THE OF MISSOURI SCHOOL OF MEDICINE BRYANT SCHOLARS PROGRAM APPLICATION Dear Applicant, The Bryant Scholars Pre-Admissions Program is designed to encourage talented, high-achieving premed students from rural areas to obtain their medical education at the University of Missouri School of Medicine. Students accepted into the program will not participate in the regular admissions process at the MU School of Medicine. Students accepted into the program are required to take the Medical College Admission Test (MCAT). MCAT scores must be submitted to the school of medicine in July of the calendar year prior to their expected date of matriculation into medical school. Students must achieve a total score of 503 or higher with sub scores of 123 or higher in both the biology and physical science. Students who do not receive the minimum score will be reviewed by the Preprofessional Scholars Program Committee and may be dismissed from the Bryant Scholars Pre-Admissions Program. Bryant Scholars who do not continue in the program after review of their MCAT scores will be granted automatic interviews through the regular admissions process. To be eligible to apply for the Bryant Scholars Pre-Admissions Program students must be in process of completing their sophomore (second) year in college; have a composite score on the ACT examination of 28 or 1260 (CR+M) on the SAT prior to entering college; show high academic achievement during high school; have a minimum 3.3 cumulative GPA and minimum 3.3 Math/Science GPA; A or B (B- is accepted but reviewed on a case by case basis) grades in required lecture/lab courses already taken at the time of application; evidence of leadership and interest in a variety of extracurricular activities; Missouri residence; graduated from a rural Missouri high school as defined by the National Center for Education Statistics (NCES); and be enrolled fulltime at a Missouri public or independent four-year college or university as defined by the Missouri Department of Higher Education. Required application materials include: 1. Application form: Complete all pages and attach a recent photograph to the first page of the application. 2. Complete the Statement of Intent and Contact Information pages and attach them to your application form. 3. Evaluation Forms: Fill out the top line and the middle portion of the first page and send to each evaluator. Have each evaluator complete the remainder of the form and return it to MU School of Medicine. Two evaluations are required, but you may submit a third. The third evaluator should be non-academic. One of the two required evaluations must come from a high school science teacher, counselor, or administrator. (Science teacher is preferred.) The second evaluation must come from a professor from whom you have taken a class and received a grade. You may submit a third optional evaluation. 4. College Transcript: Ask the Transcript Office at your college or university to send an official transcript, including current spring semester grades, to MU School of Medicine. 5. High School Transcript: Ask the high school from which you graduated to send an official copy of your final transcript to MU School of Medicine. 1
6. ACT/SAT Scores: If your ACT/SAT scores are NOT on your high school transcript, please provide a photocopy of the official score report you received from ACT/SAT. Submit your application and supporting documents to: University of Missouri School of Medicine Attn: Bryant Scholars Program MA215 Medical Sciences Building Columbia, MO 65212 Only complete applications with all required application materials will be considered. It is the responsibility of the applicant to ensure all required materials are received by MU School of Medicine. Applications postmarked after the June 1 st deadline will not be considered. Each invited applicant will receive at least two interviews with members of the University of Missouri School of Medicine Preprofessional Scholars Program (PSP) Committee. 2
APPLICATION FORM DIRECTIONS: Please print or type. Demographic Information: Attach photograph here Name Last First Middle College Address Street/number City Zip Phone Permanent Address Street/number City State Zip Permanent phone E-mail addresses Student ID No. Birthday Month Day Year Place of Birth Racial/Ethnic Self-description U.S. Citizen? Yes No Permanent Resident? Yes No Father/Guardian Name Living? Yes No Address Street/number City State Zip Phone Education/College(s) Highest degree Occupation Mother/Guardian Name Living? Yes No Address Street/number City State Zip Phone Education/College(s) Highest degree Occupation 3
Academic Information: High School Public/Private H. S. Grad Year High School Location City State ACT Composite Score High School Class Rank High School GPA Advanced Placement or CLEP credit received College credit earned while in high school: Indicate the institution, course(s), and grade(s) received and if instruction was given on the high school or college campus. Major high school and community activities, honors (You may attach a comprehensive list if you prefer). College/University Date of College Entry Projected College Graduation Date Major Minor General Honors courses taken College activities, honors (You may attach a comprehensive list if you prefer). Medically-related activities Have you ever faced any Institutional Action (suspension, probation, etc.) for unacceptable academic performance or conduct violation? Yes No. Since your 17 th birthday, have you been the recipient of any Legal Action for violation of civil or criminal law? Yes No. If your response is "Yes" to either question, please attach a separate sheet outlining your explanation of the action. 4
Required Coursework Plan of Study: Applicant Name College or University Expected Graduation Date Bryant Scholars are required to take pre-requisite courses at their home institution that are equivalent to University of Missouri courses. Outlined below are the course requirements you must meet prior to matriculation. Directions: List any pre-requisite courses already taken at the time of application. List pre-requisite courses you plan to take to meet the program course requirements. To determine course equivalency, go to University of Missouri Columbia Course Equivalency website to look up courses. Exceptions will be reviewed and approved by the Associate Dean for Student Programs and Professional Development. For all courses, include the college or university of the course, the department and course number (i.e. BIO 200), title of the course, grade received if already taken, number of credit hours, semester the course was taken or when you will take the course (i.e. FS14, WS15), and the MU course equivalency. Each applicant s plan of study will be reviewed and approved by the PSP Committee at the time of application. Any changes in a student s plan of study will need to be submitted to the PSP Committee for approval. Students currently enrolled at a Missouri two-year public or independent college will need to outline the courses they will take to meet the course requirements at the four-year college or university at which they are accepted. English composition or writing intensive, 2 semesters* COLLEGE OR MU ( ) COLLEGE OR College-level mathematics (college algebra or above), 1 semester* MU ( ) Biologic Sciences (e.g. biology, genetics, cell biology, animal physiology, molecular biology, histology), 2 semesters of lecture each with lab* COLLEGE OR MU ( ) 5
