Integrative Health Application - UW Family Medicine & Community Health

Section 1

Name *

Please enter your first, middle, and last name.

Pronouns *

Degrees/Titles (Must hold an MD or DO degree to be eligible to apply) *

Email *

Address *

Country

City

State

Zip code

Phone *

Fax Number

Do you have U.S. citizenship? *

Yes

If not, do you have permanent residency (green card)?

Yes

No (If no, you are not eligible for this fellowship. U.S. citizenship or a green card is required.)

When do you hope to start your fellowship?

How do you envision practicing diversity, equity, and inclusion during your time in fellowship and beyond?

Other Area

1. A curriculum vitae which includes:

Educational background from undergraduate training onward
Specialty certifications and activities, including those in complementary medicine modalities
Licensure information
Employment history and military service
Honors and awards
Community service and volunteer work
Publications
Presentations
Hobbies, interests, and what gives your life meaning

2. An essay (1000 words or less), which should provide us with:

A sense of who you are - e.g., interests, passions, a description of what gives your life meaning, and how you are caring for your own health
Your reasons for applying for this fellowship
Your past experiences with Integrative Health or various "complementary and alternative" treatment modalities
How you would like to use this training in your professional life
Any other information you feel would be appropriate to give

3. Three letters of recommendation:

Letters can be either sent by you or emailed directly to Vincent Minichiello (vincent.minichiello@fammed.wisc.edu), Elizabeth Bingman (elizabeth.bingman@fammed.wisc.edu), Denise Hix (denise.hix@fammed.wisc.edu), AND Christina Swords (christina.swords@fammed.wisc.edu).

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