Exit SEME Application Question Title * 1. Which SEME program(s) are you applying to? (You may select more than one.) Toronto Barrie Thunder Bay Question Title * 2. Do you have any rural emergency medicine experience? Yes No Question Title * 3. Full Name: Question Title * 4. Telephone number(s) including extension if applicable Question Title * 5. Mailing address Question Title * 6. Email address Question Title * 7. How did you hear about the SEME Program? Question Title * 8. Describe your current clinical practice, including location. Question Title * 9. What percentage of your clinical practice is in emergency medicine (based on shifts per month)? Question Title * 10. What specific area of your practice would you like to develop? Question Title * 11. How would you rate your current comfort level with emergency medicine clinical skills? Above average Average Below average Question Title * 12. What are your specific learning objectives and/or goals for the SEME program at this time? Question Title * 13. Applications are welcome in advance, but they won’t be reviewed until after the deadline. Submitting closer to the deadline is preferred. Please indicate which cohort you are applying for: January 8 - April 5, 2026 (BootCamp dates included) Fall 2026 dates TBD Question Title * 14. Please upload your letter of intent and resume or CV below. These can be uploaded online, emailed to seme.dfcm@utoronto.ca, or faxed to 416-586-4719, Attention: SEME Program. Resume or CV - whichever is appropriate PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Resume or CV - whichever is appropriate Question Title * 15. Letter of Intent (maximum of two pages) PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Letter of Intent (maximum of two pages) Two letters of reference are required, with a maximum of three accepted. These can be emailed to seme.dfcm@utoronto.ca, or faxed to 416-586-4719, Attention: SEME Program.If you are currently working in an ED, one letter must be from your current Chief of Emergency or Chief of Staff. If you finished residency within the past two years, one letter must be from your residency program director.Referees may use the optional template below and send it directly to seme.dfcm@utoronto.ca.Reference Letter Template Page1 / 1 100% of survey complete. Done