2025 Brigid Scanlan Traveling Mentorship Award Application

Brigid Scanlan Traveling Mentorship Award Application
Interested applicants will be required to submit the following application materials through this form:

Application Form
The form is provided below and includes a 250-word maximum essay question response.

Current CV

Letter of Support
A letter of support from the applicant’s medical school official or residency program director permitting the elective.

Letter of Commitment

A letter of commitment from the WTS mentor the applicant wishes to visit

The application submission deadline is December 18, 2024, 11:59 p.m. PDT.

Incomplete applications will not be considered. For questions, please email help@wtsnet.org

Application Form
Name*

PrefixFirst NameLast NameSuffix
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Training Status*

Medical StudentGeneral Surgery ResidentCardiothoracic Surgery ResidentI have completed medical school and I am a postdoctoral candidate in a research or other gap year who is committed to cardiothoracic surgery
Name of Medical School or Residency Program
Please indicate your expected year of graduation from medical school or residency program:
If you responded that you have completed medical school and you are a postdoctoral candidate in a research or other gap year, please explain your situation.
If you are a medical student, please indicate your training level:
If you are a general surgery or cardiothoracic surgery resident, please indicate your PGY:
If you are a cardiothoracic surgery resident, please specify your training pathway.
Letter of support from Program Director or medical school official provided by (Name, title, institution, email address): *
Please indicate your area of interest. Check all that apply.*

Adult Cardiac SurgeryGeneral Thoracic SurgeryCongenital Heart SurgeryTransplant SurgeryAortic SurgeryUndecidedOther
Do you have an opportunity to do a rotation with cardiothoracic surgeons?*

YesNo
By checking this box, I am confirming that I have not received of any of the following scholarship/awards: WTS Carpenter, WTS Thistlethwaite, WTS Colson Scholarship, WTS Scholarship Program, WTS Carpenter Scholarship, STS Looking to the Future Scholarship, AATS Member for a Day Scholarship, and STSA Brooks Scholarship.*

I confirmIf not, please indicate which awards you have received
How did you hear about the Brigid Scanlan Traveling Mentorship Award?*
I am interested in shadowing the following WTS member for the Brigid Scanlan Mentorship Award:*
Have you confirmed your rotation with your proposed mentor?*

YesNo
Essay Question: In 250 words or less, please describe your interest in cardiothoracic surgery and why you feel a period of time with a WTS mentor will enrich your training. (250 word maximum).*

0/250
NOTE: Mentorship rotation is 1-4 weeks
Submit: Current CV, Letter of Support, and Letter of Commitment in PDF Format:*

Cancelof
Please verify that you are human*
All application materials must be submitted by Wednesday, October 30, 2024, 11:59 p.m. Pacific Time. Incomplete applications will not be considered. If you have questions, please email help@wtsnet.org.
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Brigid Scanlan Traveling Mentorship Award Application

Application Form