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Thank you for your interest in our Emergency Medicine Student Elective at Hennepin County Medical Center (HCMC). This core emergency medicine rotation is open to all third- and fourth-year medical students who have completed a rotation in both Internal Medicine and Surgery. In order to arrange a rotation at HCMC, you'll need to provide proof of your Internal Medicine and Surgery training as well as a completed application. Please print out and complete the following registration form and fax it or return it to:

Joni Egan
Department of Emergency Medicine
Hennepin County Medical Center, Mailcode 825
701 Park Avenue South
Minneapolis, MN 55415
Fax #: 612-904-4241, attn. Joni Egan

You can also cut and paste this form into a word document, complete the form within the document, and then e-mail it as an attachment to:

Email to: Joni.Egan@hcmed.org

Students with incomplete registration forms will not be admitted for a rotation. Interested students can contact
Ms. Egan at 612-873-4906 to receive more information including available rotation dates. Your school will need
to provide proof of enrollment and malpractice insurance coverage.

Registration Form

First Name
Middle Initial
Last Name
Address
City
State
Zip
Phone
E-Mail Address
Year of Graduation
Specialty Interest

Medical School
Program (MD, PA, DO)
Institution
Address
City
State
Zip
Medical School E-Mail Contact

Below you will find the dates of our four-week rotations. Please send in your completed application with your first, second and third choice of dates from the list below. We need rotation dates from this list before an application can be processed. If you have any questions, please feel free to contact Joni Egan at the above address, or call (612) 873-3481 for more information on this year's rotation dates and availability of spots.

Out-state rotations typically begin the first Monday of the month with the exception of Monday Holiday weeks.

Four-Week Student Elective Rotation Dates

Medical Student Rotations 2008

First six months 2008	Second six months 2008

Jan. 2 - Jan. 26	July 7 - August 2
Feb. 4 - March 1	Aug. 4 - Aug. 30
March 3 - March 29	Sept. 2 - Sept. 26
April 7 - May 2	Oct. 6 - Oct. 31
May 5 - May 31	Nov. 3 - Nov. 28
June 2 - June 28	Dec. 1 - Dec. 26

Physician Assistant Rotations 2008

Jan. 2 - Jan. 26
Feb. 4 - March 1
March 3 - March 29
April 6 - May 1
November 3 - November 28
December 1 - December 26

Medical Student Rotations 2009

Jan. 5 - Jan. 30	July 6 - July 31
Feb. 2 - Feb. 27	Aug. 3 - Aug. 28
March 2 - March 27	Sept. 7 - Oct. 2
April 6 - May 1	Oct. 5 - Oct. 30
May 4 - May 29	Nov. 2 - Nov. 27
June 1 - June 26	Dec. 7 - Jan. 1, 2010

Physician Assistant Rotations 2009

Jan. 5 - Jan. 30
Feb. 2 - Feb. 27
March 2 - March 27
April 6 - May 1
Nov. 2 - Nov. 27
Dec. 7 - Jan. 1, 2010

Available Rotation Dates:

1st Choice: From ____________ to ____________

2nd Choice: From ____________ to ____________

3rd Choice: From ____________ to ____________

Students from the University of Minnesota Medical School also rotate through the department on a regular basis.

We will do our best to place you in the rotation matching your first choice.

Housing (please check one)

______ I am interested in housing information from Hennepin County Medical Center.

______ I will not need housing