COLLEGE OR General chemistry, 2 semesters of lecture each with lab* MU ( ) COLLEGE OR Organic chemistry, 2 semesters of lecture each with lab* MU ( ) COLLEGE OR General physics, 2 semesters of lecture each with lab* MU ( ) *All courses must be completed with grade of B or higher. For office use only: Verified: OME Signature: Date: Approved: PSP Chair Signature: Date: 6
Personal Comments: In the space provided, describe in your own words the development of your interest in rural medicine and in becoming a physician. If you attach a sheet, please limit your remarks to one page. You may hand-write or word-process your comments. Side margins should be at least 3/4 inch and font should be no smaller than 10- point. You may single-space. Applicant's Signature Date 7
Questions: In the space provided, answer the following questions in your own words. If you attach a sheet, please limit your remarks to one page. You may hand-write or word-process your comments. Side margins should be at least 3/4 inch and font should be no smaller than 10-point. You may single-space. How long have you lived in a rural area? Does your family still live in a rural area? What did you like most about growing up in a rural area? What did you like least about growing up in a rural area? How would these experiences influence your decision to practice in a rural area? What qualities/characteristics do you consider important to be successful as a physician? Applicant's Signature Date 8
Undergraduate Program Requirements STATEMENT OF INTENT Bryant Scholar Retreats Students are required to attend 3 of 4 retreats while in undergraduate school, including all summer retreats. Partial attendance of any retreat does not count toward this requirement. Absences must be approved by the Bryant Scholars Program Coordinator. Requests to be absent must be in writing and sent to the Bryant Scholars Program Coordinator. Mentoring Program All students are required to enter a mentoring relationship with a physician beginning their junior year in college. The Bryant Scholars Program Coordinator will help arrange the relationship if necessary. Students will have contact with their mentors at least 20 hours per program year. Additionally, students will need 20 hours of other health related experiences. These experiences may include but are not limited to: health research, leadership activities, and shadowing nurses or other health staff. Students will be required to write two one-page papers each year that reflect on their experiences. Reflection papers will be submitted prior to each retreat. For juniors, the first paper will address your personal objectives for a mentoring relationship. Community Service All students are also required to participate in 8 hours of community service per program year. The service activity is the choice of the student, but contact information from the volunteer site must be provided to the Bryant Scholars Program Coordinator for verification. I,, hereby acknowledge my interest in and commitment to the MU Bryant Scholars Program. My participation in the program will prepare me to enter practice in a rural area. I understand that failure to meet these requirements may result in immediate dismissal from the Bryant Program. Applicant Signature Date The University of Missouri School of Medicine reserves the right to modify the Bryant Scholars Program Requirements at any time the medical school faculty or administration determines the change is in the best interest of the School of Medicine. 19
Rural Commitment Bryant Scholars are required to maintain a satisfactory record of academic achievement and professional development while in medical school. In addition, Bryant Scholars are required to do the following while in medical school: 1. Volunteer at two Bryant Scholars undergraduate retreats 2. Participate in the Summer Community Program for 6-8 weeks the summer between their M1 and M2 academic years. 3. Complete 3 of 6 third year core clerkships at a community-based site. 4. Complete at least one 4 th year elective at a community-based site. The Summer Community Program allows students to work in clinical settings throughout the state in rural areas for up to eight weeks between their first and second years in medical school. Bryant Scholars are required to complete a six to eight week experience as part of the program. The Third-Year Rural Track Clerkship Program allows students to complete three of their six core clerkships in a rural community-based clinical setting. Bryant Scholars are required to complete three core clerkships. The Fourth Year Rural Track Elective Program allows students in their fourth year to complete rural electives in various specialties and locations throughout the state of Missouri. Bryant Scholars are required to complete 1 rural track elective. Students pre-admitted to the MU School of Medicine as Bryant Scholars make a commitment to participate in all components of the program. A request from a Bryant Scholar not to participate in the Summer Community Program, the Rural Track Clerkship Program, or the Rural Track Elective Program will only be considered if there are compelling health or personal circumstances supporting the request. The request will only be granted in very unusual circumstances. Students should make the request in writing or by email to the Associate Dean for Student Programs and Professional Development who will consult with the Rural Track Management Group. The student's situation may be referred to the Committee on Student Promotions, which is the faculty body responsible for reviewing the progress of all students, especially if there are issues of ethics or professionalism involved. Students who do not complete medical school curricular requirements for any reason will forfeit the Bryant Scholarship, and may have an explanatory note included in their Medical Student Performance Evaluation (MSPE) letter sent to residency programs. I,, understand that if I do not fulfill the requirements, I will forfeit the scholarship and that this change in my educational program may require an explanatory note in the Medical Student Performance Evaluation letter sent to residency programs. Applicant Signature Date The University of Missouri School of Medicine reserves the right to modify the Bryant Scholars Program Requirements at any time the medical school faculty or administration determines the change is in the best interest of the School of Medicine. 20
SUMMER CONTACT INFORMATION Please indicate below how we may contact you during the summer if you will not be available at either your college or permanent address. This could be a personal cell phone number, a temporary summer address/phone, a job address/phone, a friend or relative who will always know how to reach you, or any combination of these. Name: Address: Phone: E-mail: Personal cell phone: 21