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 (Withdrew from Match) |
3. If yes, Was your match your first choice?
Yes
No |
4. If no, Was your match in your top three choices?
Yes
No |
| 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). |
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 Month/Year:
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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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