Medical Student Sub-Internship Application

Since most students securing rotations are considering application and since the rotational slots are in high demand, we ask that you answer the following questions and provide a copy of your board scores to Scott Stringfield, MD, the faculty who administrates these rotations @ scott.stringfield@viachristi.org or fax to (316) 858-3495 c/o Scott Stringfield.
Contact Information
First Name(required)
Middle Initial
Last Name(required)
Street Address(required)
City(required)
State(required)
Zip Code(required)
Email(valid email required)
Cell Phone
May we text message you?
Medical School(required)
Graduation Year(required)
First Choice
Start Date
End Date
Second Choice
Start Date
End Date
Third Choice
Start Date
End Date
How did you hear about our program?
What are you looking for in our sub-internship program?
Are you planning to go into Family medicine?
Yes No
(If not, what are the reasons for pursuing this rotation?)
USMLE I/COMLEX I - Passed
USMLE II/COMLEX II - Passed
Clinical Skills - Passed
The color of grass is

Via Christi Family Medicine Residency