MD-MBA Program at Boonshoft School of Medicine, Wright State University, Dayton, Ohio

Combined M.D./M.B.A. Program Supplementary Application

To be considered for admission to the Boonshoft Physician Leadership Development Program, students must complete a supplementary application by submitting the form below and e-mailing answers to the four essay questions following the form; or by downloading a PDF copy of the form, completing it, and sending it to the Center for Global Health Systems, Management, and Policy at the address below.

Name:
Address:
Phone:
E-mail:

Application Completion Information: School of Medicine:
Application Date:	Interview Date:
School of Graduate Studies: Application Completed:
Yes Pending	Date Applied:
GMAT Test Taken:
Yes Pending	Date of Test:
If taken, test results: / 800

BPLD Program Additional Information:

To complete your Supplementary Application, please put your answers to the following four questions in a Microsoft Word document and send it as an e-mail attachment to jennifer.webb@wright.edu. Be sure to include your full name and an e-mail address where you can be contacted in the body of your e-mail message.

Essay Questions (maximum of 300 words for each response):

I. Please describe your future career goals.

II. What are your interests in the organization and business of health care, including health care management, health systems/organizations, population-based health care, health economics, finance, information systems/communication or quality in health care?

III. What special experiences or skills do you have that you believe will be valuable to you in the Boonshoft Physician Leadership Development Program?

IV. How do you envision the Leadership Development Program as serving your career, your community and the profession of medicine?

Submit all application materials to:
Jennifer Webb
Program Coordinator
Center for Global Health Systems, Management, and Policy
Wright State University School of Medicine
3123 Research Blvd., Suite 200
Kettering, OH 45420-4019

Campus Mail: 200 Tech Center IV; Research Park
Phone: (937) 258-5557
Fax: (937) 258-5544
E-mail: jennifer.webb@wright.edu