2025-2026 Mentorship Application – Mentors Δ Name(Required) First Last Credentials Email(Required) Position/Title(Required)Institution(Required)In what year did you complete your training?(Required)ex: 2025Which category best describes you?(Required) Clinical fellow Between 2-7 years out of training Between 7-11 years out of training More than 11 years out of training Which training or career stage would you like to mentor? Check all that apply.(Required)All mentorships for the 2026 PeDRA Mentorship Program will be a 1:1 ratio. Dermatology resident Pediatrics resident Clinical fellow Early investigator less than 2 years out of training Early investigator between 2-7 years out of training Mid-career investigator between 7-11 years out of training Other Other – please specifyWhich research area(s) do you have knowledge in and could mentor others? (Check all that apply).(Required) Basic Science Clinical Epidemiology Quality Improvement Industry Sponsored Research Translational Other Other – please specifyPlease select the top four (4) PeDRA Focused Study Groups in which you are most involved and/or interested.(Required) Acne & Hidradenitis Suppurativa Atopic Dermatitis & Psoriasis Birthmarks (includes infantile and congenital hemangiomas, lasers, and vascular anomalies) Connective Tissue & Autoinflammatory Disorders Drugs & Bugs Education Genetic Skin Disorders (includes disorders of cornification, down syndrome, EB, and NF1) Hair Disorders Neonatal Skin Care Skin of Color & Pigmentary Disorders Skin Tumors and Reactions to Cancer Therapies (STARC) Please identify the skills for which you feel comfortable providing mentorship. Check all that apply.(Required) 360 leadership Conducting basic science research Academic promotion Developing a niche Conducting translational research Grant writing Manuscript peer review Networking Negotiation/conflict resolution Statistics SMART goal setting Study design/execution Work/life balance Working with industry Working with patient advocacy Other Other – please specifyDo you plan to attend any of the following conferences in the coming year? Please check all that apply.(Required) American Academy of Dermatology – March 27-31, 2026, Denver, CO Society for Investigative Dermatology – May 13-16, 2026, Chicago, IL Society for Pediatric Dermatology – July 22-25, 2026, Minneapolis, MN 14th PeDRA Annual Conference – October 15-17, 2026, Alexandria, VI Other Other – please specifyAre you interested in presenting a topic(s) at one of the virtual mentorship mingles?(Required) Yes No What topic(s) would you like to present?Please upload a copy of your CV or NIH-style biosketch. Optional.Max. file size: 2 GB. By checking this box, you agree to meet with your mentee a minimum of three times throughout the mentorship year (January 2026-December 2026) by phone or in-person.(Required) Yes, I agree.
