南京医科大学留学生申请回国实习声明书

请附医院相关材料。Please attach the basic information of the hospital.

1.本人回国实习的计划已告知我的父母和家人，并得到他们的同意与支持。此决定已充分考虑南京医科大学国际教育学院对于海外实习感染COVID-19风险的提醒。

2.My family members including my parents have been informed that I will complete internship in my own country and I have been provided with their support. Before made this decision, the warning from SIE, NMU has been seriously considered that COVID-19 infection during the internship.

2.本人将按照南京医科大学留学生实习大纲的要求完成实习，实习医院应具备完成大纲要求的硬件和师资要求，并被本国医学会认可。

2.I will strictly abide by every term of the Internship Syllabus in order to complete my internship in the hospital withthe qualified equipments and teachers matching the corresponding requirements in Internship Syllabus. The hospital should be admitted by the local country’s Medical Council.

3.本人承诺将于20___年___月___日和20___年___月___日向学校提交实习情况报告。如预计超过一年未能完成临床实习，将于20___年___月___日前提交延期实习申请。

3.I sincerely pledge that I will submit my internship report to SIE on ______,2021 and_________, 20___. If I am unable to complete the internship within one year, I will apply for an extension of internship BEFORE _________, 20___.

4.本人将确保实习期间与南京医科大学国际教育学院的联系，如未能按期提交相关报告或失联，将自行承担应相应后果。本人已确认是否已全部通过以往课程情况，并已充分考虑可能产生的延期毕业后果。

4. I sincerely pledge that I will keep in touch with SIE during the 1-year internship. I shall be bear any responsibility if I cannot submit the internship report on time or have lost contact with SIE,NMU. I have checked whether have passed all the subjects before, and I have considered all the possibilities may happen, including extension.

备注：如学生自应提交实习报告之日起10日内仍未与学院取得联系，学院将保留进一步追究直至取消该生学籍之权利。

Note: The School of International Education remains the right to cancel students’ enrollment status if someone has lost contact with SIE within 10 days from the scheduled report submission date.

学生签名/Student’s Signature: ________________

日期/Date: __________________

父母签名/Parent’s Signature: _________________

日期/Date: _________________