME scores.

Please note that it may take up to one working day to receive an e-mail reply or several days to receive information by mail.

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