Background Check - Touro College Of Osteopathic Medicine Touro College

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Application InstructionsAll applications and supporting documents should be sent to:Touro College Master of ScienceInterdisciplinary Studies ProgramATTN: Lissette Mercado-Program Coordinator2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027Please complete the following steps: Technical Standards - For your edification and consideration, we provide our Technical Standards to ourprospective students. DO NOT return the Technical Standards with the Supplemental Application. The TechnicalStandards are provided for your review only. As part of the enrollment process, students accepted to Touro Collegeof Osteopathic of Medicine will have to complete, sign, and date the Technical Standards along with other materialsprovided during the matriculation process. The application must be filled out in its entirety, signed and dated. Applications that are not complete will notbe considered. A passport photograph is required to be submitted with your application. An application fee of 75.00 (addressed to Touro College) (money order or checks only) must be submittedwith the application Applicants must request official transcripts from all accredited colleges attended and have them sent toTouroCOM Three letters (3) of recommendation (Two should be written by individuals who can evaluate the applicant’sscience background. An official letter from the College Premedical Committee may substitute for the three letters ofrecommendation) The MCAT is required. Official scores should be added to the application packet returned or addressed and sent tothe above addressFinally Applicants are notified via email when supporting documents are received. Allow (3-4) weeks for initial responses Qualified applicant will be invited for a personal or telephone interview once the admission file is completed and ithas been found that the applicant meets the selection criteria. Background Check- If accepted, during the enrollment process, ALL students must complete afelony/misdemeanor background check in order to maintain matriculation.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

Technical Standards for MatriculationEvery student who matriculates at Touro College of Osteopathic Medicine is expected to possess those intellectual, ethical, physical,and emotional capabilities required to undertake the full curriculum and achieve the levels of competence required by the faculty.Each candidate for the DO degree must quickly and accurately be able to integrate all information received, perform in a reasonablyindependent manner, and demonstrate the ability to learn, integrate, analyze and synthesize information and data.Touro College of Osteopathic Medicine will make every effort to provide reasonable accommodations for disabled students, however,in doing so, Touro College of Osteopathic Medicine must maintain the integrity of its curriculum and preserve those elements deemedessential to the acquisition of knowledge in all areas of osteopathic medicine, including the demonstration of basic skills requisite forthe practice of osteopathic medicine.Accordingly, Touro College of Osteopathic Medicine requires each student to meet certain technical requirements, which include:1.Observation. Candidates and students must have sufficient vision to be able to observe demonstrations, and properly performexperiments and laboratory exercises in the basic sciences. They must be able to observe a patient accurately, both at a distance andclose at-hand, and be able to discern nuances of facial expressions and body language.2. Communication. Candidates and students must be able to speak, hear, and observe in order to elicit information, examine patients,describe changes in mood, activity, and posture, and to perceive non- verbal communication. Communication includes not onlyspeech, but also reading and writing. They must also be able to communicate effectively and efficiently in oral and written form, withall members of the health care team.3.Motor Function. Candidates and students must have sufficient motor function to execute movements reasonably required to providegeneral care and emergency treatment to patients. Examples of emergency treatment reasonably required of physicians are:cardiopulmonary resuscitation; administration of intravenous medication; and the application of pressure to stop bleeding; the openingof obstructed airways; and the suturing of simple wounds. Such actions require coordination of both gross and fine muscularmovements, equilibrium, and functional use of the senses of touch and vision.4.Sensory. Since osteopathic medical candidates and students need enhanced ability in their sensory skills, it will be necessary toevaluate for candidacy those individuals who are otherwise qualified, but who have significant tactile sensory or propioceptivedisabilities. This includes, but is not limited to, individuals with previous burns, malformations of upper extremities, cicatrixformation and sensory motor or special sensory deficits.5. Strength and Mobility. Osteopathic manipulative medical treatment often requires considerable upper extremity and bodystrength. Therefore, individuals with significant limitations in these areas would be unlikely to succeed. Mobility to attend toemergencies, and to perform such maneuvers as CPR, is also required.6. Visual Integration. Consistent with ability to assess asymmetry, range of motion, and tissue color and texture changes. It isessential for the candidate to have adequate visual capabilities for the integration of evaluation and treatment of the patient.7. Intellectual, Conceptual, Integrative, and Quantitative Abilities. The candidate must be able to demonstrate ability inmeasurement, calculation, reasoning, comparison and contrast, analysis and synthesis, and problem-solving.Candidates and students must demonstrate ability to comprehend three-dimensional relationships, and to understand the spatialrelationships of structures.8. Behavioral and Social Abilities. Candidates and students must possess the emotional health required for full utilization of theirintellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care ofpatients, and the development of mature, sensitive relationships with patients and co-workers. Candidates and students must be able totolerate physically and mentally taxing workloads, adapt to changing environments, display flexibility, and learn to function in theface of uncertainties inherent in treating the problems of patients. Compassion, integrity, concern for others, interpersonal skills,interest, and motivation are personal qualities that will be assessed during the admissions and education process.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

