Selection Criteria

Based on careful review of the applications and accompanying materials, the Gallagher Health Policy Scholar Program of the Public Policy Council will select one (1) scholar for the 2023 program. Applicants will be notified no later than December 9, 2022. Selection will be based on a commitment to, and strong interest in, health policy issues as evidenced by:

• Enthusiasm and relevance of the applicant’s essay
• Strength of recommendations from references
• Commitment and contributions to health policy activities, programs and of the AUA or other relevant medical organizations
• Commitment and achievements in medical and non-medical leadership opportunities
• Community service and volunteer activities relevant to health policy

Commitment

Up to 30 days away from one’s practice or academic appointment during the yearlong program is required. The award recipient must agree to participate fully in all program activities. These include, but are not limited to:

• Attendance at key meetings such as the RUC, CPT, and AMA House Delegate Meetings
• Participation in the Annual Urology Advocacy Summit in February/March 2023
• Participation in the ACS summer course held at Brandeis University in June 2023 (scholar must join ACS, if not already a member)

Notification Process

Letters will be mailed by December 2, 2022 to all applicants regarding their status.

Funding

Thanks to the generosity and commitment of the AUA Board of Directors to this program, a stipend of $15,000 will be provided to the awardee, in addition to having the AUA cover all travel, lodging and legitimate expenses associated with program participation. There will be no out-of-pocket expenses associated with the chosen candidate’s participation in this program.

Contact Information

Juliana Nicolini, Public Policy & Advocacy Coordinator
Phone: 410-689-4075
Email: jnicolini@AUAnet.org

Required Documents

References

Please provide 2 letters of recommendation attesting to your involvement and knowledge in health policy issues.

Essay

Provide a personal statement describing your experience and/or interest in health policy issues of importance to urology and why the Public Policy Council should select you to participate in this program. Expand on how your characteristics and experience have prepared you for this next step in your career and describe your commitment to serving the AUA and the profession in the future with respect to advancement of the urology health policy agenda. Tell us about your health policy related professional interests, AUA interests and experience, how this experience would prepare you to assume key health policy leadership roles on behalf of urology and how you hope to contribute to the advancement of urology’s agenda. Limit your essay to 500 words, typed and double spaced.

Photograph

Provide a recent photograph for publication should you be selected. All photographs must be at least 800x600 pixels and/or a minimum of 1 MB in size.

Curriculum Vitae

Please provide your curriculum vitate (CV) along with an expanded page on personal and professional leadership experiences, volunteerism, advocacy and interests relevant to health policy.

Submission Deadline

Email original completed application and attachments to arrive no later than Friday, October 14, 2022, to the following address: jnicolini@AUAnet.org, or fill out the application form below:

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Enter the information requested below, attach the four listed documents, verify and "sign" where indicated, and click Submit to complete this application.

All form fields with * are required

Personal Data

First Name: *

Middle Name:

Last Name: *

Birth Date (Ex: XX/XX/19XX): *

Email: *

Home Mailing Address

Street: *

City: *

State/Province: *

Country: *

Zip/Postal Code: *

Home Phone: *

Work Mailing Address

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Work Phone: *

Work Fax:

File Attachments

Upload any supporting files below. If you have any problems with submitting your documents, please email jnicolini@AUAnet.org.

Allowed file types: PDF, PNG, JPG, JPEG, GIF, DOCX, DOC

The maximum total file size for all documents should be less than 4MB.Total file size submissions exceeding 4MB may result in an error and delays with processing your application.

(El tamaño máximo de archivo total para todos los documentos debe ser inferior a 4 MB. El total de envíos de archivos que superen los 4 MB puede ocasionar un error y demoras en el procesamiento de la aplicación.)

References: *

Essay*:

Curriculum Vitae*:

Photo:*

How did you hear about this program?* - Select One - Policy & Advocacy Brief (e-newsletter) Email Colleague Other

Other:

I hereby apply for the 2023 Gallagher Health Policy Scholar Program. I am a member in good standing of the American Urological Association (AUA). I am also currently licensed to practice without restriction. I agree, if chosen, to participate in all required activities. I understand that there will be no out-of-pocket expenses. All statements made in this application are complete and true to the best of my knowledge.*

Signature: *