CDEM Letter Writer's & Speaker Bureau Sign Up
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CDEM Speaker's Bureau
CDEM Letter Writer's Bureau
Both
Name
*
First Name
Last Name, MD
Pronouns (optional):
Email:
*
example@example.com
Institution/Affiliation:
*
Academic Rank
*
Year (yyyy) since you were promoted to your current academic rank
*
Current Role/Title
*
Areas of Expertise (check all that apply):
Undergraduate Medical Education (UME)
Clerkship Leadership / Administration
Curriculum Design & Innovation
Assessment & Evaluation
Faculty Development
Health Equity, DEI, or Anti-Racism
Simulation-Based Education
Educational Scholarship / Research Methods
Residency Readiness / Transition to Residency
Advising, Mentorship, or Coaching
Wellness / Burnout / Professional Identity Formation
Other
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CDEM Speaker's Bureau Sign-Up
Speaking Topics: Proposed talk titles or topic areas (list up to 5):
Availability & Format Preferences:
In-Person
Virtual
Both
Willingness to travel (if applicable):
Yes
No
Limited
Target Audience(s):
Faculty
Grand Rounds
Leadership
Medical Students
Residents
SAEM Regional Meetings
Other
List Google Scholar Link:
List ORCID Link:
List PubMed Scholar Link:
Optional: CV
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