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ASSOCIATION OF PROFESSORS OF GYNECOLOGY AND OBSTETRICS
Application: Surgical Education Scholars (SES) Program (c/o 2027)
Applications for the Class of 2027 are being accepted now.
Name
*
First
Last
Suffix
I've Been an APGO Member Since
*
(If you intend to join APGO to participate in this class, please type “2025.” Membership is required for the duration of the program.)
Institution
*
Department Name
*
Program
*
University
Community-Based
Military
Other (if other, explain)
Other (Please explain)
Job Title
*
Academic Appointment
*
Professor
Associate Professor
Assistant Professor
Instructor
Other
Other (Please explain)
Ob-Gyn Specialty
*
Generalist
Gyn Onc
MFM
MIGS
Uro Gyn
Other (if other, please explain)
Other (Please explain)
Address
*
Home City
Home State
My Direct Phone Number
*
Email
*
Applicant's Major Educational Responsibilities
*
APGO Faculty Development Seminar 2023
Attended
Presented
APGO Faculty Development Seminar 2024
Attended
Presented
APGO Faculty Development Seminar 2025
Attended
Presented
CREOG & APGO Annual Meeting 2023
Attended
Presented
CREOG & APGO Annual Meeting 2024
Attended
Presented
CREOG & APGO Annual Meeting 2025
Attended/Will Attend
Presented/Will Present
APGO Clerkship Directors' School 101 & 201 Attended/ Will Attend
2023 or earlier
2024
2025
APGO Clerkship Directors' School 301 Attended/ Will Attend
2023 or earlier
2024
2025
I was referred to the APGO SES Program by
Upload Supporting Documents
*
Max. file size: 50 MB.
Please submit one .pdf containing all application documents.
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