The Association for Surgical Education

Impacting Surgical Education Globally

This is the application for the ASE Surgical Education and Leadership Fellowship (SELF) program, which is a one-year fellowship designed for all ASE members who wish to improve their teaching, education design, and leadership skills in surgical education. If you wish to apply for the research fellowship (SERF) program, visit: https://www.surgicaleducation.com/surgical-education-research-fellowship-overview/

SELF Application

Application Form

Course Fee: $2500.00 plus cost of travel(if applicable) to SELF sessions. The deadline for applications is January 12, 2025. Letters of notification regarding course acceptance will be sent by February 3, 2025.

Contact Information

Name(Required)
Institution Address(Required)
Please check one:(Required)

Please describe your gender identity:
Please list the ethnicity(ies) you most identify with:

* Note: The gender and ethnicity questions are asked to help make a diverse and inclusive fellow cohort.

Supporting Documents

Please merge all files in to ONE pdf and upload as a single document. The following must accompany your application:

1. A one to two page statement of interest in medical education, which includes:
Current activities/responsibilities in medical education
Current and/or near future leadership roles
Specific areas of teaching performance, education design, or assessment you wish to improve

2. Letter of support from Department Chair or Program Director agreeing to commit to fund the cost of fellowship participation and allow time off for travel to SELF sessions ($2500 tuition plus costs incurred for travel and lodging at the required seminars).
3. A current copy of your curriculum vitae.
Accepted file types: pdf, Max. file size: 512 MB.
Please check this box to agree to the Course Fee of $2500.00 as well as travel to SELF workshops (if applicable).(Required)