2024 Mentorship Program EI App Early to Mid-Career Investigator Application Welcome to the 2024-2025 PeDRA Mentorship Program. This year, PeDRA will accept 15 early to mid-career investigators for a 1:1 mentorship match. Please submit your application by 11:59PM PT, Thursday, August 15, 2024 to be considered. Late applications will not be accepted. If you have questions about the program or the application, please email PeDRA's Associate Director of Education, Jenn Dawson. Contact Details First Name Last Name Credentials Email Institution Position/Title In what year did you complete your training?Please select... 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Which category best describes you:Less than 2 years out of trainingBetween 2 and 7 years out of trainingBetween 7-11 years out of trainingMore than 11 years out of training The 2024-2025 PeDRA Mentorship Program has two options for mentees to select from. Mentees may apply for the traditional PeDRA mentorship option of 1:1 pairing. In the traditional program, mentors and mentees have the flexibility to discuss a variety of topics. A mentee may apply to be a part of a small research-intensive group (3 mentees maximum) focused strictly on one of the following disease areas: Epidermolysis Bullosa (EB) and Hidradenitis Suppurativa (HS). Are you interested in applying for one of the research-intensive groups?Yes, Epidermolysis BullosaYes, Hidradenitis SuppurativaNo, I would like to have a traditional 1:1 mentor Please tell us why you would like to be considered as a mentee for the research-intensive mentorship track? 250 word maximum What type of research are you interested in and/or currently performing? Check all that apply. Basic ScienceClinicalEpidemiologyIndustry sponsored researchQuality ImprovementTranslationalOther Please specify. Please select the top four (4) focused study groups that are of the most interest to you. Acne & Hidradenitis Suppurativa Atopic Dermatitis & Psoriasis Birthmarks Connective Tissue & Autoinflammatory Disorders Drugs & Bugs Education Genetic Skin Disorders (includes Down syndrome) Hair Disorders Neonatal Skin Care Skin of Color & Pigmentary Disorders Skin Tumors & Reactions to Cancer Therapies (STARC) Cross-Cutting Please select the top four (4) skills that are of most interest to you. 360 leadership Academic promotion Conducting basic science research Conduction translational research Developing a niche Grant writing Manuscript peer review Negotiation/conflict resolution Networking SMART goal setting Statistics Study design/execution Work/life balance Working with industry Other Please specify: Do you plan to attend any of the following conferences in the coming year? Please check all that apply.PeDRA Annual Conference - October 24-26, 2024, Phoenix, AZAmerican Academy of Dermatology - March 7-11, 2025, Orlando, FLSociety for Investigative Dermatology - May 7-10, 2025, San Diego, CASociety for Pediatric Dermatology - July 23-26, 2025, Seattle, WANoneOther(s) Please specify: Were you a mentee in the 2023-2024 PeDRA Mentorship Program?YesNo Please outline the skills you learned while in the 2023-2024 PeDRA Mentorship Program. (250 word maximum) In addition to receiving mentorship during the 2024-2025 term, you have the opportunity to serve as a mentor to a small group of medical students (maximum of 3), one resident, or one clinical fellow. Mentors will receive a small monetary stipend for their support. Please indicate your interest in also serving as a mentor below: (Check all that apply.)Yes, I am willing to mentor a small group of medical studentsYes, I am willing to mentor a residentYes, I am willing to mentor a clinical fellowNo, I do not wish to serve as a mentor at this time Please tell us about your current research projects and/or any projects you have worked on in the past. (250 word maximum) Please use this space to tell us about your future career goals. (250 word maximum) Please tell us why you would like to be considered as a mentee for the 2024-2025 PeDRA Mentorship Program. (250 word maximum) Demographics PeDRA is committed to supporting equity, diversity, and inclusion across all facets of its organization, programs, committees, leadership, and research studies. All data collected is kept safely and only de-identified aggregate data may be shared for strategic purposes. Please specify your gender:FemaleMaleNon-binaryI do not wish to provide this information. With what race(s) do you self-identify? Please select all that apply. American Indian or Alaska Native Asian Black or African American Hispanic or Latinx Middle Eastern or Northern African Native Hawaiian or other Pacific Islander White I do not wish to provide this information. Other Please specify: Please upload a current CV. By checking this box, you agree to meet with your mentor a minimum of three times throughout the mentorship year (October 2024-September 2025) by phone or in-person.Yes, I agree Contact Information
