Extramural Programs

Instructions

  1. 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.
  2. Select the link below for the corresponding department's extramural course form (Domestic OR International).
  3. 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. 
  4. 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 any questions related to the extramural course approval form, please contact Cha Viloria.

Domestic Courses and Clerkships

Department Domestic Extramural Course Approval Form Instructor of Record
Anesthesia and Perioperative Care (link is external) Kristine Beyer 
Dermatology (link is external) Tim Berger
Emergency Medicine (link is external) Eric Silman
Epidemiology (link is external) George Rutherford
Family & Community Medicine (link is external) Mike Potter
Medicine (link is external) Cindy Lai
Neurology (link is external) Vanja Douglas
Neurosurgery (link is external) Mike McDermott
Obstetrics & Gynecology (link is external) Naomi Stotland
Ophthalmology (link is external) Jacque Duncan
Orthopaedic Surgery (link is external) Nicole Schroeder
Otolaryngology-Head and Neck Surgery (link is external) Anna Meyer
Pathology (link is external) Raga Ramachandran
Pediatrics (link is external) Tim Kelly
Psychiatry (link is external) Descartes Li
Radiology (link is external) Emily Webb
Radiation Oncology (link is external) Penny Sneed
Surgery (link is external) Nancy Ascher
Urology (link is external) Kirsten Greene

 

International Courses and Clerkships

Department International Extramural Course Approval Form Instructor of Record
Anesthesia and Perioperative Care (link is external)international course Mark Rollins
Dermatology (link is external)international course Tim Berger
Emergency Medicine (link is external)international course Eric Silman
Epidemiology (link is external)international course George Rutherford
Family & Community Medicine (link is external)international course Norman Hearst
Medicine (link is external)international course Cindy Lai
Neurology (link is external)international course Vanja Douglas
Neurosurgery (link is external)international course Mike McDermott
Obstetrics & Gynecology (link is external)international course Naomi Stotland
Ophthalmology (link is external)international course Jacque Duncan
Orthopaedic Surgery (link is external)international course Nicole Schroeder
Otolaryngology-Head and Neck Surgery (link is external)international course Anna Meyer
Pathology (link is external)international course Raga Ramachandran
Pediatrics (link is external)international course Tim Kelly
Psychiatry (link is external)international course Descartes Li
Radiology (link is external)international course Emily Webb
Radiation Oncology (link is external)international course Penny Sneed
Surgery (link is external)international course Nancy Ascher
Urology (link is external)international course Kirsten Greene

 

Download Files
<p> ​</p>

T:

D:

 

T:

D:

 

T:

D: