Thank you for agreeing to act as a mentor in the AMIGO project! AMIGO is a joint effort of the ACR and CARRA to promote the career development of pediatric rheumatologists in the early stages of their careers through mentoring. This intake questionnaire is designed to help AMIGO match you with a mentee at a different institution, based upon complementary needs and expertise, while also considering common interests.

Question Title

* 1. Contact Information:

Question Title

* 2. Gender
The ACR does not discriminate based on age, ethnicity, or gender identity or expression.

Question Title

* 3. In which State, Providence, or Territory is your current primary work address?

Question Title

* 4. With which of the following fellowship programs have you been associated?
*Please include any program in which you have worked over the last 10 years. In order to ensure a fresh perspective for the mentee, we will NOT match you with a mentee from these institutions.

Question Title

* 5. What type of fellowship training did you complete?

Question Title

* 6. In which year did you graduate from fellowship?

Question Title

* 7. What is your academic rank as of July 1, 2021?

Question Title

* 8. In addition to your MD/DO degree, have you done any advanced graduate or postgraduate training, such as a PhD or Masters degree?

Question Title

* 9. What was your degree and in which field of study did you complete it?

Question Title

* 10. Which of the following would you consider to be your primary career path or role, either now or in the past?
*Please check all those that have applied to you at any point during your career.

0 of 14 answered
 

T