FCE Student Designed Course Proposal AY 2014-2015

The self-designed FCE is your opportunity to develop an experience that isn’t offered anywhere else in the medical school curriculum. Use the Capstone self-designed FCE to develop a unique experience that will specifically inform your Capstone project. You may or may not decide to ask your Capstone project advisor to be your FCE supervisor; you may want to gain experience in a department that does not naturally “fit” into your project plan; or you may want to work with another professional who has expertise in your topic. The Capstone FCE must not serve simply as “more time” to work on your project (e.g., extra digging in the library); it must be a distinct, independent piece that informs your project. You may design up to two distinct Capstone FCEs. While approving a Capstone FCE  your proposal will evaluated as if it were a standalone FCE and all rules and requirements for self designed FCEs will apply.

General program requirements apply to all self-designed FCEs. See the FCE Program FAQ webpage for specific requirements.
note: All FCE proposals that include or consist of International Medical Education (travel) must be accompanied by a completed Global Health Experience Request (GHER).

Part I Course Information

Your Name *
 Your email *
FCE Course Title 
If a Capstone self-design, start FCE title with appropriate prefix.
EG: FCE 3005 Capstone Research: [your title] 

Has this FCE been offered previously?

Course Faculty Sponsor

Hosting Department

FCE Location (include contact information if available)

Please provide contact information for supervisors who will evaluate student performance.

Faculty Evaluating Supervisor

email *

 Faculty Evaluating Supervisor


Administrative Support


Category of FCE    


(multiple clinical departments)
(multiple professionals)

List other professional(s) and or additional discipline(s) here



FCE Discipline

FCE Discipline

FCE Discipline

FCE Discipline

AY 2013-2015 Course Date(s) - Select both FEs if this is a 2 week FCE


FE-Special Dates (eg, Spring Break)



Part II Course Description


Brief Course Description (attach further information via email to UMMSFCEprogram@umassmed.edu )


Course Objectives e.g., By the end of this session students should be able to name, explain, perform, demonstrate, describe... (list 3-5 objectives) notePublication via UMMS eScholarship is required for FCEs that include a report or presentation.

 UMMS Core Competencies (check all that apply) Evaluation Type & Criteria (select at least one from each list)

Describe/explain evaluation(s) here

Explain any prerequisites for this Flexible Clinical Experience