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UTSW APAMSA Mentorship Program:
Application Form for Mentors

The purpose of the mentorship program is to bring UTSW students and physicians in the DFW area together. Physicians can make an impact on young medical students at UTSW and take a role in shaping the future of medicine by mentoring the next generation of doctors.

Mentorship program activities:
Other than interacting with the student mentee, APAMSA will host several activities over the year for participants of the program:

> Connecting Over Lunch
6 physicians and 6 APAMSA members will be randomly selected to enjoy a casual lunch together and converse with each other. It will be held at least twice a year.

> Health Issues Meetings
Interested physicians will have the opportunity to speak at APAMSA-hosted meetings about health-related topics throughout the year. These meetings are typically held during lunch and are open to all of the UTSW community. It will be held at least twice a year.

Physician Membership Requirements:
1. Register with the program: Application Form for Mentors
2. Attend the APAMSA-hosted introductory dinner where they will meet their student match.
3. Be willing to answer questions asked by the students throughout the year, primarily through email, unless the physician prefers other contact methods.
4. Be willing for their mentee to shadow them in their clinical work, if applicable.
5. Be willing to receive emails with invitations to APAMSA activities.
6. Physicians are encouraged to take two mentees, and will not be matched up with any more mentees than what they preferred in their initial agreement.
7. Physician can terminate their participation in the mentorship program at any time.

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