Below is a SAMPLE application.  Please refer to the offical U of M website for the actual application materials.


Minnesota’s Future Doctors 2009 Program Application

 

Minnesota’s Future Doctors

    

2009 Application Planning Info

 

This is not the official application for Minnesota’s Future Doctors. You may this document as a planning guide for application to the program. This document will not be accepted as your application.

 

The official, online application for the Elk Cohort (2009, 2010, and 2011 program) will be available on December 1, 2008 at  http://www.meded.umn.edu/futuredocs/ Some questions will change on the official application.  


Full Legal Name

Last Name

 

First Name

 

 

Your Contact Information

Campus e-mail

 

Personal e-mail

(Many campuses will not allow Minnesota’s Future Doctors to receive large volume emails)

 

Preferred phone number

 

Campus mailing address

 

Home mailing address

 

 

 

Demographic Information

Date of Birth (mm/dd/yyyy)

 

Gender

 

Ethnicity and Race

 

The information provided below is voluntary and will not be used in a

discriminatory manner.  The questions below comply with the U.S. Department of Education’s new mandated standards for ethnic and racial data collection.

 

1.       Ethnicity: Are you Hispanic or Latino? 

­ No      ­ Yes         (if Yes, please skip #2 below)

 

2.       Race: Please check any or all that apply.

­ American Indian or Alaska Native

­ Asian

 If Asian, do you consider yourself:

­  Chinese

­  Hmong

­  Japanese

­  Korean

­  Lao

­  Thai

­  Vietnamese

­  Other:  Please describe:

­ Black or African American

If Black, do you consider yourself:

­  Ethiopian

­  Liberian

­  Nigerian

­  Oromo

­  Somali

­  Other:  Please describe:

­ Native Hawaiian or Other Pacific Islander

­ White

­ Two or more races.  Please describe:

 

 

 

I grew up in this setting:

 

Rural environment (community of less than 30,000 people within Minnesota)

 

 Suburban environment (not the actual cities of Minneapolis or St. Paul)

 

Urban environment (Minneapolis or St. Paul)

 

Rochester, St. Cloud and Duluth do not fit these categories above. Please select one of those cities individually.

Please select one of the following (erase all others):

 

Rural Minnesota

 

Urban Minnesota  - Minneapolis or St. Paul (select one)

 

Suburban Minnesota

 

Rochester, Duluth or St. Cloud (select one)

 

Other (please explain):


Citizenship

Citizenship

Please select one of the following (erase all others):

U.S. Citizen
Permanent Resident
Temporary or nonimmigrant visa holder
Refugee/political asylee
Other (please explain)

If you are not a U.S. citizen, of  what country are you a citizen?  

 

State in which you claim legal residence

Please select one of the following (erase other choice):

Minnesota

Other (please explain)  

How long have you lived in Minnesota?

 

 

College/University Education

Current College/University

(If you are a U of M, Twin Cities student – please state U of M, Twin Cities and provide your college)

 

Intended Graduation (Month, Year)

 

Major

 

Minor

 

What is your cumulative college/university GPA?

 

What college/university-sponsored clubs/activities are you currently involved in?

 

What offices do you hold within these clubs and organizations?

 

 

 

High School Education

What year did you graduate from high school?

 

Name of High School

 

City and State of High School

 

What was your cumulative high school GPA?

 

What courses did you most enjoy as a high school junior and senior?

Provide four examples of your favorite courses:

 

Did you take Post Secondary Enrollment Options (PSEO), College in the Schools, Advanced Placement (AP), International Baccalaureate (IB), or any college equivalent coursework while in high school?

If yes, describe your coursework:

What was your ACT score?

Provide score here:

Or select, I did not take the ACT

What was your SAT score?

Provide score here:

Or select, I did not take the SAT

What school-sponsored clubs/activities were you involved in while attending high school? What years?

 

What offices did you hold in your high school sponsored clubs or activities? What years?

 

 

Question about Minnesota’s Future Doctors

Where did you learn about Minnesota’s Future Doctors (who was the first person to introduce you to the concept/when/how)?

 

What web sites influenced your decision to apply for the program?

 

 

Describe Your Family

Number of adults and children in your immediate family:

Adults (over age 18)
Children (17 or younger)

 

Mother's education background: Select one and delete the other choices


Did not complete high school
Completed High School
Completed an Associate Degree (2-Year)
Completed a Bachelors Degree
Completed a Masters Degree
Completed a Doctoral/Professional Degree

Mother's profession/work:

 

Mother’s annual income (estimated, before taxes):

 

 

Father’s education background: Select one and delete the other choices


Did not complete high school
Completed High School
Completed an Associate Degree (2-Year)
Completed a Bachelors Degree
Completed a Masters Degree
Completed a Doctoral/Professional Degree

Father’s profession/work:

 

Father’s annual income (estimated, before taxes):

 

 

Does your family participate in any programs designated for low-income and/or working families? If yes, describe them: (Examples: Free or reduced lunches for children, ACT or SAT fee waiver, food stamps, your current involvement in TRIO or related programs)

 


Backup/Family Contact Information
Please select one person whom we may contact to give you a message if needed.

