Botsford Hospital
28050 Grand River Ave.
Farmington Hills, MI 48336-5919
(248) 471-8000
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Medical Student Rotation Application

Externships for MS3 generally will not be scheduled during the months of June-Dec but may be considered on a case-by-case basis.

Fax: (248) 471-8837

On March 1, 2017 we will begin accepting applications through December 2017.

Only rotation requests for dates listed above will be considered.

A rotation fee is charged for each rotation. Please check with your institution regarding this fee.

First Name:
Last Name:
Middle Initial:
Gender: M F
Official School Email Address ONLY:
Date of Birth:
Last 4 SSN:
Medical School:
Year: MS3 MS4
Rotation Requested:

All Rotations Begin on a Monday!

All General Surgery Rotations are 2 Weeks!

Rotation Dates Requested (First Choice):
Rotation Dates Requested (Second Choice):
Rotation Dates Requested (Third Choice):
Have you rotated here before? If so, what service and when?

All students with a surgical rotation must attend BH Scrub Procedure Class!
Require Housing? Yes No
Your Field of Interest:
COMLEX Board Scores
Part 1 Part 2
USMLE Board Scores Part 1 Part 2
Have you failed either COMLEX Part 1 or Part 2? Yes No
Are you considering applying to one of our programs? Yes No
What is your current class ranking and/or GPA?