Mentee Form for Medical Students Interested in Dermatology
This program matches applicants to dermatology residency with dermatology residents. Priority is given to mentees who are underrepresented in medicine and do not have home medical programs.
Please email Surya Veerabagu at sveerabagu@tulane.edu with any questions/suggestions
Questions with an asterisk* must be answered for automated algorithm to match mentor/mentees smoothly
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Email *
First Name *
Last Name *
Email *
Phone Number
What medical school will/did you graduate from? *
Does your medical school have a home dermatology department? *
What is your current status? *
Are you applying to dermatology residency 2022 - 2023 cycle? *
Definitions/Instructions for Following Questions:
UIM: "Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population." This lens currently includes students who identify as African Americans and/or Black, Hispanic/Latino, Native American (American Indians, Alaska Natives, and Native Hawaiians), Pacific Islander, and mainland Puerto Rican. The definition also refers to students who come from disadvantaged backgrounds." (AAMC)

NIH definitions: https://diversity.nih.gov/about-us/population-underrepresented


For the following questions you will be asked about what is MOST important and what is SECOND MOST important to you. Please answer accordingly.
What do you value MOST in a mentor? What would you like guidance most on from your mentor? Remember mentors are current and recently graduated dermatology residents *
What do you value SECOND MOST in a mentor? What would you like guidance on in addition to above from your mentor? Remember mentors are current and recently graduated dermatology residents *
What is your MOST favorite free time activity? *
What is your SECOND MOST favorite free time activity? *
Please answer the following questions
Definitions:

Mentor in dermatology is defined as a mentor who helps their mentee match into dermatology in the near or distant future. This does not include mentors for research projects.
Do you already have a mentor in dermatology (mentor defined above)? This does NOT affect the mentorship match and is for educational purposes only. *
Should there be more formal initiatives to provide medical students interested in dermatology/applying to dermatology residency with mentors in dermatology? *
Outside of the DIGA Mentorship Program, how difficult is it to find a mentor within dermatology? *
Fun fact about you - will be shared in your intro email when you are set up with your mentor:
Is there anything else you would like to share?
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