Download International Mentee Application

International Mentoring Program
Mentee Application
Overview
The International Mentoring Program focuses on reaching out to Early Career members who reside
outside the United States. The objectives of this program are:
1) to help young physicians, clinicians and scientists develop their professional careers;
2) to promote the highest possible quality of science and practice in cardiovascular and
cerebral vascular disease throughout the world by enriching the scientific base of junior
scientists, clinicians, and physicians;
3) to increase international collaboration in basic and clinical research in cardiovascular
and cerebral vascular disease; and
4) to increase the involvement of physicians, clinicians and scientists from other countries
in the American Heart Association.
Mentor/Mentee Matching
1) Each mentor will be assigned only one mentee at a time.
2) The term of mentorship of an individual mentee will be limited to a maximum of three years.
Participation Requirements:
1) Participants must be active members of the American Heart Association (AHA) at the Early
Career level. To become a member of the AHA please visit the AHA Professional Membership
web page.
2) Participants must permanently reside outside the United States.
3) The program requires the mentor and mentee to meet regularly via telephone, email or other
electronic means to discuss issues and strategies for career development.
4) When feasible, face-to-face individual mentoring at the AHA Scientific Session or specialty
meeting each year.
5) Mentee and mentor must complete a survey 4-months after the match to help AHA determine
how success of the match.
6) Mentee and mentor must complete and submit an annual report on their mentoring
experience.
Applications must include the following:
1)
Completed application form
2)
Up-to-date curriculum vitae including publications
3)
Photograph (jpeg or tiff format)
4)
Email application and required documents to [email protected].
International Mentoring Program
Mentee Application Form
Thank you for your interest in participating in the International Mentoring Program. Please complete the application form
in full, attach a copy of your up-to-date curriculum vitae including publications, a head and shoulder photograph, and
submit to [email protected].
Demographic Information
First Name:
MI:
Last Name:
Degree(s):
Current Position/Title:
How long at the above position (number of years):
Institution:
Mailing Address:
City:
State/Province:
Phone:
Postal Code:
Country:
Fax:
Email:
AHA Affiliation
AHA Membership ID:
Council Affiliation:
Arteriosclerosis, Thrombosis & Vascular Biology
Basic Cardiovascular Sciences
Cardiopulmonary, Critical Care, Perioperative
& Resuscitation
CV Disease in the Young
CV Nursing
CV Radiology & Intervention
CV Surgery and Anesthesia
Clinical Cardiology
Epidemiology & Prevention
Functional Genomics & Translational Biology
High Blood Pressure Research
Kidney in CV Disease
Nutrition, Physical Activity& Metabolism
Peripheral Vascular Disease
Quality Care & Outcomes Research
Stroke
Please describe your clinical experience:
Please describe your research experience:
Research Funding:
Personal Statement about your career goals, and what you hope to accomplish by participating in this program:
Science Interests
To help us match you with an appropriate mentor, please select the areas of your science interests:
ATVB
Angiogenesis and Arteriogenesis
Aortic aneurysm disease
Apolipoproteins - structure and function
Blood coagulation and fibrinolysis
Carotid and peripheral artery disease
Cellular lipid metabolism
Clinical aspects of diabetes, obesity and insulin
resistance
Clinical lipidology - diagnostics and therapeutics
Diabetes, obesity and metabolic disorders
Endothelium, Vascular Tone and Nitric Oxide
Hemostasis, Thrombosis and Fibrinolysis
Immunity and inflammation in vascular biology
and atherosclerosis
Inflammation and Adhesion Molecules
Lipid and Lipoprotein Metabolism: Clinical
Lipids, Lipid Mediators and Lipoprotein
Lipoprotein metabolism and therapeutic targets
Mechanisms of Atherosclerosis
Mechanisms of atherosclerosis
Metabolism: Cellular and Animal
Microcirculation and Cerebral/Coronary/
Peripheral Circulation
Molecular and cellular biology of the vessel wall
Platelet production, signaling, and function
Proliferation, Remodeling, Extracellular Matrix
