Trainee Council Application

Trainee Council Application Requirements(Required)

Prior to officially applying, all interested trainees are encouraged to discuss the application requirements and time commitment of the position with their program director or faculty mentor. Please check to attest that you have discussed the time requirements with your program director or faculty mentor.

Yes, I have reviewed this with my program director.

Name(Required)

First Last

Institution as of July 2025(Required)

Anticipated Specialty(Required)

Which best describes your status as of July 2025?(Required)

Fellow

Resident

Medical Student

Why do you want to participate in The PERT Trainee Council?(Required)

What ideas or initiatives would you bring to The PERT Trainee Council?(Required)

How would you create a culture that invites a diverse group of trainees?(Required)

Describe any experience you have in leadership positions or with committee service.(Required)

Explain your clinical experience or research interest in VTE.(Required)

Share any experience with PERT at your hospital and/or with The PERT Consortium™.(Required)

Describe any other qualifications or achievements that would be valuable to The Council.(Required)

Who should we contact for your recommendation letter? This should be a program director, mentor, advisor, or similar. Please advise this person to expect an email from The PERT Consortium™.(Required)

Please include Name, Credentials, Title, Email Address

Please Upload Your CV

Max. file size: 200 MB.

Trainee Council Application

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