Residency Placement Survey Form |
| Residency placement results directly affect the accreditation and licensure of AUC School of Medicine, and in turn, the value of your medical doctor degree. Please complete the brief form below.
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| 1. What year did you participate in the match?
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2. Please indicate whether you obtained a residency in this year’s match?
Yes
No
N/A (I did not certify and submit my rank order list to be used in this year’s match) |
3. If No, why do you feel you did not match?
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4. If N/A, why did you not participate in this year’s match
Did not pass Step 2
Did not receive any interviews
Other
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| 5. If yes, Please provide the details of your match, including Match Choice (First, Second, Third, Other.) and Match Event (PreMatch, Main Match, Postmatch, or Other). |
| PGY1 |
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Program/Specialty:
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Hospital Name:
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Location (city/state)
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Match Choice:
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Kind of Match:
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| PGY2 |
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Program/Specialty:
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Hospital Name:
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Location (city/state)
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Match Choice:
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Kind of Match:
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| 6. Student Information: |
First Name:
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Last Name:
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Student ID:
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Graduation Date (mm/dd/yy):
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Address:
Apt.
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City:
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State:
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Zip:
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Phone Number:
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Email:
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