Robert Wood Johnson Medical School Alumni Mentorship Survey
The purpose of this form is to create a database to improve mentoring and relationships between medical students and alumni. Please complete the form to identify your interests.
Obstetrics and Gynecology
Physical Medicine & Rehabilitation
Location of current workplace
Would you be willing to
Have students shadow you
Help students with residencies or away rotations at your workplace
Involve students in research
Be featured in a RWJMS newsletter*
Speak at RWJMS events
Connect with students in your city
Host an alumni Event
Have undergraduate students shadow you
To which racial or ethnic group(s) do you most identify?
Hispanic or Latino
Native American or Aleut
Please describe yourself (check all that apply)
Underrepresented minority physician
Female physician in neurosurgery, orthopedics, urology, general surgery or radiology
please check all that apply.
*Those interested in being featured in our newsletter will be contacted shortly for followup.
Interests and Affiliations
Academic Medicine/Medical Education
Basic Science Research
Thank you for taking the time to fill out this form. We hope to use this database to increase mentoring opportunities and relationships with alumni and students. We appreciate all of your help!
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