Adam Stevenson MD Associate Dean of Student Affairs January 14th, 2014

Adam Stevenson MD Associate Dean of Student Affairs January 14th, 2014
The Fourth Year Adam Stevenson MD Associate Dean of Student Affairs January 14th, 2014 (C) 2013 University of Utah School of Medicine

Curriculum Map

Match Day – March 2015

Commencement – May 2015

Today’s Schedule Step 2 requirements and Grad Review – Helen Anderson Financial Aid and AOA – William Shiflett Match and MSPE – Adam Stevenson Career Advising – Adam Stevenson Break and snacks 4th year Curriculum – Dr. Dani Roussel Lottery and Visiting Rotations – Carol Stevenson Class Address - Reetu and Chris (C) 2013 University of Utah School of Medicine

Graduation Checks MD Program Requirements
Required Credits – Track Specific Passing Scores on USMLE Step 1, Step 2 CK & Step 2 CS Community Service Learning Hours Scholarly Activity Fulfillment ed “Quarterly” June 15 November 15 January 15 April 15 © 2014 University of Utah School of Medicine, Office of Student Affairs

USMLE Step 2 Apply for USMLE Step 2 CK & Step 2 CS by April 5, 2014, at NBME's website Step 2 CK = $580 Step 2 CS = $1230 Select exam dates by June 15, 2014 (highly recommended!) Take Step 2 CK by October 31, 2014 Take Step 2 CS by December 31, 2014 LOA students must take both Step 2 exams by August 15, 2014. © 2014 University of Utah School of Medicine, Office of Student Affairs

Senior AOA AOA Consent to Release Academic Information will be sent to you ~ January 20th. Regardless of assumed ability/eligibility everyone is strongly encouraged sign and return their release. Please return release to William Shiflett at or deliver to SOM 1C100. © 2014 University of Utah School of Medicine, Office of Student Affairs

Financial Aid Exit Interviews
Financial Aid Exit Interviews are mandatory and each student will have two exit interviews. Main Campus Financial Aid Representative (Erica Rojas) UUSOM Financial Aid Representative (Wendy Clark) Exit interviews will be scheduled in Spring of your 4th year. © 2014 University of Utah School of Medicine, Office of Student Affairs

14 months and counting…

National trend: 2013 Match 40,335 total applicants 17,487 US allopathic seniors 29,171 positions, an increase of 9% National match rate = 93.7% 78% percent match in top 3 choices t (C) 2013 University of Utah School of Medicine

Unmatched Seniors vs. Unfilled positions NRMP 2002-2012
(C) 2012 University of Utah School of Medicine

t UU SOM Match 2013 95.8% Initial Match rate
Primary Care 26 Surgical 15 Other 32 Military Match 1 San Francisco Match 4 Urology Match 1 NRMP only 95.8% Initial Match rate 97.2% Match rate after SOAP t

UU SOM Match 2013 - Specialties
(C) 2012 University of Utah School of Medicine UU SOM Match Specialties Anesthesiology 3 Dermatology 2 Emergency Medicine 9 Family Medicine 10 General Surgery 5 Internal Medicine 4 Prelim Medicine (Only)2 Medicine/Pediatrics 2 Medicine/Psychiatry 1 Neurology 2 OB/Gyn 3 Ophthalmology 4 Orthopedic Surgery 2 Otolaryngology 3 Pathology 1 Pediatrics 4 Triple Board 1 PM&R 1 Psychiatry 3 Radiology (Diagnostic) 6 Urology 1 t (C) 2013 University of Utah School of Medicine

2013 The Un-Matched Record number of applicants were not fully matched 13,808 total 2,076 US seniors Record number of US seniors remain un-matched after the SOAP process 528 US seniors without a job! t (C) 2013 University of Utah School of Medicine

What is your likelihood of Matching?
Very little to do with how good of a student you are Has everything to do with your preparation and backup plans Very specialty and student specific NRMP CHARTING OUTCOMES DATA t (C) 2013 University of Utah School of Medicine

NRMP.org

NRMP “Program Director Survey”
(C) 2012 University of Utah School of Medicine

Specialty Specific Information
NRMP “Charting Outcomes” NRMP “Program Director Survey” AAMC.org/CIM t (C) 2013 University of Utah School of Medicine

