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Conflict of Interest Disclosure (COI)

Conflict of Interest Disclosure

As course coordinators/clerkship coordinators are preparing your schedules, we would like to ask you to submit any potential conflicts of interest you foresee during your courses, clerkships, and rotations. 

Conflicts of interest important to consider include but are not limited to:

  • You are an immediate family member of the individual.
  • You are in a consensual relationship with the individual.
  • You have a personal financial relationship with the individual.
  • You have received medical or mental healthcare from the individual.
  • Any other issue not included in the above-mentioned situations you may perceive as a conflict (additional information about the nature of the perceived conflict may be requested under this circumstance).

For further details, please see the Conflict of Interest Related to Student Assessment policy.

Follow this link to complete the UGME Conflict of Interest Disclosure. Please provide the full name (first and last) of any faculty member and/or house officer in a department(s) or section(s) with whom you perceive as having a conflict of interest. This information will be forwarded to the Associate Dean of Academic Affairs and his/her designee(such as course coordinators and directors) for consideration and, if necessary, management.


Quick Reference

Phone: 336-716-4271
Fax: 336-716-5812


Mon - Fri: 8:30am - 4:30pm


Bowman Gray Center for Medical Education, 2nd Floor

475 Vine St.  Winston-Salem, NC 27101

Mailing Address:

Office of Student Affairs
Wake Forest Baptist Health
PO Box 573184
Winston Salem, NC 27157

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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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