International GME Grant Application Form

International GME Grant Application Form 2017-04-07T20:12:46+00:00

Foreign GME Scholarship Grant

Service Experience in Developing World Health Care

Purpose

The AOCOO-HNS Foundation, Inc. desires its resident members to engage in humanitarian efforts. A humanitarian is one who charitably lays down his life for others in need (i.e. his professional skills, his time, his physical efforts, his spiritual commitment and his financial resources). The AOCOO-HNS Foundation as an organization, supports the AOCOO-HNS residents as individuals who serve mankind’s needs throughout the world in their medical specialty. Our goal is achieved through domestic and international patient care, preventative medicine, and education. As an extension of this desire, Foreign GME Scholarship Grants given to provide an opportunity for residents in ophthalmology and otolaryngology to benevolently give a period of professional service to the people of a developing country.

Duration of Service

A minimum of one week at one site.

Hospital Location

The recipient of this grant is responsible for contact and agreement with officials of the institution and the country in which he or she desires to serve. The AOCOO-HNS Foundation will not assist in providing possibilities for institutions desiring such service. This grant is specifically for service in underserved areas outside the United States. (Rev. 5/29/01)

Financial Aid

Foreign GME Scholarship Grants of $2,000 are available. Other funds for travel, living expenses, etc., must be raised by the recipient. The service must be completed within one calendar year after the grant is awarded. Grant recipients who are unable to make their planned trip within the one year period will be required to return the grant monies, but will be eligible to re-apply for future grants.

Source of Funds

The American Osteopathic Colleges of Ophthalmology and Otolaryngology-Head and Neck Surgery Foundation, Inc. Foreign GME Scholarship Grant Fund.

Eligibility and Deadlines

An application may be received from residents of the AOCOO-HNS who will have completed at least one year of ophthalmology residency training (excluding surgical internship) or two years of otolaryngology residency training (excluding surgical internship) in an accredited program at the time of service. AOCOO-HNS members in post-residency fellowship training programs are also eligible. The applications will be accepted at any time. Selection is competitive. Allow a minimum of 30 days for notification, depending upon the dates of travel.

Method of Application

Please complete the application below.

Allocation of Funds

Funds will be dispersed at the completion of the trip.

Application Form

Before completing this form, please ensure that you have read thoroughly through the AOCOOHNS Foundation Foreign GME Scholarship Grant guidelines. Failure to comply with the stated guidelines or to complete the application may render your application invalid.

Contact Information

College

Medical School

Residency

The residency program must have a current approval status by the Council of Medical Education and AOA.The residents annual logs must be current.



Proposed Itinerary

It is suggested that applicants look for placement one year in advance.

YesNo
By this individualBy head of missionBy head of institution

Do you know any language other than English? If so, indicate below your ability to read, write and speak the language.


NoneGoodFairExcellent

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Program Director from which you received trainingA physician with whom you have workedA non-medical person, such as your pastor, personal friend, etc.

YesNo

Training Statement

All medical experiences while on a trip are intended as supplemental training and do not fulfill training requirements.

"I understand that if my application is accepted and I am given this grant, I will be responsible for my own actions and further agree to release and hold harmless the American Osteopathic Colleges of Ophthalmology and Otolaryngology-Head and Neck Surgery Foundation, Inc., their agents and employees from any damages, liabilities or expenses that might be incurred by reasons of my actions of whatever nature or kind in connection with this award. I agree to fully accept responsibility for all personal insurance I deem necessary during my tenure of service should I receive this grant. I have read the connotations of this grant and agree to abide by them."

Address application and questions to:
Stephanie Whitmer, Administrative Director
AOCOO-HNS Foundation, Inc.
142 E. Ontario Street, Suite 1500
Chicago, Il, 60611
phone 800-455-9404
fax 937-233-5653
e-mail swhitmer@aocoohns.org