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Graduate Certificate in Academic Medicine Application

GCAM Application

 

  • Submit complete, official transcripts from highest degree granting institution.
  • Application package must include:
    • Completed Online GCAM Application (below)
    • Two (2) completed Online Reference Form (one preferably from current employment expressing support for participation in the certificate program)
    • Email Personal Statement (1 double spaced page) to fdc@unthsc.edu
      • Describe your career goals and how completing this graduate certificate aligns with these goals.

Application package and official transcripts must be submitted by June 30.

GCAM Application

"*" indicates required fields

Name

Home Address

Office Address

MM slash DD slash YYYY

Institution Name and Address -- Dates Attended -- Major Field of Study -- Degree
Internship -- Dates of Training -- Medical Specialty
Institution Name and Address -- Dates of Training -- Medical Specialty
Institution Name and Address -- Dates of Training -- Dept. or Field of Study -- Position
If so, email a copy of certificate. If not, please indicate your plans to obtain it. Email -- fdc@unthsc.edu

Rank -- Department -- Institution -- Dates
Rank -- Department -- Institution -- Dates
Rank -- Department -- Institution -- Dates
Please provide an official transcript from the institution where you completed your highest level degree. Email to fdc@unthsc.edu

References:

At least three recommendations are required with each application. Please complete the reference form waiver and list your references. You will need to provide each reference with the form link to be completed online.
Personal Statement:
Please provide a one paged typed personal statement addressing your career goals and how completing the certificate program aligns with those goals. Email to fdc@unthsc.edu
Applicant’s Name
is applying to the Texas College of Osteopathic Medicine Certificate in Academic Medicine Program.
Waive access to this letter under the Family Educational Rights and Privacy Act of 1974, or any other law, regulation, or policy.
Waive access to this letter under the Family Educational Rights and Privacy Act of 1974, or any other law, regulation, or policy.
It is the policy of the University of North Texas Health Science Center and the Texas College of Osteopathic Medicine not to discriminate on the basis of race, color, religion, sex, age, national origin, disability, or disabled veteran or veteran of the Vietnam Era status in their educational programs, activities, admissions, or employment policies.
It is the policy of the University of North Texas Health Science Center and the Texas College of Osteopathic Medicine not to discriminate on the basis of race, color, religion, sex, age, national origin, disability, or disabled veteran or veteran of the Vietnam Era status in their educational programs, activities, admissions, or employment policies.

This field is for validation purposes and should be left unchanged.

 

Questions? email us at fdc@unthsc.edu

This page was last modified on September 6, 2024