Application

MITE Academy Graduate Scholars Program Application

Graduates of the Academy are active teachers within Maine Medical Center and its educational partners who have completed the Scholar program within the past 3 years. To join the academy as a Graduate Scholar, scholar program alumni must submit a current CV (TUSM format required) and a brief statement of current teaching activities. Application materials can be sent to the Academy at any time. Approval will be made by the executive committee. Graduates have a 5-year renewal term. One Graduate Scholar is elected to the executive committee and serves for 2 years.

Questions? Please contact Kathleen Fairfield, MD, MPH, DrPH or Linda Chaudron, MD, MS.

If you have any technical questions, please contact Melinda Hull, Ed.D. in the Department of Medical Education.

Applicant Information
Name*
Email*
Current Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Professional Information
Current Practice Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Documents
CVs*
Please attach your CV (.pdf, docx, doc).
Accepted file types: pdf, docx, doc, Max. file size: 128 MB.
Statement of Current Teaching Activities*
Please attach your statement(.pdf, docx, doc).
Accepted file types: pdf, docx, doc, Max. file size: 128 MB.
Name
This field is for validation purposes and should be left unchanged.

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MITE Academy Graduate Scholars Program Application

Applicant Information

Professional Information

Documents