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ASSOCIATION OF PROFESSORS OF GYNECOLOGY AND OBSTETRICS
APGO Surgical Education Scholars (SES) Program Application
Applications for the Class of 2022 are being accepted now.
I've Been an APGO Member Since
(If you intend to join APGO to participate in this class, please type “2020.”)
Address Line 2
State / Province / Region
ZIP / Postal Code
My Direct Phone Number
My Local (Home) Mentor Will Be
Local home mentor will be a resource for scholars at their home institution. They should be well-versed in conducting surgical education or research projects and should be able to help scholars navigate institutional policies/procedures regarding such research. Home mentors should also be available to meet with scholars monthly for progress updates, preferably in person.
Home Mentor Phone Number
Home Mentor Job Title
Home Mentor Email
Is Home Mentor an APGO Member?
Applicant's Major Educational Responsibilities
APGO Faculty Development Seminar 2018
APGO Faculty Development Seminar 2019
APGO Faculty Development Seminar 2020
CREOG & APGO Annual Meeting 2018
CREOG & APGO Annual Meeting 2019
CREOG & APGO Annual Meeting 2020
APGO Clerkship Directors' School 101 & 201 Attended
APGO Clerkship Directors' School 301 Attended
I was referred to the APGO SES Program by
Upload Supporting Documents
Please submit one .pdf containing all application documents.
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