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SOM Acceptance Form

* - Required field

First Name :*
Last Name :*
Submitter Email :*

INFORMATION AND INSTRUCTIONS

  1. Carefully read, certify and submit the following forms within 15 days:

    Statement of Acceptance
    Criminal Background Check
    Technical Standards
    White Coat Ceremony
  2. Your acceptance is conditional; the Admissions Committee may rescind an offer of acceptance at any time before matriculation if an applicant fails to maintain expectations upon which the acceptance was based. Examples include, but are not limited to, a significant decline in academic performance, failure to complete medical school prerequisites or other course work and degrees in progress, failure to complete and return forms sent to you by the Division of Student Services and Records, unprofessional behavior and incidents contained in a criminal background check.
  3. Promptly supply Student Records and Registrar, which is the Registrar's Office, with an official transcript at the end of each school term (semester or quarter), including one that shows any degree listed as in progress on your AMCAS application has been awarded.
  4. All changes in postal or email address and telephone number(s) must be submitted as changes to your preferred address in the AMCAS? application; however, once this is done, notify Student Records and Registrar and the Admissions office.
  5. Certification Statement - By typing "Certified by Applicant" on subsequent forms, an applicant certifies that he/she has read, understands and agrees to comply with instructions and terms described therein and that the information submitted on these forms are current, complete and accurate to the best of his/her knowledge.

STATEMENT OF ACCEPTANCE

To the Admissions Committee of the University of Mississippi's School of Medicine:

I hereby accept the position offered me in the freshman medical class that will enroll in next August.

I understand that my acceptance is conditional and that the Admissions Committee may review and rescind an offer of acceptance at any time before matriculation if I fail to maintain expectations upon which the acceptance was based. Examples include, but are not limited to, a significant decline in academic performance, failure to complete medical school prerequisites or other course work and degrees in progress, failure to complete and return forms sent to me by the Division Student Services and Records, unprofessional behavior and incidents contained in a criminal background check.

My acceptance signals my intention at this time to enroll. It does not preclude me from considering offers from other medical schools; however, I agree not to hold multiple acceptances beyond May 15.

I also understand that if I am offered and accept a scholarship, this also does not preclude me from considering offers from other medical schools.

I must comply with all instructions and directions sent to me; failure to do so will subject my position in the freshman medical class to review and possible cancellation.

Enter "Certified by Applicant" :*

CRIMINAL BACKGROUND CHECK (CBC)

Acceptance to the University of Mississippi's School of Medicine is conditional and contingent on an applicant having an acceptable CBC. To accomplish this, all accepted applicants must undergo the two CBCs summarized below and report any subsequent convictions. For further details, see our CBC information page.

AAMC-Facilitated CBC

All accepted applicants to the SOM first undergo a centralized Association of American Medical Colleges (AAMC)-facilitated CBC.

Certiphi Screening, Inc. a Vertical Screen? Company, will conduct a CBC based on inspection of local, state and national records. Upon initial acceptance to this or any other participating medical school, applicants will be provided access electronic access to consent that will give permission to initiate the CBC.

When the Certiphi CBC is complete, accepted applicants will be given 10 calendar days to review the report on a secure website. Applicants may release reports immediately or contest inaccuracies prior to releasing it to the requesting medical school. If the applicant does not respond within 10 calendar days, the report will be released automatically.

Fingerprint-Based CBC

Effective July 1, 2004, Section 37-29-232 of the Mississippi Code requires that students enrolled in a health care professional academic program undergo fingerprint-based CBC before any clinical rotation in a licensed health care facility may occur.

All accepted applicants must call the SOM admissions office to schedule an appointment with UMMC Human Resources sometime between December 1 and June 1 prior to enrollment so that a set of digital fingerprints and photograph can be acquired.

Fingerprints will be submitted to the Mississippi Public Safety Commission and Department of Justice Federal Bureau of Investigation for a criminal background check. If any potentially disqualifying event is reported, Human Resources will mail to the medical school applicant a letter (such as Determination of Non-Suitability for Employment in a Healthcare Facility) indicating that a potentially disqualifying event(s) has been reported and a copy of the criminal history report record. Copies will be sent to the associate dean for medical school admissions.

If a criminal history exists, an accepted applicant may not matriculate in medical school until the following process has been completed. The associate dean for medical school admissions will mail the applicant a registered letter indicating that he/she may provide a written explanation for listed offenses including mitigating circumstances and planned appeals of inaccurate information and documentation supporting adjudications and subsequent actions (such as rehabilitation) taken since the offense and any other information that may assist the SOM in determining whether or not the potentially disqualifying event should affect an admissions decision.

Steps involved in evaluating a criminal background history are described in the School of Medicine Procedures for Criminal Background Checks.

If any incidents are reported by either CBC component, the associate dean for medical school admissions will summarize all reported incidents and present this information, along with information regarding any misdemeanor, felony, or institutional action reported by you on the AMCAS application, to the School of Medicine's Dean's Council for consideration. All documents submitted, including the accuracy of information provided by you in AMCAS materials, will be considered on a case-by-case basis and a recommendation, based on the seriousness and/or pattern of reported incidents, will be made to the dean as to what impact this information might have with regard to medical school admission.

Subsequent Convictions

Applicants are responsible for notifying the associate dean for medical school admissions if any further criminal action occurs subsequent to submitting an AMCAS? application or the conduct of CBCs described above. This includes the following: if you are convicted of, or plead guilty or no contest to, any misdemeanor or felony crime(s) after the date of your submission of the medical school application and prior to your medical school matriculation. Your communication must be in writing, and must occur within 30 days of the occurrence of the criminal action.

I have read and understand this CBC policy and agree to report to the associate dean for medical school admissions any further criminal incident(s) that may occur between the time when a CBC is conducted and my enrollment in medical school.

