OMSBF: Named Bursary Application Form

Important Reminders

  • Please have the following required documents before starting the online application:

    • Your OMA Number and Password. Please note your OMA number must be active to successfully complete the application form and upload the required documents.
    • Cover letter (1-page, max 500 words), outlining all OMSBF bursaries you are applying for, detailing how you meet the bursary criteria. Include details about your journey to medical school and your accomplishments.
    • Signed Proof of Enrollment from your University
    • Signed Academic Standing Form (required for select bursaries as noted in bursary descriptions).
    • Registered as a student member with the OMA. If not, please register now (membership are renewed annually and must be current in order to submit the application)
  • Applications without a cover letter otherwise incomplete will not be considered.

Bursary Frequently Asked Questions

A: Personal Information

  • Given Name(s):
  • Surname:
  • Title:
  • OMA Number
  • Mailing Address:
  • City:
  • Province:
  • Postal Code:
  • Phone Number:
  • Email Address

I am a current or former resident and/or high school graduate of:

  • Burlington
  • District 4
  • Durham District
  • Manitoba
  • Nipissing District
  • Northeastern Ontario
  • Northern Ontario
  • Ottawa
  • Ottawa Valley
  • Sault Ste. Marie
  • Other
  • Current University:
  • Year:
  • Campus Location (specify city):

Please list any undergraduate or graduate programs you completed before entering medical school.
For each program please provide (program, number of years, degree)

Program Name Number of Years Degree

B: Bursary Details

I am applying for the following named bursaries (Please review individual bursary descriptions for criteria details)

  • Burlington Medical Student Bursary
  • District Four - Physicians Care Bursary
  • Doctors of Toronto Bursary Fund
  • Dr. Adam Linton Medical Student Bursary
  • Dr. Arlene MacIntyre Medical Student Bursary
  • Dr. Christina Hill / Academy of Medicine Ottawa Medical Student Bursary
  • Dr. Gilbert Hopson Medical Student Bursary
  • Dr. Gordon Jasey Medical Student Bursary
  • Dr. Richard Boyd Medical Student Bursary
  • Dr. Ronald Twiddy Medical Student Bursary
  • Dr. Stephen J. Kosar Memorial Bursary
  • John & Margaret Walley Medical Student Bursary
  • Kitchener-Waterloo Academy of Medicine Medical Student Bursary
  • OMA District 11 and BPAO Medical Student Award
  • Pauline Yee Harrison Medical Student Bursary
  • Sun Life Financial Medical Student Bursary
  • The Essex County Medical Society Student Bursary
  • The Liam Medical Student Bursary in Honour of Dr. Walter J. Cassidy

  • The following bursaries will be awarded at the discretion of the OMF Review Committee to a student who has applied for and met the criteria for one or more Named Bursaries (listed above) but was not otherwise selected

    • Dr. Csaba Oliver Vargha Medical Student Bursary
    • Dr. Martyn Roberts Medical Student Bursary
    • Meta M. Sawyer Bursary Fund

C: Financial Statement (For the current academic year)

1. Income (Annual - Current Academic Year)

Will you be working during the academic year? Yes | No
Estimated earnings for the academic year $
Did you work during this past summer? Yes | No
Total earnings from summer employment $
Interest/Dividend Income $
Rental/Investment Income $
Other Income $

Total Income $
(If you did not work during the summer, please provide a brief explanation)

2. Expenses (Annual - Current Academic Year)

Tuition and Compulsory Fees $
Living Expenses
Living Expense Total $
Debt Repayments (do not include mortgage)
Debt Repayment Total $
Other Expenses $
Please Specify

Total Expenses $

Net Income = Income - Expenses $

3. Other Resources (Current Academic Year)

Parental contribution
Spousal contribution
Awards/ Bursaries/ Scholarships/ Grants $
University of Toronto Financial Aid (UTAPS) $
Other $

Total Other Resources $

4. Assets

Do you own a car? Yes | No
Estimated value of vehicle? $
Year
Savings/ Chequing Accounts $
RESP $
RRSP $
Investments $
Trust Fund $
Property $
Other $
Please Specify

Total Assets $

5. Liabilities

Are you currently eligible for OSAP? Yes | No
Total amount of OSAP loans received to date $
OSAP loan received for current academic year $
Other repayable government loans/assistance $
Please Specify
Line of Credit Loan $
Personal Loans $
Mortgage $
Credit Card Balance $
Other Liabilities $
Please Specify

Total Liabilities $
Net Worth = Assets - Liabilities $

Do you currently reside:

  • With Parents
  • Spouse/Partner
  • Shared Accommodation
  • Alone

Do you:

  • Own
  • Rent
  • Pay Room & Board
  • N/A

Privacy Statement

The Ontario Medical Student Bursary Fund (hereafter the OMSBF) a program of the Ontario Medical Foundation (OMF) is committed to respecting the privacy rights of individuals, including safeguarding the confidentiality of information provided. Your information will only be shared in accordance with this policy as set out below.

Submission of your application constitutes your consent to the collection, use, storage, and disclosure of your personal information by OMF. Personal information provided on the application form and the supporting documents is collected for the purpose of administering the Named Bursary Program.

If you are chosen to receive a bursary, you may have your information used for the following purposes: to communicate with you to collect testimonials for promotional material, to promote the program on social media, to invite you to events related to your program, for statistical purposes, or to solicit your support at a later date.

Your name and the name of your school and award may be shared:

  • With staff employed with the Ontario Medical Foundation
  • With sponsors of the named bursary
  • On social media or in other promotional materials

Final Notes and Reminders

  • Please ensure you include all attachments with your application including:

    • A 1-page cover letter that lists all of the OMSBF bursaries you are applying for, and details of your journey to Medical School and accomplishments.
    • Signed Proof of Enrollment from your University
    • Signed Academic Standing Form required for select bursaries (see individual bursary descriptions)
  • Applications without a cover letter otherwise incomplete will not be considered for a bursary.

Please do not click Submit button more than once.

After clicking Submit, you will be directed to a file upload page to attach your supporting documents to your application. This page is time sensitive so please have all supporting documents ready to attach before clicking submit.

Thank you for applying!