Redox Signaling and Oxidative Stress
Stem/Progenitor Cells
Vascular cells, inflammation, and thrombosis
Vascular Development, Differentiation, and
Regeneration
Vascular development, differentiation,
regeneration and angiogenesis
BCVS
Apoptosis and Necrosis
Arrhythmias in Experimental Models
Autonomic, Reflex, and Neurohumoral Control
of Circulation
Autophagy, Mitochondria, and Protein
Homeostasis
Cardiac Development
Cardiac Failure and Remodeling
Cardiac Regeneration/Cellular Therapy Experimental
Cellular Electrophysiology and Excitationcontraction coupling
Experimental Myocardial Infarction
Gene Expression/Molecular Biology
Growth Factors, Cytokines, Signal Transduction
Ion Channels and membrane Transporters
Molecular Basis of Hypertrophy
Myocardial Energetics/Intermediary Metabolism
Myocardial Structure and Pathology
Protection of Ischemic Myocardium
Ventricular Function/Mechanics
Cardiac Regeneration, Stem Cells and Tissue
Engineering
Cardiac Reprogramming and iPS Cells
Cell Death Mechanisms, Apoptosis, Necrosis and
Autophagy
Clinical/Translational Research
Contractility and Calcium-Handling
Genetics and Genomics of Cardiovascular
Disease
Growth and Development
Heart Failure Biology
Hypertrophic Signaling Pathways
Mechanisms of Cardiac Aging
Mitochondria and Metabolism
Myocardial Ischemia and Cardioprotection
Myofilament Proteins
Systems Approach to Cardiovascular Biology
Transcriptional and Epigenetic Regulation of
Gene Expression
3CPR
Resuscitation, CPR, Emergency Cardiac Care, Critical Care, AED and Trauma
Pulmonary Hypertension
CVDY
Adult Congenital Heart Disease
Cardiac Development
Pediatric Cardiac Surgery
Pediatric Congenital and Acquired Heart Disease
Pediatric Electrophysiology
Pediatric
Pediatric
Pediatric
Pediatric
Epidemiology and Prevention
Heart Failure
Imaging
Interventional Catheterization
CVN
Physiologic Aspects of Acute and Chronic Care
Prevention, Education, and Disease Management
Psychosocial and Behavioral Aspects
CVRI
Computed Tomography (CT): Coronary Artery
Computed Tomography (CT): Heart (NonCoronary)
Congenital Heart Disease (CT/MRI)
Hybrid Imaging (Heart): SPECT-CT/PET-CT/MRPET)
Magnetic Resonance Imaging (MRI): Heart
Molecular Imaging (Heart/Vasculature)
Nuclear Cardiology (SPECT/PET)
Computed Tomography (CT): Heart (NonCoronary)
Non-Coronary Vascular Imaging (CT/MRI/Other)
Peripheral Vascular Disease: Non-Invasive
Imaging (CT/MRI/Other)
Peripheral Vascular Disease: Intervention
Plaque Imaging (CT/MRI/Other)
Pulmonary Hypertension (CT/MRI/Other)
Whole Body Imaging: Vascular (CT/MRI/Other)
CVSA
Cell, Tissue Engineering, and Gene Based Therapies
Thoracic Aortic Disease
Surgical Revascularization for Ischemic Heart Disease
Myocardial Protection, Intraoperative Management, and Postoperative Critical Care
Surgical Therapy for Valvular Heart Disease
Surgical Treatment of Heart Failure, Transplantation, and Arrhythmias
CLCD
Arrhythmia: Clinical Electrophysiology,
Diagnosis and Risk Stratification
Catheter-Based Coronary Imaging and
Hemodynamics
Catheter-Based Coronary Interventions:
Experimental & New Technology
Catheter-Based Coronary Interventions: Stents –
Clinical Use
Chronic Ischemic Heart Disease
Echocardiography in CAD: Stress and Contrast
Echocardiography in Clinical Syndromes: Valve
disease, Stroke and Arrhythmias
Echocardiography: Emerging Technologies
Echocardiography: Evaluation of Diastolic
Function
Echocardiography: Evaluation of Systolic
Function
Heart Failure: Disease Management, Quality of
Care, and Clinical Outcomes
Heart Failure: Pacing and Other Therapeutic
Devices
Heart Failure: Pathophysiology & Diagnosis
Heart Failure: Pharmacologic Therapy
Medical Aspects End Stage Heart Failure:
Transplantation and Device Therapies
Myocardial (including Hypertrophy)/Pericardial
Disease
Nuclear Cardiology: Isotope Imaging and PET
Percutaneous Non-Coronary Cardiac
Intervention (including Percutaneous Valves)
Pharmacology for ACS and PCI
Stress Testing Exercise and Pharmacologic
Treatment of Arrhythmias: Ablation
Treatment of Arrhythmias: ICD/Pacemaker –
excluding CRT
Treatment of Arrhythmias: Pharmacologic
Unstable Angina, NSTEMI and STEMI: Diagnosis
and Pathophysiology
Unstable Angina, NSTEMI and STEMI: Prognosis
and Pharmacologic Therapy
Valvular Heart Disease: Diagnosis,
Pathophysiology and Medical Management
Ventricular Function/Hemodynamics and
Biomarkers
EPI/PREV
Aging
Arrhythmia
Behavior
Biomarkers