Specialty Specific Information
NRMP “Charting Outcomes” NRMP “Program Director Survey” AAMC.org/CIM You need to know what your likelihood is for matching into the specialties you are consiering t (C) 2013 University of Utah School of Medicine

What is your likelihood of Matching?
Very little to do with how good of a student you are Has everything to do with your preparation and backup plans Number of applications Which programs to apply to Dual applications Improving LOR Step 2 Rotations t (C) 2012 University of Utah School of Medicine

SOAP Replaced the Scramble in 2012 8 rounds of a electronic Supplemental Offer and Acceptance Program Lots of sitting and waiting for the phone to ring Miserable and not very helpful t (C) 2012 University of Utah School of Medicine

Eight Utah SOAP Students (2012-13)
Mix of specialties Some had obvious difficulties Step 1 failure, clerkship failure, etc Some were strong applicants Average Step 1 score 234 Too few applications Interview issues? t (C) 2013 University of Utah School of Medicine

Where Our Students End-up?
1 Orthopedic surgery candidate SOAP’d into Surgery-preliminary position 1 Radiology candidate SOAP’d into Anesthesia position 1 Radiation Oncology candidate SOAP’d into Surgery-Preliminary position 1 Diagnostic Radiology found a position in May outside of the SOAP 2 Emergency Medicine Candidates found prelim Medicine position in May outside of SOAP 1 still looking for Family Medicine position 1 still looking for Med/Peds position t (C) 2013 University of Utah School of Medicine

Summary You want to be Matched! SOAP is miserable and is not a backup plan Not finding any position is extremely miserable Determining your specialty now helps immensely Use NRMP data now to determine your likelihood of matching Start thinking about backup plans now if you need them (C) 2013 University of Utah School of Medicine

What do you need to do in the next 6 months?
Identify a specialty, Track and a Mentor (Carol) Complete the 4th year lottery process (Carol) Determine your Step 2 times Review your LOR options Ace your clerkships Be ready for 4th year Orientation Meeting in June t (C) 2013 University of Utah School of Medicine

Electronic Residency Application Service (ERAS)
© 2013 University of Utah School of Medicine, Office of Student Affairs © 2012 University of Utah School of Medicine, Office of Student Affairs

ERAS Technically optional but almost everyone uses it All NRMP match uses ERAS Military match uses ERAS Urology match uses ERAS and AUA San Francisco match uses CAS Very separate from NRMP and NBME (C) 2013 University of Utah School of Medicine

ERAS Students responsibility: Letters of Recommendation (shared) NBME scores (shared) Personal Statement(s) CV Photograph Program List We will talk about each one of these in the Longitudinal Course (C) 2013 University of Utah School of Medicine

Letters of Recommendation
Four slots in ERAS for LOR Few student will meet four letter writers in the next eight months You need to start finding them now Rholinda will discuss in June the detailed process for getting LOR into ERAS (C) 2013 University of Utah School of Medicine

Qualities of a good letter writer: Attending (not resident or chief resident) Clinical exposure is my primary consideration I do not care about rank or national status (some specialties might) Research letters are the main exception to the clinical focus Someone that can attest to your professional identity (i.e. “brand”) (C) 2013 University of Utah School of Medicine

How to ask? Set up a meeting Bring your CV Be prepared to answer “What should I focus on in the letter?” Provide a deadline For now, have them keep the letter (C) 2013 University of Utah School of Medicine

NBME Deadlines Schedule exam by June 15th (recommended) Take CK by October 31st (required) Take CS by December 31st (required) Disability and accommodation request must go through main campus CDS SINGLE PRACTICE CK EXAM PROVIDED BY THE SOM (C) 2013 University of Utah School of Medicine

Word of Caution… “Our evaluation of applicants includes the USMLE Step 2 CK score. I would be happy to further evaluate this applicant once I have that score.” Program Director, 2012 Match (C) 2013 University of Utah School of Medicine

Step 2 timing More program directors are using Step 2 for initial interview decisions Clear decline in scores the further away from Clerkships Institutional requirement to take exam by Oct 31st (C) 2013 University of Utah School of Medicine

NBME Deadline to take exam and have results available for ERAS? ERAS due Oct 31 Deadline NBME Deadline to take exam and have results available for MSPE? MSPE released (C) 2013 University of Utah School of Medicine

