PROPOSED EDUCATIONAL PLAN (PEP), Class of 2016

Purpose of the PEP: The Proposed Educational Plan (PEP) is a mechanism for students and their assigned Learning Community Mentor to discuss the goals and objectives of the students' Advanced Studies education. Section A of the PEP reflects the 'ideal' schedule of the student if all things go as planned. Additional electives that may be considered should be listed in Section B. In Section C, note the fields of medicine you're considering taking electives in. Any elective on an approved PEP or if the elective is within a field of concentration listed on the PEP (Section A, B or C) will be approved by the Associate Dean of Student Affairs. If the elective is approved at a different time / location than originally listed on the PEP, a revised PEP is not necessary (time and location are for discussion purposes only). A PEP can be revised at any time by mutual consent of the student and the Mentor. Students are encouraged to discuss all electives with their Mentor if questions/concerns arise (even if previously approved). All students must have an approved PEP on file for Advanced Studies curriculum by February 1st . Student: Complete the Student's Information Sections highlighted in green. Section A, should outline your 'ideal' Advanced Studies Schedule. Include a location if possible. Select if this is a Type A, B or C elective. List any other electives you may consider taking in Section B. In Section C, note the field(s) of medicine you're educational will focusing on. Email a copy of your proposed PEP to your Mentor. Make an appointment with your mentor to review your PEP. Bring a hard copy of your PEP to this meeting. Mentor: Review and discuss the proposed PEP with your mentee. When you and your mentee have agreed on a PEP, both of you should sign (electronic signature is accepted) and date Section D of the PEP. As confirmation of Mentor approval, the Mentor (not the student) must e-mail the approved PEP to [email protected] and cc it to the mentee. Student Affairs will only accept electronic submissions of PEPs.

Student's Information: First Name: Last Name:

Class of: Cell Phone # / Pager #: SECTION A: Month [See approved Calendar Dates [if different Elective Name Proposed location Elective Type for exact dates] from UMMS calendar] [Select Type A, B, or C] Month EE1 (5/4/15 – 5/29/15) Select A, B1, B2 or C Month EE2 (6/1/15 – 6/26/15) Select A, B1, B2 or C Month 1 (6/29/15 – 7/24/15) Select A, B1, B2 or C Month 2 (7/27/15 – 8/21/15) Select A, B1, B2 or C Month 3 (8/24/15 – 9/18/15) Select A, B1, B2 or C Month 4 (9/21/15 – 10/16/15) Select A, B1, B2 or C Month 5 (10/19/15 – 11/13/15) Select A, B1, B2 or C Month 6 (11/16/15 – 12/11/15) Select A, B1, B2 or C Month 7 (1/4/16 – 1/29/16) Select A, B1, B2 or C Month 8 (2/1/16 – 2/26/16) Select A, B1, B2 or C Month 9 (2/29/16 – 3/25/16) Select A, B1, B2 or C Month 10 (4/4/16 – 4/29/16) Select A, B1, B2 or C Month 11 (5/2/16 – 5/27/16) Select A, B1, B2 or C Month 12 (5/31/16 – 6/24/16) Select A, B1, B2 or C (5th Year Plan only) SECTION B: Tentatively Planned Comments Elective Name Proposed location Select A, B1, B2 or C Select A, B1, B2 or C Select A, B1, B2 or C Select A, B1, B2 or C Select A, B1, B2 or C Select A, B1, B2 or C

SECTION C: What field(s) of medicine will your advanced studies be focused in: SECTION D We have reviewed this PEP in relation to the proposed career path of this student and agree that the above list of proposed electives may be pursued.

Signature of Student Date Signature of Learning Community Mentor Date

Revised 4/8/14