Request for Student Provider Placement 
(MD, DO, PA, NP, CNM)
Catalyst Medical Group – Lewiston Orthopedics & Valley Medical Center

Gain valuable clinical knowledge and experience by observing our expert medical professionals in your chosen field. Our student provider program at Catalyst Medical Group is designed to enhance your understanding of patient care and medical practice.

Please review the program details and requirements below and complete the provided form to submit your application for placement.

Requesting Clinical Placement
Clinical placement must be requested through a Catalyst Medical Group/Valley Medical Center student coordinator by completing the online application below. Please complete a separate application for each rotation.

Clinical placement at Catalyst Medical Group is not guaranteed for any student.
Currently, there are more student requests than providers available to teach. Clinical placement decisions are based on multiple criteria. Priority placement is given to Catalyst Medical Group employees and students who are seeking to establish a practice in rural Idaho.

Application Deadline
60 days prior to rotation start date.

Affiliation Agreement
A current affiliation agreement must be in place between your university and Catalyst Medical Group. To confirm if there is an agreement, please contact your school coordinator. We cannot schedule you until an agreement is in place.

Contacting Providers & Staff
Do not send mass communications to providers or staff at Catalyst Medical Group requesting clinical placement. If you know a provider professionally or personally and would like to schedule a rotation with them, please indicate their name on the application. Catalyst Medical Group will verify if the provider is available. Submission of your application signifies agreement with this stipulation.

Application Instructions
The purpose of the application is to facilitate a comprehensive experience for students and providers. Submit an application for each rotation you would like to complete at Catalyst Medical Group. Remember to update the required objectives for each application to clearly identify the purpose and goals for each rotation.

Fees

  • $100 initial administrative fee
  • $25 weekly administrative fee
  • $10 an hour provider education fee

Student Coordinator
LeAnna Dudley
students@catalystmedicalgroup.com


1. Is financial reimbursement offered from your school?
2. Who is completing this request?

3. Student Contact Information

Address

4. Emergency Contact

5. What type of program are you in?
6. What year of your program are you requesting time for?
7. Are you currently employed at Catalyst Medical Group?

8. School Information

School Address

9. Student Coordinator Contact Information

Address

10. Specific dates of your clinical rotation (an application is needed for each rotation)

12. Select all areas or population of preference for this clinical rotation (read your program requirements carefully to indicate qualifying areas for your rotation).
15. Please indicate the information your university needs from your preceptor: