WES Mentoring Programme 2022 - Mentor application form
The World Endometriosis Society has developed a mentoring programme for its members that aims to support early-career researchers or clinicians working on endometriosis or seeking to develop their expertise in this field.

Its objective is to facilitate individual virtual meetings between mentees (early-career researchers or clinicians) and mentors (mid-career/senior scientists or clinicians) on a regular basis during 12 months – quarterly at least, more often if desired. During these meetings, mentor-mentee pairs discuss the mentee’s career goals, and mentors offer guidance, support, and career advice to their mentee.

This form is intended to record applications from mentors; it collects information that will help us match mentees to mentors based on a number of criteria including mentoring domain of interest, expertise in endometriosis, or language.

The deadline for completing this form is November 1st, 2022.

Thank you in advance for your application!

To help mentees select a mentor, it would be greatly appreciated if you could send us a 1-min video (filming yourself with your phone/Zoom) in which you introduce yourself (name, title, institution, country), your experience in endometriosis and your field of expertise, your experience in mentoring and what brought you to participate in the programme, with a welcoming message for mentees. Only participants of the mentoring programme will have access to mentor videos. You may send the video through WeTransfer at marina.kvaskoff@inserm.fr or by Whatsapp at +33659354559.
Sign in to Google to save your progress. Learn more
Email *
First name *
Last name *
Gender *
Are you a WES member? *
Clinician or researcher? *
What is your current professional title? *
What is the name of your current institution? (please specify University and/or hospital/clinic if applicable) *
In which city and country do you work? *
Number of years of professional experience (including PhD/medical residency) *
What are your specific areas of expertise in endometriosis? *
Please describe your motivation to become a mentor in the WES mentoring programme: *
Have you ever been a mentor? (by mentoring we mean guiding students, fellows, or junior colleagues) *
If you have already been a mentor, how many years of experience do you have in mentoring students, fellows or junior colleagues?
Clear selection
If you have already been a mentor, in which domains have you already provided guidance? *
Required
Please rank the following domains according to your interest for mentoring younger WES members (from 1: most interested to 8: least interested) *
1
2
3
4
5
6
7
8
Academic careers
Careers in the private sector
Day-to-day research work
Day-to-day clinical work
Combining research with clinical work
Career development
Work/life balance
Soft skills
Are there any other domains in which you would like to offer mentoring? *
Considering the commitment to have at least one 1-hour meeting with your mentee every trimester (4 meetings/year), up to how many mentees would you be willing to guide during the 12 months of the programme? *
In which languages would you be comfortable to communicate with your mentee? *
Required
If you have any questions or comments, please feel free to leave them below:
Thank you for your application!
Many thanks for taking the time to fill in this form, and thank you for your interest in the WES Mentoring Programme. If you have any questions, please contact me at marina.kvaskoff@inserm.fr. Otherwise we will get back to you over the course of November-December with information on the start of the programme.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms