AMSPDC’s New Bridge Program Application

AMSPDC Bridge Program Application

A one-month research exposure experience where you go into a laboratory to learn about the processes and questions that the laboratory is pursuing. Gain exposure to other divisional clinical and research meetings; opportunities to participate in lab meetings, other informal research meetings, spend time with the research mentor and other individuals in the labs to see if it’s a good fit for your fellowship training. You will probably be put onto an existing project where you will participate in that project but given the short nature of the experience you would not have time to develop your own initial project and get something off the ground during this one-month experience.

Name:(Required)

First Last

Degree(s):(Required)

Phone:(Required)

Email:(Required)

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Institution:(Required)

If institution is not listed please add it here:

Gender:(Required)

Race:(Required)

Do you identify as a URiM (Under-represented in Medicine)?(Required)

Yes

Do you have a specific laboratory institution you would like to do your preview of a fellowship?(Required)

If yes, where:(Required)

If no, what area of clinical and research training are you interested in?(Required)

If no, what area of the country are you interested in?(Required)

*If you are unsure, we will meet with you to help identify laboratories that would be a good fit.

Personal statement (no more than 350 words) that includes your long term professional goals:(Required)

Two individuals Name/Email/Relationship that can serve as a letter of reference:(Required)