Scholarly Extension

Please fill out this form to request a program extension. This may include taking a year away from the medical school curriculum to pursue research at Penn; pursue a fellowship; enroll in a second degree at Penn (note that second degrees at outside institutions require a leave of absence);

Name Name First Last
Current Graduation Date (Month, Year)
New Graduation Date (Month, Year)
Program Extension Begin Date (Month, Year)
Program Extension End Date (Month, Year)
Program Plans

Program Plans Research External Fellowship Global Health Combined Degree (at Penn only) Combination of activities (please explain)
Where?
Costs for Year and Registration

During a scholarly extension year, you will remain a registered, full-time student as you work towards fulfilling your scholarly pursuit graduation requirement.

Many students opt to pay the research rate during the scholarly extension year. If you are paying the research rate:

• You will be charged the general fee, clinical fee (for student health services), technology fee, and disability insurance (approximately $6000/year).
• You will have a reduced financial aid budget.
• PSOM awards and scholarships will NOT be applied during MD tuition paying semesters.
• Direct loans will be available to assist to cover living expenses.
• Loans continue to be eligible for deferment.
• You will be required to have health insurance. You are eligible to participate in the University’s health insurance plan (approximately $4000/year).
• You are expected to be focused on research activities that fulfil your scholarly pursuit graduation requirement.
• Per the Additional Course Policy, if you take any non-MD courses, you will be required to pay tuition for the non-MD courses.
• Per the Tuition Policy, you will pay full tuition and fees in your fifth year.
My plan is to:

My plan is to: Pay research rate (fees only) in your scholarly year (4th year) and pay full tuition and fees in final year (5th year). Pay fees and tuition during your scholarly year (4th year) and pay the research rate (fees only) in the fifth year. Pay the second degree program’s tuition.

You may also opt to pay full tuition and fees during your scholarly year extension. In that case, you will be charged the general fee, clinical fee (for student health services), technology fee, and disability insurance (approximately $6000/year) in your fifth year.

If you are completing a second degree at Penn you are responsible for Masters degree tuition (grants and stipends possible) as defined by the program. Any MD scholarship will not apply to Masters tuition.
Type of Health Insurance

You will also be charged for health insurance (approximately $4,000/yr) should you opt to participate in the University’s plan.

Which type of insurance will you have during the extension?

Type of Health Insurance

You will also be charged for health insurance (approximately $4,000/yr) should you opt to participate in the University’s plan.

Which type of insurance will you have during the extension? Penn Other
Financial Aid

Students considering an extra year should meet with the PSOM Office of Financial Aid to discuss financial planning.

Financial Aid

Students considering an extra year should meet with the PSOM Office of Financial Aid to discuss financial planning. I have met with the PSOM Office of Financial Aid I have not met with the PSOM Office of Financial Aid
Scholarly Pursuit:

The purpose of this form is to update graduation date and enrollment information. You will still need to register for your scholarly pursuit in the Arranged Activity Portal (unless you are completing a second degree at Penn). Please submit your Scholarly Pursuit proposal and mentor form at least 1 month before starting your scholarly extension year, and no later than September 15.

Please check below to indicate you understand these terms.

Scholarly Pursuit:

The purpose of this form is to update graduation date and enrollment information. You will still need to register for your scholarly pursuit in the Arranged Activity Portal (unless you are completing a second degree at Penn). Please submit your Scholarly Pursuit proposal and mentor form at least 1 month before starting your scholarly extension year, and no later than September 15.

Please check below to indicate you understand these terms. I understand these terms.
Today's Date Today's Date / MM / DD YYYY

Scholarly Extension

Scholarly Extension

Costs for Year and Registration