USA Medical Alumni Mentor Match - Student Form
Thank you for your interest in the USA Medical Alumni Mentor Match Program! Our aim is to pair USA medical students with alumni (residents or attending physicians) based on your specific needs, specialty interest, and preferred communication style. Your responses will help us tailor any potential mentor pairing to your specific needs for residency preparation.

How it works:

  1. Complete this form: Be as specific as possible regarding your interests.

  2. The "Human" Element: Your answers, including your final response (the "Icebreaker"), will be shared with potential mentors to help them get to know you personally.

  3. The Match: Once a mentor is identified, we will introduce you via email to kick off your first meeting.

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Consent Statement: I understand and consent that the information I provide on this form will be shared only with the Office of Student Affairs, the USA Medical Alumni Association, and my assigned mentor(s). *
Required
First Name *
Middle Name
Last Name *
Class Year *
Example: M3, Class of 20XX
Personal Email (NOT your South student email) *
South Student Email *
Cell Phone Number *
Residency Goals & Specific Needs
What is your primary specialty interest?  *
Please select one speciality that best represents your top choice.
What is your secondary specialty interest?  *
If you only have a singular, primary specialty of interest, you may reselect your primary option here.
Top geographic areas/states you are targeting for residency.

Example: Mobile AL, Southeast US, Texas, West Coast

List up to 3 specific residency programs or academic health systems you are interested in exploring. 
Note: While optional, this response helps us to target potential alumni mentor connections (such as "UAB OB/GYN," "Vanderbilt Surgery")
What specific type of help do you need from an alumni mentor RIGHT NOW?
Note: Some of the more time-intensive opportunities may not be readily available, depending on volunteer availability.
Would you be interested in a brief, one-time "MedAsk" call? *
MedAsk is a brief 15-minute phone call with a volunteer alumni mentor to discuss a specific topic - like the merits of a particular program or city.
Mentoring Logistics & Support
How frequently would you like to communicate with your primary mentor? *
Select your preferred methods of communication: *
Required
Do you have any preferences/requests to help us make a personalized match?
Examples: Interest in a mentor who is a parent, in academic vs. private practice, Military career/service, or first-generation medical student status.
IceBreaker Information: Help us introduce you to potential mentors! Please share 3 to 5 sentences that tell your future mentor a bit more about who you are. 
Consider mentioning: your hometown, your undergraduate/graduate school, hobbies or interests outside of medicine, or a "fun fact."
Example: "I’m originally from Mobile, so I’m a sucker for a Mardi Gras parade and anything in or near the water. I went to Auburn for Biomedical Sciences (though I’m happy to mentor with a Tide fan!) before becoming a USA Jaguar. To keep my balance during med school, I’ve recently taken up pickleball and spend as much time as I can adventuring outdoors with my golden retriever."
Thank you for taking the time to complete the USA Medical Alumni Mentor Match survey!
Your USA Medical Alumni Association staff and board members will work with our alumni and the USA Whiddon COM Office of Student Affairs to try to locate a suitable volunteer mentor to reach out to you via your provided contacts and preferred methods of communication. Please note that this process may take some time to pair you with a suitable volunteer. If you have any questions or would like an update your match request, please contact medalum@southalabama.edu.
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