Other Information

Select your first language (the language of your birth). If you speak additional languages, select Yes. Then, select the language(s) and the level of your proficiency in each. Note that the proficiency scale was developed for spoken languages. For reporting proficiency in a signed language, select American Sign Language or Sign languages, and select the proficiency level that most closely matches your skill level.

• Native/Near-Native: I converse easily and accurately in all types of situations, including communicating health care concepts. Individuals at the native/near-native level may think that I have native/near-native skills, too.
• Advanced: I converse very accurately, and I understand others very accurately. Language ability only rarely hinders me in performing any task, including communicating health care concepts. Individuals at the native/near-native level have no problem understanding me, but they probably perceive that I do not have native/near-native skills.
• Good: I communicate well enough to participate in most conversations. Individuals at the native/near-native level notice some errors in my language production or my understanding, but I am generally able to repair the conversation if errors or misunderstandings occur. I have some difficulty communicating health care concepts.
• Fair: I communicate and understand well enough to have casual conversations about current events, work, family, or personal life and can get the general idea of most everyday conversations. Individuals at the native/near-native level notice many errors in my language production or my understanding. I have difficulty communicating about health care concepts.
• Basic: I can use the language at a level that permits me to understand and respond to 2 to 3 word entry level questions and meet minimum courtesy requirements. I have difficulty participating in or understanding conversations. I am unable to understand or communicate most health care concepts.

These definitions are sourced from the Association of American Medical Colleges (AAMC), the Accreditation Council for Graduate Medical Education (ACGME), and the American Medical Association (AMA), in conjunction with the Interagency Language Roundtable for Healthcare (ILR-H). 

Indicate if you received a Pell Grant as an undergraduate student.

Indicate if you are a first-generation student (i.e., neither parent/legal guardian attended college).

If you have US military experience, select your anticipated status at the time of enrollment from the drop-down. Select Not a member of the military if this does not apply.

If a member of the military, select your branch of the Armed Forces from the drop-down and indicate the dates of service.

Indicate if you are required to fulfill a US military active duty commitment or in deferment. If yes, enter additional details.

Indicate whether you've ever been convicted of a misdemeanor or felony. Failure to disclose and provide accurate information about prior convictions may have serious consequences, such as annulment of acceptance offers, program dismissal, or other sanctions.

Be aware of the potential impact on program acceptance. Contact the programs you wish to apply to for advice if you have a felony conviction or a criminal record. If you are uncertain of the status of a charge versus a conviction on your record, or if you are uncertain as to whether your offense was an infraction, misdemeanor, or a felony, contact the city, county, or state jurisdiction where the incident occurred.

If you are convicted of a misdemeanor or felony prior to admission and/or matriculation, it is your responsibility to immediately inform your program(s).

Indicate whether you have ever had any certification, registration, license, or clinical privileges revoked, suspended, or in any way restricted by an institution, state, or locality. If yes, enter an explanation in the spaces provided.

Enter your medical IDs, if applicable.