MILESTONE Advanced IBD Fellows Initiative - Applications for 2026-27 Survey

1.PLEASE TELL US ABOUT YOURSELF:(Required.)

First Name

Last Name

Designation (MD, DO, etc.)

Your permanent email address

Your phone number

Medicine Residency Program

Graduating Year

GI Fellowship Program

Graduating Year

3.AREAS OF INTEREST (Select all that may apply)(Required.)

Clinical Research

IBD Education

Translational Research

Clinical Operations

Other (please specify)

4.PLEASE TELL US YOUR ACADEMIC AND CLINICAL GOALS FOR THE FIRST 3 YEARS POST-GRADUATION (250 word limit) (Required.)

5.PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOUR PROGRAM.(Required.)

Advanced IBD Fellowship Program (enter N/A if not an advanced IBD fellow)

Advanced IBD Fellowship Address (enter N/A if not an advanced IBD fellow)

Address 2

City/Town

State/Province

ZIP/Postal Code

Advanced Fellowship Program Director's Name

Advanced Fellowship Program Director's Email address

6.Please review the 2026-27 MILESTONE calendar of events.

By answering this question with "Agree" you are confirming that you are able to participate in the following:

At least 80% of the virtual sessions
Attend the in-person Career Development Retreat (Oct 22-24, 2026 in Scottsdale, Arizona)
Attend the Intestinal Ultrasonography Hands on Module 1 Training (November 14-15, 2026, in Cleveland, Ohio)

**If you have a conflict of interest for any of the dates provided, please be sure to notify us during the application process. It is the expectation of the program that fellows participate in all activities and exceptions can only be granted on a case by case basis after review by the Steering Committee. (Required.)

Agree

Disagree

Please share any date conflicts here:

7.Please attach your current CV.(Required.)

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8.Please attach your signed MILESTONE Statement of Participation form.(Required.)

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9.Please attach your completed Fellow Stipend form.(Required.)

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