Externship Application - Rogue Equine & Companion Animal Clinic

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Todays Date?*

Applicant Full Name*

Given Name Surname 1 Surname 2

For foreign students, do you possess a valid VISA to enter the United States, if required?*

Yes
No

Mailing Address - Home*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile Phone Number*

Email*

Are you currently a student enrolled in a program at university studying veterinary medicine?*

I am not yet in veterinary school
I am in my first year of veterinary school
I am in my second year of veterinary school
I am in my third year of veterinary school.
I am in my fourth year of veterinary school
I am in my final year and will finish with a degree in veterinary medicine.
I have finished veterinary school.

Do you have an interest in equine medicine, surgery and reproduction or small animal medicine and surgery?*

Equine Medicine
Small Animal Medicine
Both

Please list in order of preference up to three specific interests within the area(s) above.*

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Do you have health insurance - in case of sickness or injury, unrelated to an externship?*

YES
NO

Do you have Liability Insurance provided by AVMA?.*

YES
NO

If your answer is yes to Liability Insurance, what is your certificate number? Mark as N/A if not applicable.*

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Days available: As a clinic/hospital, we operate 7 days per week. Do you agree to be available every day of the week?*

Yes
No

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Holidays available: As a clinic/hospital, we operate 7 days per week. Do you agree to be available holidays, if asked or needed?*

Yes
No

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Hours available: As a clinic/hospital, we operate 24 hours per day. Do you agree to be available more than 8 hours per day and overnight?*

Yes
No

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Are you able to lift 50 lbs routinely and regularly?*

Yes
No

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If you are not able to lift 50 lbs, please explain below. Otherwise mark as N/A*

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Are you able to work under hot climate conditions (over 100 degrees) or cold (below freezing)?*

Yes
No

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Are you able to work under conditions of high or low humidity?*

Yes
No

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If you answered no to any of the two climate questions above, please explain. Otherwise mark as N/A.*

First available date?*

Preferred finish date?*

For Equine, please rank your experience in handling horses.*

Significant Experience
Moderate Experiece
No Experience
Not Applicable

Final two questions! Please list three things you would like to learn or experience while at an externship*

Please tell us what believe you can contribute to an externship program. This can be a personal, medical or social answer.*

If your career/postgraduate plans were to work out exactly as you wish, what would your early career look like (type of practice and species) and where (geographically) would you be? Please briefly state.*

Applicants Statement*

I agree to the below statement:

APPLICANT’S STATEMENT:
I understand the position as extern is not paid.
Internships may be paid or unpaid, depending on arrangements.
Generally, on site housing is offered.

Externships/Preceptorships and Internships*

I understand and agree with the below statement.

Extnernships/preceptorships and Internships are similar in that an extern/preceptor or intern is seeking exposure and education to the field of veterinary medicine. While externships/preceptorships are designed to be short and potentially structured, internships (undergraduate or postgraduate) are longer, usually structured and paid. Oregon labor law does not provide an option for unpaid long term "observation" or learning.
It is acknowledged that externs/preceptors are using valuable time, albeit short, in the final period of formalizing their veterinary education. The time spent has potential critical impact on their future and career path. Undergraduate and postgraduate interns are in a very different stage of their education - one exploratory and the other refinement.
The "Practice", or veterinarians that constitute the practice, are, by accepting externs/preceptors or interns, making a commitment to accept and share their knowledge, experience, energy and emotional intelligence. What a practitioner is able to share is divided among patients, clients, employees, business operation, externs/preceptors/interns, family and self.
Both parties are making sacrifice and investing for future gain.
To understand this - is critical to a successful experience.

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Date of signing*

Applicants Signature*

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Comments

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for compassionate, personalized, expert veterinary medical care
serving Southern Oregon and Northern California.

Externship Application Form - Secure