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JDD Thought Leaders of Distinction Awards
CALL FOR NOMINATIONS!
Thank you for taking a moment to make your nominations
for the JDD Thought Leaders of Distinction Awards.
*
1.
Professional Status:
(Required.)
Dermatologist
Dermatology Resident or Fellow
Dermatology Nurse Practitioner
Dermatology Physician Assistant
Physician, Other
Industry Professional
Other
Other (please specify)
2.
How many years of experience do you have?
0-10
11-23
24+
3.
How influential are thought leaders opinions in your decision making?
Extremely influential
Very influential
Somewhat influential
Occasionally influential
Rarely influential
Not influential
4.
Please indicate the top thought leaders in any of the therapeutic areas listed below:
Ex: Dr. John Smith
Acne
Anti-Aging
Atopic Dermatitis
Cutaneous Manifestation
Dermatopathology
Fillers & Injectables
Infectious Diseases
Lasers
Mohs Surgery
Pediatric Dermatology
Psoriasis
Practice Management
Skin Cancer
Skin of Color
Sun Protection
Additional Comments:
5.
Please indicate the top medical associations for any of the therapeutic areas below:
Ex: The Medical Society
Acne
Anti-Aging
Atopic Dermatitis
Cutaneous Manifestation
Dermatopathology
Fillers & Injectables
Infectious Diseases
Lasers
Mohs Surgery
Pediatric Dermatology
Psoriasis
Practice Management
Skin Cancer
Skin of Color
Sun Protection
Additional Comments:
6.
Please select the residency program that has made the most significant contribution to dermatology?
DO Advanced Desert Dermatology
MD Albert Einstein College of Medicine Program
MD Baylor College of Medicine Program
MD Baylor University Medical Center (Dallas) Dermatology Program
MD Boston University Dermatology Residency Program
DO Bostsford General Hospital/Pontiac Osteopathic Hospital Program
MD Brown University Program
MD Case Western Reserve Metrohealth System Dermatology Program
MD Cleveland Clinic Foundation Dermatology Residency Program
MD College of Medicine, Mayo Clinic (Jacksonville) Program
MD College of Medicine, Mayo Clinic (Rochester) Program
MD Dartmouth-Hitchcock Medical Center Dermatology Residency Program
MD Drexel University College of Medicine (MCP Hahnemann) Program
MD Duke University Medical Center Residency Program in Dermatology
MD East Carolina University, Brody School of Medicine
MD Eastern Virginia Medical School Program Department of Dermatology
MD Emory University Dermatology Residency Training Program
MD Geisinger Medical Center Program
DO Genesys Regional Medical Center
MD Harbor-UCLA Medical Center Dermatology Residency Program
MD Henry Ford Medical Center-New Center One
MD Howard University Hospital Dermatology Residency Program
MD Indiana University School of Medicine Program
MD John H. Stroger, Jr. Hospital of Cook County Program
MD Johns Hopkins University Program
MD Kaiser Permanente Los Angeles Dermatology Residency Program
DO LECOM/Alta Dermatology Residency Program
DO Lehigh Valley Dermatology Residency Program
DO Lewis Gale Hospital Montgomery/VCOM
MD Loma Linda University Program
MD Louisiana State University Health Science Center Program
MD Loyola University Program
MD Marshfield Clinic-St. Joseph's Hospital/Dermatology Program
MD Massachusetts General Hospital/Harvard Medical School
MD Mayo Clinic Arizona Dermatology Residency
MD Medical College of Georgia Program
MD Medical College of Wisconsin Affiliated Hospitals Program
MD Medical University of South Carolina Dermatology Program
MD Dermatology-Mount Sinai School of Medicine Program
MD National Capital Consortium Dermatology Program
MD Naval Medical Center San Diego Dermatology Residency Program
DO New North East Regional Medical Center
MD New York Medical College Metropolitan Hospital Center Program
MD New York Presbyterian Hospital (Columbia Campus) Program
MD New York Presbyterian/Weill Cornell Medical College
MD New York University School of Medicine Program
MD Northwestern University Program
DO NSUCOM/N. Broward Hospital District Dermatology Program
DO Oakwood Southshore Medical Center
MD Ohio State University Dermatology Residency Training Program
MD Oklahoma University Health Sciences Center Department of Dermatology
MD Oregon Health & Science University Program
DO OUCOM/O'Bleness Memorial Hospital
DO Palm Beach Centre for Graduate Medical Education-Columbia Hospital
MD Penn State University/Milton S. Hershey Medical Center Program
MD Roger Williams Medical Center, Department of Dermatology & Skin Surgery
