Since 2006, the FAFP Foundation has presented annual scholarships to outstanding third-year family medicine residents in Florida.* The program is merit based, and scholars are chosen by an FAFP Foundation selection committee. The winner(s) will be awarded $1,000 each at the 2019 Family Medicine Winter Summit, December 6-8, 2019, at The Ritz-Carlton Amelia Island. The FAFP provides one complimentary hotel night and awards are presented at the Annual Business Luncheon Saturday afternoon.

All nominations must include the following information to be eligible for consideration:
  • A completed nomination form via this application
  • Current Curriculum Vitae (attached below):
    • Written for three periods: premedical, medical school and residency. (If there is an interim period between educational levels, include this information at the appropriate interval.)
    • In each section, include academic honors, political/organizational activities, research, extra-curricular activities — sports, music, hobbies and occupational activities.
    • Please include leadership roles.
    • List formal education (high school to current status)
  • A minimum of two letters of recommendation
  • Personal Statement
    • To illustrate your reasons for studying medicine and why you chose family medicine. What distinguishes you from other candidates? Please state briefly why you should receive this award.
    • Please indicate your present intentions as to professional activity upon completion of your family medicine residency (type of practice, further training, faculty position and location). Please limit your personal statement to no more than two (2) pages
  • Evaluation forms (one from Residency Program Director and one from an active member of the FAFP). Click here for a copy of evaluation form.
  • Color 5x7 professional photo (with high quality resolution)
*You must be a third-year resident in an ACGME accredited Florida family medicine residency for the 2019-2020 academic year at the date of application.

The application and supporting documents must be sent together in this application and received at FAFP no later than August 30, 2019.  Questions, please contact Jennifer Young at jyoung@fafp.org or (904) 726-0944.

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* 1. Name of individual completing application (include email address):

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* 2. Resident Nominee Name:

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* 3. Resident AAFP/FAFP Member ID:

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* 4. Current Residency Program:

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* 5. Name of Program Director:

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* 6. Resident Home Address (include address, city, state and zip code):

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* 7. Resident Home Phone Number:

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* 8. Resident Office Address (include address, city, state and zip code):

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* 9. Resident Office Phone Number:

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* 10. Resident Email address:

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* 11. Please upload a copy of the resident's CV for review (limited to 5 pages):

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 12. Resident's Personal Statement:

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* 13. Please upload copies of supporting documentation (minimum of 2 letters, maximum of 5 letters).

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* 14. Please upload Evaluation Form (one from Program Director and one from Active FAFP Member). Click here for copy of form.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 15. Please upload resident professional photograph (color 5x7 photograph)

GIF, JPEG, JPG, PNG file types only.
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