HUMANITARIAN TRAVEL

GRANT APPLICATION

DEADLINES

NOVEMBER 15: Humanitarian medical outreach trips taking place January 1-June 30

MAY 15: Humanitarian medical outreach trips taking place July 1-December 31

APPLICATION INSTRUCTIONS

Please read the instructions and Frequently Asked Questions carefully. To be considered, the following items must be e-mailed as a single PDF file

to Katie Stous Grimes, Director of Global Aairs, at [email protected]:

• Completed application form

Project Proposal

The selection panel gives heavy weighting to the Project Proposal. Include a one-page Project Proposal including the

following information:

• Sponsoring organization

• Service site

• Target population

• Planned clinical activities

• Planned teaching activities or participation of local physicians/nurses/trainees

• Physician who will supervise you onsite

Clearly define your:

Please submit three (3) letters of recommendation from the following required and optional sources (Note: ensure you give ample notice before

the deadline). Letters should be addressed to the “Humanitarian Travel Grant Selection Panel” and on ocial letterhead:

Required

• Otolaryngology department chair or director of your training program

• If you will not be Board-eligible by the ABO to at the time of your service, a Board-certified otolaryngologist or plastic surgeon who will supervise your

clinical activities during your service.

Optional

• A physician with whom you have worked

• A non-medical individual such as a friend, mentor, or close associate

HUMANITARIAN TRAVEL

GRANT APPLICATION

Have you received an AAO–HNSF Humanitarian Travel Grant in the past? Yes No

PROFESSIONAL INFORMATION

Otolaryngology Program Name:

Program Mailing Address: Oce/Suite No.:

City: State/Province: Postal Code: Country:

Otolaryngology Program Chair

Name:

Email Address:

Residency/Fellowship Program Director

Name:

Email Address:

Will you be Board Eligible by the ABO at the time of your trip? Yes No

If you receive the grant, do you wish it to be paid to your university/department? Yes No

List other funding sources for your travel:

What is your estimated cost for the trip before financial support?

What is the last date that you can receive funding?

If you have had previous experience abroad, medical or otherwise, please describe with dates, places, and purpose.

Please list foreign languages in which you are proficient:

I understand that if my application is accepted, and I am given this grant, I will be responsible for my own actions and further agree to release

and hold harmless the American Academy of Otolaryngology—Head and Neck Surgery, the American Academy of Otolaryngology—Head

and Neck Surgery Foundation, their agents and employees from any damages, liabilities or expenses they incur by reason of my actions

of whatever nature or kind in connection with this award. Should I receive this grant, I agree to accept full responsibility for all personal

insurance I deem necessary during my tenure of service. If the mission trip is canceled or changed, I will immediately notify the AAO–HNSF

HUMANITARIAN TRAVEL

GRANT APPLICATION

I am an Academy Resident Member interested in going on an

overseas medical outreach trip. How do I apply for an AAO–HNSF

travel grant for $1,000?

Resident members who are PGY3, PGY4, or PGY5 are eligible to apply

but priority will be given to PGY4 and PGY5 residents, because of their

more advanced surgical training. Download the application at

www.entnet.org/about-us/grants/srf-travel-grants.

For humanitarian medical outreach trips in the first six months of the year

for a resident travel grant?

Yes, if you are still studying in an otolaryngology program

I received a humanitarian travel grant; can I apply again?

No, you are not eligible for a second travel grant.

I am a board-eligible or board-certified otolaryngologist; can I apply for

a fellowship for a medical outreach trips of more than six weeks?

Yes, we have a limited availability of funds for such a fellowship. To

learn more, please contact humanitarian@entnet.org.

Can you advise me on finding a humanitarian medical outreach

trips I can join?

Do you have advice about joining an overseas humanitarian medical

outreach trips?

Yes, please read James D. Smith, MD’s “What to Expect from a

Medical Mission” at www.entnet.org/get-involved/humanitarian-

eorts/what-to-expect-from-a-medical-mission/

Do I need a support letter from my department chair or residency

training program director?

Your department chair or training program director needs to confirm

that time will be made available for you to leave the department

for the outreach trip. It is an opportunity for your chair or program

program directors are away from their oces. Late arriving letters of

reference will not be included in your package.

Any advice on the travel grant application?

After completing the professional and personal information, write

a detailed and specific project plan. Attach a short version of your

CV (no more than three pages), including relevant background on

previous volunteer work in the US and/or overseas. A CV longer than

three pages will be truncated at the third page. Include letters of

recommendation from your department chair and/or training program

director, from a board-certified otolaryngologist who will supervise

of volunteerism. The panel looks for your prior experiences,

preparedness, ability to make an impact, and motivation/plans

for future humanitarian work. Senior residents and fellows in

training receive preference because they can generally work more

independently and so are more able to teach others.

What other letters are required?

If you are not board certified, you will need a letter from a board-

certified otolaryngologist or plastic surgeon who will supervise you on

the humanitarian medical outreach trips.

Should letters of recommendation be sent to the Academy?

HUMANITARIAN TRAVEL

GRANT APPLICATION