Application

Thank you for your interest in the Scaife Medical Student Fellowship in Substance Use Disorders! Please complete the information requested on this application form. Application deadline is February 28, 2020.

Question Title

* 1. Please complete the following school information.

Question Title

* 2. Your contact information

Question Title

* 3. How do you identify your gender?

Question Title

* 4. Session Availability

Question Title

* 5. How many years of study have you completed in medical school?

Question Title

* 6. Do you need school credit for this fellowship? (*Check Yes if you would like to take this fellowship for credit. Students are responsible for contacting their medical school to obtain the necessary forms and instructions for receiving credit. Students are also responsible for alerting IRETA about the information your school requires).

Question Title

* 7. With 1 being most important and 9 being least important to you, please rate your level of interest in the following topics. These answers will NOT impact your selection to the program, but will help us get a jump start on scheduling session activities.

ESSAY QUESTIONS - IMPORTANT - The answers to the following essay questions will be scored to determine your acceptance into this program. Please answer each question with details and specific examples. Please note there is a 350-word limit for each essay question.

Question Title

* 8. Why are you interested in the Scaife Fellowship in Substance Use Disorders?

Question Title

* 9. Based on the philosophy of the program, describe how you will apply the knowledge and skills that you learn to your practice. (Note that the program philosophy is described on IRETA's website: https://ireta.org/training/apply-for-the-scaife-medical-student-fellowship-in-substance-use-disorders/)

Question Title

* 10. Substance use and addiction are connected to a number of other issues, both at the individual and community levels. Discuss some of those connections.

Question Title

* 11. Where did you hear about the Scaife program?

Question Title

* 12. Please upload your current Curriculum Vitae

PDF, DOCX, DOC file types only.
Choose File
Thank you for your interest in the Scaife Fellowship!

Application deadline is February 28, 2020. Only complete applications will be considered.

Students will be notified if they are accepted or wait-listed by mid-April.

Questions? Contact Jessica Williams at jessica@ireta.org or call 412-258-8561.

T