2018 Physician Interest Form

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* 1. Please enter your contact information.

Name

Organization

Email Address

Please take a moment to fill out and return this form if you are interested in volunteering for community service opportunities, serving on a 2019 SSVMS Committee or remaining a member of a Committee you currently serve on, by November 16, 2018. You may select one or more choices from the list below.

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* 2. Community Service Opportunities (For more information visit: ssvms.org/programs.aspx)

SPIRIT PROGRAM (Sacramento Physicians’ Initiative to Reach out and Teach): Provides volunteer opportunities for specialty physicians. Whether you are interested in providing specialty services in your private office, or surgical services at a partner hospital or surgery center, SPIRIT makes it easy for you to give back to the community by coordinating volunteer schedules and providing case management services.

FUTURE OF MEDICINE: Provides opportunities to share your professional experiences and inspire the next generation of physicians by providing guidance as they pursue a future in medicine. Opportunities include meeting at SSVMS sponsored mentor events or providing guidance on student-led research projects.

MEDICAL MUSEUM DOCENT: Serve as a docent and lead school classes on museum tours that highlight the history of medicine in the Sacramento region. Student visitors range from fourth grade through adults participating in a variety of medical training programs. Tours are scheduled Monday through Friday, and usually run 1.5 hours long.

SPEAKERS BUREAU: Occasionally, SSVMS is asked to provide physician speakers for community organizations, schools or other groups.

If you selected Speakers Bureau, please list the topics on which you would present.

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* 3. SSVMS Committees (For more information visit: ssvms.org/AboutUs/committees.aspx) Meetings are held at SSVMS. Lunch is served for meetings held during the lunch hour. Committee members may participate by conference call.

EDITORIAL: Meets monthly, second Thursday, 12:15 – 1:30 p.m. Responsible for planning, soliciting articles, editing, and publishing the Society's official publication, Sierra Sacramento Valley Medicine.

HISTORICAL: Meets monthly, first Thursday, 12:15 – 1:30 p.m. Maintains SSVMS’ collection of historical artifacts related to the history of medicine. Committee members may serve as docents for school tours of SSVMS' Museum of Medical History.

PUBLIC & ENVIRONMENTAL HEALTH: Meets monthly, third Tuesday, 12:15 – 1:30 p.m. Studies public health and environmental issues that affect the health and well-being of our community.

SCHOLARSHIP & AWARDS: Meets twice a year (September, November), 12:15 – 1:30 p.m. Reviews and makes recommendations for recipients of the SSVMS Medical Student Scholarship Fund. Makes recommendations for special awards such as the Golden Stethoscope, Medical Honor and Medical Community Service Awards.

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* 4. Leadership (For more information visit: ssvms.org/about-us/leadership.aspx)

BOARD OF DIRECTORS: The Sierra Sacramento Valley Medical Society's Board of Directors is committed to advocating for physicians’ rights while building a stronger, more unified healthcare community in El Dorado, Sacramento and Yolo counties. They actively work with physician members, patient groups, local and state elected officials, and our partners in the California Medical Association to advance our common goals.

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* 5. Delegation

DELEGATES AND ALTERNATE-DELEGATES: Delegates and Alternate-Delegates represent their colleagues at the CMA House of Delegates. As a member of the SSVMS Delegation, you will have a voice and participate in deliberations, caucuses and policy determinations of the 11th District.

Thank you!