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Home
Medical Student Mentee Seeking Resident/Fellow Mentor
Basic Information
First Name:
MI:
Last Name:
Gender:
- Select -
Male
Female
Non-binary
Prefer not to answer
Email:
Current Institution:
Country:
Are you an STS member? Mentees are required to be STS members.
Apply here
.
- Select -
Yes
No
What is your Member ID?
Stage of Training
Year in Medical School:
Year in Medical School:
- Select -
MS1
MS2
MS3
MS4
Other…
Please specify:
Anticipated Medical School Graduation Date:
CT Surgery Interests
I am interested in applying to the following CT surgery residency program types. Select all that apply.
Traditional 2-3 year residency program
Integrated 6-year residency program
Combined 4/3 residency program
Undecided
Please indicate your area of interest. Select all that apply.
Adult Cardiac
General Thoracic
Congenital
Undecided
Other
Please specify:
Objectives
Why are you seeking a CT surgery resident/fellow mentor?
In what areas are you seeking mentorship? Select all that apply.
Residency Application Process
Residency Interviews
CT Surgery Rotations
Awards and Scholarships
Research
Clinical Advice
Career Development
Work/Life Balance
Leadership Development
Networking
Issues of Inclusion/Diversity
Wellness
Other…
Enter other…
If you selected more than one area, please rank them by order of importance.
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Residency Application Process
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Wellness
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What do you hope to gain from this mentorship opportunity?
Leave this field blank
