ISD Mentorship Program

Eligibility of Applicants

1. All Applicants must an ISD member at the time of application and throughout the program.
2. Preference in all categories is given to medical dermatology programs.
3. Categories:

   Category 1

   These young Dermatologists/Residents will receive US $1000 per month from the ISD, up to US $2000 for 2 full months. Mentorships for cosmetic procedures and cosmetic surgery will not be given preference. Applicant must be an ISD member for at least two years (or if a resident, ISD member at time of application). Resident-applicants who are 35 years old and below will be given priority. Only 2 awards per country each year.

   Category 2

   Young Dermatologists/Residents suggested by the Mentorship Committee and receiving variable financial support from outside sources. No age limit set.

   Category 3

   Dermatologists/Residents not financially supported. ISD member for at least two years (or if a resident member at time of application). No age limit set.

Applications for 2024 Mentorship Programs are due November 1, 2023. Please complete the form below:

Mentorship Application

Please complete the form below:

Name *

Last Name *

Credentials (MD, PhD, etc)

Gender *

Male

Female

Clear Selection

Date of Birth (Please spell month) *

Address *

City *

State AB AK AL AR AZ BC CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NB NC ND NE NF NH NJ NM NV NY OH OK ON OR PA PE PQ PR RI SC SD SK TN TX UT VA VT WA WI WV WY

Zip/ Postcode

Country * Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island And Mcdonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic Of Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts And Nevis Saint Lucia Saint Pierre And Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia And Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province Of China Tajikistan Tanzania, United Republic Of Thailand Timor-Leste Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis And Futuna Western Sahara Yemen Zambia Zimbabwe

Telephone *

Email *

ISD Member *

Yes

No

Clear Selection

Current Medical Position * Resident Private Academic Other

Position Description *

Do you have a subspecialty? *

Yes

No

Clear Selection

If yes, please describe your specialty

Field(s) of Interest for Mentorship Program. Please limit to top three fields. Note: Programs focused primarily on cosmetic dermatology may not be funded. *
(Maximum characters: 2000)
You have characters left.

Are you willing to participate in a virtual mentorship program should you not be chosen for a face-to-face program? *

Yes

No

Clear Selection

Please indicate any awards, grants, or scholarships that you have received from ISD, including a mentorship program that was not completed. (N/A if not applicable) *

Reason for choosing ISD Mentorship and include anticipated outcome (part of a research project, integration into practice, etc.) *
(Maximum characters: 2000)
You have characters left.

Are you active on any social media platforms? *

Yes

No

Clear Selection

If yes, please indicate which platforms and share your handles.

For a list of available Mentors approved by ISD, click here.

List the names of possible Mentors (up to three) for your program. Please list in order of preference. If you do not have the name of a mentor please review the approved mentor list to expedite your application. Note: Mentors must be ISD members.

Letters of Support

Please upload the letter from your department/training chair (files accepted PDF, WORD).

Please upload your letter of support from your dermatological society (MS Word, PDF files accepted).

Brief Biosketch

Please upload a short biosketch or Curriculum Vitae (CV) *

Please upload a copy of your passport that shows proof of age and photo *

PLEASE NOTE:

This application must be accompanied by a letter of support from your local, regional or
national dermatologic society and a letter from head / training officer of your institution.

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