UAB IME International Visiting Medical Observers Application Fee Payment Form
The University of Alabama at Birmingham (UAB) is very happy to welcome international visiting medical scholars to our premier facilities.
If accepted and matched, your clinical observership opportunity will be strictly observational, under the direct supervision of a UAB Faculty member and consist of clinical observership and non-credit earning activities.
International Visiting Medical Observers are STRICTLY PROHIBITED from engaging in any form of direct or indirect interactions with patients. Any departure from these guidelines will be regarded as a breach of the UAB policies and may result in immediate removal from the facility and restrictions on any future request to observe in UAB Clinical Facilities.
There is a nonrefundable application fee of $350 required for international visiting medical observership opportunities. Please use this form to pay that application fee.
*
First Name
Middle Name
*
Last Name
*
Highest Degree
*
Address1
Address2
*
City
*
State
Select Value
Alabama
Alaska
AP
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Foreign
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Territories Except Puerto Rico
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip
Country
Select Value
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ashmore
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Baker Island
Bangladesh
Barbados
Bassas da India
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burman (Myanmar)
Burundi
Cameroon
Canada
Canal Zone
Canton and Enderbury
Cape Verde
Cayman Islands
Central African Republic
Central and Southern Line Is
Chad
Chile
China
Christmas Island
Clipperton Island
Cocos (Keeling) Island
Colombia
Comoros
Congo Democratic Repub of the
Congo Republic of
Cook Islands
Coral Sea Islands
Costa Rica
Cote D Ivoire (Ivory Coast)
Croatia
Cuba
Cyprus
Czech Republic
Czechosloviaka (use EZ)
Dem + Fed Republic of Germany
Democratic Republic Viet-Nam
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Europa Island
FalklandIslands(IslasMalvinas)
Faroe Islands
Federated States of Micronesia
Fiji
Finland
FR Southern + Antarctic Lands
FR Ter of the Afars and Issas
France
French Guiana
French Polynesia
Gabonk
Gambia The
Gaza Strip
Georgia
German Democratic Republic
Germany (use GM)
Ghana
Gibraltar
Gilbert and Ellice Islands
Gilbert Islands
Gloriso Islands
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island+ McDonald Islands
Honduras
Hong Kong
Howland Island
Hungary
Iceland
India
Indonesia
Iran
Iraq
Iraq-Saudi Arabia Neutral Zone
Ireland
Israel
Israel-JordanDemilitarizedZone
Israel-Syria DemilitarizedZone
Italy
Jamaica
Jan Mayen
Japan
Jarvis Island
Jersey
Johnston Atoll
Jordan
Juan de Nova Island
Kampuchea
Kazakhstan
Kenya
Kingman Reef
Kiribati
Korea North
Korea South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Man Isle of
Marshall Islands
Martinique
Mauritania
Mauritus
Mayotte
Mexico
Midway Islands
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Namibia
Nauru
Navassa Island
Nepal
Netherlands
Netherlands Antilles
Neutral Zone
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palmyra Atoll
Panama
Papua New Guinea
Paracel Islands
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Portuguese Timor
Puerto Rico
Qatar
Republic of Viet-Nam
Reunion
Romania
Russia
Rwanda
S Georgia and S Sandwich Is
Saint Kitts and Nevis
Samoa
San Marino
Sau Tome and Principe
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro
Seychelles
Sierra Leone
Sikkim
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Southern Rhodesia
Southern Ryukyu Islands
Spain
Spanish North Africa
Spanish Sahara
Spratly Islands
Sri Lanka
St. Helena
St. Lucia
St. Pierre and Miquelon
St. Vincent and Granadines
Stateless
Sudan
Surinam
Svalbard
Svalbard and Jan Mayen
Swan Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tromelin Island
TrustTerritory Pacific Islands
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U. S. Misc. Pacific Islands
Uganda
Ukraine
Union of Soviet Soc. Republics
United Arab Emirates
United Kingdom
United States
Unknown
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands
Wake Atoll
Wallis and Futuna
West Bank
Western Sahara
Yeman (Sanaa)
Yemen (Aden)
Yemen (Aden) - South Yemen
Yugoslavia
Zambia
Zimbabwe
*
Email
*
Phone
Alt Phone
Fax
UAB International Visiting Medical Observer Application Fee
International Visiting Scholar - physician, clinician, or student $350.00
Payment Method
Credit Card
Please note:
Upon payment of this nonrefundable fee and submission of all required documents for the International Visiting Medical Observer program, we will start the review of your application. Incomplete applications will not be reviewed.
Due to the highly competitive application process, there is no guarantee of acceptance.
You should not arrange travel or arrive at UAB until you have received notification to come to UAB by International Medical Education as the nonrefundable application fee does not guarantee your acceptance.
If accepted and matched, you will be required to pay $4,250.00 (US Dollars) to guarantee your position.
We strive to maintain an inclusive environment that value differing perspectives, people, and experiences. This diversity is essential to fulfilling the enduring mission of UAB. Your time with us will be mutually enriching.
For more information, email
internationalMD@uab.edu.
Please complete the CAPTCHA.