9. Participation is required in all physical examination courses and laboratories, including but not limited to OsteopathicManipulative Medicine, Physical Diagnosis, Primary Care Skills, Objective Structured Clinical Examination, and ClinicalRotations. Active participation in physical examination courses is an admission, matriculation, and graduation requirement. Forexample, during the first two years of Osteopathic Manipulative Medicine (OMM) training, each student will palpate, in the laboratorysetting, a variety of people representing both genders and individuals with different body types to simulate the diversity of patientsexpected in a practice setting. Being palpated by other students and faculty helps the student appreciate how palpation feels from thepatients' perspective, and enables students to provide feedback to their laboratory partners, thus enhancing their palpatory skills.Reading and observation, although helpful, do not develop the skills required to perform palpatory diagnosis and/or manipulativetreatment. Again, each student is required to actively participate in all skills development sessions of the physicalexamination courses, laboratories, and OMM. Occasionally, a student may have a physical problem, which may restrict or prevent useof a specific type of manipulation in a specific anatomical location in the physical examination courses. A student who feels his/hermanipulation might be so limited, is required to contact the head of the specific departments before the beginning of the course, andpresent documentation of the problem. The student is expected to actively participate in all laboratory sessions not directly affected bythe problem.Touro College of Osteopathic Medicine is committed to ensuring that qualified students receive the benefits of our medical program.Touro College of Osteopathic Medicine's ultimate responsibility is to the future patients treated by the students that we educate andtrain. Touro College of Osteopathic Medicine will make reasonable accommodations necessary to enable otherwise qualified studentswith disabilities to meaningfully participate in our osteopathic medicine program. However, notwithstanding the accommodationsprovided, in order to be granted a degree, every student must pass COMLEX USA Level 1 and COMLEX USA Level 2- CE and PEwithin six years of matriculation at the Touro College of Osteopathic Medicine. These examinations are administered through theNational Board of Osteopathic Medical Examiners (NBOME). Students are advised that even though Touro College of OsteopathicMedicine may offer a reasonable accommodation, NBOME has its own requirements and standards. The accommodations, if any, astudent receives at the Touro College of Osteopathic Medicine may not be available or offered by NBOME. Please contact theNBOME for individual concerns. Students are cautioned to address these concerns to avoid upset and a potential situation where thestudent has expended great time, money, and effort in their education but cannot pass COMLEX exams. Touro College of OsteopathicMedicine expects that all students meet all essential requirements of the program as well as the technical standards for the safe,efficient, and effective performance during clinical rotation assignments and for the practice of medicine.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

YEAR OF INTEREST: FALL 2014STUDENT IDOFFICE USE ONLYSTUDENT INFORMATIONAACOMAS ID#:Last NameFirst NameMiddle InitialPlease note: Your application will be processed under the name given above. If you were registered under any other name at anotherinstitution, or use any variation of that name, please write that name below.Maiden/Other nameEmail:Social Security Number--Gender Male FemalePermanent AddressNumber and StreetApt. #CityStateCell / Day Phone # ()ZipEvening phone # (Current Address (if different from permanent)Good Until:)//MonthDayYearNumber and StreetApt. #CityStateCell / Day Phone # (Date of Birth)Evening phone # (/MonthZip)/DayYearPlace of Birth (City, State, Country)2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

