2026 Resident Leadership Award

Resident Leadership Award Nomination Form

This award is presented to residents in good academic standing who have demonstrated a sustained interest in rural medicine.
Residents, you may either be nominated by preceptors, colleagues, or self-nominate.

For Nominations:

If you are nominating a resident, kindly provide a reflection on the personal impact of their engagement in rural and remote health. Share their experiences in rural residency, whether they involve their electives, participation in health groups dedicated to these regions, involvement in volunteer or community-based projects, or advocacy for rural and remote health initiatives.

For Self-Nominations:

Kindly provide a self-reflection on the personal impact of your engagement in rural and remote health. Share your experiences in rural residency, whether they revolve around your electives, participation in health groups dedicated to these regions, involvement in volunteer or community-based projects, or your advocacy for rural and remote health initiatives.

*If submitting as self-reflection please include a letter of support from a peer, preceptor, or community member.

Tell us a great story and share your experience. We look forward to reading your submission.

Essay Format and Rules:
- One essay per Resident
- Both R1's and R2's are eligible to apply or be nominated.
- Must be a Resident in good academic standing
- Length 500 – 1000 words
- Option to include imagery/art/poetry
- Collate everything into one Word or PDF file
To submit your nomination online, please provide the following information:
Resident's Name*

First NameLast Name
Resident's Email Address*
example@example.com
Resident's Phone Number *
Please enter a valid phone number.
I am:*

The nominatorThe nominee (self-nomination)
Nominator's Name:

First NameLast Name
Nominator's Email Address:
info@example.com
Nominator's Contact Number:
Please enter a valid phone number.
Supporting Documentation

For Nomination by Others:
If you are nominating a resident for this award, please submit an essay detailing the nominee’s achievements, leadership, and contributions to their community. Additionally, provide letter of support from a peer or community member that highlight the nominee's impact in their field.

For Self-Nomination:
If you are applying for this award through self-nomination, please complete the self-reflection essay form. In addition, submit a letter of support from a peer, preceptor, or community member.
Essay Letter (PDF, Word Doc)*

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Letter of Support (PDF, Word Doc)*

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Should be Empty:

Resident Leadership Award Nomination Form

To submit your nomination online, please provide the following information: