National Conference Resident & Student Delegate Application

Family Medicine Foundation of Michigan is seeking applications from MAFP members interested in serving in one of the following roles in 2024:

Michigan student delegate / alternate delegate to the National Congress of Student Members
Michigan resident delegate / alternate delegate to the National Congress of Family Medicine Residents

The Foundation will select one resident delegate, one resident alternate delegate, one student delegate, one student alternate delegate from applications received by Feb. 1.

Each delegate and alternate delegate will receive a Family Medicine Foundation of Michigan scholarship following the conference to cover conference-related expenses (e.g., conference registration, airfare, food, lodging).

RESPONSIBILITIES

Delegates are responsible for:

Attending the conference and all sessions of their respective congress
Casting the Michigan Chapter’s vote in elections for national resident / student officers
Polling colleagues about issues or concerns that could be the basis for resolutions aimed at bringing about change
Participating in writing, debating, and voting on resolutions
Attending the Michigan Reception
Participating in the pre-conference webinar to prepare for serving as a delegate / alternate delegate

Alternate Delegates have the same responsibilities as Delegates, except they do not cast votes in elections.

DELEGATE ELIGIBILITY

Must be an MAFP resident (PGY1, 2, or 3) or student member (M1, 2, 3, or 4) at the time of the conference
Preference will be given to residents and students who have shown previous involvement in MAFP and/or Family Medicine Foundation of Michigan committees and/or initiatives
Are able to attend all sessions of their respective congress, reference committee hearings, and the Michigan Reception. For the full schedule, visit aafp.org/events/national-conference.html.
Required to submit a final report of their conference experience to MAFP

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* 1. At the time of the 2024 National Conference (in summer 2024), I will be a:

Resident member of MAFP

Student member of MAFP

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* 2. I am applying for the following position:

Resident delegate / alternate delegate

Student delegate / alternate delegate

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* 3. Contact Information

First/Last Name, Designation/Certification (if applicable) *

Residency Program / Medical School

Year in school / training (e.g., M1, PGY-2) *

City *

Email Address *

Cell Phone Number *

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* 4. Have you attended the National Conference in the past?

Yes

If yes, please list year(s)

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* 5. Have you applied for an AAFP scholarship to attend National Conference?

Yes

National Conference Resident & Student Delegate Application

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* 1. At the time of the 2024 National Conference (in summer 2024), I will be a:

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* 2. I am applying for the following position:

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* 3. Contact Information

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* 4. Have you attended the National Conference in the past?

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* 5. Have you applied for an AAFP scholarship to attend National Conference?

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* 6. Why are you interested in serving as a Michigan Delegate/Alternate Delegate?

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* 7. Do you plan to stay in Michigan for residency and/or to practice Family Medicine?

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* 8. What qualities, skills and/or expertise do you believe make you the best individual to represent Michigan as a Delegate/Alternate Delegate?

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* 9. Will you be working in the Expo Hall at your residency program's booth?

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* 10. How do you stay informed of the issues and concerns facing the specialty of Family Medicine?

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* 11. Is there any additional information or other comments you would like to share?