new certificate transmittal form - university of...
TRANSCRIPT
New Certificate Transmittal Form
Department Name and Number
CIP Code
Certificate Name ______________________________________________________________________________ Certification Name for Transcript (Maximum 35 characters) ___________________________________________
Effective Year and Term
Amount of Credit __________
Certificate Description (50 words or less)
Requirements (Courses, internships, etc.)
Prerequisites
Certificate Level Baccalaureate Graduate Professional
Rationale and place in curriculum
Large Animal Clinical Sciences 2804-0000 51.2599
International Veterinary Medicine
Certificate International Vet Med
Current program 15
This is a 15-credit program parallel to the DVM curriculum that allows students to examine global health issues relevant to the public and the veterinary profession, and to apply veterinary knowledge in animal health, public health, or wildlife and conservation programs in a foreign country.
VEM 5931 Topics in Veterinary Medicine: seminars in international veterinary medicine (1+1 = 2 credits). VEM 5506 International Veterinary Medicine (1 credit). VEM 5904 Independent Study (2 credits). VEM 5892 Externship (abroad) (2 credits). VEM elective courses approved by the UF CVM veterinary curriculum (8 credits)
The student must be enrolled in the UF College of Veterinary Medicine DVM degree program. The student must be in good academic and professional standing. The student must identify a UF CVM faculty adviser willing to provide guidance and assistance throughout the course of the certificate program.
In 2003, the UF College of Veterinary Medicine established an Office of International Programs (OIP) in response to one of the ten areas considered in the UF Strategic Plan: Internationalization of the curriculum. The main objective is to provide DVM students with international education opportunities on campus and abroad during the 4-year curriculum. Students with interest in international veterinary medicine can participate in education initiatives offered at three levels. Level 1 is on campus, and students can sign for credit in the elective course VEM 5931 Topics in veterinary Medicine (Seminars in International Veterinary Medicine offered annually in the Fall semester). Level 2 is abroad, and students can sign for credit in the elective course VEM 5506 International Veterinary Medicine (offered in Spring, Summer, or Fall semester). Level 3 is on campus and abroad, and students can enroll in the certificate program in international veterinary medicine (15 credits).
✔
Student Learning Outcomes: List each outcome with its associated courses, assessment type (e.g. course-related exam/assignment/grade, final paper/project/presentation, standardized exam, capstone) and method (e.g. rubric, faculty committee, single faculty member).
Department Contact Name Phone Email
College Contact Name Phone Email
Outcome 1: The student will examine global health issues relevant to the public and the veterinary profession. Course: VEM 5931 Topics in Veterinary Medicine: seminars in international veterinary medicine (on campus) (1+ 1 = 2 credits). Assessment type: Attendance and seminar assignments. Grade is Satisfactory/Unsatisfactory/Incomplete. Method: Student must attend 8 of 10 seminar sessions. After each seminar, the student must complete a quiz-assignment with key topics covered in each seminar presentation. The student must have a passing score of 80% or greater in each quiz-assignment. Outcome 2: The student will apply veterinary knowledge in animal health, public health, or wildlife and conservation programs in a foreign country - under the supervision of a UF faculty member. Course: VEM 5506 International Veterinary Medicine (abroad) (1 credit). Assessment type: Attendance and pre- and post-evaluations. Grading system is S/U/I. Method: To obtain a satisfactory grade, the student must attend all lectures included in the course syllabus and must obtain a passing score of 80% or higher in the post-evaluation. Outcome 3: The student will conduct a literature review and describe the geography, history, cultural, socio-economical and political aspects of a selected foreign country in preparation for her/his international externship. Course: VEM 5904 Independent Study (on campus) (2 credits). Assessment type: The student prepares a final paper, which is a literature review and reaction paper of the country of interest. Grading system is letter grade. Method: Final paper is reviewed and graded by two UF CVM faculty members based on student’s writing skills and content. Outcome 4: The student will apply veterinary knowledge in animal health, public health, or wildlife and conservation programs in a foreign country - under the supervision of an international scholar. Course: VEM 5892 International Externship (abroad) (2 credits) Assessment type: Externship evaluation. Grading system is S/U/I. Method: Externship evaluation sheet is completed by an international scholar (host). Elective course-work (8 credits in elective courses approved by the UF CVM curriculum). An example of elective courses is the following: VEM 5352 Dairy Production Medicine: 1 credit. VEM 5176 Poisonous Plans: 1 credit. VEM 5510 Emerging diseases: 1 credit. VEM 5501 Clinical Epidemiology: 1 credit. VEM 5737 Large Animal Surgery Clerkship: 2 credits. VEM 5991 Individualized Investigation: 2 credits.
Jorge Hernandez 294 4305 [email protected]
Pam Ginn 294 4193 [email protected]
Jorge Hernandez
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VEM 5931 Topics in Veterinary Medicine: seminars in international veterinary medicine
Fall 2012
Revision: October 23rd, 2012
I. Course information
Number: VEM 5931
Course Title: Topics in Veterinary Medicine (seminars in international veterinary medicine)
Phase: 1,2,3
Semester: Fall
Year: 1VM, 2VM, 3VM
Course credits: 1
II. General information
Course director: Jorge Hernandez
Office location: Deriso Hall, Room 120
Office hours: email is the best way to schedule an appointment
Office phone number: 352 294 4305
Email: [email protected]
www.ufvetmedepidemiology.com
Course Faculty: Jorge Hernandez and invited speakers
III. Course description
The seminar series in international veterinary medicine is an education initiative designed to
enhance student awareness in global health issues relevant to the public and the veterinary
profession, and to facilitate student international education/research opportunities. The seminar
series include an introductory session and ten seminar presentations by UF veterinary students,
residents, graduate students, faculty, and invited speakers engaged in international work. The
class meets at the UF CVM Lecture Hall B on Tuesdays and Thursdays from 530 to 700pm (see
schedule below). The seminar series in international veterinary medicine is offered in the Fall
semester only.
Student learning outcomes
Students will examine global health issues relevant to the public and the veterinary
profession.
Students will identify international education/research opportunities.
Seminar’s format
5.00 – 5.30pm Social gathering (refreshments)
5.30 – 6.30pm Seminar presentation
6.30 - 7.00pm Seminar discussion (Q&A)
Schedule: Fall 2012
Date Day Topic Presenter
9/18 T Seminars in International Veterinary Medicine:
Introduction
Jorge Hernandez
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Schedule: Fall 2012 (continued)..
Date Day Topic Presenter
9/25 T Malnutrition and zoonotic GI parasite burden in
children in rural YUCATAN
Joelle Glenn (2013)
9/27 Th Proyecto Tití: An Integrate Approach to Conserving
COLOMBIA’s Most Endangered Primate
Ann Savage*
10/2 T Wildlife conservation efforts in GALAPAGOS Nicole Compo (2013)
10/4 Th No seminar today
10/9 T Food animal (dairy) practice in ARGENTINA Lucas Ibarbia
Natalie Yoguel (2015)
10/11 Th Elephant conservation efforts in THAILAND Sean McFly (2015)
10/16 T Food animal (dairy) practice in BRAZIL Joao Bittar
10/18 Th Jaguar conservation efforts in BELIZE Alexandra Gould
(2015)
10/23 T International experiences in a career Paul Nicoletti
10/25 Th Small & Food animal education opportunities in
BOSNIA & HERSEGOVINA
Scott Cornwell**
Herbert Maisenbacher
10/30 T UF and USDA FAS capacity building and training
efforts in animal health in PERU: what, why, how…
Jorge Hernandez
*Anne Savage, PhD, Conservation Director, Walt Disney Parks and Resorts.
** Colonel, US Army (retired).
IV. Course materials
Course materials (abstract of seminar presentation, biographies of speakers, assigned
reading materials) will be distributed to students 2 or more days before each seminar
presentation.
A seminar quiz-assignment will be distributed at the beginning of each seminar
presentation.
V. Evaluation
Exams: No.
Other assignments: Yes.
Students must read course materials before class.
Students must complete a quiz-assignment after each seminar presentation.
