AMWA ELEVATE APPLICATION

Certificate of Leadership Fundamentals-1 for Women Physicians
The American Medical Women’s Association invites you to be the diversity women physicians who will take on leadership roles in medicine and healthcare. AMWA ELEVATE will provide competency-focused guidance and insights to give you greater clarity in your career aims and to assure you feel satisfaction as a confident, competent leader.
In submitting an application to participate in AMWA ELEVATE, you commit to a 6-month (April - September 2023) virtually conducted leadership program.

The AMWA ELEVATE Certificate in Leadership Fundamentals-1 focuses on six core leadership competencies.

To participate, you agree to the following time commitment monthly:
- 15-40 minutes to view an assigned prerecorded video or article
- 1.5 hours of virtual, small-group coaching (exploration and active learning)
- 1 hour Mastermind session
- 1 individual professional coaching session
- Submit reflection questions as part of a final project that invites you to explore your growth as a leader
- Option to earn up to 18 coaching-focused, reflective-CME credits
Participants who fulfill the required elements will receive a Certificate of Leadership Fundamentals-I from AMWA.

Course Dates

Saturdays @ 10 am ET April 15, May 13, June 17, July 29, Aug 26, Sept 30
Tuesdays at 11 am or 6:30 pm ET April 11, May 9, June 13 July 25, Aug 22, Sept 26

Program Fee

AMWA members: $3400*; non-members: $4500 [Retail value: $10850]
*If you are not eligible for institutional support and this cost is prohibitive, you may apply for an AMWA Leadership Diversity Grant
Name*

First NameLast Name
Credentials*
Title/Position(s)*
Are you an active AMWA member?*

YesNo, but I plan to joinNot yet, I would like to learn moreNot interested at this time
Employer/Institution*
Specialty*
Years in Practice*
Birthplace (City, State)*
State/City of Current Residency*
Please tell us why you want to participate in this program? How do you know you are ready?*
How do you contribute diversity to this program cohort? (i.e. race, ethnicity, religion, background, gender or sexual orientation, disability, etc.)*
Share 3 adjectives to describe yourself *
What does leadership mean to you?*
How will you contribute to the long-term success of this program?*
Are there any other factors that you consider important to your personal profile that you wish us to consider in assessing your participation.*
Course Date Preference: Select the option(s) that fit your schedule*

Tuesday morningsTuesday eveningsSaturday morningsThese times don't work for me but I am still interested
Email*
example@example.com
Mobile Number*
Please enter a valid phone number.
Attach Current CV*

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Date of Submission*

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Date
How did you learn about AMWA ELEVATE?*

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Do you plan to apply for a Leadership Diversity grant?*

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Certificate of Leadership Fundamentals-1 for Women Physicians