Are you are a U.S citizen?If not a U.S citizen or permanent resident: Country of citizenshipVisa typeExpiration dateIndication of ethnic origin (optional)EthnicOrigin: American Indian/Alaskan Native Hispanic (regardless of race) Asian or Pacific Islander White (Non-Hispanic) African American (Non-Hispanic) Other (please specify)EDUCATIONAL INFORMATION MCAT1. Scores: P V B W Overall(Indicate dates taken)2. Scores: P V B W Overall3. Scores: P V B W OverallCOLLEGE LEVEL STUDIES (List all undergraduate and graduate institutions attended in chronological order)NAME OF INSTITUTIONCAMPUS /LOCATIONSTATE# OFCREDITSGPASci.GPAMajorDATES DtototototoEMPLOYMENT HISTORY / HEALTH CARE EXPERIENCE (LIST IN ORDER, THREE MOST RECENT)WHERE (HOSPITAL/CLINIC/OFFICE)WHEN (DATES)# OF HOURSIN WHAT CAPACITY?PAID/VOLUNTEERtototo2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

List honors, scholarships or awards received both in and out of school (list on a separate sheet if necessary):List the significant activities and organizations in which you have participated both in and out of school and offices held, if any(list on a separate sheet if necessary):LETTERS OF RECOMMENDATIONList the names of three people who will be submitting letters of recommendation on your behalf. These individuals should include someonewho can evaluate your personal background and academic experience, and someone who can evaluate your knowledge of and potential for acareer in medicine. They may include, but are not limited to, instructors, supervisors, etc. They should not include personal friends. Lettersof recommendation should be on professional letterhead. Please indicate your relationship with the individual giving the recommendation.LOR WritersHow will your LORs be submitted? (Check all that apply) Interfolio VirtualEvals Hard CopyLO R W r i t e r s :1 .2 .3.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

HOW DID YOU LEARN ABOUT TOURO COLLEGE?Please be specific Your School Friend Internet Newspaper Radio OtherPERSONAL STATEMENTOn a separate sheet of paper, type an essay discussing your interest in seeking admission to the Master’s program inInterdisciplinary Studies and your motivation toward a career in Osteopathic Medicine. Include such items as your personal andacademic background, your career goals, experiences which nurtured your interest in the health field. (no more than 2 pages)SIGNATUREMy signature below indicates that all information given in this application is true and complete to the best of my knowledge.SIGNATUREDATETOURO DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, SEX, AGE, DISABILITY, OR NATIONAL OR ETHNIC ORIGIN IN THE ADMINISTRATION OF ITS ADMISSIONPOLICIES.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

PRE-REQUISITE REQUIREMENTS1.A baccalaureate degree from an accredited college or university is required.Name of InstitutionDate Degree Granted (or Expected)2.At the time the application is filed, applicants shoulda. possess an undergraduate science grade point average of at least 3.0 on a 4.0 scaleb. possess an overall grade point average of at least 2.9 on a 4.0 point scale.3.Applicants must have completed an acceptable academic sequence in the major pre-requisite courses.Review of individual course grades is as important as the grade point average. English Composition (6 Semester Hours)Behavioral Sciences (6 SH)One year course of Biology w/lab (8 SH)One year course of General Chemistry w/lab (8 SH)One year course of Organic Chemistry and/or Biochemistry w/lab (8 SH)One year course of Physics w/lab (8 SH)One year of Mathematics which may include Statistics (4 SH)On the next page thoroughly complete the following chart indicating which pre-requisite requirements havebeen satisfied.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

PRE-REQUISITE VERIFICATION iochemistry1.2.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

Physics1.2.Math1.2.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

PLEASE LIST ADDITIONAL RELEVANT COURSES ON THE PAGE radeCredithours.1.2.1.2.1.2.1.2.1.2.1.2.1.2.2090 Adam Clayton Powell Jr. Blvd Suite 519New York, NY 10027FIG.APP110613Email: lissette.mercado@touro.edu Telephone: (646)981-4602

Touro College of Osteopathic Medicine's ultimate responsibility is to the future patients treated by the students that we educate and train. Touro College of Osteopathic Medicine will make reasonable accommodations necessary to enable otherwise qualified students with disabilities to meaningfully participate in our osteopathic medicine program.