Medical Imaging Externship Checklist

Students are responsible for:

Deadline Date

Externship checklist must be completed 30 days prior to the start of the externship. There are no exceptions. If the externship checklist is not completed by the above deadline, the student will not be permitted to attend clinical for that semester.

Externship Checklist
1.___ State authorization approval. For a complete listing contact the Enrollment and Advising office or your program director
2.___ Clinical site obtained
3.___ Clinical Affiliation Agreement complete. (Several hospitals in the Omaha metro area have affiliation agreements with Clarkson College; ask the externship instructor if an agreement is needed)
4.___ Contact information for clinical liaison given to externship instructor. (Contact information should include: name, address and phone number)
5.___ Meet with clinical liaison and complete a schedule for the semester. The minimum number of clinical hours for a three credit hour-externship is 180. More hours may be required per clinical site and externship modality.
6.___ Meet with externship instructor and discuss syllabus, clinical handbook and schedule
7.___ Give externship instructor information for radiation badge distribution if applicable. (Date of birth and social security number)
8.___ Mammography & pediatric externships ONLY: ARRT certification and state license
9.___ CI and VI externship ONLY: ACLS certfification, ARRT certification and state license

By signing below, I attest to the fact that I have not had any previous infractions within the R/MI programs to include but not limited to:

  • Anecdotal report
  • Educational contract
  • Academic Integrity violation
  • Student Code of Conduct violation

Student Signature:  __________________________    Date:  ________________

*If infractions have occurred please set up an meeting with the appropriate externship instructor.

Radiography & Medical Imaging