Step 2 timing In general, it is nearly always better to have a CK score posted by September 15th. In order to post by Sept 15th, you probably need to take the exam by ~July 29th CS not typically used for granting interviews (unless you fail it or have significant problems with clinical evaluations) (C) 2013 University of Utah School of Medicine

Longitudinal Course - Mentoring
ERAS Step 2 Personal Statements Letters of Recommendation NRMP data Making a program list Interviews Making a rank list t (C) 2013 University of Utah School of Medicine

What do you need to do in the next 6 months?
Identify a specialty, Track and a Mentor (Carol) Complete the 4th year lottery process (Carol) Determine your Step 2 times Review your LOR options Be ready for 4th year Orientation Meeting in June Ace your clerkships t (C) 2013 University of Utah School of Medicine

MSPE National History Wide variation historically
Guidelines published by AAMC in 2002 “Letter of evaluation” rather than letter of recommendation Standardized format Release deadline moved from Nov 1st to Oct 1st

Local history Excellent adherence to AAMC guidelines
Input fields from all other areas of Dean’s Office (OIO, PEL, Med ED, etc.) Compilations 8-10 pages in length

My Vision Accurately portray the true consistent performance of our students Provide useful information to the end user (program directors) Maintain institutional integrity Foster student desire to excel rather than compete

First Page IDENTIFYING INFORMATION Chelsea Smith is a fourth-year student at the University of Utah School of Medicine applying to your program for residency training. This letter is meant to provide an overview of Chelsea’s academic performance and personal characteristics to assist you in your assessment of her application. Chelsea came to the University Of Utah School Of Medicine in 2011 after earning a Bachelor of Science degree in Biology from University of Notre Dame, and her PhD in Anthropology from the University of Utah.

First Page UNIQUE CHARACTERISTICS Chelsea is a resourceful innovator, looking for opportunities in learning and service. As a first year student, she noticed that there were plenty of opportunities addressing global health for medical students, but none addressing the unique needs of Utah's own population. Over the course of the year she developed contacts within the Utah Navajo Health Service. In doing so, she created an alternative spring break program for students interested in volunteering for under-served populations just hours from Salt Lake City in Montezuma Creek and Monument Valley. Chelsea has held positions of leadership. She served as the president of the Pediatric Medicine Interest Group. Chelsea is also very excited to be the principal investigator for her research project, a quality improvement study to help identify possible socio-demographic factors contributing to poorly controlled asthma in the pediatric population. She expects to publish her abstract and to present her research findings later this year.

Unique Characteristics
The Unique Characteristics is the first page of your MSPE (8-10 pages total) You will write a Personal Statement for your ERAS application, this is a different document. I will finalize and edit this statement using material that you create. Remember, this is written from my perspective t

Second page

Second page ACADEMIC HISTORY Combined Degree: No
Leaves of Absences, Extensions, Gaps: Yes. Chelsea took a personal leave of absence from August 2012 to December 2012. Coursework Remediated or Repeated: Yes. Chelsea successfully remediated her Comprehensive Clinical Skills Examination at the end of her third year. Disciplinary Action(s): No

ACADEMIC PROGRESS: PRE-CLERKSHIP YEARS (Phases I and II)
Pre-clerkship Academic Record: Chelsea successfully passed all courses during the first two years of medical school, including the following units: Foundations of Medicine (Pass/Fail only) Molecules, Cells and Cancer - Honors Host and Defense Life Cycle Brain and Behavior - Honors Metabolism and Reproduction Circulation, Respiration and Regulation Skin, Muscle, Bone and Joint

Clinical Experiences: Chelsea successfully completed all expectations for her Longitudinal Clinical Experience (LCE) and Subspecialty Clinical Experience (SCE) in her first two years of medical school, giving her over 1,700 hours of clinical exposure before beginning her Clerkship Year, Phase III. Details on LCE and SCE are provided in the Appendix. Chelsea’s LCE faculty attending physician noted the following: “Very professional and interested in outpatient medicine.”

Scholarly Expectation: Medical students are required to participate in an independent program of study that promotes students’ expertise in one or more areas of medicine, their ability to perform inquiry-based research, to ask scholarly questions and to effectively communicate the rationale for and results of their scholarly work. Chelsea reviewed patient charts and culled data from an Intermountain Healthcare database of infectious diseases affecting Utah communities. She used these data to examine the relationship between community viral infections and childhood leukemia. Chelsea presented her work at the 2010 annual Frank Tyler Medical Student Research Symposium in Park City, UT.

