2023-2024 Mentorship Program Application for Students 2023-2024 Mentorship Program Application for Students Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Welcome to the 2023-2024 PeDRA Mentorship Program. This year, PeDRA will accept 45 medical students for a 3:1 mentee-mentor ratio focused on pediatric dermatology research. Please submit your application by 5PM PST, Thursday, September 14, 2023 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.This program does not offer mentoring on how to match into dermatology or pediatrics residencies. The PeDRA Mentorship program is focused on pediatric dermatology research. Contact Details First Name Last Name Credentials Email Institution as of September 1, 2023 Please describe your status as of September 1, 2023Year OneYear TwoYear ThreeYear Four To which type of residency program do you plan to apply? PediatricsDermatologyOther Please specify: Have you applied for residency? Yes, PediatricsYes, DermatologyYes, otherNo Please specify. What will be your primary medical training activity during the 2023-2024 mentorship program period (October 2023-September 2024)? CourseworkClinical rotationsResearch yearOther Please specify: In what year do you expect to complete/graduate medical school? YearPlease select... 2023 2024 2025 2026 2027 2028 2029 2030 Please select the top four (4) skills that are of most interest to you. 360 degree leadership Conducting basic science research Conducting translational research Developing a niche Grant writing How to propose a research idea Manuscript peer review Negotiation/conflict resolution Other SMART Goal setting Study design/execution Working with industry Working with patient advocacy Please specify: What type of research are you interested in and/or currently performing? Check all that apply. Basic ScienceClinicalEpidemiologyQuality ImprovementTranslationalOther Please specify: Please select the top four (4) PeDRA Focused Study Groups that are of the most interest to you. Acne & Hidradenitis Suppurativa Atopic Dermatitis & Psoriasis Birthmarks Connective Tissue & Autoinflammatory Disorders Down Syndrome (Genetics sub-group) Drugs & Bugs Genetic Skin Disorders Hair Disorders Neonatal Skin Care Skin of Color & Pigmentary Disorders Skin Tumors & Reactions to Cancer Therapies (STARC) Cross-Cutting Do you plan to attend any of the following meetings in the coming year? Please check all that apply.PeDRA Annual Conference - November 9-11, 2023, Atlanta, GAAmerican Academy of Dermatology - March 8-12, 2024, San Diego, CASociety for Investigative Dermatology - May 15-18, 2024, Dallas, TXSociety for Pediatric Dermatology - July 11-14, 2024, Toronto, CanadaOther(s) Please specify: Were you a mentee in the 2022-2023 PeDRA Mentorship Program?YesNo Please outline the skills you learned or projects you may have started while in the 2022-2023 PeDRA Mentorship Program. (250 word maximum) Please tell us about your current research projects and/or any projects you have worked on in the past. (250 word maximum) Please tell us why you would like to be considered as a mentee for the 2023-2024 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 Other I do not wish to provide this information. Please specify: Please upload a current CV. By checking this box, you agree to meet with your mentor a minimum of three times with in the program year, either by phone or in-person.Yes, I agree Save my progress and resume later | Resume a previously saved form Contact Information Return to Mentorship program Overview
