Rev. 11/26/18
SPECIALTY YEAR for REGIONAL CAMPUS STUDENTS
A current medical student at a regional campus may request a fourth year of studies for the purpose of
pursuing a specialty upon graduation. The request must be submitted between February 15 of the M2 year
and August 15 of the M3 year. Once a request is approved, a student may not revert to the three-year
curriculum. All students pursuing this option are encouraged to discuss this with their deans, the Office of
Financial Aid and the Office of Student Accounts.
Section 1
Name: _________________________________________________________________________________
Last name First name Middle name
Home campus (circle one): CW GB
If request is approved, intended graduation term/year: Fall Spring ______________________
Year
Intended specialty: ________________________________________________________________________
Student Signature: __________________________________________________ Date: ________________
Section 2
I approve/deny the student’s request.
Required Campus Dean Signature: ___________________________________ Date: _________________
ALL COMPLETED FORMS MUST BE SUBMITTED BY CAMPUS DEAN TO:
Office of the Registrar, M3200, 8701 Watertown Plank Road, Milwaukee, WI 53226 · acadreg@mcw.edu /414-955-8733