Grading system: Satisfactory/Unsatisfactory/Incomplete.
To obtain a satisfactory grade:
The student must attend at least 8 of 10 seminar presentations.
The student must complete each quiz-assignment and obtain a passing grade of 80% or
higher in each assignment.
VI. Administrative Policies: see Student Handbook @
http://www.vetmed.ufl.edu/education/documents/studentHandbook.pdf
Remediation
Attendance
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Academic Honesty
Professional Behavior
Deadline
Student Evaluation of Instruction
Accommodations for Students with Disabilities
Student Safety
VII. Other information
Seminar’s etiquette
Please arrive at least 5 minutes before the seminar presentation starts.
Please read course materials before class.
Engage and participate in the Q&A sessions.
Reading/studying for other courses or texting or taking phone calls during a seminar
presentation is not allowed.
For more information, please contact Dr. Jorge Hernandez, Professor and Director of
International Programs at [email protected]; www.ufvetmedepidemiology.com; Tel (352)
294 4305.
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VEM 5506 International Veterinary Medicine: Colombia
Spring 2013
Revision: October 23rd, 2012
I. Course information
Number: VEM 5506
Course Title: International Veterinary Medicine
Phase: 1,2,3
Semester: Fall, Spring, or Summer
Year: 1VM, 2VM, 3VM
Course credits: 1
II. General information
Course director: Jorge Hernandez
Office location: Deriso Hall, Room 120
Office hours: email is the best way to schedule an appointment
Office phone number: 352 294 4305
Email: [email protected]
www.ufvetmedepidemiology.com
Course Faculty: Natalie Isaza, Ramiro Isaza, Jorge Hernandez
Invited Instructor: Anne Savage
III. Course description
This is an introductory course in wildlife conservation, animal health and public health in
Colombia in collaboration with Proyecto Tití http://proyectotiti.com/ and Walt Disney. UF DVM
students can gain academic credit under the elective course VEM 5506 International Veterinary
Medicine (1 credit).
The Cotton-top tamarin Saguinus oedipus is a critically endangered primate found only in
Colombia. These tamarins are a popular exhibit animal in zoos and an important research subject
in the study of colon cancer and reproductive biology and
behaviour; efforts to create a self-sustaining captive-breeding
population for this species have been very successful. With the
wealth of information on biology, captive management and status
in the wild, efforts are now focused on ensuring that Cotton-top
tamarins continue to remain in the wild. With large-scale
development threatening some of the last remaining forested areas
for the species and its popularity in the illegal pet trade,
compounded by the constant extraction of forest resources by
impoverished communities, strategies are needed to protect this
species effectively for the future. This presentation will be an
overview of a successful, multi-disciplinary conservation program
developed by Proyecto Tití, which involves local communities,
national and international agencies, and the conservation
community in the long-term protection of one of Colombia’s most threatened species.
Photo by: Lisa Hoffner
Hoffner
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General student learning outcome
Students will apply veterinary knowledge in animal health, public health, or wildlife and
conservation programs in a foreign country - under the supervision of a UF faculty
member(s).
Specific student learning outcomes
Students will examine the hazards that threaten the survival of the Cotton-top tamarin in
Colombia.
Students will examine zoonotic diseases that can affect domestic animals and people in
rural communities near the Cotton-top tamarin’s habitat in Colombia.
Students will conduct an epidemiologic study to estimate the population of domestic
animals in the rural communities.
Students will assess and identify exposure factors associated with a positive diagnosis to
selected pathogens (eg, gastro-intestinal parasites) in domestic animals in the rural
communities.
Students will apply veterinary knowledge and clinical skills required for animal control
education efforts and prevention of diseases in dogs and cats in the rural communities.
The course is structured in two parts. Part I will be held at University of Florida and Part II in
Colombia. The course will be comprised of 22 instructional units (1 semester credit - elective)
and will be delivered as detailed in the course syllabus (below). This course will be offered in
English. Proficiency in Spanish is preferred but not required.