Childhood
Cigarette Smoking
Clinical and Hospital-Based Observational Studies
Clinical Trials
Diabetes/Metabolic Syndrome
Environmental Agents
Epidemiology: Population Studies, Risk Factors,
Biomarkers
Ethnic Health Disparities
Genetic Epidemiology, Genomics and
Pharmacogenomics of Cardiovascular Disease
Genetics
Global Health
Health Services/Outcomes
Heart Failure
Hypertension
Infection/HIV
Lifecourse
Lifestyle Interventions
Lipids & Lipoproteins
Metabolism
Methodology
Molecular epidemiology
Nutrition
Obesity
Peripheral Artery Disease
Pharmacoepidemiology
Physical Activity/Fitness
Pregnancy
Preventive Cardiology
Preventive Interventions: Population and
Clinical Trials
Preventive Interventions: Population and
Clinical Trials
Psychosocial
Quality of Life
Reaching the AHA 2020 Goals: Strategies for
Success
Renal Disease
Sleep
Stroke
Subclinical Disease
Sudden Death
Surveillance
Technology to Promote/ Measure Health Behaviors
Translational Research
Venous Thrombosis
FGTB
Functional Genomics, Transcriptomics, Proteomics and Metabolomics of Cardiovascular Disease
Genetic Epidemiology, Genomics and Pharmacogenomics of Cardiovascular Disease
HBPR
Aging
Aldosterone and Adrenal Mechanisms
Angiotensin Converting Enzymes
Blood Pressure Monitoring
Brain Mechanisms
Cardiac Hypertrophy and Dysfunction
Cardiovascular-Renal Interactions
Cerebrovascular Disease and Stroke
Chronic Kidney Disease
Clinical Studies and Trials
Diabetes
Endothelial Function
Epidemiology
Experimental Models
Gender Differences
Genetics, Gene Therapy and Proteomics
Hormones & Natriuretic Factors
Hypertension: Clinical
Hypertension: Experimental
KCVD
Inflammation, Immunity and Cytokines
Novel Therapeutic Approaches
Nutrition and Hypertension
Obesity and Metabolic Syndrome
Oxidative Stress
Peripheral Neural Mechanisms
Pregnancy and Preeclampsia
Prorenin and (Pro)renin Receptor
Receptors and Signal Transduction
Renal Hemodynamics & Renovascular
Hypertension
Renal Tubular Transport
Renin-Angiotensin System
Resistant Hypertension
Salt and Hypertension
Vascular Biology
Vascular Remodeling and Dysfunction
Vascular Stiffness
Cardiorenal Physiology/Pathophysiology
Receptor Pharmacology
LIFESTYLE AND CARDIOMETABOLIC HEALTH
Arrhythmia/Sudden Death
Behavior/Lifestyle
Biomarkers
Biomarkers/Environmental Agents
Clinical Epidemiology/Outcomes
Diabetes Mellitus and CVD: Prevention and
Management
Drug Safety
Ethnic Health Disparaties
Exercise, Physical Activity and Rehabilitation
Genetics
Heart Failure
Hypertension
Lifecourse
Lipids
Lipids and lipoproteins
Metabolmics
Nutrition
Nutrition in CVD Risk and Prevention
Obesity
Obesity in CVD Risk and Prevention
Peripheral Arterial Disease
Physical Activity/Fitness
Prevention
Psychosocial
Renal Disease
Risk Factors
Stroke
Venous Thrombosis
PVD
Endovascular Therapy
Vascular Medicine (non-coronary): Clinical Science
QCOR
Acute and Chronic Coronary Artery Disease:
Quality Care and Outcomes
Adherence
Appropriateness/Efficiency of Care
Behaviorial/Psychosocial Factors
Cardiac Arrest/CPR
Cardiovascular Registries
Clinical Trials – Main Results and Substudies
Cost Effectiveness Analysis/Economic Assessment
Disparities in Care
Innovations of Care/Health IT/Technology
Assessment
International Research (Studies Outside the US)
Late-Breaking Clinical Trials
Methodology of Outcomes Research
Patient Safety
Pattern of Care Description
Quality Improvement Initiatives – Local Level
Quality Improvement Initiatives –
Regional/National Level
Quality of Care Assessment
Quality of Care, Outcomes Research and Health
Policy
Quality of Life/Functional Status Assessment
Risk Factor Assessment and Treatment
Risk Stratification and Prognosis
Women and Cardiovascular Disease
STROKE
Acute Endovascular Treatment
Acute Neuroimaging
Acute Nonendovascular Treatment
Aneurysm
Basic and Translational Neuroscience of Stroke
Recovery
Cerebrovascular Disease/Stroke (Basic)
Cerebrovascular Disease/Stroke (Clinical)
Cerebrovascular Occlusive Disease
Community/Risk Factors
Diagnosis
Emergency Care/Systems
Experimental Mechanisms and Models
In-Hospital Treatment
Intracerebral Hemorrhage
Multidisciplinary Clinical Rehabilitation
Need Stroke conf categories
Nursing
Outcomes, Quality and Health Services Research
Pediatric Stroke
Preventive Strategies
SAH and Other Neurocritical Management
Vascular Biology in Health and Disease
Vascular Cognitive Impairment
Vascular Malformations