Community Service Learning Experience: All students are required to participate in community service learning projects in the first two years of the curriculum. Chelsea exceeded the service requirements of the UUSOM, completed at the following venues: 4th Street Clinic 4th Street Triathlon Flu Vaccines for the Homeless Maliheh Free Clinic Chelsea received an “Honors” in this service-learning requirement. “Honors” is awarded to students who completed 75+ hours directly with Utah and the surrounding communities in clinical, education and premedical programs supervised by the Office of Inclusion and Outreach.

Professionalism: The professionalism of our students is routinely addressed throughout all elements of the 4-year curriculum. Chelsea has met the professional expectations of the UUSOM as outlined in the Student Handbook, including: Honesty, Confidentiality, Respect for others and Responsibility.

MSI Comprehensive Clinical Skills Examination (Pass/Fail): Pass MSII Comprehensive Clinical Skills Examination (Pass/Fail): Pass

ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III)
Student performance is based upon achievements in the areas of medical knowledge, patient care and professionalism. Each component is used to calculate an overall clerkship score using a four point scale: 4 = Exceptional; 3 = Above expectation; 2 = Meets Expectation; 1 = Below Expectation; 0 = Unacceptable. Narrative comments are provided by faculty and clerkship directors and are edited the Associate Dean of Student Affairs only for grammar and length.

Clerkship MSPE Example
Internal Medicine (12 weeks) Score: 2.97, Pass Chelsea’s Internal Medicine attendings made the following comments about her: “Chelsea had a solid performance during this rotation and I am sure she will go on to do well.” “Student was very engaged during rounds, would read about her patient’s issues and overall did a very good job on Medicine.” “Chelsea was a valuable member of the Internal Medicine team during her first third-year clerkship.” “Chelsea was easy to work with. She seemed to really care about her patients. She was a hard worker and sought out responsibility.” “Excited about patient care and medicine. Took responsibility for patients and would call consultants. Very helpful.” “Organization, willingness to learn, works well with team (are her strengths).”

ACADEMIC PROGRESS: CLERKSHIP YEAR (Phase III)
Cumulative (year-long) performance on individual clinical competencies required for passing the clerkships Clinical Knowledge Professionalism Patient Care Scores (0-4 scale) taken directly from Clerkship Final Grade Form

Clinical Knowledge Score

3.65 3.79 3.81 Pass

ACADEMIC PROGRESS: Track Curriculum (Phase IV)
Grades and narrative from any courses that have a grade submitted prior to Sept 22nd. A list of fourth year courses scheduled to be completed

SUMMARY Chelsea is a caring professional who is dedicated to her profession and to community advocacy. As of the submission of this letter, she has successfully completed the University of Utah School of Medicine curriculum. Based on all aspects of Mary’s educational experience, she has demonstrated competency in all of the general domains established by the medical school and is prepared to enter residency. She is considered to be an excellent candidate for your residency program.

AOA Calculation and Class Description
AOA Calculated at the completion of Phase III Includes Junior AOA calculation and clerkship scores No class rank is every released or made public No quartile is calculated Descriptors are used instead of class rank or quartiles

Summary Descriptor Descriptors of summary performance
“Outstanding, Excellent, Very Good, Good” Describe the criteria needed to achieve each level Provide relative percentages for top descriptors (i.e. “Outstanding”)

Summary Descriptor

Descriptor Criteria Large list of potential inclusion points
Will includes Phase II score and honors, Phase III score and honors, and Step 1 scores End of year 3 OSCE?

