The UAMS Medical Center
Externship Program/Contract

Name: _____________________________________________________

School: ____________________________________________________

Date of Graduation:______________

Are you currently employed? (circle one) Yes      No
If yes, state name of employer: ___________________________________

Are you currently under contract to work upon graduation? (circle one) Yes      No
If yes, state name of employer: ___________________________________

Area/Shift:
The purpose of the Extern Program is to enhance clinical competencies.  Therefore, students will be assigned to work A or P shift on a specific nursing area.  Opportunities to work in alternative settings will also be offered.  Every effort will be made to accommodate rankings but is not guaranteed. Please use numbers to indicate choice using 1 as first choice, etc.

         A: 6:30A-7P; P: 6:30P-7A                                            

Shifts Available: Areas Available:
___  A  M-F (rotation to WE)  ___ Med./Surg.
___  P  M-F (rotation to WE) ___ ICU
___  A  Sa./Su.  (+1 shift M-F) ___ Nurseries
___  P  Fri./Sa./Su.  

Program Requirements:

  • Student committed to work at least 1 year with UAMS Medical Center upon graduation.
  • Student required to purchase “designated” uniform. 
  • Student required to work same schedule as preceptor. 
  • Student required to attend additional two (2) hour bi-weekly seminar. Specific days/times vary based on instructor availability.
  • Student cannot be paid for any time over 40 hours/week. 
  • Student allowed to continue working after completion of program, if opening available.
  • Student required to adhere to hospital policies and standards.
  • Student committed to no absences or tardiness.
    *college credit will not be issued for any absences
  • Signed contract indicates student’s obligation to adhere to program requirements.

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Signature                                                       Date