{"id":191,"date":"2013-02-25T11:29:37","date_gmt":"2013-02-25T16:29:37","guid":{"rendered":"http:\/\/209.15.213.109\/~shelterh\/?page_id=191"},"modified":"2023-10-13T11:40:54","modified_gmt":"2023-10-13T15:40:54","slug":"education","status":"publish","type":"page","link":"https:\/\/shelterhealthnetwork.ca\/?page_id=191","title":{"rendered":"Residents and Medical Students"},"content":{"rendered":"<p><strong>To apply for an elective, please fill out the following form:<\/strong><\/p>\n<p><em>Please note that we can only take one learner (resident or student) for a block elective at any given time so elective spots fill up quickly. \u00a0To avoid disappointment , please try to apply for the elective well ahead of time. \u00a0At present we would appreciate that the request be made at least 3 months prior. If there are questions, please do not hesitate to contact Dr Rabia Bana at rabia.bana@medportal.ca.<\/em><br \/>\n<em>Please note we are unable to accommodate learners during July and August. Horizontal electives must be arranged directly with individual practitioners of the SHN.<br \/>\n<\/em><\/p>\n<p><em>After you have filled out the elective form, you will hear from our office about whether any of the times requested are available or not and once confirmed, a clinic schedule will be planned for your elective.<\/em><\/p>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f478-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"478\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F191#wpcf7-f478-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"478\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.7\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f478-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<p><b>Your Name * <\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n<\/p>\n<p><b>Your Email *<\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n<\/p>\n<p><b>What university do you currently attend? * <\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"university\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"university\" value=\"McMaster\" \/><span class=\"wpcf7-list-item-label\">McMaster<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"university\" value=\"Other:\" \/><span class=\"wpcf7-list-item-label\">Other:<\/span><\/span><\/span><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"otheruniversity\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"otheruniversity\" \/><\/span>\n<\/p>\n<p><b>What type of elective are you applying for? * <\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"elective\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"elective\" value=\"Block\" \/><span class=\"wpcf7-list-item-label\">Block<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"elective\" value=\"Horizontal\" \/><span class=\"wpcf7-list-item-label\">Horizontal<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><b>Please select your current educational status. *<\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-education\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-education\" value=\"Pre Clerk (1st year medical student - any time prior to starting your formal clerkship)\" \/><span class=\"wpcf7-list-item-label\">Pre Clerk (1st year medical student - any time prior to starting your formal clerkship)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-education\" value=\"Clerk (2nd year medical student - from start of clerkship until June of your second year)\" \/><span class=\"wpcf7-list-item-label\">Clerk (2nd year medical student - from start of clerkship until June of your second year)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-education\" value=\"Clerk (3rd year medical student)\" \/><span class=\"wpcf7-list-item-label\">Clerk (3rd year medical student)<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-education\" value=\"PGY1 Family Medicine Resident\" \/><span class=\"wpcf7-list-item-label\">PGY1 Family Medicine Resident<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-education\" value=\"PGY2 Family Medicine Resident\" \/><span class=\"wpcf7-list-item-label\">PGY2 Family Medicine Resident<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-education\" value=\"IMG Observer\" \/><span class=\"wpcf7-list-item-label\">IMG Observer<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-education\" value=\"Other:\" \/><span class=\"wpcf7-list-item-label\">Other:<\/span><\/label><\/span><\/span><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"othereducation\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"othereducation\" \/><\/span>\n<\/p>\n<p><b>Please provide, in order of preference, 3 timespans you would prefer for your elective *<\/b>\n<\/p>\n<p><i>Ie. 1st Choice - January 6, 2024 to January 20, 2024; 2nd Choice - March 2, 2024 to March, 2024 etc. ***Please note that for medical students and residents we accommodate block electives for a maximum of two weeks and horizontal electives for a minimum of 4 weeks and maximum of 6 weeks.<\/i><br \/>\n<b>1st choice:<\/b> Beginning <span class=\"wpcf7-form-control-wrap\" data-name=\"datebegin1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"datebegin1\" \/><\/span> --- Ending <span class=\"wpcf7-form-control-wrap\" data-name=\"dateend1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dateend1\" \/><\/span>\n<\/p>\n<p><b>2nd choice:<\/b> Beginning <span class=\"wpcf7-form-control-wrap\" data-name=\"datebegin2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"datebegin2\" \/><\/span> --- Ending <span class=\"wpcf7-form-control-wrap\" data-name=\"dateend2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dateend2\" \/><\/span>\n<\/p>\n<p><b>3rd choice:<\/b> Beginning <span class=\"wpcf7-form-control-wrap\" data-name=\"datebegin3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"datebegin3\" \/><\/span> --- Ending <span class=\"wpcf7-form-control-wrap\" data-name=\"dateend3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dateend3\" \/><\/span>\n<\/p>\n<p><b>If you would like to do a horizontal elective, please indicate