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UCLA Head and Neck Surgery Mentored Research Pathway Application

The UCLA Department of Head and Neck Surgery seeks to foster a culture in which issues of justice, equity, diversity, and inclusion underscore our missions in delivering patient care, in training the next generation of leaders in Head and Neck Surgery, and in expanding our academic reach through the pursuit of leading edge research. The UCLA Head and Neck Surgery Mentored Research Pathway provides financial support for two U.S. medical students to conduct full-time research training at UCLA for 9 months. In addition to research and academic achievement, these students must demonstrate experience or interest in fostering equity, diversity, and inclusion in healthcare professions, in advancing efforts to reduce healthcare inequities, or in the pursuit of social justice.

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First and Last Name

Email Address

Medical School

Year in Medical School

Please upload a copy of your CV

Do you self-identify as an individual from a disadvantaged background according to the NIH (https://www.training.nih.gov/new_nih_definition_of_socioeconomic_disadvantage)

Yes
No
Decline to State

Please briefly describe your academic and personal achievements including barriers overcome (300 words or less).

Please describe your previous research experience and research interests (500 words or less).

Please describe your rationale for interest in Otolaryngology - Head and Neck Surgery, a career in academic medicine, and this UCLA training program (300 words or less).

Please describe your previous experience or interest related to fostering diversity, equity, and inclusion in healthcare professions, in reducing healthcare inequities (300 words or less).