International GME Application

Service Experience in Developing World Health Care

Purpose

The AOCOO-HNS 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, International GME funds will be 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 funding 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

International GME funds 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. International GME 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.

International GME Application Form

Before completing this form, please ensure that you have read thoroughly through the AOCOO-HNS Foundation International GME guidelines. Failure to comply with the stated guidelines or to complete the application may render your application invalid. *Funding is restricted to one trip per person.

Contact Information
College
Medical School
Residency
Proposed Itinerary
Foreign Languages (indicate below your ability to read, write and speak languages other than English)
Other Requirements
Application Files

Drop files here or click to upload.

Attach project proposal describing sponsoring organization, site of service, target population, and planned clinical activities. (Microsoft Word or PDF format)

Drop files here or click to upload.

Please attach two (2) passport size photographs of yourself taken within the last six months. These may be used for placement purposes. (JPG, JPEG, GIF, PNG)

Terms and Conditions

I understand that if my application is accepted and I am given these funds, 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 these funds. I have read the connotations of receiving these funds and agree to abide by them.

Address application and questions to:
Ralph McClish
AOCOO-HNS Foundation, Inc.
3200 Carlisle Blvd NE, Ste 225
Albuquerque, NM 87110
phone 855.262.6646
e-mail ralph@aocoohns.org
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