FREDERICK A. COLLER SURGICAL SOCIETY

APPLICATION FOR TRAVELING FELLOWSHIP FOR SURGICAL RESIDENTS

 

The intent and spirit of the Coller Traveling Fellowship is to provide resources to defray the costs (partially or entirely) of a clinical experience whereby (through the assistance and connections of your Coller Society member sponsor) you travel to another center and gain clinical experience through, for example, observing multidisciplinary clinics or procedures or interacting with leaders in your field. The stipend is reimbursement of travel expenses up to $2000.

TO THE COUNCIL OF THE FREDERICK A. COLLER SURGICAL SOCIETY

I hereby make application for a Frederick A. Coller Traveling Fellowship.


I SUBMIT THE FOLLOWING DATA CONCERNING MY MEDICAL EDUCATION AND SURGICAL TRAINING


Premedical education

Medical education

Training Following Internship

1. Residency or Fellowship