Committees Application - 2025-2026 Term

SHM Committee Application

Application for 2025-2026
Thank you for your interest in SHM's Committees

Committees play an essential role in SHM’s operations. Joining a Committee allows you to play a bigger role in SHM’s major initiatives, from building resources for the specialty to ensuring that SHM remains at the forefront of hospital medicine. As a Committee Member, you will work with your hospital medicine colleagues from across the country.

Committees meet monthly and are led by the chair and supported by an SHM staff liaison. Meetings are held virtually, with the exception of the first meeting of the term which is held at SHM Converge, SHM’s annual conference. You may review the current charges for all Committees on SHM’s website.

If appointed, Committee members may serve for a maximum of five consecutive terms. Additionally, please be aware that in order to provide more volunteer engagement opportunities, SHM members may not serve on both a Committee and an Advisory Council. If you are appointed to a Committee, you will not be appointed to an Advisory Council should you apply (applications open in October 2024 for the 2025-2026 term)

Thank you for your interest!
Before applying please note all individuals MUST meet the following conditions:
- Be an active member of SHM
- Be prepared to dedicate no less than 2 hours each month to the work of the Committee (this includes participation on conference calls and task forces as assigned)
- Demonstrate a professional background or interest that can enhance the objectives of the Committee
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Thank you, again, for your interest in SHM's Committees. It appears that you are not currently an active member of SHM. Please check your My Account page to join/rejoin/confirm your member status with SHM. If you believe that this is an error, you can call to member support at 800-843-3360 or email at customerservice@hospitalmedicine.org.

Who You Are
Name*

First NameLast Name
Designation(s)*
How long have you been a practicing hospitalist?*
Which of the following best describes your practice setting?*
Institution/Hospital System*
City and State*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com

DEI Information

*Optional
The Society of Hospital Medicine is committed to advancing change that supports our vision for diversity, equity, inclusion and justice in hospital medicine. To move towards where we want to be, we need to understand where we are right now. To help us effectively serve and engage our members, please update your membership profile today. Responses will be kept fully confidential.
Gender
Sexual Orientation
Ethnicity

Committee Application

You may select up to three (3) Committees to apply for
Please complete your Committee application(s) in order of interest.

Your ranking (i.e. first, second, third choice) is important in the decision-making process, as SHM seeks to limit multiple committee appointments in the interest of increased opportunity for members and a greater diversity of perspectives.

To assist with you decision making, please feel free to review the current charges for all Committees on SHM’s website.
First Choice*
Why are you interested in serving on the Committee selected above?*
If you are already serving on this committee you may indicate "I am already serving" and that will suffice
What relevant skills, expertise, or experience do you possess that would add value to the current charge of the Committee selected above?*
If you are already serving on this committee you may indicate "I am already serving" and that will suffice
Second Choice
Why are you interested in serving on the Committee selected above?*
If you are already serving on this committee you may indicate "I am already serving" and that will suffice
What relevant skills, expertise, or experience do you possess that would add value to the current charge of the Committee selected above?*
If you are already serving on this committee you may indicate "I am already serving" and that will suffice
Third Choice
Why are you interested in serving on the Committee selected above?*
If you are already serving on this committee you may indicate "I am already serving" and that will suffice
What relevant skills, expertise, or experience do you possess that would add value to the current charge of the Committee selected above?*
If you are already serving on this committee you may indicate "I am already serving" and that will suffice
Prior Experience and CV
Please list any prior or current Committee and/or volunteer leader experience you have (either through SHM or other organizations/institutions)*
If you are already serving on this committee you may indicate "I am already serving" and that will suffice
CV Upload (optional)

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Conflict of Interest

On appointment to an SHM position, Board Officers, Board Members, Committee Chairs and Members, Editors of SHM publications, Chapter District Leaders, the CEO and Senior Staff, and other elected or appointed leaders shall complete this statement, update it yearly, and have an ongoing duty to update disclosures when there has been a change. Disclosures must be inclusive of yourself and your spouse or domestic partner.
To access the full conflict of interest policy, please review it here.
I acknowledge that SHM has made its COI Policy (listed above) clear and available to me. Furthermore, I agree to report all information in this form accordingly as required:*

YesNo
Relationships Pertinent to SHM:*
Please list any relationships (companies or organizations)that involve holding a position of responsibility or a financial interest(other than a less than 1% interest or $50,000 investment in a publicly traded company), or the receipt of any unusual gifts or favors from an outside entity or person, from which SHM obtains substantial amounts of goods or services, or which provides services that compete with SHM
Financial Interests:*
Please list any companies or organizations in which you have financial interests such as receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g. stocks, stock options or other ownership interest, excluding diversified mutual funds),other financial benefit, or positions of responsibility in entities providing goods or services in support of the practice of hospital medicine (e.g. physician practice management company, billing company, physician placement company, book publisher, medical supply company, malpractice insurance company), other than owning less than a 1% interest in a publicly traded company.

Eligibility Statement
Thank you for your interest in serving on an SHM Committee. Please be aware that in order to maximize member engagement and allow a larger number of members to participate in volunteer leadership, SHM will be limiting members from serving on multiple Committees and/or Advisory Councils.

If you are appointed to a Committee for 2025-2026 (decisions will be provided in December 2024) you will be removed from consideration to be appointed to an Advisory Council for 2025-2026. Conversely, if you are not appointed to a Committee you will be encouraged to apply to serve on an Advisory Council.
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SHM Committee Application

Who You Are

DEI Information

Committee Application

Committee Application

Prior Experience and CV

Conflict of Interest

Eligibility Statement