So what do you need to do in the next month?
(Ace your clerkships) Use your token to open your ERAS account Begin your Personal Statement Begin your Unique Characteristic paragraph Set an appointment with me to review your UCP Schedule your Step 2 exams Review your LOR options t (C) 2013 University of Utah School of Medicine

What do you do if you do not know your specialty?
Relax Do well on your clerkships Differential diagnosis approach Most likely, most dangerous, off the list, different paradigms Create opportunities to refine the list Shadowing, rotations, research, mentors t (C) 2013 University of Utah School of Medicine

What do you do if you do not know your specialty?
Ask your friends and family Ask “Why?” AAMC.org/CIM It’s OK to put your nickel down and be wrong It’s OK to dual apply t (C) 2013 University of Utah School of Medicine

Required Courses

Step 2 CK (Oct 31st) and CS (Dec 31st)
Timeline Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Administrative Lottery ERAS MSPE Rank Match Grad Exams OSCE Step 2 CK (Oct 31st) and CS (Dec 31st) Interviews Courses off Transition Course Mentoring Pre-lottery Pre-ERAS LOR, CV, PS Submit Rank List

General Requirements 32 weeks total credit minimum Required courses
22 weeks in University of Utah system 4 weeks of local Sub-Internship Minimum 8 weeks of clinical electives Variable specialty requirements Required courses Longitudinal Course Transition to Internship Course Intense clinical experiences 4-weeks High Stakes Rotation!

Assessment Honors, High Pass, Pass and Fail 4 week deadline for grades
Some courses are pass/fail only 4 week deadline for grades Four types of evaluation forms: Sub-Internship Clinical Elective Didactic Elective Research Elective

Track Curriculum

Tracks and Specialties
Primary Care Internal Medicine Pediatrics Family Medicine Psychiatry IM-Peds Triple Board Medical Sciences Dermatology Medical Genetics Radiology Neurology PM&R Radiation Oncology Nuclear Medicine Applied Anatomy General Surgery Specialty Surgeries OB/Gyn Pathology Acute Care Emergency Medicine Anesthesiology

Track Directors Primary Care Applied Anatomy Medical Sciences
Rick Henriksen, MD Family Medicine Applied Anatomy Amalia Cochran, MD Burn Surgery Medical Sciences Phil Caligiuri, MD Radiology Acute Care Megan Fix, MD Emergency Medicine

Sample Track Requirements

Track Mentors Specialty Specific
Required for Approval of Phase IV Initial Schedule Request A Resource throughout the Year Personal Statements Program Lists Mock Interviews Rank Lists

Changing Tracks Allowed at any time up to Transition Course
Find the right specialty for you! Held to requirements of new track Stay in communication with your Mentors, Track Directors, and Student Affairs Contact Rachael Smith to formally change tracks

Track Questions?

Longitudinal Course

Course Dates 2 credits Year-long course July through March
Wednesday afternoons ~twice a month 1-5PM

Longitudinal Course Mentoring content Choosing your specialty
ERAS application process CV Personal Statement Program lists Residency Interviews Rank Lists Curriculum content Relevant to Intern Role Effective Communication Risk Management Health Care System Navigation DNR/DNI

Longitudinal Course Attendance
Attendance is Required Excused Absences Allowed Absences Away Rotation Residency Program Interviews Not Allowed Vacation USMLE Step 2 CK or CS Make-up Assignments For Excused and Allowed Absences

Longitudinal Course Questions?

Transition to Internship

Transition to Internship Course
March 30-April 24, 2015 No concurrent course enrollment allowed Class, Track, and Specialty sessions Skills Foundational Knowledge Processes Procedures Communication Codes, Mega-Codes Task Trainers Simulation Labs Standardized patients

Transition Course Questions?

Hints Relax Focus on your Sub-Internships
Remember you can switch tracks Prioritize the time prior to the MSPE being released (Oct 1st) Begin thinking of Letters of Recommendation now Be mindful of deadlines Enjoy fourth year

Fourth Year Scheduling Basics January 2014

2014-2015 Fourth Year Fall Semester (7/7 – 12/19)
Spring Semester (1/5 – 5/22) 2 and 4 week rotations 1 week = 1 credit Jul Aug Sep Oct Nov Dec Block 1 Block 2 Block 3 Block 4 Block 5 Block 6 Jan Feb Mar Apr May Jun Block 7 Block 8 Block 9 Block 10 Block 11

2014-2015 Fourth Year Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
ERAS app due 9/15 Step 2 CK deadline 10/31 MSPE due 10/1 Step 2 CS deadline 12/31 Jul Aug Sep Oct Nov Dec 7/7–8/1 8/4 –8/29 9/1–9/26 9/29-10/24 10/27-11/21 11/24-12/19 Match Day 3/20 Graduation 5/24 Jan Feb Mar Apr May Jun 1/5-1/30 2/2-2/27 3/2-3/27 3/30-4/24 Transitions 4/27-5/23

Creating Your Fourth Year Schedule

You will need - 1. Track Curriculum Outline
2. UUSOM Senior Elective Catalog Copy of the 2014/15 Fourth Year Graphic Faculty Mentor UUSOM Lottery Course Scheduling system

1. Track Curriculum Outline
- Outlined by Dr. Dani Roussel

2. UUSOM Senior Elective Catalog
- medicine.utah.edu

2. UUSOM Senior Elective Catalog, cont.
- 22 departments offering 160+ courses

- Description, rotation length, A/C/S/R, restricted months….

