Purpose: The URGT award is designed to provide skills for eligible surgeons and residents to grow a robotic general thoracic surgical practice, and is supported by Intuitive. Support of up to $10,000 is available for eligible general thoracic surgeons and residents.

Eligibility: American Board of Thoracic Surgery certified (or eligible) thoracic surgeons, and cardiothoracic surgery residents. The applicant must meet at least one of the following descriptors:

1) Underrepresented in medicine minority group as defined by the Association of American Medical Colleges: “Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.”

2) Practices in a rural county as defined by the Federal Office of Rural Health Policy to include all non-metropolitan areas (core population less than 50,000), or a Rural-Urban Commuting Area (RUCA) code of 4 to 10 https://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes.aspx.

3) Practices in a medically underserved area/population as designated by Health Resources and Services Area (HRSA) as having too few primary care providers, high infant mortality, high poverty or a high elderly population. (https://data.hrsa.gov/tools/shortage-area/mua-find), and/or Health Professional Shortage Areas (HPSAs) as designated by HRSA as having shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), population or facilities. (https://data.hrsa.gov/tools/shortage-area/hpsa-find)

Application Materials:
1) Completed application form
2) Applicant’s curriculum vitae
3) Letter of support from the chair/chief of surgery at the applicant’s hospital documenting the following: a) Support and permission to travel for both the surgeon (or resident) and surgical assistant to the on-site Intuitive training, the mentor institution and the STS Workshop on Robotic Thoracic Surgery (if offered during the year of the award; b) Financial support to cover extemporaneous costs, including additional travel-related expenses; c) Financial support to cover any costs incurred if an external proctor is needed, in addition to the one visit by the STS mentor, in order to satisfy the home institution’s privileging requirements for the surgeon awardee to obtain robotic surgery privileges.

Please visit the TSF webpage to learn more details about this award before applying: www.thoracicsurgeryfoundation.org/urgt/

Contact TSF Headquarters at tsf@sts.org or (312) 202-5868, with any questions.

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* 1. Applicant Information:

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* 2. Gender Identity:

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* 3. Race/Ethnicity: (Please check all that apply)

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* 4. Please check the appropriate boxes below to affirm that you meet all eligibility criteria for this award. (Note: Both boxes below must be checked in order to be eligible to apply for this award).

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* 5. Please indicate the number of years you have been practicing cardiothoracic surgery after completion of a cardiothoracic surgery residency or other training.

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* 6. What type of medical environment best describes your current work situation?

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* 7. What type of robotic thoracic surgery are you interested in expanding? Please rank the following in the order of your preference.

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* 8. Please describe why you want to participate in this program, and what do you hope to achieve (100 words max):

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* 9. Please describe your practice setting. What are the challenges, if any, you face within your practice setting (100 words max):

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* 10. Please describe your patient population.  What are the challenges, if any, your patient population faces (100 words max):

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* 11. Mentor: Please indicate if you have a preference for a mentor. However, please note, a preferred mentor can't be guaranteed. You can select multiple mentors, or choose a mentor that is not listed. Use the comment field to explain why you have chosen a designated mentor.

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* 12. Average number of pulmonary lobectomies you perform per year in your practice:

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* 13. Total career (including training) number of pulmonary lobectomies performed:

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* 14. Average number of pulmonary segmentectomies you perform per year in your practice:

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* 15. Total career (including training) number of pulmonary segmentectomies performed:

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* 16. Average number of thymectomy/mediastinal procedures you perform per year in your practice:

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* 17. Total career (including training) number of thymectomy/mediastinal procedures performed:

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* 18. Average number of esophagectomy for cancer you perform per year in your practice:

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* 19. Total career (including training) number of esophagectomy for cancer performed:

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* 20. Average number of benign esophagus procedures (i.e. non-endoscopic, e.g. Nissen, Heller, Paraoesophageal hernia repair, etc.) you perform per year in your practice:

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* 21. Total career (including training) number of benign esophagus procedures performed:

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* 22. Upload CV

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* 23. Upload Letter of support from the chair/chief of surgery at the applicant’s hospital. The letter should indicate:

a) Support and permission to travel for both the surgeon (or resident) and surgical assistant to the on-site Intuitive training, the mentor institution and the STS Workshop on Robotic Thoracic Surgery (if offered during the year of the award).

b) Financial support to cover extemporaneous costs, including additional travel-related expenses.

c) Financial support to cover any costs incurred if an external proctor is needed, in addition to the one visit by the STS mentor, in order to satisfy the home institution’s privileging requirements for the surgeon awardee to obtain robotic surgery privileges

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