APPLICATIONS AND ALL MATERIALS LISTED ABOVE ARE DUE POSTMARKED NO LATER THAN JULY 15, 2005 LATE APPLICATIONS WILL NOT BE ACCEPTED.

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Wayne State University School of Medicine Transfer with Advanced Standing 2005 Wayne State University School of Medicine will accept applications for transfer with advanced standing from students currently enrolled in a U.S. or Canadian allopathic (LCME accredited) or osteopathic medical school to fill openings which may exist in Year II or Year III for the 2005-2006 academic year. The number of available positions will not be known until mid-july. Only students currently enrolled in a school of medicine and in good standing will be considered. Students applying to Year III are required to pass Part I of the USMLE in order to be considered. Priority will be given to U.S. citizens enrolled in allopathic institutions. Consideration is also given to students with ties to the state of Michigan. Only applicants who are either American citizens or who have a Permanent Resident Visa (green card) and have completed at least two years of their undergraduate classes (must include pre-med classes) in an accredited U.S. or Canadian college or university will be considered for transfer. Students applying for transfer will be required to submit the following by the application deadline: 1. Official transcripts from each undergraduate and graduate university. 2. Official transcript from the medical school in which the applicant is currently enrolled. 3. Official test scores from Part I of United States Medical Licensing Exam (USMLE) for students requesting transfer into Year III. 4. Three letters of recommendation. These must be from faculty of the medical school the applicant is currently attending. One of the three letters MUST be from the Dean of Student Affairs at the medical school verifying the candidate is a student in good academic standing at the institution. (copies will not be accepted) 5. Most recent MCAT scores (must be official). Website for request is www.aamc.org 6. Completed Wayne State University School of Medicine application for advanced standing. 7. A non-refundable processing fee of $50.00. APPLICATIONS AND ALL MATERIALS LISTED ABOVE ARE DUE POSTMARKED NO LATER THAN JULY 15, 2005 LATE APPLICATIONS WILL NOT BE ACCEPTED. Files will NOT be reviewed until all the materials listed above have been received by our office. Decisions concerning an interview will only be made after the committee is informed as to the number, if any, of positions available. All candidates offered places will have been interviewed by at least one member of the Admissions Committee. It is the candidate s responsibility to see that all of the requirements have been met and all requested documents have been received by the Admissions Office by the deadline date listed above. Exception to any policy must receive approval from the Dean/Director of Admissions. FAILURE TO SUPPLY THE REQUESTED MATERAL WILL RESULT IN YOUR APPLICATION BEING DENIED FOR FURTHER CONSIDERATION. MAILING ADDRESS: Wayne State University School of Medicine Office of Admissions 540 East Canfield Detroit, MI 48201 TELEPHONE NUMBER: (313) 577-1466

Application for Transfer with Advanced Standing You must answer each of the following questions for your file to be reviewed. 1. Are you currently enrolled in a U.S. or Canadian allopathic or osteopathic medical school? 2. Are you currently a student in good standing at your medical school? 3. Are you currently a U.S. citizen or do you hold a permanent resident visa? Citizen of the U.S. Permanent Resident Visa 4. Have you completed at least two(2) years of academic course work in a U.S. or Canadian college or University? Signature DATE Name (printed)

Social Security Number \ \ AAMC ID (if available) Citizenship Name Last First Middle Suffix Permanent Address Number and Street City County State Telephone ( ) State Residency Zip Code Father: Living ( ) Deceased ( ) Mother: Living ( ) Deceased ( ) Name Occupation State of Residence Education/College Name Occupation State of Residence Education/College Ages of your brothers sisters dependents Secondary School State Year of Graduation ALL UNDERGRADUATE COLLEGES ATTENDED (LIST IN CHRONOLOGICAL ORDER): Institution Location Dates Attended Major Degree/Date ALL GRADUATE OR PROFESSIONAL SCHOOLS ATTENDED: Institution Location Dates Attended Major Degree/Date MEDICAL SCHOOL CURRENTLY ATTENDING: Institution Location Dates Attended Major Degree/Date Has your education to date been continuous other than for vacations? Yes ( ) No ( ) If no, indicate what you have been doing while out of school: Were you ever required to leave any college or denied readmission for any reason? Yes ( ) No ( ) If yes, you must explain this in the Personal Comments Section. Military Service: Branch of Service Rank Dates

SUMMARY OF ACADEMIC INFORMATION A. Overall undergraduate GPA: on a scale of B. Overall graduate GPA: on a scale of C. Medical School: Pass-Fail System (circle if applicable) GPA to date: on a scale of. Rank in Class of. (Include GPA and rank in Class only if normally derived by school) First Year Second Year Credit Credit Course Hours Grade Course Hours Grade PLEASE CIRCLE THE YEAR (CLASS) FOR WHICH YOU ARE SEEKING ADMISSION: A. YEAR II B. YEAR III C. EITHER YEAR II OR YEAR III Students admitted into Year II will have extremely limited time for response. Interviews will be scheduled in mid late July and classes will begin in early August. Students admitted into Year III will begin later than current students which will reduce their open months in 4 th year. They will have no options for rotation scheduling.

D. Medical College Admissions Test (MCAT) Scores: (Official Scores must be sent from MCAT) Date: \ Verbal Reasoning Physical Sciences Writing Sample Biological Sciences Date: \ Verbal Reasoning Physical Sciences Writing Sample Biological Sciences E. United States Medical Licensing Exam (USMLE) Part I (Official Scores must be sent from USMLE) For students requesting transfer into Year III only. Date: \ Attach scores here: F. Personal Comments:

F. Personal Comments (Continued): I certify that the information submitted in this application is complete and correct to the best of my knowledge and belief. Date Signature Printed Name Please return this application to: Wayne State University School of Medicine Office of Admissions 540 East Canfield, Room 1310 Detroit, MI 48201