Thank you for your interest in the Mount Sinai Public Health Internship Program. Please fill out the questionnaire below and press "Submit" at the bottom of the page in order to apply.
You will also be asked attach the following documents to complete your application:
1. 1-page personal statement describing how this program will enhance your career, including a description of your current research interests and professional goals after completing the program.
2. 1-page statement on your past research experience, describing the subject of research projects, dates conducted and your role and duties.
3. Most recent CV/resume.
In addition, you will be asked to provide contact information for two (2) persons who can serve as your reference.
If you have any questions, please contact us at healthinternship@mssm.edu. First Name* must provide value
Last Name* must provide value
Date of Birth* must provide value
Today M-D-Y
Phone Number * must provide value
Email Address* must provide value
Secondary Email Address
Street Address* must provide value
Street Address 2
City * must provide value
State* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia Puerto Rico Guam American Samoa U.S. Virgin Islands Northern Mariana Islands
Country* must provide value
Afghanistan Albania Algeria Andorra Angola Antigua & Deps Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia Herzegovina Botswana Brazil Brunei Bulgaria Burkina Burundi Cambodia Cameroon Canada Cape Verde Central African Rep Chad Chile China Colombia Comoros Congo Congo {Democratic Rep} Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland {Republic} Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique {Burma} Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russian Federation Rwanda St Kitts & Nevis St Lucia Saint Vincent & the Grenadines Samoa San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe
Zip Code* must provide value
Permanent Address (if applicable)
Residency Status
* must provide value
US Citizen
Non-Citizen National
Permanent Resident
Other statuses not listed here are not eligible
Race/Ethnicity (Check all that apply)* must provide value
African American
Hispanic American
Native American
Hawaiian Native
Native Pacific Islander
Asian American
White
Do you have physical or mental impairment that substantially limits one or more major life activities?
* must provide value
Yes
No
Do you or your family receive one or more of the following? (Check all that apply)* must provide value
Federal disadvantaged assistance
Health Professions Student Loans
Loans for Disadvantaged Students Program
Scholarships for Individuals with Exceptional Financial Need (USDHHS)
No
STOP: We're sorry, but your answers indicate that you're not eligible for this program. If you have any questions, please contact us at healthinternship@mssm.edu. Earliest possible start date
Today M-D-Y
How long will you be able to commit to this program?
Name of School Attended* must provide value
Degree (BA, MPH, etc.)* must provide value
Date Awarded or Expected* must provide value
Today M-D-Y
Area(s) of Study* must provide value
Is your current or final cumulative GPA from this school 3.0 or higher?* must provide value
Yes
No
Have you attended any additional schools?* must provide value
Yes
No
Name of School Attended* must provide value
Degree (BA, MPH, etc.)* must provide value
Date Awarded or Expected* must provide value
Today M-D-Y
Area(s) of Study* must provide value
Have you attended any additional schools?* must provide value
Yes
No
Name of School Attended* must provide value
Degree (BA, MPH, etc.)* must provide value
Date Awarded or Expected* must provide value
Today M-D-Y
Area(s) of Study* must provide value
Have you presented (poster or oral) at professional conference(s)?* must provide value
Yes
No
Name of Conference
Title of Work Presented* must provide value
Do you have additional conference presentations to add?* must provide value
Yes
No
Name of Conference
Title of Work Presented* must provide value
Do you have additional conference presentations to add?* must provide value
Yes
No
Name of Conference
Title of Work Presented* must provide value
Do you have additional conference presentations to add?* must provide value
Yes
No
Name of Conference
Title of Work Presented* must provide value
Please provide a brief list of your research areas of interest* must provide value
Please provide a list of publications you have authored* must provide value
Please provide a list of your research skills (ie. PRC, statistical programs, scientific writing, microscopy, clinical training, etc.)* must provide value
Please attach your personal statement (maximum 1 page), describing how this internship program will enhance your career. Include a description of your current research interests and professional goals after completing this program.
***Please type your name at the top of the page. Only PDF files are accepted.**** must provide value
Please attached your statement on your past research experience (maximum 1 page), describing the subject of the research projects, dates conducted and your role and duties.
***Please type your name at the top of the page. Only PDF files are accepted**** must provide value
Please attach your most recent CV/resume.
***PDF file only**** must provide value
Name* must provide value
Institution* must provide value
Title* must provide value
Phone Number* must provide value
Email Address* must provide value
Name* must provide value
Institution* must provide value
Title* must provide value
Phone Number* must provide value
Email Address* must provide value
Underrepresented Populations in the U.S. Biomedical, Clinical, Behavioral and Social Sciences Research Enterprise
In spite of tremendous advancements in scientific research, information, education, and research opportunities are not equally available to all. NIH encourages institutions to diversify their student and faculty populations to enhance the participation of individuals from groups identified as underrepresented in the biomedical, clinical, behavioral, and social sciences.
Please fill out the survey form. The following racial and ethnic groups have been shown to be underrepresented in biomedical research. Do you identify yourself as: Black or African American, Hispanic or Latino, American Indian or Alaska Native, Native Hawaiian, and other Pacific Islander. Black or African American
Hispanic or Latino
American Indian or Alaska Natives
Native Hawaiians
Other Pacific Islander
N/A
Do you have any disabilities? (Disability: defined as those with a physical or mental impairment that substantially limits one or more major life activities, as described in the Americans with Disabilities Act of 1990, as amended.) Yes
No
Please state your disability
Individuals from disadvantaged backgrounds. Please check off any choice that applies to you. Were or currently are homeless, as defined by the McKinney-Vento Homeless Assistance Act.
Were or currently are in the foster care system, as defined by the Administration for Children and Families.
Were eligible for the Federal Free and Reduced Lunch Program for two or more years.
Have/had no parents or legal guardians who completed a bachelor's degree.
Were or currently are eligible for Federal Pell grants.
Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child.
Grew up in one of the following areas: a) a U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) Rural Health Grants Eligibility Analyzer, or b) a Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas.
I hereby confirm that the information provided above is true and accurate. I understand that if the statements are found to be inaccurate, the program will revoke my acceptance to the program. * must provide value
Date* must provide value
Today M-D-Y