your availability (select all that apply). <\/b><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"availability\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Monday mornings\" \/><span class=\"wpcf7-list-item-label\">Monday mornings<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Monday afternoons\" \/><span class=\"wpcf7-list-item-label\">Monday afternoons<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Tuesday mornings\" \/><span class=\"wpcf7-list-item-label\">Tuesday mornings<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Tuesday afternoons\" \/><span class=\"wpcf7-list-item-label\">Tuesday afternoons<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Wednesday mornings\" \/><span class=\"wpcf7-list-item-label\">Wednesday mornings<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Wednesday afternoons\" \/><span class=\"wpcf7-list-item-label\">Wednesday afternoons<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Thursday mornings\" \/><span class=\"wpcf7-list-item-label\">Thursday mornings<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Thursday afternoons\" \/><span class=\"wpcf7-list-item-label\">Thursday afternoons<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Friday mornings\" \/><span class=\"wpcf7-list-item-label\">Friday mornings<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"availability[]\" value=\"Friday afternoons\" \/><span class=\"wpcf7-list-item-label\">Friday afternoons<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><b>What will your educational level be at the time that you indicated as your first choice for your elective? *<\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"educationfuture\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"educationfuture\" value=\"Pre Clerk (1st year medical student - any time prior to starting your formal clerkship)\" \/><span class=\"wpcf7-list-item-label\">Pre Clerk (1st year medical student - any time prior to starting your formal clerkship)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"educationfuture\" value=\"Clerk (2nd year medical student - from start of clerkship until June of your second year)\" \/><span class=\"wpcf7-list-item-label\">Clerk (2nd year medical student - from start of clerkship until June of your second year)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"educationfuture\" value=\"Clerk (3rd year medical student)\" \/><span class=\"wpcf7-list-item-label\">Clerk (3rd year medical student)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"educationfuture\" value=\"PGY1 Family Medicine Resident\" \/><span class=\"wpcf7-list-item-label\">PGY1 Family Medicine Resident<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"educationfuture\" value=\"PGY2 Family Medicine Resident\" \/><span class=\"wpcf7-list-item-label\">PGY2 Family Medicine Resident<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"educationfuture\" value=\"IMG Observer\" \/><span class=\"wpcf7-list-item-label\">IMG Observer<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"educationfuture\" value=\"Other:\" \/><span class=\"wpcf7-list-item-label\">Other:<\/span><\/span><\/span><\/span><span class=\"wpcf7-form-control-wrap\" data-name=\"othereducationfuture\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"othereducationfuture\" \/><\/span>\n<\/p>\n<p><b>Why do you want to do an elective with SHN? *<\/b>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"whyelective\"><textarea cols=\"100\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"whyelective\"><\/textarea><\/span>\n<\/p>\n<p><b>What are your learning objectives from this elective? *<\/b>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"whatelective\"><textarea cols=\"100\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"whatelective\"><\/textarea><\/span>\n<\/p>\n<p><b>If you are an IMG, have you passed your MCCEE? (Please note that you will be requested to submit proof of passing MCCEE) <\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"imgmccee\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"imgmccee\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"imgmccee\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"imgmccee\" value=\"N\/A\" \/><span class=\"wpcf7-list-item-label\">N\/A<\/span><\/span><\/span><\/span>\n<\/p>\n<p><b>Do you have any other comments you would like to make regarding your request? <\/b>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"comments\"><textarea cols=\"100\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"comments\"><\/textarea><\/span>\n<\/p>\n<p><b>if you are a resident, please indicate when your half day backs are.<br \/>\nIf you are a medical student and have a PPI scheduled during the elective, please indicate when it is. <\/b>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"ifapplicable\"><textarea cols=\"100\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"ifapplicable\">N\/A (Not Applicable)<\/textarea><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>To apply for an elective, please fill out the following form: Please note that we can only take one learner (resident or student) for a block elective at any given<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-full.php","meta":{"footnotes":""},"class_list":["post-191","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/shelterhealthnetwork.ca\/index.php?rest_route=\/wp\/v2\/pages\/191","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/shelterhealthnetwork.ca\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/shelterhealthnetwork.ca\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/shelterhealthnetwork.ca\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/shelterhealthnetwork.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=191"}],"version-history":[{"count":0,"href":"https:\/\/shelterhealthnetwork.ca\/index.php?rest_route=\/wp\/v2\/pages\/191\/revisions"}],"wp:attachment":[{"href":"https:\/\/shelterhealthnetwork.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=191"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}