Application Form

The Residency Program Director of the Year Award honors one AEGD or GPR program director who actively engages their residents with AGD and demonstrates outstanding leadership, mentorship and a commitment to lifelong learning. The activities shared below will be directly considered for the award.

Applications close Friday, April 17, 2026. More details on the award can be found on the Residency Program Director of the Year Award webpage.

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1. Your name: (Required.)

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2. Your email address: (Required.)

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3. First and last name of the residency program director you’re nominating: (Required.)

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4. Residency program director's email: (Required.)

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5. Name of their residency program (including if it's an AEGD or GPR): (Required.)

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6. Is the residency program director an AGD member? (Required.)

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7. In what ways has this program director engaged their residents with AGD and encouraged involvement? (Required.)

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8. Please describe the leadership qualities and actions that distinguish this nominee as an outstanding residency program director. (Required.)

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9. Please describe how the program director mentors residents and fosters their professional growth. (Required.)

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10. Any additional details you would like to share to help support your award nomination?

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