International Gynecologic Oncology Observership Application

The Division of Gynecologic Oncology at Massachusetts General Hospital offers two types of observerships: a three-week virtual program and a two-month in-person program. Please visit our website for more information about eligibility and application requirements.

To start the application process, fill out and submit the form below. NOTE: Your application will not be complete until you submit all the materials listed on the website under “How to Apply.”

If you are applying for the three-week virtual observership:

What month/year is your first choice?

What month/year is your second choice?

If you are applying for the two-month in-person observership:

What two months/year are your first choice? (options listed below)

What two months/year are your second choice? (options listed below)

Available rotations are: January-February, March-April, May-June, July-August, September-October and November-December.

Last (Family) Name

First (Personal) Name

Middle Name

Other names used

Gender

Date of birth

mm/dd/yyyy

Place of birth (city, country)

Primary language

Secondary languages

Street address

City

State

Zip code

Country

How long at this address

Primary phone number

Alternate phone number

Email address

Alternate email address

Current employer

Employer address

Employer phone number

Your current title

Department

Current supervisor's name

Supervisor's phone number

Supervisor's email address

Date of hire

mm/dd/yyyy

Name of medical school

Medical school address

Medical school phone number (please include country and city code)

Medical school fax number (please include country and city code)

Degree earned (ex: MD, MBBS, PhD)

Graduation date

mm/dd/yyyy

I attest that I am fluent in spoken and written English

YesNo

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International Gynecologic Oncology Observership Application