Bassett Fellowship Application

The Foundation for International Education in Neurological Surgery (FIENS)/Bassett Fellowship offers an international traveling fellowship for neurosurgeons who, at the time of their application, are either training in a residency program in a low-or-middle income country or who have completed residency training in a low-or-middle income country within the past five years.

The fellowship will cover the traveling and living expenses for a three-month period to be spent observing the activities of a neurosurgical service that has an established relationship with FIENS. Fellowships will be awarded yearly on the basis of a competitive evaluation by a committee composed of FIENS members. The maximum fellowship stipend is $7,000.

Applications are accepted on a rolling basis with review periods occurring May 1 and November 1 of each year. Applicants will receive notification by the end of May and the end of November.

Your application must include:

A statement defining the purpose of your proposed fellowship that includes a statement of your intention to return to your home country after completion of the fellowship.
A letter of recommendation from your neurosurgical program director or other neurosurgeon with whom you have worked closely with.
A letter of acceptance from the institution where you intend to pursue the fellowship, confirming the description of your planned activities during the period of the award.
Your current curriculum vitae.

Please explain the purpose of your proposed fellowship.*

Please list all grants, fellowships and/or awards that you have received, are in consideration for, or are intending to apply to in addition to this fellowship. **Please note, failure to disclose this information could result in your application being disqualified. *

Name*

FIRST NameLAST Name

E-mail*

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Please include country code

Do you have a phone number registered on WhatsApp?*

YesNo

If you answered yes to the question above, may we contact you via WhatsApp?

YesNo

Please enter your WhatsApp number if it is different than the number you already entered above

Please include country code

Please enter the name of the country you will return to and will be practicing in once you complete your fellowship.*

Is this the first time you have submitted an application for this fellowship?*

YesNo

If you answered 'No' to the previous question, please note what years you have applied. *

Please tell us how you heard about this fellowship

If you enter Other, above, please tell us how you heard about the fellowship

Bassett Fellowship Application

Contact Information

Demographic Information

Statement of Purpose

Letter of Recommendation

Letter of Acceptance

Education/Research/Work Experience

Host/Sponsor Information

Reporting and Requirements