SUMMARY - UNC School of Medicine
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OIA Application
Please visit the OIA website for a full description of requirements for the School of Medicine
International Activities Resident Physician Global Health Scholars application.
SUMMARY
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Title: UNC Office of International Activities (OIA) Resident Global Health Scholars Program
Resident Application Deadline: March 1, 2019
Recommendation Letters Deadline: March 15, 2019
Eligibility:UNCH resident physicians and fellows applying to the 2-year UNC Office of International A
Global Health Scholars Program. Trainees must have at least two years of postgraduate training tim
be in good professional standing and have the approval and support of their Program Director to ap
travel for four weeks. Applicants must commit to traveling internationally for four weeks in duration
program timeline and have the ability to meet all program requirements outlined on the OIA Global
Scholars website. Residents are strongly encouraged to apply in January of the PGY1 year to start a
beginning of the subsequent academic year. It is anticipated that completion of requirements will ta
two years.
Scholars are not eligible to receive additional OIA funding through the travel awards offered throug
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biannual scholarships.
Timeline: Decisions announced by April 1 for a program start date of July 1 of the same year.
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Program Contact: Shay Slifko
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CONTACT INFORMATION
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All fields must be filled in. Submitting an application where fields are left blank will rend
application incomplete and will not be considered for the scholarship. Please write "NA"
applicable (i.e. ONYEN).
Name:
First Name
Last Name
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Email:
Primary email
Alternative email
Program
Training Program
Current Training level
Expected program
completion date
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Contact:
Cell Phone:
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Pager:
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Mailing Address:
Street address and
number
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Apt. number
City
State
Zip
Applicant's ONYEN (example: Seslifko)
Applicant's PID (example 9 digit UNC personal Identification: 123456789)
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Country of Citizenship:
Languages Spoken Fluently:
(Hold CTRL to select multiple items)
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International Experience
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Have you been involved in previous global health educational experiences? (i.e. excluding personal travel)
Yes
No
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Please describe your global experience using the following details: Location, organization, duration, and what you did ? Fo
clinical experience, research, community health, any leadership role. If you are unsure of the specific dates, please provide
estimate.
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Description of
Dates Location/Organization
Travel
ex: Mexico City, Mexico/Universidad Nacional A
Research
02/2015-04/2015 de México
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Flexibility and adaptability are necessary when working in an international setting that may be resourced differently than w
accustomed to. Please describe a specific example of a time when you were able to demonstrate flexibility and adaptability
page limit)
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Proposal Material
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Statement of Purpose
Describe your experience, area of interest, and your future career goals in global health. This can include work/volunteer in
experiences, academic coursework, global public health programming or global health-related research. You should explic
how this program will help you achieve your career goals. (1 page limit)
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Global Health Project Proposal
Applicants are to include a brief outline of a potential longitudinal project that the Global Health Scholars funding will suppo
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sections on background, methods for investigation or objectives, a work plan, and outcomes. (1 page limit)
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Departmental Global Health Mentor Name and Contact Information: Include a description of your mentor's involvemen
health and how this aligns with your project proposal (1 page limit)
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Provide your program budget expenses below. Please be as specific as possible.
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Item Description/Explanation Amount (In US D
ex: Airfare RDU to London, UK 1130.00
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Line-Item Budget Total
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Total Funding Requested
Budget Justification (optional)
Please provide any budget comments, justifications, or additional line items that do not fit in the budget matrix.
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Provide information on other funding sources you have received, applied for, or that you plan to apply for in support of you
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Additional Funding Details
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Amount
Organization/Department Description/Additional Information (In US
Dollars)
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Please provide your CV as a PDF file
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Program Information
Total Anticipated Travel Dates (Jan 1 - Jan 25, 2019)
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This application requires two letters of recommendation.
Resident applications must be submitted in the online application by March 1, 2019. Two letters of recommendation are du
2019. Upon submission of this application, an automatic email will be sent directly via email to the references prompting th
complete the letter of recommendation on your behalf. Once submitted, the recommenders will receive an email confirmin
their letter on your behalf and you will receive an email verifying each letter submission. Please do not email the OIA to ve
1. One letter from the Residency or Fellowship Program Director attesting the applicant is in good standing and has pe
enroll in the OIA Global Health Scholars Program including four weeks of international travel permitted over the two
2. A second letter from a designated faculty contact for global health who will either be serving as the international on
supervising physician or principal investigator for your proposed project OR a UNC designated faculty for global hea
committed to supervise/mentor the applicant's longitudinal project. This individual should comment on your suitabil
scholars program, your candidacy for scholarship support, and the training quality of the international site.
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Letter of Recommendation #1. UNCH Residency or Fellowship Program Director
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Full Name:
Email:
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Title
UNC Clinical Department:
Letter of Recommendation #2. UNC Faculty Mentor or Host site mentor directly involved in propose
project
Full Name:
Email:
Title
Employer
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Does your department have a Global Health Track/Pathway/Area of Concentration? If so, how are you involved? (Optional
By my electronic signature below, I authorize the Office of International Activities Scholarship Selection Committee to que
Residency/Fellowship Program Director and UNC Office of Graduate Medical Education about my standing in the program.
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permission for the committee to review all materials pertinent to my application for this scholarship. I also agree to purcha
travel insurance providing repatriation and medical evacuation for a period covering the duration of my travel abroad, to re
UNC Global Travel registry and to complete all other GME paperwork and processes involved for UNC resident physicians t
understand that I must satisfy all other requirements from my training program, parent clinical department, and/or Office
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Medical Education. to write the question text
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