GME Trainee Professional Development Series Learner Information Form

GME Trainee Professional Development Series Learner Information Form
The purpose of this form is to learn more about our Baylor learners and the career paths they are interested in exploring. The information will be used to connect you with recruiters in our vast affiliate network that includes CommonSpirit Health and St. Luke's Health.
Name*

First NameLast Name
Preferred first name
Title*

M.D.D.O.PANPCNMSRNA/CRNAOther
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Home state*
Specialty or practice*

AnesthesiologyEmergency MedicineEndocrinologyFamily MedicineGastroenterologyGeneral SurgeryHematologyHospital MedicineInternal MedicineNeurologyNeurosurgeryOncologyRadiologyUrologyOther
Status*

ResidentChief ResidentFellowStudent
What year will you graduate?*

2024202520262027Other
Will you pursue a fellowship?

YesNoMaybe
What is your expected graduation date from the fellowship?
What state(s) are you targeting for a position after graduation?
What are your cities of interest?
How did you hear about the Professional Development Series?

My ProgramRecruiterSocial MediaReferralOther
What topics would you be interested in learning more about for your professional development? Any feedback is also greatly appreciated.
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