Fellow Application

Thank you for considering the Benacerraf Ultrasound Fellowship. Before filling out the application below, please arrange to have a mentor to work with. GOHO has a list of approved experts and if you would like to choose someone from that list, send an email to joanne@gohofoundation.org and we will send it to you.

If you would like to work with someone not on the list, please have that expert fill out the mentor application form here.

Full Name(Required)

Email(Required)

Program(Required)

Program Director(Required)

Year of Fellowship(Required)

CV(Required)

Max. file size: 2 MB.

Why this experience is important for you and what do you wish to gain from this fellowship? (Max 250 words)(Required)

Goals of Rotation

Anticipated depth and breadth of clinical experience during the rotation. (Max 250 words)(Required)

Are you expecting to physically perform the ultrasound examinations yourself?(Required)

Yes

Research opportunities (if desired). If so, provide a project topic and brief outline. (Max 250 words)(Required)

Letter of support/recommendation from current program(Required)

Max. file size: 2 MB.

Which expert in the field do you hope to study with?(Required)

Field of Interest. (Max 250 words)(Required)

Research projects can be the foundation of or initiated during the fellowship.

How do you envision utilizing your newly acquired ultrasound skills in your future career? (Max 250 words)(Required)

Gottesfeld-Hohler GOHO Memorial Foundation is a qualified 501 (c) (3) tax-exempt organization.

info@gohofoundation.org

Fellow Application

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