ASA-SAAS Surgical Leaders Fellowship Grant

This award is sponsored by the American Surgical Association and SAAS to provide funds to travel to an ASA member’s home institution for a shadowing experience of being a surgical leader in academic surgery. A SAAS member will be selected every other year, on even years.

The grant funding is $5,000 (SAAS and ASA will each contribute $2500) and will be awarded to the Fellow’s home institution. The home institution and/or Fellow will be responsible for any additional expenses incurred during the Fellowship.

Previous Recipients

2022

Ankush Gosain, MD PhD
UT Memphis

2020

Tracy Wang, MD, MPH
Medical College of Wisconsin, Milwaukee

ASA-SAAS Surgical Leaders Fellowship Grant

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Required Information

Name*

First Last

Email*

Degree*

Title*

Institution*

SAAS Membership Status

ASA Membership Status

Rank of Associate Professor (for a minimum of 3 years) or Professor?*

Board Certification?*

Specific Board of Certification*

Preliminary Fellowship itinerary, including names of confirmed ASA members who have agreed to serve as host leaders?*

The candidate must have had either: educational courses in leadership either from the home institution or a national organization such as the ACS, SUS, AAS, SBAS, AAMC, etc.; or be enrolled in or have completed an MBA program?*

Please list any of the educational courses in leadership either from the home institution or a national organization such as the ACS, SUS, AAS, SBAS, AAMC, etc.; or be enrolled in or have completed an MBA program.

Completed education courses in leadership or MBA or equivalent degree?*

Please list education courses in leadership or MBA or equivalent degree.

Date of Birth*

MM slash DD slash YYYY

Additional Demographic Information

What gender do you identify as?

What race do you primarily identify as?

Do you identify your ethnicity as Hispanic, Latino, or Spanish origin? (categories based on U.S. Census)?

In free text, if asked what your ethnicity is, what would you state?

If you selected, 'More than one', please select from below:

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or Pacific Islander

Hispanic

Other

Prefer not to say

If you answered 'Asian', how would you further identify?

Bangladeshi

Burmese

Cambodian

Chamorro

Chinese

Filipino

Guamanian

Hmong

Indian

Indonesian

Japanese

Korean

Laotian

Malaysian

Native Hawaiian

Nepalese

Other Pacific Islander

Pakistani

Samoan

Sri Lankan

Taiwanese

Thai

Vietnamese

Other

In which country were you born?

If applicable, in which state/province do you currently reside in?

Upload Required Documents

Upload: Personal Statement, maximum 500 words (two double-spaced pages), describing what you want to achieve from the Fellowship experience (e.g., what your career goals are, how you have trained so far, and what you hope to get out of the Fellowship)*

Max. file size: 64 MB.

Statement on your involvement with SAAS, including number of years as a SAAS member, and meetings attended*

Max. file size: 64 MB.

Upload: Current CV*

Max. file size: 64 MB.

Upload: Letter of recommendation from Chair of Surgery*

Max. file size: 64 MB.

The sponsoring society and the ASA shall assume that, in supporting the candidate’s nomination, the Chair guarantees the availability of the candidate to travel for a period of two weeks within the award year and to cover any expenses incurred beyond the Grant.

Upload: Letter of recommendation from SAAS Member*

Max. file size: 64 MB.

Upload: Preliminary Fellowship itinerary, including names of confirmed ASA members who have agreed to serve as host leaders*

Max. file size: 64 MB.

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