Tentative schedule: March 11-23, 2013
Date Day Time Location Topic/Activity Instructor(s) IU
Part I
3/11 Mon 600-800pm UF CVM Course overview
Course pre-evaluation
Hazards that threaten the
survival of the Cotton-top
tamarin in Colombia.
J Hernandez 1-2
3/12 Tues 600-800pm Introduction to Colombian
culture
TBA 3-4
3/13 Wed 600-800pm Zoonotic diseases affecting
domestic animals and people in
rural communities near the
Cotton-top tamarin’s habitat
R Isaza 5-6
3/14 Th 600-800pm Spay-neuter and vaccination
procedures in dogs and cats
N Isaza 7-8
3/15 Fri 600-800pm Field epidemiologic studies:
data collection
J Hernandez 9-10
3/16 Sat Departure to Rafael Nuñez International Airport in Cartagena, Colombia (CTG).
Students make own travel arrangements.
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Tentative schedule: March 11-23, 2013 (continued)..
Date Day Time Location Topic/Activity Instructor(s) IU
Part II
3/18 Mon 700-900am Colombia Travel from Cartagena to the Forest of El Ceibal
900-200pm
On-going efforts to support the
survival of the Cotton-top
tamarin
Field observations of Cotton-
top tamarin in the Forest
A Savage 11-12
200-300pm Travel to Los Límites
300-400pm Town hall meeting in Los
Límites
NA
400-600pm Travel to Cartagena
3/19 Tue 700-900am Travel from Cartagena to Los Límites
900-400pm Team A: Spay-neuter and
vaccination clinic in dogs and
cats
N Isaza
R Isaza
13-16
900-400pm Team B: Field epidemiologic
studies: data collection and
house-to-house vaccination of
dogs and cats
J Hernandez
400-600pm Travel to Cartagena
3/20 Wed 700-900am Travel from Cartagena to Los Límites
900-400pm Team A: Spay-neuter and
vaccination clinic in dogs and
cats
N Isaza 17-20
900-400pm Team B: Field epidemiologic
studies: data collection and
house-to-house vaccination of
dogs and cats
R Isaza
J Hernandez
400-600pm Travel to Cartagena
3/21 Th 700-900am Travel from Cartagena to Los Límites
900-200pm Team A: Post-operatory
observations in dogs and cats
N Isaza 21-22
900-200pm Team B: Field epidemiologic
studies: data collection and
house-to-house vaccination of
dogs and cats
R Isaza
J Hernandez
200-400pm Meeting with Principal and Teachers at the local
School in Los Límites: the curriculum, brainstorm of
initiatives or collaborations that can potentially
empower the curriculum, and tour of facilities
400-600pm Travel to Cartagena
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Tentative schedule: March 11-23, 2013 (continued)…
Date Day Time Location Topic/Activity Instructor(s) IU
Part II
3/22 Fri 700-900am Colombia Travel from Cartagena to Los Límites
900-100pm UF Science Lab for Kids N Isaza
R Isaza
A Savage
J Hernandez
NA
100-300pm Travel to Cartagena
3/23 Sat Return to the States + course post-evaluation and feedback
IV. Course materials
Reading materials will be distributed to students during the first session (course overview).
V. Evaluation
The course grade (satisfactory/unsatisfactory/incomplete) will be determined by the student’s
lecture attendance and a pre- and a post-evaluation. The student must attend all lectures included
in the course schedule. The pre- and post-evaluations will cover topics presented in Parts I and II
of this course. A passing score ≥ 80% in the post-evaluation is required to obtain a satisfactory
grade.
VI. Administrative Policies: see Student Handbook @
http://www.vetmed.ufl.edu/education/documents/studentHandbook.pdf
Remediation
Attendance
Academic Honesty
Professional Behavior
Deadline
Student Evaluation of Instruction
Accommodations for Students with Disabilities
Student Safety
VII. Other information
Requirements
Students in this class must be in good academic and professional standing.
Students in this class must be vaccinated against rabies and/or have current, positive
titers.
MEDEX (emergency evacuation insurance) on-line travel registration at the UF
International center http://www.ufic.ufl.edu/travelregistration.html
Students in this class must have current medical insurance.
Approval of the course coordinator.
