Mary Duke Biddle Clinical Scholars Program
2015-2016 Academic Year
Mission
The Mary Duke Biddle Clinical Scholars Program was established in 2009 at Stanford through a generous
contribution from the Mary Duke Biddle Foundation. Through this program, we hope to encourage the global
health pursuits of trainees particularly interested in caring for children in underserved areas overseas. With
these experiences, we hope many of the scholars will be motivated to incorporate the care of children in
developing countries into their long-term career goals.
ELIGIBILITY
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Medical students (must have completed their clinical pediatric rotations by time of proposed travel)
Pediatric residents
Pediatric fellows
Pediatric faculty
The above must be involved in improving the quality of life of children needing medical care.
INSTRUCTIONS
All documents must be received via e-mail by 9am Pacific Time on Monday, February 9, 2015.
You will need the following:
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This completed application
Current CV
Two letters of recommendation, including one from your program director
Please email all materials to Jenny Kang, Program Manager at jlkang@stanford.edu.
__________________________________________________________________________________________
PERSONAL INFORMATION
Name: ____________________________________
Email Address:
Street Address: ______________________________
Home/Mobile Telephone: (___)_________
City, State, Zip:
________________________
________________________
Please provide three emergency contacts:
Name: _____________________________________________ Phone: ____________________________
Name: _____________________________________________ Phone: ____________________________
Name: _____________________________________________ Phone: ____________________________
BACKGROUND/EXPERIENCE
Current Training Year:
Medical Student
Intern
PGY2
PGY3
PGY4
PGY5
Faculty
Other: _______________
Languages Spoken: __________________________________
Have you had prior international experience?
Yes
No
If yes, where was this experience, when was it, how long did it last, and what role did you play? What
do you hope to gain through this program?
If no, please share your reasons for wanting to participate.
ROTATION
1. Please list the dates during which you would be unable to participate in this program based on your own
schedule. Requirement: A minimum of 4 -6 weeks at any of the below sites.
____________________________________________________________________________
2. Please rank the work sites below by applying a score of 1-4 in order of preference (1 being the most
preferred and 4 being the less preferred).
a. Bangladesh: ICDDR,B (International Center for Diarrhoeal Disease
Research – Bangladesh), Dhaka
____
b. Ecuador: Cachamsi program,
Pediatric hospital and community clinics, Riobamba
____
c. Nepal: Patan Hospital, Kathmandu
____
d. Uganda: Mulago Hospital, Kampala
____
We will try to accommodate your site selection. If you have specific reasons for your ranking above, please list
them: ____________________________________________________________________________
MDB scholars are expected to contribute to the capacity of the sites at which they rotate. What
presentations/talks would you be able to deliver to medical students, residents and/or faculty at the site?
Please list the expectations and titles of the presentations below:
Title: _____________________________________________ Expectation: _________________________
Title: _____________________________________________ Expectation: _________________________
Title: _____________________________________________ Expectation: _________________________
If you have any questions about the application process or requirements, please contact Jenny Kang at
jlkang@stanford.edu.