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Application

Note: Select candidates will be invited to the Regional Offices in Oakland, California for in-person interviews on Thursday, December 12, 2019.

If you have questions about the application, please contact Jennifer Ly.

  • Applicant Information

  • RoleDatesDepartmentNUID (if applicable) 
  • Education History

    Residency/Fellowship Experience
  • Start DateEnd Date
  • First NameLast NamePhoneEmail 
  • Start DateEnd Date
  • First NameLast NamePhoneEmail 
  • Start DateEnd Date
  • First NameLast NamePhoneEmail 
  • Education History

    Medical School Education, Graduate School Education, Undergraduate Education
  • Start DateEnd Date
  • MajorDegree
  • Start DateEnd Date
  • MajorDegree
  • Start DateEnd Date
  • Start DateEnd Date
  • MajorDegree
  • Start DateEnd Date
  • MajorDegree
  • Examinations

  • USMLE Step 1:USMLE Step 2:USMLE Step 3:COMLEX Level 1:COMLEX Level 2:COMLEX Level 3:
  • Licenses

  • State:License #:Date Issued:Expiration: 
  • References

    List 3 references who will be submitting letters (one must be your residency program director):
  • Additional Information

  • Additional Documents

    Please attach the following documents to your application: • Curriculum Vitae • One (1) letter of recommendation from your Residency Program Director • Two (2) additional professional letters of recommendation • USMLE / COMLEX Transcript • Medical School Transcript • MSPE (Dean’s Letter)
  • Drop files here or
  • Fellowship Preference

  • (Check all that apply)
  • What previous global health experiences have you had? What was meaningful and what lessons will you incorporate in future trips? (1-2 paragraphs)
  • What previous integrative medicine experiences have you had? How do you see integrative medicine playing a role in reducing health disparities and/or improving the total health of diverse communities? (1-2 paragraphs)
  • I certify that the information provided in the application as well as submitted materials are truthful and accurate to the best of my knowledge. I understand that any false or missing information may disqualify me for this position. I further declare that by submitting this application, I authorize Kaiser Permanente and its representatives to contact persons associated with hospitals or institutions at which I have studied or trained as well as individuals whose names I have submitted in connection with this application. I hereby release from any liability all representatives of the hospital and its professional staff for information provided in connection with evaluating my application, suitability for employment or training, and credentials.
  • This field is for validation purposes and should be left unchanged.
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