Please fill out the form below.

Basic Information

First Name

Middle Initial

Last Name

GWID

Date of Birth

mm-dd-yyyy

GW Email

Current Address

Current Street Address	Current Street Address 2
Current City	Current State
Current Zip	Current Phone
Address Current Until mm-dd-yyyy

Application Questions

Select desired joint degree.

Select desired degree.

Select desired program.

Confirm your start term with the School of Public Health.

Confirm your start year with the School of Public Health.

What year are you in medical school?

Do you have any MD Program requirements that will need to be completed after 5/1 (e.g. Step, Shelf exams, Clerkships, etc.)?

If yes, please describe the requirements and provide any information on the scheduling for each (including the number of weeks for any Clerkships)

Please list your Advising Dean:

Have you consulted your Advising Dean about plans to pursue the MD/MPH?

Do you have any grade that is less than passing (e.g., Conditional, Fail) that has NOT yet been remediated?

*No student with less than a Passing Grade (
i.e.
Conditional, Fail) that has not been remediated is eligible to apply for the MD/Certificate or the MD/MPH. MS1s and MS2s may re-apply for the MD/MPH as an MS3.

Statement of Purpose (500 words maximum)

Please describe your interest in pursuing the joint degree program. For example, how will a MPH or Certificate in Public Health advance your overall learning objectives and career goals.

By submitting this joint degree application, I agree to the release of my original AMCAS application to be shared and reviewed by both the Milken Institute School of Medicine & Health Sciences.

Please enter the initials for your First and Last name.

Contact Information