Travel documents
Entry requirements for US citizens into Colombia are: valid US passport.
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Housing accommodations in Cartagena, Colombia: TBD.
CDC travel information
Please see health information for travelers to Colombia at:
http://wwwnc.cdc.gov/travel/destinations/colombia.htm
Course (class) size limit: In 2013, this course is limited to a maximum of 6 UF DVM students.
Student scholarships: There is funding available to cover the cost of airfare (to/from Cartagena,
Colombia) to students selected for this course.
Estimated cost: ~ $500 (students manage own funds) for hotel accommodation (7 nights) and
meals (B,L,D) while in Colombia.
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VEM 5904 Independent Study
Revision: October 23rd, 2012
I. Course information
Number: VEM 5904
Course Title: Independent study
Phase: 1,2,3
Semester: Fall
Year: 1VM, 2VM, 3VM
Course credits: 2
II. General information
Course director: UFCVM faculty
Office location: Deriso Hall, Room 120
Office hours: email is the best way to schedule an appointment
Office phone number: 352 294 4305
Email: [email protected]
www.ufvetmedepidemiology.com
Course Faculty: UF CVM faculty
III. Course description
Students pursuing the Certificate in International Veterinary Medicine must complete this course
before they begin the required International Externship. This is a two-credit course designed to
prepare the student with information she/he needs to know about the country where the
international externship will be conducted.
Student learning outcomes
The student will conduct a literature review and describe the geography, history, cultural,
socio-economical and political aspects of a selected country in preparation for her/his
international externship.
After the literature review is completed, the student will identify cultural, socio-
economical and political aspects (or other aspects) that may have an impact on her/his
ability to successfully complete the international externship, and explain what measures
she/he will implement to mitigate such impact(s).
Course format
The student will identify a faculty adviser, who will provide guidance and assistance to
accomplish the student learning outcomes.
The student will be responsible to conduct a literature review covering at least 16 topics
relevant to the country of interest and course objective. For example: (1) geography (2)
history (3) demography (4) political system (5) justice system (6) religion (7) economy
(8) natural resources (9) transportation (10) telecommunications (11) public health (12)
animal health, (13) environmental health (14) education (15) veterinary medicine
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education (16) social issues: women (17) men (18) teenagers (19) children (20)
immigration (21) AIDS (22) poverty (23) animal control (24) animal welfare (25) historic
or current events linked to the US (26) US embassy (27) other topics identified by the
student and faculty supervisor as relevant.
The student will meet with her/his faculty adviser bi-weekly (or more often) for guidance
and assistance and to assess progress.
Outputs
The student will prepare a 20-page document (singled-spaced) structured in two parts. Part I
should be a literature review describing the sixteen topics of interest (16 pages). The literature
review section must include references clearly identified on the text and a references’ section.
Part II should be a synthesis with the student's reaction to the information presented in Part I (4
pages). Specifically, the student will identify issues that may have an impact on her/his ability to
successfully complete the international externship and explain what measures she/he will
implement to mitigate such impact(s). The student should consult with the UF CVM Office of
International Programs (OIP) or her/his faculty advisor for further instructions on how to prepare
and submit the 20-page document electronically for review and grading. The software "Turnitin"
is an on-line tool used by the OIP to check the originality of the paper submitted for review and
grading.
IV. Course materials
The student is expected to use library resources (on campus, online) to accomplish the
student learning outcomes identified above.
V. Evaluation
Exams: No
Other assignments: No
Students must complete a quiz-assignment after each seminar presentation.
Grading system: letter grade.
The 20-page document will constitute 100% of the final grade. The document should be
submitted to the course director via email ([email protected]). The document will be
reviewed and graded by two UF CVM faculty members (faculty within the college or university;
or scholars from participant institutions abroad). Course grade will be based on student’s writing
skills and content. The final course grade will be assigned by the course director based on
feedback provided by the two reviewers.
