Clerks Application Form

All rotations must be a minimum of 4 consecutive weeks to be accepted, set up, and funded by ERMEP.  We do not accept 2-week electives.

4th Year Electives - all Ontario medical learners can apply diretly to ERMEP.  If you are an out-of-province/country medical learner looking to complete an elective with ERMEP, you must apply with the University of Ottawa via the AFMC Student Portal website.  Do not apply with ERMEP unless you have been approved by the AFMC (uOttawa) and you have been given instructions to apply.

Preferred community/preceptor suggestions cannot be guaranteed.  You will be placed where an available preceptor is located.  If you do not have a vehicle, this will affect your community locations.  A vehicle is highly recommended so all ERMEP communities can be considered.  

Thank you for your understanding.


Personal Information
(Please use your University e-mail address)
Please use the format (xxx) xxx-xxxx
Please use the format (xxx) xxx-xxxx
Information is required for accommodation purposes.
Current Address
Please use the format xxx xxx
Permanent Address
Please use the format xxx xxx
School Information
Placement Information
Please choose up to three locations
Please choose your special interests, if any.
Expectations of learning experience
Cancellation Policy
The Eastern Regional Medical Education Program [ERMEP] along with the Distributed Medical Education [DME] considers it unprofessional to cancel a rotation once a preceptor is confirmed. ERMEP considers it a breach of professionalism when the learner cancels without a valid reason less than four weeks from the start date of the rotation. ERMEP will then report this to the schools and ask that they deal with this as unprofessional behavior. It is important to recognize that preceptors are often very annoyed by late changes due to their scheduling requirements. Accommodation cancellations must be made through ERMEP a minimum of four weeks prior to placement start date. By submitting this application, I agree to abide by all of ERMEP policies and confirm that I have not applied to any other Networks. I understand that once the Eastern Regional Medical Education Program has contacted me with the name of a preceptor, it is unprofessional for me to cancel the rotation. I acknowledge that ERMEP will notify my school of any unprofessional behaviour.
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