SPAQI Fellowship Application

SPAQI OFFICERS

Jeanna Blitz, MD
President
Duke University School of Medicine

Avital O'Glasser, MD, FACP, FHM
Vice-President
Oregon Health & Science University

Angela Selzer, MD
Secretary
University of Colorado Medicine

Adriana Dana Oprea, MD
Treasurer
Yale University

Kurt J. Pfeifer, MD, FACP, SFHM
Immediate Past-President
Medical College of Wisconsin

SPAQI 2023/2024 Fellowship Application

Name *

Current Position/ Title *

Email Address *

Years in Practice *

Career and Personal Statements:

Please describe your current work environment and professional role. How did your interest in Perioperative Medicine develop? (Max 250 words) *

0/250 words

Why are you interested in the SPAQI Perioperative Medicine Fellowship? What skills do you hope to attain from participating in the fellowship? (Max 250 words) *

0/250 words

Describe a quality improvement or perioperative medicine initiative that you are interested in pursuing. How do you envision the project enhancing the quality of perioperative care at your institution, and what potential the barriers do you foresee? (Max 250 words) *

0/250 words

Please describe your individual characteristics that enable you to be (or become) an effective leader. (Max 250 words) *

0/250 words

Please describe the characteristics of your ideal mentor. (Max 250 words) *

0/250 words

Please upload a current CV *

Please upload a letter of support from your clinical supervisor (i.e. section or division chief, chair, etc.) describing your leadership potential and clinical engagement. *

Please confirm that you are a current member of SPAQI *

I am a current SPAQI member

Questions? Please contact us at info@spaqi.org.