Extramural Course or Clerkship Application Forms
Away Rotations (VSLO Program) 2026 - 2027 Update
Away Rotations will continue to operate normally for the 2024 - 2025 Cycle.
Please note the following:
- It is REQUIRED that you fill out an Extramural Course or Clerkship Application Form. If the form has not been fully signed then you cannot go on an Away rotation.
- You cannot rotate at an institution if a Training Affiliation has not been set up with UCSF. You can check the Training Affiliation Agreement Report. If an affiliation has not been set up, you can reach out to Visiting Student Manager Valerie Jones to start an affiliation.
- International away rotations will need the approval of Global Health Advisor Michael Lipnick, MD, who will guide you through the process
- You will need to adhere to current UCSF Travel Guidelines.
- Contact Clinical Student Advisor Cassie Pitkin with an questions regarding your schedule.
1/23/26
Instructions
- If you haven’t already activated your UCSF DocuSign account, please follow these instructions:
- Login to MyAccess: https://myaccess.ucsf.eduhttps://myaccess.ucsf.edu
- Scroll down to “DocuSign – UCSF” and click on the link to DocuSign. This will initiate creating your account if you don’t already have one (the account creation takes a minute or so).
- Once signed in, you will see a status box, as well as help resources should you want more info about DocuSign.
- Select the link below for the corresponding department's extramural course form (Domestic OR International).
- Follow the instructions for completing the form at least 4 weeks prior to the start of the rotation. Please note that you are required to attach a description of the rotation. Your form will be sent electronically to the listed Instructor of Record.
- When the course is approved, you will receive an email confirmation. If you have attached documents that require a seal, please come by S-245 to pick up your documents after you have received a COMPLETED application email notification.
For questions contact Career Launch Advisor Wenia Lee.
Domestic Courses and Clerkships
| Department Domestic Extramural Course Approval Form | Instructor of Record |
|---|---|
| Domestic form for Anesthesia and Perioperative Care | Kristine Breyer |
| Domestic form for Dermatology | Joanna Tu |
| Domestic form for Emergency Medicine | Aaron Harries |
| Domestic form for Epidemiology | George Rutherford |
| Domestic form for Family & Community Medicine | Mike Potter |
| Domestic form for Medicine | Cindy Lai |
| Domestic form for Neurology | Megan Richie |
| Domestic form for Neurosurgery | Manish Aghi |
| Domestic form for Obstetrics & Gynecology | Naomi Stotland |
| Domestic form for Ophthalmology | Neeti Parikh |
| Domestic form for Orthopaedic Surgery | Nicole Schroeder |
| Domestic form for Otolaryngology-Head and Neck Surgery | Tokunbo Ayeni |
| Domestic form for Pathology | Stephanie Siegmund |
| Domestic form for Pediatrics | Sara Buckelew |
| Domestic form for Psychiatry | Descartes Li |
| Domestic form for Radiology | Emily Webb |
| Domestic form for Radiation Oncology | Steve Braunstein |
| Domestic form for Surgery | Matthew Lin |
| Domestic form for Urology | Alan Shindel |
International Courses and Clerkships
