Online Application

Applicant Personal Data

Email Address *

Full Name *

First Name (Given Name) Middle Name Last Name (Surname)

Please include your full legal name: First Name (Given Name), Middle Name, Last Name (Surname). This is how your name will appear on your transcript, diploma and all other university documents. If you do not have a middle name, please indicate “N/A”.

Gender

Male
Female

Birth Date *

Last Four Digits of Social Security / National Identity Number

Place of Birth *

City State / Province / Region Country

Legal Permanent Address *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Permanent Phone Number *

Preferred Mailing Address *

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred Phone Number *

Single / Married

Single
Married

Number of Children

None
One
Two+

Citizenship (list every country of citizenship) *

Please click plus sign (+) to add countries.

Passports

Passport Details *

Passport Number	Issuing Country	Expiration Date	Add or remove row

Please click plus sign (+) to add passports.

Father's Name *

First Last

Father's Citizenship *

Father's Occupation *

Mother's Name *

First Last

Mother's Citizenship *

Mother's Occupation *

Academic Information

High School / Secondary School *

State / Country *

State / Province / Region Country

If you did not attend college immediately after high school, or if there was more than a six-month break in your studies, briefly state the reasons.

Highest Level of Education

As of August 2019, what will your highest level of education (resulting in a degree) be? *

Bachelor’s degree
Master’s degree
Doctoral degree

Undergraduate Degree

I have received, or expect to receive before August 2019, the degree of *

From (institution) *

State / Country *

State / Province / Region Country

Dates Attended — Start Date *

Dates Attended — End Date *

Major *

Please click plus sign (+) to add majors.

GPA *

Science GPA *

Additional Institutions/Degrees

If you studied at more than one undergraduate institution or hold an advanced (graduate) degree, please list the school(s) and date(s) of study:

School	Dates of Study	Degree Type	Add or remove row

Please click plus sign (+) to add schools.

Prerequisite Courses

Applicants must have or expect to receive an undergraduate degree before entering MSIH. Coursework must include one year each of biology and physics (or one semester of physics and one semester of math, preferably calculus or statistics), and two years of chemistry (with labs), one of which must be organic chemistry or biochemistry with labs and lectures.

List of Applicable Courses

Please list the courses that you are currently taking, or plan to take before matriculation, that are required for admission. You are only to enter prerequisite courses that do not yet appear on your transcripts. You must submit transcripts for all coursework upon completion. Please click plus sign (+) to add courses.

Academic Year	College / University	Subject	Course Title	Add or remove row

Test Scores

AAMC ID #

Total MCAT Score

MCAT Verification Code

Total GAMSAT Score

GAMSAT ID #

We accept MCAT scores that are no more than three years old and GAMSAT scores that are no more than two years old. To retrieve your 16-digit MCAT alphanumeric code, please go to the AAMC website, log in, find the option to “print an official copy of my MCAT scores” and enter that code above. To retrieve your seven-digit GAMSAT ID, please visit the ACER website.

If English is not your first language, please provide your TOEFL score.

Month / Year

Please note that the TOEFL must have been taken within the past two years.

History

Have you previously applied to the Medical School for International Health? *

Yes
No

Please provide the year of your previous MSIH application.

Have you previously attended, or are you now attending, another medical school? *

Yes
No

Please provide the name of your previous medical school and the dates attended.

Have you ever been suspended or placed on academic probation at any institution of higher learning? *

Yes
No

Please explain your suspension or academic probation

Have you ever been convicted of a felony? *

Yes
No

Essays

1. Please provide a biographical essay (up to 500 words). *

Upload in PDF format with file named “ESSAY1_Last Name_First Name”.

2. Please describe your education, skills, experiences and/or career plans that are relevant to global health (up to 500 words). *

Upload in PDF format with file named “ESSAY2_Last Name_First Name”.

3. What is the biggest challenge that you have faced to date? How did you handle it? In retrospect, what would you or could you have done differently (up to 500 words)? *

Upload in PDF format with file named “ESSAY3_Last Name_First Name”.

Recommendations and Committee Letter

All recommendations should be submitted directly by the letter writer or an authorized school official via third-party entities like Interfolio or emailed directly on official letterhead to MSIH Admissions.

Does your college or university have a pre-medical committee? *

Yes
No

Have you requested a recommendation from your college pre-medical committee or advisor? *

Yes
No

If you will not have a committee letter, please list the names of at least three people who will submit recommendations. At least one letter must be academic (you may submit additional recommendations if desired).

Name	Relationship	Add or remove row

Please click plus sign (+) to add names. Please include at least three. A minimum of one must be academic.

Additional Uploads

Please upload the following:

Complete CV in PDF format, with file named “CV_Last Name_First Name”. No page limit *

A photo in JPG format, with file named “PHOTO_Last Name_First Name”. *

How did you hear about us?

Application Signature and Submission Process

Application Checklist

Application: Complete all fields.
CV/Resume: Upload a complete CV in PDF format.
Photo: Upload a photo in JPG format.
Essays: Upload copies of all required essays in PDF format.
Application fee: Pay the $120 application fee online here. Applications will not be processed until payment is made.

The below items must be submitted on official letterhead, independently by the letter writer or by an authorized school official.

Transcripts: Submit official academic transcripts from all education after high school.
Recommendation(s): Submit a committee letter or a minimum of three letters of recommendation.

Official transcripts and recommendations may be submitted by email to msihadmissions@post.bgu.ac.il, via third-party entities like Interfolio, or by mail to the following address: Medical School for International Health 601 West 168th Street, Suite 63 New York, NY 10032

The admission and registration of the undersigned, if granted pursuant to this application, is subject to all rules and provisions set forth by the university. I hereby certify that all information provided in my application is truthful, accurate and complete.

Signature *

Date *

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