Banner Image for Standardised Patient Program Application Form

Duke-NUS Standardised Patient Program Application Form

Thank you for your interest in the Duke-NUS Medical School Standardized Patient Programme. Please complete the following form to apply to be part of our program. Standardized Patients are hired as “on-call” part-time workers based on need. In addition to completing this application, please email any acting resume to:

You can find answers to many of the questions prospective applicants ask about the Standardised Patient Programme on the FAQ page.

Personal Information

Contact Details

Please upload a recent passport sized (400 pixel by 512 pixel) photograph of yourself.

This field is required

Your Interest in the SP Program:

3. Some Standardized Patients are needed for physical examinations. Are you comfortable wearing a hospital gown while a student examines you?

Education Background

Proficiency Level

Proficiency Level

Computer literacy

Are you comfortable using a computer and a mouse?

Health Background:

Do you have any illnesses at the moment? (E.g.: Asthma, Diabetes, etc)

Have you had surgery or an accident in the past that left a visible scar?

Employment History

Are you currently employed?

Select a choice

By submitting your details, you represent that your personal data/information as provided are true and accurate and you consent to Duke-NUS/NUS collecting, using and /or disclosing your personal data/information to third parties (including any third party located outside of Singapore) for the purpose of managing and administering your application for the Standardized Patient Program, including contacting you for application review/ interview/ training/ simulation session(s) and having your photographs and videos taken by NUS through Duke-NUS, others on behalf of Duke-NUS/NUS and third parties for use in promotional materials, publications or media including social media and other related purposes.