LGBTQ+ Health Application - UW Family Medicine & Community Health

Applications now open for the 2024-2025 academic year.

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.)

Section 2

Are there any barriers to starting the fellowship on July 1, 2024?

Please list three persons whom we may contact for letters of reference. At least one must be your residency program director, associate program director, or department chair. A separate letter is required from a fellowship director or supervisor for other post-residency role if applicable.

Contact 1

Name/Degree

Email Address

Phone Number

Contact 2

Name/Degree

Email Address

Phone Number

Contact 3

Name/Degree

Email Address

Phone Number

Section 3

Please submit the following to epetty@wisc.edu, william.schwab@fammed.wisc.edu, AND christina.swords@fammed.wisc.edu.

1. A curriculum vitae which includes:

Educational background from undergraduate training onward
Specialty certifications and activities
Licensure information
Employment history and military service
Honors and awards
Community service and volunteer work
Publications
Presentations
Hobbies, interests (optional)

2. Four separate short answer responses in a single document addressing each of the following areas (300-word limit per answer):

Describe why are you interested in pursuing an integrated primary care and public health LGBTQ+ health fellowship at the University of Wisconsin
Briefly describe a meaningful experience(s) you have had related LGBTQ+ health that has helped to prepare you for this fellowship, highlighting the unique skills or knowledge you would bring to the fellowship based on that experience.
Discuss your career goals and plans and how the fellowship would help you achieve those goals.
Describe a general topic idea or a key focus area for a primary care or public health scholarly project designed to optimize health for LGBTQ+ and/or gender diverse patients or populations that you might consider doing during your fellowship. Please include why you think work in this area is relevant and significant. (Please know that if you are selected as a fellow, you will not be required to do this particular project. The goal of this question is to better understand your scholarly interests.)

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