ESGE Mentoring Programme – Mentor Application

ESGE Mentoring Programme - Mentor Application

Comments

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This is a one-year supporting programme directed to GI endoscopist who would like to receive mentorship in their professional career development and/or research and academic development. The programme aims to trigger diversity in our community and will try to help specially the endoscopists who have had difficulties in findings mentors and/or role models in their close community and/or encounter difficulties related to their personal and/or economic or social conditions. The mentorship will help other/younger endoscopists to achieve progress in different fields. .....

1. Personal and contact information

This section collects the personal and contact information required for administration of the mentoring programme, communication with applicants, and mentor–mentee matching.

Salutation(Required)

Name(Required)

First name Surname (family name)

Email(Required)

ESGE Member's ID Number(Required)

Telephone number (with country code)(Required)

e.g.+49 788 778976765

Date of birth(Required)

Gender(Required)

Please indicate your primary language(Required)

Please describe your proficiency in English languge by selecting one of the available options(Required)

What other languages do you speak fluently?(Required)

One language per line. To enter more than one, please use the "+" at the end of a row to add a new line.

Place of residence(Required)

City Country

Time Zone you are usually based in.(Required)

Provide UTC +/- hours (e.g. -5)

Please enter a number from -12 to 13.

2. Medical and professional background

This section provides information about your medical training, specialty, current professional position and clinical practice, helping us assess your professional background and eligibility for the mentor role.

Medical degree(Required)

Other

Please specify(Required)

Your primary medical specialty(Required)

Please specify(Required)

What best describes your current professional position?(Required)

I am currently in specialist medical training (e.g. residency, fellowship or equivalent)

I have completed my specialist medical training

What is your current clinical position? Please select one(Required)

What is your current status regarding endoscopy training?(Required)

How long have you been practicing endoscopy since completing your endoscopy training?(Required)

How frequently do you currently perform endoscopy?(Required)

Do you currently perform interventional/therapeutic endoscopy?(Required)

Yes

3. Endoscopy expertise and clinical activity

This section helps us understand your areas of endoscopic expertise and current procedural activity, which will support appropriate mentor–mentee matching.
This section is particularly important for the matching process, as the information you provide about your endoscopic expertise and clinical activity will be used to identify mentees whose interests and development needs align with your experience. Please consider your responses carefully and indicate the areas in which you have the relevant expertise and experience to provide guidance.

What is your primary area of expertise in endoscopy? (please select one)(Required)

Please specify(Required)

What is your secondary area of expertise in endoscopy? (please select one)(Required)

Please specify(Required)

Approximately how many of the following procedures do you personally perform in an average month?
Please enter the approximate number of procedures you personally perform. If you do not perform a particular procedure, please enter 0.

1. Diagnostic upper GI endoscopy (gastroscopy)(Required)