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The Association for Surgical Education

The Association for Surgical Education

Impacting Surgical Education Globally

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SELF Application Form

This is the application for the ASE Surgical Education and Leadership Fellowship (SELF) program, which is a one-year fellowship designed for all ASE members who wish to improve their teaching, education design, and leadership skills in surgical education. If you wish to apply for the research fellowship (SERF) program, visit: https://www.surgicaleducation.com/surgical-education-research-fellowship-overview/

SELF Application

  • Application Form

  • Course Fee: $2500.00 plus cost of travel(if applicable) to SELF sessions. The deadline for applications is January 13, 2023. Letters of notification regarding course acceptance will be sent by February 3, 2023.

    Contact Information

  • Please describe your gender identity:
  • Please list the ethnicity(ies) you most identify with:
  • * Note: The gender and ethnicity questions are asked to help make a diverse and inclusive fellow cohort.

  • Supporting Documents

    Please merge all files in to ONE pdf and upload as a single document. The following must accompany your application:

    1. A one to two page statement of interest in medical education, which includes:
    Current activities/responsibilities in medical education
    Current and/or near future leadership roles
    Specific areas of teaching performance, education design, or assessment you wish to improve


    2. Letter of support from Department Chair or Program Director agreeing to commit to fund the cost of fellowship participation and allow time off for travel to SELF sessions ($2500 tuition plus costs incurred for travel and lodging at the required seminars).
    3. A current copy of your curriculum vitae.
  • Accepted file types: pdf, Max. file size: 512 MB.

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11300 W. Olympic Blvd
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Los Angeles, CA 90064 USA
(310) 215-1226
info@surgicaleducation.com

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Advanced Training in Laparoscopic Suturing

The Official Journal of the Association for Surgical Education

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