NJMS Secondary Application

Welcome to the NJMS Admissions Process! A few important points about our process:
  • The NJMS secondary application is sent to all applicants and supplements the AMCAS application with additional information considered important for our interview screening process
  • The interview screening committee will not review your file until all application requirements, including letters of recommendation are received
  • We prefer you submit your secondary application within 2 weeks of being invited to do so. We will not process a secondary application received after January 1st
  • Fee waivers are only granted to those applicants approved and designated through the AMCAS Fee Assistance Program (FAP)
Please upload a photo
      Image Specifications:
  • A color photo of only you, taken within the last 6 months in JPEG file format (.jpg)
  • Dimensions of photo should be no more than: 150 x 180
          Width: 150 pixels and Height: 180 pixels
  • The maximum file size accepted is 100 KB
      
       
Last First Middle Nickname
AMCAS ID # DOB SSN  
Email Cell # ( ) - Alternate # ( ) -  
 
1. Please indicate if you have an interest in any of the following Dual Degree programs:
MD/MPH     MD/MBA     MD w/Thesis     MD/PhD
 
2. Have you previously participated or are you currently participating in any programs affiliated with NJMS? (To select more than one program, hold down 'Ctrl' key or 'Command' key and select.)
Yes No


Date(s):
 
3. Do you have any relatives currently attending or who have graduated from NJMS?
Yes No       Please provide their name, their relationship to you, and graduation year.
 
4. Do you have any other connection to NJMS, UMDNJ, or Rutgers?
Yes No       Please provide their name, their relationship to you, and institution.
 
5. Have you applied to NJMS before, either through AMCAS or an accelerated/combined degree program?
Yes No       Application Year(s):       Program(s):
 
6. Prior to July 1, 2017, have you met with either Dr. Heinrich or Ms. Rivero?
Yes No       Dr. Heinrich Ms. Rivero       Approximate Date(s):
 
7. We value qualities of integrity, humanism, and passion and are committed to fostering a climate for diversity and inclusion. We feel these factors are critical to your growth as a future physician-leader. How will you contribute to our medical school community?

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8. Please discuss any additional information you believe important for the screening committee to know about you. Feel free to elaborate on any special circumstances, personal examples of resilience, discrepancies in academic history, etc.

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9. Please share any other information you feel uniquely enriches your candidacy for admission to NJMS:

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10. If you don't currently reside in NJ, please share connections (if any) you may have.

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11. If you will not be a full time student between June 2017-August 2018, please describe in detail your planned activities, including chronology and time commitment.

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12. Are you the first in your immediate family who will/has graduate(d) from a four year college? Yes No
 
13. Are you the first in your immediate family who will attend medical school? Yes No
 
14. How do you self-identify:
Asian Hispanic, Latino, or of Spanish origin
Chinese Argentinean
Filipino Colombian
Japanese Cuban
Korean Dominican
Indian Mexican/Chicano
Pakistani Peruvian
Vietnamese Puerto Rican
Other Other Hispanic
 
Black Native Hawaiian or Other Pacific Islander
African American       Native Hawaiian or Other Pacific Islander
Afro-Caribbean
African White
Other White
 
American Indian or Alaskan Native Other
Tribal affiliation Other
 
15. I agree that New Jersey Medical School may request and I hereby authorize all appropriate sources, such as educational institutions and employers, to release transcripts and any other information to the Admissions Office for purposes of confirming or supplementing information contained in my application or relating to the admissions process.
 
16. I understand that, as a condition of admission, I may be required to authorize NJMS to obtain a supplemental criminal background check. I may also be required to obtain a background check myself or authorize clinical training facilities to conduct this check, and to permit the results to be provided by the reporting agency to NJMS and/or to clinical facilities.
 
17. I understand that as per New Jersey Medical School policy, every accepted student will be required to complete the Student Health Immunization requirements and submit the necessary forms as instructed prior to matriculation. I also understand that I will be unable to use my student health insurance to cover the cost of these requirements because satisfaction of these requirements is due in advance of student health insurance activation.
 
18. I certify that the information submitted on this application is complete and accurate. I understand that failure to provide complete and accurate information may affect my admission. I also understand that my application will not be considered until the Office of Admissions receives all the necessary documents.

Application Fee:
 
I am submitting my secondary application and the $90.00 secondary application fee by Credit Card as per the NJMS application requirements. I understand that this fee is non-refundable.
 
I am requesting a fee waiver because I have received approval for the AMCAS Fee Assistance Program (FAP). I certify that "FAP" is indicated on my AMCAS application.
NJMS - Office of Admissions
185 South Orange Avenue, C-653
Newark, NJ 07103
(973) 972-4631
NJMSapplicant@njms.rutgers.edu
http://njms.rutgers.edu/admissions