Skip to content
Check Screen Reader Mode to make this survey compatible with screen readers.
Check Screen Reader Mode to make this survey compatible with screen readers.
WENTS UK mentor sign-up
WENTS UK mentor sign-up
Thank you for your interest in the WENTS UK mentor scheme. Kindly complete the below form and we will be in touch.
OK
*
1.
Full Name
(Required.)
*
2.
Email
(Required.)
3.
Are you an ENT UK Member?
Yes
No
4.
Would you like to take part in the WENTs mentorship scheme as a:
Mentor
Mentee
Both
5.
What grade are you?
Medical Student
Foundation Doctor
Core Trainee
Specialty Registrar
SAS grade
Consultant
Other (please specify)
6.
Time in post (years)/level of training eg ST6, or the length of time you have been a in post eg 5 years full/
part time
7.
Can you write a few sentences for your future mentees/mentors as an introduction please, including which
region are you based in?
8.
Do you have any preferences regarding the gender of your mentor/mentee?
Female - mentee
Male - mentee
Don't mind - mentee
Female - mentor
Male - mentor
Don't mind - mentor
9.
If there is a choice would you like to be mentored by a...
Medical Student
Foundation Doctor
Core Trainee
Specialty Registrar
Specialty Doctor (SAS)
Consultant
Don't mind
N/A
Other (please specify)
10.
If there is a choice would you like to mentor a: (note: you may choose more than one option)
Medical Student
Foundation Doctor
Core Trainee
Specialty Registrar
Specialty Doctor (SAS)
Consultant
Don't mind
N/A
Other (please specify)
11.
What format would you prefer the mentoring programme to take?
Face-to-face
Video call
Telephone
Email
Please suggest any other format if applicable
Current Progress,
0 of 11 answered
