2025 GIMSPP Application

GIMSPP 2025 Application
The General Internal Medicine Statewide Preceptorship Program (GIMSPP), established in 1992, pairs Texas medical students with practicing internal medicine physicians for mentoring experiences that focus on the field of internal medicine. This program provides a comprehensive, hands-on learning opportunity where students gain exposure to the daily activities of a General Internal Medicine physician, including office work, hospital rounds, and community involvement. Students develop clinical skills, learn patient interaction, understand the balance between professional and personal life, and explore office management and team dynamics. GIMSPP offers more than traditional shadowing by allowing students to immerse themselves in the day-to-day workings of a physician and cultivate their medical values and career goals.

Contact GIMSPP Program Manager Alyssa Muckelroy with any questions.

Phone: 512-285-8932, Email: Alyssa@aminc.org.
Student Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please Select Your Medical School*
You must be an MS1 or MS2 at a Texas Medical School to be eligible to participate in GIMSPP.
Please upload a photo of your student ID*

Cancelof
What year of medical school are you currently enrolled? Please note GIMSPP participants must be enrolled in either their first or second year of medical school in order to be eligible to participate.*

FirstSecond
Anticipated Graduation Year? *
Name of Internal Medicine Interest Group Faculty Advisor (Please provide the name the IMIG faculty member at your institution who could be contacted regarding your participation in this preceptorship if the need arises)*
Email of IMIG faculty member listed above*
example@example.com
In what field do you intend to practice medicine?*

Internal MedicineSubspecialtyUndecidedOther
Do you speak language(s) other than English? Please list all. *
I understand that submitting the application does not guarantee me a place in the program*

Yes, I understand.
I understand that living stipends are not guaranteed*

Yes, I understand.
I am not dependent on receiving a stipend to be able to participate in the program*

YesNo
In submitting this application, I understand that should a match be made, it is my responsibility to inform the GIMSPP office if a conflict arises at least one month prior to my preceptorship start date. Failure to do so will prevent me from applying for GIMSPP in the future.*

Yes, I understand.
This application and the contents therin will be used by the GIMSPP office for scheduling and reporting purposes only and will not be released to any unrelated third party*

Yes, I understand
I understand that it is my responsibility to notify GIMSPP staff should any changes occur to my availability*

Yes, I understand
I understand that if I am matched, it is my responsibility to complete any paperwork, training, or other items needed by my preceptor or their practice before my start date. I understand that it is my responsibility to find out what these items are and I will contact the GIMSPP staff for assistance prior to my start date if I encounter difficulties. I understand that if I do not do this, I may not be able to participate in the GIMSPP program.*

Yes, I understand
Why do you want to do the GIMSPP Program? *
Availability Dates and Location Requests
Please list 2, 3, or 4 consecutive weeks during the summer to participate. You may select as many weeks as you wish. The more flexible you are, the easier it is to match you to a physician!

If you are available for more than 4 consecutive weeks, please put the start as the first Monday available and the end as the last Friday. Example: Start: 6/30/2025 End: 7/11/2025. If you have any changes to your availability once submitted, it is your responsibility to let GIMSPP staff know.
First Choice Start Date*

MonthDayYear
Date
First Choice End Date*

MonthDayYear
Date
Second Choice Start Date*

MonthDayYear
Date
Second Choice End Date*

MonthDayYear
Date
How many weeks would you like your preceptorship to be maximum? The minimum placement is 2 weeks and the maximum placement is 4 weeks. Preceptorships are consecutive and begin on a Monday and end on a Friday.*

2 Weeks (10 Days)3 Weeks (15 Days)4 Weeks (20 Days)
Please list your first choice location city *
Please list your first choice location zip code*
Please list your second choice location city *
Please list your second choice location zip code*
I am flexible and can be placed outside of the above cities/zip codes*

YesNo
Are you willing to relocate for your preceptorship? This may be to a city across the state or in a rural area. You would be willing to accept a placement in and find your accommodations for this placement. This would likely be to a rural area not near a metro area such as Brownwood, TX or Center, TX for example.*

YesNo
Please specify relevant details about placement preferences.*
Please list any preceptor requests or needs, transportation issues, or any other items that will help us find the best placement. Please note: We are a General Internal Medicine program. We do not match based on subspecialty requests.*
Preceptor Information

GIMSPP encourages students to recruit their own preceptors. Please list your recruited physicians information below. PLEASE ONLY LIST CONTACT INFORMATION FOR PHYSICIANS YOU HAVE PREVIOUSLY SPOKEN WITH ABOUT PRECEPTING.
I have recruited my own preceptor, and the physician I have recruited has agreed to precept.

YesNo
Preceptor Name

First NameLast Name
Name of Preceptor's Practice
Preceptor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preceptor Email
example@example.com
Preceptor Phone Number
Please enter a valid phone number.
Additional Comments
Learning Profile

If you are matched with a preceptor through our program, GIMSPP will send your learning profile to your preceptor.
Learn about the role of Internal Medicine in relation to other medical fields *
Learn about primary care in Internal Medicine *
Learn about preventative medicine *
Learn about patient education *
Develop history-taking and physical examination skills*
Develop communication skills*
Develop skills in developing a differential diagnosis*
Obtain hospital experience *
Briefly describe the type of learning experience desired from your preceptorship*
How do you learn best? What are your preferred learning styles? *
What stifles or hinders your learning? *
Should be Empty:

GIMSPP 2025 Application

Availability Dates and Location Requests

Preceptor Information

Learning Profile