University of Western Sydney

UNIVERSITY OF WESTERN SYDNEY

Bachelor of Medicine/Bachelor of Surgery (MBBS)

Application for Transfer to the MBBS from another Medical Degree 2011
The School of Medicine will consider transfer applications from students who have partly completed a medical degree program at another university or have previously been enrolled in a medical degree. Applications will only be considered if there is an available place, applicants are in good academic standing and have compelling reasons for applying to transfer. Students who resided in NSW and accepted a medical school placement in another State are unlikely to be successful in gaining a transfer place.
Instructions
· This form is to be used by applicants who are currently or have previously been enrolled in a Bachelor of Medicine/Bachelor of Surgery (or equivalent course) at a university other than UWS. The completed form must be submitted by 5pm (AEST), 30 September 2011. Late applications cannot be considered.
· The outcome of your application will be advised during November, 2011 for the 2012 intake.
· Please submit via:
- fax: (+61 2) 4620 3888 OR
- scan and send as an email attachment to: OR
- mail: Lyndal McCulloch, UWS School of Medicine,
Locked Bag 1797 Penrith NSW 2751 Australia
· Applications for transfer must be accompanied by a certified copy of academic transcripts.
· All applications will be acknowledged by return email upon receipt.
· Overseas-qualified medical practitioners are not eligible to apply via this method. They are advised to contact the Australian Medical Council.
· Please ensure all sections of this form are completed and transcripts are attached – incomplete applications will not be considered.
· There is no academic credit offered to successful International applicants from an overseas medical school – successful applicants will commence in Year 1 of the course.
· If successful applicants will be asked to provide original academic transcripts.

Applicant Details:

Title

Family Name

Given Name(s)

Date of Birth

Gender

Male / Female

Citizenship/Residency:

International Applicant:

YES / NO

Local Applicant: (Au Citizen/Au Permanent Resident/NZ Citizen): YES / NO

Contact Details:

Address

Suburb

State

Post Code

Country

Home Phone

Mobile Phone

Applicant Name:

Current Course Details: (the MBBS Course you are currently undertaking)

Course Name
University/Institution
Country
Please indicate length of course (in years) and which year you are in:
Length of course (in years): I am currently enrolled in Year ...... of the course
If you sat either UMAT or ISAT, please indicate your registration number and year of completion:
UMAT No: ISAT No: Year undertaken:

Reason for Transfer Request: (further documentation may be attached if applicable)

Support statement from current University Medical Dean

(only required if you are enrolled in a medical school in Australia or New Zealand)
Name (print): Signature:
Current University Stamp/Seal