- review catalog information carefully

3. Copy of the Fourth Year Graphic

4. Faculty Mentor - select a recommended mentor within chosen Track
- they agree to review your proposed schedule and discuss plans

Faculty Advisor Form ________________ _________________
Faculty Advisor Form (return to Rachael Smith by March 3, 2014) _____________ and I have discussed his/her plans for the upcoming year and reviewed his/her fourth year schedule requests. I have considered the career interests, interview schedule, Boards requirements, and curriculum for this student. I find this schedule request acceptable. ________________ _________________ Printed Name/Advisor signature Date Preliminary Track Designation __________________________ Preliminary Specialty Designation __________________________ *Note: an alternative to this form is to have your faculty advisor (from their own account) a brief message stating they have met with you and approved your scheduling requests. Include Faculty Advisor Form for XXX in subject line

5. Lottery Course Requesting system
- previously used for third year lottery

5. Lottery Course Requesting system, cont.
- select “ me the password” - HSC account only

- select available 2014/15 courses

Guidelines -10 is highest priority, 20 is second highest… - only request ONE Sub-I in the lottery (others added later) - try to request 20 – 24 credits* - select coursework for blocks you anticipate away rotations * Six credits of Transitions and Longitudinal courses work will be added for you

Coursework to Consider

Think about - Course selection - 22 departments, 160+ courses
2. Track requirements 3. Personal interests/Scheduling issues Advice of faculty mentor

Think about - course selection
- Certificate Programs INTMD 7036: Geriatrics (UU Graduate Certificate) - Continuity Clinics Family Medicine Internal Medicine Pediatrics Med-Peds - Honors courses and deadlines DERM April 15 FPMD April 1 OBST Early Spring OPHTHO April 1

Think about - course selection
- Humanities courses INTMD 7992: Dr/Pt Relationship in Lit. – Imagining Medicine (Fall semester) Medicine In Arts (Spring semester) Writing the Dr/Pt Relationship (Spring) - Global Health Elective - Newly created courses Continuity Clinics Peds ED Vascular Surgery Sub-I Medical Students as Teachers *new courses announced throughout year

Course Registration Not Available in Lottery

Courses Approved Outside of Lottery
Research Restricted courses Away rotation

1. Research* - 40 hours effort = 1 week = 1 credit
- contact department regarding approval for registration provide research proposal, preceptor name and contact information project scope - leave space in schedule for planned research - 40 hours effort = 1 week = 1 credit 2. Restricted courses* - certain courses require departmental approval prior to registration with Student Affairs (Palliative Care, Internal Medicine in the Community, Pediatric IV Wound Care) *have department contact me via giving their approval for registration, noting course number and month of enrollment, so the course may be added to your schedule

3. Away Rotations - information regarding VSAS to be mailed this week
- Rotations must be at LCME accredited institution - information regarding VSAS to be mailed this week ($35 for first application, $15 for additional applications) - non VSAS institutions utilize alternate application system

Other Scheduling Considerations

Unscheduled time - NBME Board Exams - Oct. 31 for 2 CK
- Dec. 31 for 2 CS (no enrollment for Spring 2014 if deadlines missed) Interviews - leave Nov. through Jan. unscheduled

Upcoming Deadlines

Mar. 3 Faculty Mentor form due Mar. 10 Lottery closes
Mar. 14 Fourth-Year Schedules sent to you* April 5 NBME 2 CK/CS registration due May 1 Must achieve 32 weeks registration June 15 (rec) NBME 2 CK/CS date selection due *scheduling changes/waiting lists available after schedules sent to you

Questions….

Adam Stevenson MD Associate Dean of Student Affairs January 14th, 2014

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