Community-Based Clerkship – Doctor Application
Application to the Community Based Clerkship
Thank you for your interest in our Community Based Clerkship (CBC) program. Clinicians like you invite students into their practices, providing expert guidance, instruction, and opportunity critical to learning the science, art, and philosophy of health care. We appreciate the significant commitment doctors make to the interns. We hope you will also derive many benefits from the CBC program and the relationships you will build.
We are excited to learn about your clinic and how your experience and knowledge will benefit our students. The steps outlined below and the information required is important to Clinical Education in determining fit for our CBC program. Submitting a complete application will move you through our credentialing program quickly.
- Complete the “Doctor Profile”
- Choose three recent (within the last year) patient files to be sent. It is critical that identifying patient information is removed/redacted. The file will be rejected if any patient-identifying information is included. Print the “File Check List” to each patient file and attach it as a cover sheet to the patient file.
- Complete the “Teaching and Learning Questionnaire.” Your answers provide Clinical Education information to better understand your teaching philosophy and mentorship style. The questions also provide you with some insight into the responsibilities of a CBC Clinician.
- Please upload the following additional items:
- – CV (resume)
- – Copy of current Chiropractic license
- – Evidence of malpractice insurance
- – Copy of your current BLS certificate
Once all information in Steps 1-4 has been received by Clinical Education department, you will receive notification whether your application has been accepted (fully accepted, or conditionally accepted with recommendations). Once accepted you will receive a packet containing the CBC handbook and other related information about the program. In the case your application has been conditionally accepted or denied you will receive notification and recommendations. You will also receive notification to schedule a credentialing visit performed by a Clinical Education representative. This visit (interview) will be done either remotely via Zoom / Teams or in person, depending on your clinic location.
Dr. Brian Wentz
Director of Clinical Education