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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,
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