AHS Call for Mentors & Mentees

2. I am interested in being a: *This question is required.

• Mentor
• Mentee

3. Please select one: *This question is required.

• Resident
• Fellow
• In practice less than 3 years
• In practice 3-5 years
• In practice 5-10 years
• In practice 10-20 years
• In practice 20+ years

4. Practice Environment *This question is required.

• Academic
• Community
• Private
• Rural
• Hybrid- Write In Please enter an 'other' value for this selection.
• Other - Write In Please enter an 'other' value for this selection.

5. To which gender identity do you most identify? *This question is required.

• Female
• Male
• Transgender Female
• Transgender Male
• Gender Variant/Non-Confirming
• Prefer Not to Answer
• Not Listed Please enter an 'other' value for this selection.

6. Describe your ethnicity: *This question is required.

• Asian or Pacific Islander
• Black or African American
• Hispanic or Latino
• Native American or Alaskan Native
• White or Caucasian
• Multiracial or Biracial
• Prefer Not to Answer
• Not Listed Please enter an 'other' value for this selection.

7. What does your current practice consist of (check all that apply): *This question is required.

• Hernias
• General Surgery (gallbladders, appendix, colon, etc)
• MIS (foregut, solid organ)
• Bariatrics
• Acute Care
• Plastic Surgery
• Other - Write In Please enter an 'other' value for this selection.

8. Please indicate areas of interest in a mentorship relationship: *This question is required.

• Abdominal Wall Fellowship
• Research
• Professional Networking
• Personal Wellness
• Transition to Practice
• Professional Development
• Other - Write In Please enter an 'other' value for this selection.

9. What do you envision would be a reasonable time commitment for a mentorship relationship? *This question is required.

• Once every month
• Once every quarter
• Twice a year
• In person at AHS Meeting
• Other - Write In Please enter an 'other' value for this selection.

Would you be receptive to working with more than one mentee, if needed? *This question is required.

• Yes
• No
• Possibly, but please check with me first if the opportunity arises