THE UNIVERSITY OF NEBRASKA MEDICAL CENTER COLLEGE OF MEDICINE

On-line Application for Graduate Medical Education Program

After you submit this form your information will appear in the browser and you can print the page for your records.

* required fields
Name
Last: * First: * Middle: *
Present Address:   *
City: * State: * ZIP: *
Phone: (include area code)
Permanent Address: *
City: * State: * ZIP: *
Phone: (include area code)
Hometown:
Start date: Must enter as format mm/dd/yyyy
Department:
Type of position desired:
Program of Interest:
NRMP#
Please check the Year of training for which you are applying:
HOI HOII HOIII HOIV HOV Fellow
Date of Birth: * Must enter as format mm/dd/yyyy
Education Name and Location of Institution Dates
enter as mm/dd/yyyy		 Degree
High School

Start 
Finish

College

Start 
Finish

Medical School

Start 
Finish

Other

Start 
Finish

Post-Graduate Training

Name and Location of Institution

Type of Program

Dates
enter as mm/dd/yyyy

PG1

Start 
Finish

PG2

Start 
Finish

PG3

 

Start 
Finish

Test Scores, Honors, Teaching/Research Experience

Note: test scores information is optional. If provided, please give average score.

USMLE Step 1 USMLE Step 2 USMLE Step 3 COMPLEX

Honors and awards (include college and medical school honors, awards, scholarships and offices held.

Teaching and research experience (publications, academic appointments, research interests.

Licensure

State: Date Issued: Number:

Service obligations (PHS, NHSC, military):

Military Service:

Branch:

Dates of service:

Foreign Medical School Graduates

Type of Visa:

ECFMG Date: VQE Date:

Hobbies, Activities

List the names and addresses of professional references and have them forward their letters of recommendation. Make sure to include someone who has experienced your clinical performace.

Application Directions

For the general cardiovascular fellowship, we are participating in the ERAS electronic application process. We encourage you to submit your application by this method, although you may also apply through this web-site. Our deadline for the general cardiovascular fellowship is December 31.

For the EP and Interventional Fellowships, you must apply directly through this web-site. ERAS does not accept applications for these specialized fellowships. Our deadline for each of these fellowship programs is October 31.

Please contact us if you have questions.

Forward the following material to the address listed below after you have submitted your on-line application form:

  • Personal statement concerning your short and long-term career goals
  • Letter of recommendation from your internal medicine residency director
  • Two additional letters of reference from other physicians who know you well
  • Arrange for your Dean's letter and other credentials to be sent to the address above
  • Contact the department to which you are applying to arrange an interview
  • Curriculum vitae
  • Medical school transcript
  • ECFMG certificate, if applicable
  • All three steps of USMLE are required
  • Applications will be accepted after June 1
  • Stamped, self-addressed postcard to be returned to you when your application is complete

    Fellowship Coordinator
    Section Cardiology
    University of Nebraska Medical Center
    982265 Nebraska Medical Center
    Omaha, NE 68198-2265

For additional information, please contact the Fellowship Coordinator, (office) 402-559-9252 or (fax) 402-559-8355.