VI. Administrative Policies: see Student Handbook @
http://www.vetmed.ufl.edu/education/documents/studentHandbook.pdf
Remediation
Attendance
Academic Honesty
Professional Behavior
Deadline
Student Evaluation of Instruction
3
Accommodations for Students with Disabilities
Student Safety
VII. Other information
For more information, please contact Dr. Jorge Hernandez, Professor and Director of
International Programs at [email protected]; www.ufvetmedepidemiology.com; Tel (352)
294 4305.
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VEM 5892 Externships in International Veterinary Medicine (2 credits)
I. Course information
Number: VEM 5892
Course Title: VEM 5892 Externships in International Veterinary Medicine
Phase: 3
Semester: Summer
Year: 3VM
Course credits: 2
II. General information
Course director: Jorge Hernandez
Office location: Deriso Hall, Room 120
Office hours: email is the best way to schedule an appointment
Office phone number: 352 294 4305
Email: [email protected]
www.ufvetmedepidemiology.com
Course Faculty: UF CVM faculty
III. Course description
The International Externship is an education opportunity for veterinary students who are
pursuing the Certificate in International Veterinary Medicine. The externship must be held in a
foreign country over a two-week period during the summer semester, after the junior year is
completed. During this time, the student will work with a mentoring veterinarian involved in
animal health, public health, or wildlife and conservation programs.
All externship sites are approved through an application process conducted through the College
of Veterinary Medicine Office of Students & Instruction and evaluated by the college
Curriculum Committee.
Student learning outcome
The student will apply veterinary knowledge in animal heath, public health, or wildlife
and conservation programs in a foreign country – under the supervision of an
international scholar.
IV. Prerequisites VEM 5904 Independent Study (2 credits).
Successful completion of the freshman and sophomore veterinary curriculum.
The student must be in good academic and professional standing.
V. Course Materials
Required texts: No texts are required for this course.
Required Attire: Students will comply with the CVM dress code and the requirements of the
host facility.
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VI. Evaluation/ Grading/ Testing
Grading system is Satisfactory/Unsatisfactory/Incomplete
Students who miss more than an average of 1 day per week will receive an incomplete
until the externship is completed to the satisfaction of the supervising veterinarian.
Students will write a summary report describing the activities and cases during the
externship.
Students will provide their externship supervising veterinarian with the ‘Evaluation of
Student by Supervising Veterinarian’ sheet to complete and submit to the Office of
Students and Instruction. Clinical knowledge and performance in several areas will be
evaluated on a 5-point scale from “poor” (1 point) to “excellent” (5 points).
A passing externship grade requires a minimum of 80% attendance, an acceptable
externship report, and an average score of 3.0 or higher on the evaluation by the
supervising veterinarian.
VII. Administrative Policies
For more information about professional veterinary student expectations, policies, and
requirements, see the Veterinary Student Handbook at: http://education.vetmed.ufl.edu/student-
services/student-handbook-pdf/
Academic Honesty Policy
Plagiarism includes any attempt to take credit for another person’s work, even in a discussion.
Cheating, lying, misrepresentation, or plagiarism in any form is unacceptable and inexcusable
behavior.
All students registered at the University of Florida have agreed to comply with the following
statement: “I understand that the University of Florida expects its students to be honest in all
their academic work. I agree to adhere to this commitment to academic honesty and understand
that my failure to comply with this commitment may result in disciplinary action up to and
including expulsion from the University.” In addition, on all work submitted for credit the
following pledge is either required or implied: “On my honor I have neither given nor received
unauthorized aid in doing this assignment.” To review the student honor code please visit:
http://www.dso.ufl.edu/judicial/honorcodes/honorcode.php
Accommodations for Students with Disabilities
Students requesting accommodations must first register with the Dean of Students Office,
Disability Resource Center. For more information, visit the Disability Resource Center website
at: http://www.dso.ufl.edu/drc/
Software Use
All faculty, staff and students of the University are required to obey the laws and legal
agreements governing software use. Failure to do so can lead to monetary damages and/or
criminal penalties for the individual violator. Because such violations are also against University
policies and rules, disciplinary action will be taken as appropriate.
