EM Resident Diversity Group Information Request Form - RSA Diversity & Inclusion Committee
Dear Doctor,

I am writing on behalf of the AAEM Resident and Student Association (AAEM/RSA) Diversity and Inclusion Committee. We are a new committee whose goal is to increase, support, and celebrate diversity within the field of emergency medicine be it in religious beliefs, sexual orientation, gender identity, or ethnicity.

One of our focuses this year is to promote a sense of community for current underrepresented residents and we are seeking your help in this endeavor. Our goal is to create a national database of all emergency medicine resident diversity groups. This can then be used to share resources, encourage collaboration on projects between residency programs, and to discuss issues pertinent to underrepresented in medicine (URiM) residents.

If your residency program has a specific group focused on diversity (for example UCSF Emergency Medicine Diversity Committee that is comprised of residents and faculty interested in issues our underrepresented residents face) we would greatly appreciate it if you could please complete the form below. We will then send one email to see if they are interested in participating and then, with their approval, will add them to the list.

Please feel free to contact us with any questions at 1-800-884-2236 or info@aaemrsa.org. We appreciate your help and are looking forward to hearing back from you.

Best regards,
Cortlyn Brown, MD
AAEM/RSA Diversity and Inclusion Chair
2017-2018
Program Director Full Name *
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Program Director Email *
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Residency Program Name *
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Name of Resident Diversity Group *
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Resident Diversity Group Main Contact Name
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Resident Diversity Group Main Contact Email
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Does your resident diversity group have a Facebook or Twitter page? *
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Please provide any other contact name and information for your resident diversity group here:
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