Faculty Mentor of the Year

USU AOA Faculty Mentor of the Year

Thank you for taking the time to recognize the excellence of a faculty member in our military health system. This award with recognize one outstanding attending physician directly involved in mentoring that may encompass one of more of the following categories: medical students, residents, and/or faculty. Selection for this award will be evaluated based on contributions and impacts in mentoring and those candidates continuing to exemplify the AOA ideals of scholarship, professionalism, leadership and service.

Nominations should be made by the protege(s) of the mentor being nominated or can be made by a program director or department chair with input from the protege(s) being mentored. Nominees do not need to USUHS graduates or existing AOA members, and can have a M.D. or D.O. degree. To nominate an applicant, submit a letter no more than 1 page highlighting the exceptional contributions to mentoring made by the nominee and other outstanding attributes in line with the values of AOA. Submissions of a nominee’s CV will not be necessary or considered during award evaluation.

Please return nominations by 11 April 2022. The awards committee, chaired by an AOA Faculty chapter member, will evaluate the applications and selection and announcement of the award recipient will be made by mid-to-late April. The award recipient will be invited to attend the USU AOA Chapter Annual Banquet in mid-May if they are able to attend. We thank you very much for your time and look forward to recognizing outstanding achievements in mentoring.

Please follow all directions carefully, and be advised that there is no save feature on this form, so we suggest copying and pasting your letter from a saved document.

Honor Statement

I hereby affirm that all of the information I am going to report in this form is truthful to the best of my knowledge, and that I am eligible to nominate by the guidelines stated above.

Agree

Your Information

Your Name

First Name

Last Name

Your Institutional Email Address

Please use your verifiable professional email, such as one ending in ".mil" or ".edu" so that we can confirm who you are and your eligibility to nominate.

Your AOA Membership Number

If you are not a program director or department chair, you must provide an AOA Membership Number to verify your eligibility to nominate.

Your Current Position and Where You Are Stationed

Nominee Information

Nominee's Name

First Name

Last Name

Nominee's Institutional Email

This is how we will contact the nominee to complete their application

Nominee's Phone Number

This will be our backup means of contacting the nominee. Please use numbers only, no punctuation or spaces.

(###)

###

####

Where is the nominee currently stationed?

This is important to verify the applicant's eligibility to be nominated.

Nominee's Medical Specialty

Please let us know the field in which the nominee works.

Letter of Recommendation

Please copy and paste your letter of recommendation here, detailing your reasons for nominating this candidate. Application packages are evaluated based on five areas: scholarship (i.e. academic achievement/research), leadership, service, professionalism, and teaching/mentoring.

Confidentiality

We do not inform candidates of the source of their nomination as a matter of course, but if you would like us to ensure that your nomination is kept anonymous, please select "yes."