GH Elective Add Form

This form is for fourth-year students who would like to add a Global Health (GH) Elective to their fourth year schedule.

Directions for the Student

Complete the form below. Once the form is submitted, the elective will be approved by Ana Gregory and/or Joseph Leanza, MD (GH Program) then added to your schedule by the registrar. Please allow 4-5 business days to see the elective on your schedule. All students must complete the waiver of liability form for the elective to be approved.

The form below will ask if your elective is an inside or outside elective:

  • Inside electives (those with established affiliations and automatically approved) are listed here: inside electives
  • All other electives are considered outside electives

Approval of Electives

Any inside elective or any elective that is listed in the GH Health Post-Experience Summaries (database of elective summaries by BU medical students who have undertaken GH electives in the past) is automatically approved. If you do not find your elective in the directory (i.e., it is new to us), you must meet with Dr. Leanza for approval.

Required Responsibilities for Students Undertaking GH Electives

All students who undertake a GH elective must complete the list of required responsibilities. You will be asked to indicate below that you understand this.

GH Elective Add Form

  • MM slash DD slash YYYY

  • Student Information

  • Emergency Contact Info

  • This information is collected in the event of an emergency while you are abroad.

  • Course to Add to Your Schedule

  • E.g., Infectious Disease in India, Medical Spanish in Guatemala
    See info above on inside and outside electives.
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

  • Evaluator Information

  • Please provide information for the person who will evaluate you. An evaluation will be sent directly to this person.
  • This must be an organizational or institutional email address (not Gmail, e.g.).

  • Understanding Your Responsibilities