MD Rush University Medical Center Program
MD St. Louis University Department of Dermatology Program
MD San Antonio Uniformed Services Health Education Consortium, Dermatology
MD Southern Illinois University Program
DO St. Barnabas Hospital
DO St. John's Episcopal Hospital
DO St. Joseph Mercy Hospital-Livingston
MD St. Luke's-Roosevelt Hospital Center
MD Stanford University School of Medicine
MD State University of New York Downstate Medical Center Program
DO Summa Western Reserve Hospital
DO Sun Coast Hospital/Largo Medical Center
MD SUNYSB/Department of Dermatology Residency Program
MD Texas A&M College of Medicine-Scott and White Program
DO Texas College of Osteopathic Medicine Dermatology Residency Program
MD Texas Tech University Health Sciences Center Program
MD Thomas Jefferson University Program
DO TUCOM/Valley Hospital Medical Center
MD Tufts Medical Center Program
MD Tulane University Program
MD UC Davis Dermatology Program
MD UMDNJ-New Jersey Medical School Program
MD UMDNJ-Robert Wood Johnson Medical School
MD UMDNJ-Robert Wood Johnson Medical School (Camden) Program/
Cooper University Hospital
MD State University of NY at Buffalo
MD University Hospitals Case Medical Center Program
DO University Hospitals Richmond Medical Center
MD University of Alabama Medical Center Dermatology Program
MD University of Arizona College of Medicine Dermatology Residency Program
MD University of Arkansas for Medical Sciences Dermatology Residency Program
MD University of California (San Francisco) Program
MD University of California at Los Angeles Program
MD University of California San Diego Medical Center Program
MD University of California, Irvine Dermatology Program
MD University of Chicago Section of Dermatology Program
MD University of Cincinnati College of Medicine/University Hospital Program
MD University of Colorado Dermatology Residency Program
MD University of Connecticut School of Medicine Program
MD University of Florida Program
MD University of Illinois College of Medicine at Chicago Program
MD University of Iowa Hospitals And Clinics Program
MD University of Kansas Medical Center Program
MD University of Louisville Program
MD University of Maryland Program
MD University of Massachusetts Program
MD University of Miami Miller School of Medicine/Jackson Health System Program
MD University of Michigan Program
MD University of Minnesota Dermatology Program
MD University of Missouri Program
MD University of New Mexico Department of Dermatology Program
MD University of North Carolina Dermatology Residency Program
MD University of Pennsylvania Program
MD University of Pittsburgh Medical Center Medical Education Program
MD University of Puerto Rico Dermatology Residency Program
MD University of Rochester Dermatology Program
MD University of South Florida Program
MD University of Southern California/ LAC+USC Medical Center Program
MD University of Southwestern-Austin Dermatology Residency Program
MD University of Tennessee Program
MD University of Texas at Houston Program
MD University of Texas Health Science Center at San Antonio Program
MD University of Texas Medical Branch Program
MD University of Texas Southwestern Medical School Program
MD University of Utah Department of Dermatology Program
MD University of Vermont College of Medicine
MD University of Virginia Program
MD University of Washington Program
MD University of Wisconsin Program
MD Vanderbilt University Program
MD Virginia Commonwealth University Medical Center Program
MD Wake Forest University School of Medicine Program
MD Washington Hospital Center/Georgetown University
Dermatology Residency Program
MD Washington University/B-JH/SLCH Consortium Program
MD Wayne State University Program
DO Wellington Regional Medical Center
MD West Virginia University Dermatology Residency Program
DO Western University/Pacific Hospital
MD Wright State University Dermatology Residency Program
MD Yale University School of Medicine Dermatology Residency Program
MD Ackerman Academy of Dermatopathology*
Other (please specify)
7.
What company would you nominate for their commitment to:
A Specific Therapeutic Area:
Innovative Research:
Resident Education:
Underserved Communities
*
8.
Your contact details:
(Required.)
Name:
Company:
Address:
Address 2:
City/Town:
State:
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Country:
Email Address:
Phone Number:
Thank you for your participation!