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2022-23 Mentorship Application - Mentors Only

Welcome to the 2022-23 Mentorship Application!

PeDRA is in need of mentors willing to mentor medical student groups as well as resident groups. Please fill out the application below to become a mentor by Friday, September 30.


The mentorship program runs from October 2022 - September 2023, with the option to renew for one additional year if desired.
 
1. Applicant Information *This question is required.
2. Please select your current standing. *This question is required.
Are you a:
Are you a:
What residency program are you in? 
What type of fellow are you? 
3. Are you willing to commit to at least three mentorship check-ins during the year-long program as a requirement of this program? Meetings may take place in person or virtually. *This question is required.
Please indicate which training level you would like to mentor. (Check all that apply).
Space Cell YesNo
Pre-graduate trainees (includes medical students, non-medical students, and research fellows)
Residents
Clinical Fellows
Postdoctoral Fellows
4. What type of research are you interested in and/or currently performing? Check all that apply. *This question is required.
5. Please rank, in order the focused study groups that interest you, starting with your top priority and working your way down the list. Drag and drop your choices in your preferred order. (It is not necessary to rank the entire list - only your preferences). Order the items from the following list. First select an item with the spacebar to show a menu of possible ranking positions. Next, click a ranking position to order it in the ranked list. Note the menu will display more ordering options as you add items to the ranked list.
6. Please rank, in order the skills that are of most interest to you, starting with your top priority and working your way down the list. (Drag and drop your choices in your preferred order. It is not necessary to rank the entire list - only your preferences. These topics are a priority for this mentorship program). Order the items from the following list. First select an item with the spacebar to show a menu of possible ranking positions. Next, click a ranking position to order it in the ranked list. Note the menu will display more ordering options as you add items to the ranked list.