University of Iowa Carver College of Medicine
Application for Individually Arranged Elective
Please fill out the form below with the appropriate information and attachments. There are five sections to complete. Be sure to read all the directions and requirements.
Completion of this application requires:
- Attachment of acceptance letter / email from the sponsoring physician or administrator indicating that you have been approved for the elective for the dates provided.
- Attachment of description of the proposed elective. Include a statement of the educational objectives, an outline of the program, a description of the type of activities and student responsibilities, and type of supervision by staff members. The elective description may be pre-written (often found on online) or you may write the description with objectives yourself. For research electives, attach a proposal outlining the research project.
Note: Global clerkship requests should be routed separately through Robin Paetzold, Director of Global Programs.