Resident Electives Program (REP) Application

OMB Number: 0925-0698
OMB Expiration Date: 10/31/2026
Public Reporting Burden Statement
Instructions: If you already have a saved an application click on the Login button
Before you begin, you may want to review a statement about privacy. After you fill out the application form below, press the [Save] button at the bottom of this page to resume your application later. You MUST Press the [Submit] button to complete the application process.
Applicants are advised to apply a minimum of three months prior to the start date of the elective in which they would like to participate.
Eligibility Requirements for the NIH Resident/Fellow Electives Program
All required fields are notated with an asterisk*.






Contact Details

Title*:
First Name*:
Middle Initial:
Last Name*:
Degree*:
Email Address*:
Current Home Address*:
City:
State:
Zip Code:
Phone Number*:
Current PGY Level*:

Status

Citizenship Status*:
Previous research experience at NIH: