Primary Care Accelerated Track Program Application

2025 ACT Program Application

Complete the form below to apply for Mercer University School of Medicine's Primary Care Accelerated Track. The deadline to apply is 11:59 pm on Sunday, February 2, 2025.

Name*
First Last
Preferred Name*
Date of Birth*
MM slash DD slash YYYY
Primary Email Address*
Alternate Email Address
Phone*
Current MUSM Location*
- Macon
- Savannah
- Columbus
Current Residence*
Street Address Address Line 2 City State ZIP Code
Name of College/University Attended (Undergrad)*
Undergraduate Degree & Major*

Example: B.S., Biology
Month & Year Undergraduate Degree Received*
ACT Track Applying for*
(select one)
- Family Medicine
- General Internal Medicine
- General Pediatrics
Please list campus choice for acceleration (1-3 in order of preference)*
Example: 1. Macon, 2. Savannah, 3. Columbus (FM only)
Have you contacted or shadowed at any site prior to application?*
List all cities/counties, states where you have resided since birth. Include dates (MM/YYYY) of residency.*
Example: Tifton, GA (04/1992-07/2010); Athens, GA (08/2010-05/2014); Tifton, GA (05/2014-date)
What city do you consider to be your hometown and why?*
Describe any life experience that fueled your desire to become a primary care physician serving in a rural setting or a medically underserved area in Georgia.*
What are your career plans?*
What are your thoughts on the attributes needed to become a successful primary care physician?*
What attributes do you possess that make you a top candidate for the ACT program?*
Please attach a two-page CV*
Max. file size: 98 MB.
Service Commitment
By submitting this application, I understand that if I am awarded this scholarship, I will be required to work AND reside in a Georgia county with a population of 50,000 or less, as approved by the School of Medicine, for a minimum of three years.