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UF Counseling and Wellness Center
Many resources are available for students who need help with stress-related problems or
emergencies. Assistance is available both by appointment and after hours by calling 352-392-
1575 or visiting the website at: http://www.counseling.ufl.edu/cwc/
Crisis intervention is always available 24/7 from Alachua County Crisis Center: (352) 264-6789.
BUT – Do not wait until you reach a crisis to come in and talk with us. We have helped many
students through stressful situations impacting their academic performance. You are not alone
so do not be afraid to ask for assistance.
Grade Changes
Grades will be changed only when a grading error has been made.
Attendance
Attendance is mandatory and any unexcused absence may result in a failing grade for this course.
Class Participation and Professionalism
Students are expected to participate constructively and professionally in all discussions and
activities. Every interaction between classmates and/or faculty must be polite and professional.
While traveling, your appearance and actions reflect on the UF College of Veterinary Medicine.
You are expected to dress professionally in appropriate attire as directed by your instructors and
to represent the University of Florida in a favorable manner through your dress, good
communication skills and actions.
Performance Expectations
Students are expected to produce quality work of a standard comparable to any graduate-level
didactic course. All assignment submissions and discussions must be legible, constructive and
appropriate. Students are required to think for themselves and will be expected to complete
assignments that require the application of logic and reasoning skills when the answer may not
be found in a book or the course notes. Factual information should be documented and
referenced during discussions and within assignments.
Request for Externship Program Approval
University of Florida (UF) College of Veterinary Medicine (CVM)
The UF CVM Curriculum Committee will use this form to make initial decisions regarding whether to approve or deny your proposed externship. Please complete this form giving appropriate attention to all areas and then return the form directly to Ms. Dot McColskey,
Veterinary Curriculum Office at, Box 100125 Health Science Center, College of Veterinary
Medicine, Gainesville, Florida 32610 either by mail, e-mail [email protected] or fax (352) 846-2744 respectively.
*** Please Print Legibly or Type Requested Information ***
Name of Supervising Veterinarian:_________________________________________________________ Note: Only one veterinarian may serve as externship supervisor. Practice Name:___________________________________________________________________ Street Address: ___________________________________________________________________ City, State, Zip Code: _____________________________________________________________ Telephone Number: ( ) - Fax Number: ( ) - E-mail Address: ________________________________________________________________
Classification of Proposed Externship Program (please check only one classification).
Small Animal Externship Mixed Animal Externship Humane Society Externship Feline Externship Food Animal Externship Wildlife Externship Equine Externship Public Health Externship Zoological Externship Other Externship (Please Specify): _____________________________________________________
Externship Type (please check only one)
Academic/Research Patient Care/Private Practice Public Health/Animal Shelter Other: ___________________________
Number of veterinarians with whom student would directly interact: ______________________________ Do any of these veterinarians hold If yes, please list specialty board(s) specialty board certification? ________________________________________________________
Yes ________________________________________________________ No ________________________________________________________
Proposed externship duration: Note - College will only approve externships 2-8 weeks in total duration 2 weeks 4 weeks 8 weeks Variable 2-8 weeks: to meet individual student needs During the externship, will the student receive: Stipend? Housing?
Yes If yes, amount: $_______ Yes No hourly weekly biweekly No
-continued on back-
Key Accompanying Documents Required for Program Approval
Please attach a typed statement detailing the following: *Please do not answer the questions below on this same application. Please adhere to the request above and attach
a separate paper to the application with the details. All applications not in compliance with this request will be
returned for revision(s).
Reason(s) you have decided to offer your proposed externship program.
Responsibilities/work load extern will have.
Hours extern will be required to work, including any optional hours they may work.
How a student may apply to your externship program. (Please include point-of-contact person).
Details on housing (if provided/offered).
Details on stipend (if provided).
Brief description of practice including, how things run and operate, average number of cases seen weekly, monthly or annually, types of cases seen, description of facility, etc.
Any additional information our college and applying student(s) should know. I have read and understand my responsibilities to both teach and evaluate each extern granted permission to complete this proposed externship program. Signature of Supervising Veterinarian Date
For College Use Only Date Received: __________________ Approved Denied
——————————————————————————— ————————————— Signature of Curriculum Committee Chair Date