Enter "Certified by Applicant" :*

TECHNICAL STANDARDS FOR ADMISSION, RETENTION, PROMOTION AND CERTIFICATION FOR THE DEGREE OF DOCTOR OF MEDICINE

The University of Mississippi School of Medicine is committed to training competent, compassionate physicians prepared to meet society's healthcare needs. Earning the Doctor of Medicine degree signifies that the holder is prepared to enter postgraduate training and ultimately assume clinical practice responsibilities. Therefore, students must demonstrate not only the accumulation of knowledge but also the acquisition of essential skills and professional attitudes and behaviors.

To meet these expectations, all students must have the necessary abilities to navigate a rigorous curriculum, participate in patient care activities in varying clinical settings, and provide patient care safely and effectively. This document outlines the core competencies required for admission, progression, and graduation from the program. These competencies encompass skills and attributes across five key domains: (1) Observation, (2) Communication, (3) Motor and Sensory Function, (4) Intellectual, Cognitive, and Conceptual Skills, and (5) Behavioral, Social, and Professional attributes.

The School of Medicine complies with the Americans with Disabilities Act and other applicable laws, striving to provide reasonable accommodations to qualified students with disabilities. However, all students must be able to independently perform the essential functions of the curriculum without the assistance of intermediaries that would alter their judgment or the nature of the required tasks. Meeting these standards must be possible with or without reasonable accommodations.

Reasonable accommodations will be provided to qualified students to ensure equal access to the curriculum and the opportunity to succeed. These standards are intended to promote inclusivity and patient safety, ensuring all graduates meet the high standards expected of physicians. Graduates of the program must be able to deliver safe, effective patient care in a broad range of clinical situations. Thus, admission is offered to individuals who can demonstrate the abilities outlined in this document, with or without reasonable accommodations, to ensure they are prepared to meet the demands of medical education and future clinical practice.

Observation - Students must be able to observe and acquire information presented through demonstrations and experiences in the basic sciences. In addition, students must be able to observe and acquire relevant health information from patients and utilize medical records, diagnostic studies, and medical literature to provide care. The required observation and information acquisition necessitate the functional use of visual, auditory, and somatic sensation. The functional use of smell enhances these skills.

Communication - Students must be able to demonstrate proficiency in the English language to effectively, accurately, and efficiently communicate in the clinical setting. Students must be able to utilize both verbal and non-verbal communication to engage with patients, their families, and their caregivers. Students must be able to communicate professionally with all patients, regardless of demographic factors. In addition, students must be able to utilize a medical translator if the patient's primary language is not English. Students must be able to participate in patient care settings and effectively communicate in oral and written form with all members of the health care team.

Motor and Sensory Function - Students must possess sufficient motor and sensory function to participate effectively in classroom, laboratory, and simulation activities and the clinical setting. The motor and sensory functions must be adequate to complete and interpret the physical exam, perform diagnostic and therapeutic procedures, and provide general and emergent care to patients.

Intellectual, Cognitive, and Conceptual Skills - Students must demonstrate the intellectual and conceptual skills to accurately and effectively assimilate, integrate, and apply the complex information presented within the curriculum. Required abilities include measurement, calculation, analysis, integration, and synthesis. Students must be able to comprehend three-dimensional relationships and understand spatial relationships of structures.

Behavioral, Social, and Professional Attributes - Students must possess the psychological and emotional health to promptly complete the responsibilities attendant to the diagnosis and treatment of patients and to develop mature, appropriate, and sensitive relations with patients. In addition, students must be able to adapt to changing environments, function under physical, psychological, and emotional stress, manage heavy workloads, and care for patients in the face of the ambiguities inherent to medicine. Students must demonstrate interpersonal skills such as compassion, empathy, integrity, honesty, concern for others, and care for all individuals in a respectful manner. Students should develop an awareness of their unconscious biases and strive to understand how these biases affect their interactions with patients. Students must act as professionals and be responsible for their actions and behaviors. Professional conduct includes promptly completing all assignments and tasks in a timely manner, being prepared for and participating in all required activities, and fulfilling responsibilities attendant to the diagnosis and treatment of patients. Students should be able to evaluate their own social, emotional, and psychological well-being, recognize when they require support, and proactively seek out the necessary resources or assistance.

I have read and understand the above Technical Standards.

Enter "Certified by Applicant" :*

ACADEMIC ACCOMMODATIONS

The University of Mississippi Medical Center is committed to ensuring equal access to a quality education for qualified students through the provision of reasonable academic accommodations which support UMMC standards and academic integrity. UMMC policy provides for reasonable academic accommodations to be made for students with verified disabilities on an individualized and flexible basis as specified under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990(ADA).

UMMC provides reasonable academic accommodations to students on campus who request accommodations and who meet eligibility criteria. For more information or to request academic accommodations, individuals should go to the Office of Academic Support webpage and complete the Request Academic Accommodations online form.

Office of Academic Support
University of Mississippi Medical Center
Verner Holmes Learning Resource Center, U155-A
(601) 815-4233
Fax: (601) 815-5828
http://www.umc.edu/academic_support/

I have read and understand the above Academic Accommodations.

Enter "Certified by Applicant" :*

WHITE COAT CEREMONY FORM

1. Complete Legal Name (Your complete legal name is what appears on your birth certificate or other official document.) :*
2. Preferred Name (You should only show what you go by or what people call you.) :*

3. Indicate your coat size or dress size, as appropriate, below:

Coat Size :
Use numeric size indicating Short, Regular or Long (i.e., 44S, 44R, 46L)
Dress Size :
Use numeric size (i.e., 2, 6,..16)
Enter "Certified by Applicant" " :*