Thank you for your interest in the Association of Medicine and Psychiatry’s mentorship program!  This template is designed to collect the information of those individuals who WANT TO BE A MENTOR to physicians, trainees or students in a lower-seniority phase of career.  

What type of training program are you enrolled in/graduated from?
If you are a resident, what program are you in?
If you are an ECP or established physician, what kind of practice do you currently have?