LEAP Mentee Application

WHAT: The Leadership, Engagement, and Academic Pathway Program (LEAP) is a longitudinal development and mentorship program co-sponsored by the SAEM Equity and Inclusion Committee and ADIEM for students interested in careers in academic emergency medicine.

WHO: Current M3s interested in a career in academic emergency medicine from historically marginalized groups and other unique populations including but not limited to individuals with disabilities, sexual or gender minorities, and historically marginalized ethnic and racial groups.

Selected students will receive a 1K stipend, longitudinal group mentoring with academic emergency medicine faculty for the duration of medical school with the potential to extend through residency training and additional opportunities for scholarly activity through SAEM. Mentees will be required to attend the SAEM annual conference each year they participate in the program.

Additional Mentee Requirements:

One yearly ADIEM/E&I committee-sponsored SAEM Pulse article per participant with mentorship collaboration
One yearly ADIEM/E&I committee-sponsored presentation at SAEM annual meeting as a workshop, didactic, innovation, ignite, abstract, OR short presentation at the ADIEM business meeting if not accepted to full SAEM meeting with mentorship/collaboration from an ADIEM/E&I committee faculty member
One indexed publication/2-year period (can be research, educational initiatives, perspective pieces, etc) with mentorship/collaboration from an ADIEM/E&I committee faculty member
Leadership role on ADIEM committee or E&I committee yearly. Mentees will be aided in this by their mentors.

Name*

First NameLast Name

Pronouns*

Email*

example@example.com

Medical School*

Gender Identity*

What is your race and/or ethnicity? Select all that apply.*

Which of the following best describes your sexual orientation?*

Do you identify as having a disability (a physical or mental impairment that substantially limits one or more major life activities)?*

YesNo

How do you describe your disability?*

Please Attach Your CV or Resume*

Please Attach a Letter of Recommendation *

This letter may come from outside emergency medicine faculty.

ADIEM is devoted to promoting equity in healthcare, elimination of healthcare disparities, and the recruitment and retention of individuals from historically marginalized groups. Please describe ways you have demonstrated a commitment to promoting these principles within medicine. *

How do you expect your participation in this experience will aid in your pursuit of a career in academic medicine? *

Please list your areas of interest in EM. Select all that apply.*