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Thank you for being willing to help us update the CMDA Student Medical Missions International Rotation Handbook. By completing this survey your healthcare ministry will be listed in the handbook with the updated information you provide. Most of our inquiries are from medical and dental students and residents but we increasingly are contacted by students in all health professions and at all levels of training as well. Be aware of this as you answer the questions. Once again, thank you for your help and all you do for Him.
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Provide the following information for the person completing this survey. This information will not be included in the handbook. It is for internal purposes in case we need to contact you to clarify answers. Thank you!
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Information for hospital, clinic, healthcare program or project.
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Information for the parent agency or mission sending agency associated with the project (if applicable).
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How does one obtain further information about or make application for this opportunity? We suggest you establish a permanent contact email and mailing address. When the contact person changea this causes problems if personal addresses are used. The permanent addresses can easily be forwarded to a new contact person. Example: visitingstaff@xxxxx.org
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Students often have a special interest or area they would like to gain experience or to have exposure. While you may not have a "specialist" in the following areas, a student would be able to gain meaningful supervised experience in the following areas. Please choose as many as apply to your situation.
| Community Health/Development |
| Dentistry |
| Nursing |
| Chaplaincy/Counseling |
| Social services |
| Pharmacy |
| Internal medicine |
| Pediatrics |
| Surgery |
| OB/GYN |
| Radiology |
| Physical Therapy |
| Ophthalmology |
| Other, please specify |
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Students desire international experience early on in their training. While those who have had little to no practical training are more work for the preceptor you may be able to influence a young student more than an advanced student in choosing a career in missions. Are you able to provide experience for students at the various levels listed? For example, if you check yes to a pre-professional student this would be someone hoping to get into a professional school, such as medical or dental school, in the future.
| College level - general |
| Pre-professional college i.e. pre-med, dental, pharmacy, pre-P.T., |
| Nursing at entry level |
| Nursing in last year only |
| Professional school entry levels |
| Professional school - in last year(s) only |
| Post professional - residents, fellows |
| Other, please specify |
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Is there a minimum length of time a student or resident must stay? Please be careful you check the right boxes as you go down the list. The survery setup does not allow the "box" numbers to be changed.
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2 weeks | 2
4 weeks | 3
8 weeks | 4
12 weeks or more | 5
No minimum | N/A
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| College |
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| Additional Comment |
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| Professional school including nursing |
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| Additional Comment |
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| Post professional school resident or fellow |
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| Additional Comment |
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Do you assist in finding housing?
| Yes, we help find housing. |
| No, students (visitors) must find their own accommodations. |
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The next four questions relate to the expenses students/residents/volunteers will incurr. Not every question will apply to your situation. Answer those that do.
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Answer this question if you combine all costs into one lump sum. This would include lodging and meals but not international travel. For example, a camp in South Africa has a total cost of $6000 (USA) for the "summer camp " program. Our total cost is (please enter in $ USA):
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Answer this question if you combine costs into one daily rate that includes food and lodging. Daily rate is: (in $ USA)
| Less than $25 | $25 to $50 | $51 to $75 | $76 to $100 | Over $100 |
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What does housing generally cost per day per person? (In $ USA) This is at the locality of the rotation and does not include hotel charges while traveling.
| Less than $15 | $15 to $25 | $26 to $50 | $51 to $75 | $76 to $100 | Over $100 | No charge |
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What is the average cost per person per day for food while at the site of the rotation? (in $ USA)
| $10 or less | $11 to $20 | $21 to $30 | $31 to $40 | More than $40 | No charge |
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We are working on a method to include a picture representing your hospital, clinic, or program. If you desire a picture to be included send it to cmm@cmda.org It must be clearly marked with the ministry/facility/program name. Please clearly indicate it is for the student handbook. The picture can be a logo if desired. We reserve the right to edit/crop/delete the picture. Will you send a picture?
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If desired you may include a brief simple description of your facilty, program, hospital, clinic or other project. Please limit your response to 1 or 2 sentences or phrases. We will edit the reponses into a similar style and we reserve the right to not include descriptions. Expanded information should be on your website if you have one. examples: 1. Community health and development program serving the Frozenite people of Antarctica. 2. Primary care outpatient clinic in the slum area of Surveyville. 3. Full service hospital with teaching and referral services in the rural highlands of Michcartenya.
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If desired you may include a brief description of what a student may experience, learn, or accomplish. Please limit comments to 2 or 3 sentences. We reserve the right to edit comments into a similar style or not use responses.
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