Contact's Name

 

Relationship to You

 

Telephone Number

 

Email Address

 

 


Work Experience

What paid work experiences/jobs have you had in the last three years?

Or, what unpaid work have you done? (Examples include: working in a family business or taking care of a younger sibling/elderly adult.)

Please give the beginning and end dates of all positions you held and estimate how many hours each week you spent at each job/position.

 

 

 

 

 

 

 


Community Service/Volunteering Experience

What community service and volunteer activities have you been involved in over the last three years (and what are you involved in currently)? 

Please give the beginning and end dates of each service you provided and estimate how many hours per week you served/volunteered within each setting.

 

 

 

 

 

 

 


Awards and Achievements  

What awards or achievements have you received within the last three years?

Who gave these awards/achievements? What year were they granted?

 

 

 

 

 

 

 











Essay Question
Please respond using no more than 500 words for the following essay question. This essay is an essential piece of your application. College-level spelling and sentence structure is expected.  

 

[Helpful Hint: To learn how many words you've written, use Microsoft Word’s word count tool. Click on Tools, then choose Word Count. Some newer Microsoft Word systems may have different means for doing a word count.]  

 

 

Essay:

Minnesota's Future Doctors seeks individuals who will become doctors and represent or serve the diverse communities within our state. Take a moment to think about a specific diverse or underserved community within Minnesota. Describe the most critical health issue facing this Minnesota community and explain how you would serve in this area of need.

 

 

 

Undergraduate Course Planning Question
The University of Minnesota Medical School and the Mayo Medical School have a list of required courses that you must take in order to apply to medical school. There are also several recommended courses/types of courses that you may consider taking in order to be prepared for the medical school curriculum and the MCAT (Medical College Admissions Test).

Please take a look at the required and recommended courses below as detailed by the University of Minnesota. Then read through the notes provided.

Use the grid found below to explain when you MAY complete the required and recommended courses.

 

Additional Thoughts:

·       Do your best on this planning grid known as My Plan.

 

·       The Minnesota’s Future Doctors selections committee is looking to see how well you plan your coursework. We understand that your goals and plans will change. You will not be required to adhere to this draft plan.

 

·       You should have a conversation with your academic advisor about this course plan.

 

·       You may choose to detail your course plans below using a four year or five year academic undergraduate plan.  We understand that some future docs will finish their undergraduate programs in four years, while others will need five years (or more).

 

·       For additional information on the University of Minnesota Medical school prerequisite requirements, please see http://www.meded.umn.edu/admissions/

 

·       For additional information the Mayo Medical School prerequisite requirements, please see http://www.mayo.edu/mms/md-prerequisites.html Mayo’s required courses include:

·       One year of biology and/or zoology (with lab)

·       One year of inorganic chemistry (with lab)

·       One year of organic chemistry (with lab)

·       One year of physics (with lab)

·       One course in biochemistry

 

Required Courses for University of Minnesota Medical School

Semesters

Quarters

Biology (with lab)
Biological sciences coursework with emphasis on general principles, cell biology and/or physiology.

1

1

Chemistry (with lab)
General or Organic Chemistry

1

1

Life Sciences (additional courses)
Biology, genetics, zoology, botany, parasitology, biochemistry, chemistry (general or organic, but must be in addition to the general or organic chemistry listed above), physics, etc. At least two must be upper-level courses.

4

4

Humanities or Social Sciences
One upper-level course in the humanities or the social sciences, with an intensive writing requirement

1

1

 

 

 

Recommended (not required) Courses for University of Minnesota Medical School

 

 

Biochemistry
Ethics
Genetics
Psychology
Statistics
Foreign language
Independent learning courses
Seminar-type courses involving small group discussions
Social and behavioral sciences and humanities

Note from the Dean of Admissions, University of Minnesota Medical School:

  • All prerequisite courses must be completed and bachelor's degree earned by July 1st of the summer that you start medical school. (Medical school starts in August).
  • These course requirements CANNOT be fulfilled with CLEP credits.

·       These course requirements CANNOT be fulfilled by AP credits. Those who received AP credit for courses such as general chemistry or biology still will need one additional semester of chemistry and biology with labs while in college.  This can be an advanced chemistry, organic chemistry, or any advanced biology course during your college years.  Do not re-take coursework for which you already received AP credit. Instead, take more advanced courses.
My Plan

Name:

Major:

Institution/College:

 

You may alter this plan in any way that you wish. You are welcome to include a full plan, including ALL courses that you intend to take during your undergraduate program.

 

You may also provide additional lines that demonstrate when you will fulfill the pre-req requirements for the Mayo Medical School.  

 

Required Courses for Admission to the U of M Med School

 

Course

Actual Name and Number of Course

Semester/Year

Freshman, Sophomore, Junior, Senior or 5th Year?

Biology lecture