Bursary application Checklist

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ABORIGINAL, TORRES STRAIT ISLANDER
AND MĀORI COMMUNITY MEMBERS
BURSARY APPLICATION FORM
LIME CONNECTION VI
KNOWLEDGE SYSTEMS, SOCIAL JUSTICE AND RACISM
IN HEALTH PROFESSIONAL EDUCATION
11 – 13 August 2015
Townsville, Australia
KEY DATES
Bursary Applications will close on: 12 April 2015
Notification of Acceptance: By 28 April 2015
Deadline for Online Registration: 22 May 2015
LIME NETWORK PROGRAM
The Leaders in Indigenous Medical Education (LIME) Network is a program of Medical Deans
Australia and New Zealand, supported by financial assistance from the Australian Government
Department of Health*.
LIME is a dynamic network dedicated to ensuring the quality and effectiveness of teaching and
learning of Indigenous health in medical education, as well as best practice in the recruitment and
graduation of Indigenous medical students.
We seek to do this through establishing a continuing bi-national presence that encourages and
supports collaboration within and between medical schools in Australia and Aotearoa/New
Zealand and by building linkages with the community and other health science sectors.
The LIME Network recognises and supports the primacy of Indigenous leadership and
knowledge.
*The LIME Network is hosted by the Faculty of Medicine, Dentistry and Health Sciences at the University
of Melbourne.
LIME CONNECTION
The sixth biennial LIMECONNECTION will be held in Townsville, Australia from 11 – 13
August 2015. LIMECONNECTION VI: Knowledge Systems, Social Justice and Racism in
Health Professional Education will build on evidence based presentations from previous LIME
Connection conferences and capture new initiatives, share successful methods and workshop
visions for the future.
The theme encourages strengths based presentations relating to Indigenous health teaching and
learning, curriculum development and research in health professional education, as well as
models for community engagement and the recruitment and graduation of Indigenous students.
LIMECONNECTION provides an opportunity for:
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Collaboration, information sharing and networking amongst peers;
Professional development and capacity-building;
Linking with community, colleges and those from all health disciplines;
Discussion and critique of current practices; and
Exploration of emerging tools and techniques to drive improvement in outcomes for
Indigenous health.
The conference also hosts the LIMElight Awards that acknowledge and celebrate the many
current successes in the field.
Keynote speakers will include experts in Indigenous health and medical education from Australia,
Aotearoa/New Zealand, Hawaii and Canada. The target audience includes Indigenous and nonIndigenous health professional educators, health practitioners, policy makers, students and
community members.
LIMECONNECTION VI is hosted by James Cook University and is held under the auspices of
Medical Deans Australia and New Zealand, the Australian Indigenous Doctors’ Association
(AIDA) and Te Ohu Rata O Aotearoa (Te ORA) - Māori Medical Practitioners Association. The
Connection is an outcome of the Leaders in Indigenous Medical Education (LIME) Network
Program.
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ELIGIBILITY CRITERIA
To be eligible to apply for the LIMECONNECTION VI Aboriginal, Torres Strait Islander and
Māori Community Member Bursaries, candidates must:
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be of Aboriginal and/or Torres Strait Islander descent, identify as Aboriginal and/or
Torres Strait Islander and be accepted as such by the Indigenous Australian communities
in which they live or have lived;
or be of Māori descent (have Whakapapa); and
be actively involved in working with a Medical School.
SELECTION CRITERIA
Bursaries will be awarded on the recommendation of a selection committee and will be based on
the following criteria:
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active involvement in working with Medical Schools;
a demonstrated interest and experience in Aboriginal and Torres Strait Islander or Māori
health;
a commitment to improving Aboriginal, Torres Strait Islander or Māori health in the
future; and
approval of the relevant LIME Reference Group member; and
community members who have submitted successful abstracts to present at LIME
Connection VI will be considered first for bursary places.
APPLICATION PROCESS
You must submit:
1. An application form;
2. A personal statement of up to one A4 page in support of your application. Your personal
statement may include a description of:
 how the bursary will assist you with your personal and/or professional development;
 your service to Aboriginal and Torres Strait Islander or Māori health or role in
supporting medical education within a Medical School; and
 your future aspirations.
3. A signed checklist from the LIME Network Reference Group member at the university
you work with (see Attachment 1 for Reference Group members).
APPLICATION DUE DATE
Community Bursary applications are due: 12 April 2015
Applicants will be notified of their application outcome by 28 April 2015
Applications must be received by email to the LIME Secretariat
E: lime-network@unimelb.edu.au
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SELECTION PROCESS
The LIME Connection VI Bursary Committee will consider each candidate’s application against
the eligibility and selection criteria.
In the case that more applications than the committee can fund are judged to be equally meeting
the selection criteria, the committee will also take ethnicity of the applicant into consideration, in
order to ensure representation from Māori, Aboriginal and Torres Strait Islander people. The
Committee’s decision will be final. The composition of the committee will include
representatives from the Australian Indigenous Doctors’ Association (AIDA), Te Ohu Rata O
Aotearoa (Te ORA) - Māori Medical Practitioners Association and the LIME Network
Secretariat.
TERMS AND CONDITIONS
 All successful applicants must satisfy the Community Bursary eligibility criteria (see p.2).
 The award of the LIME Connection VI Community Bursary is conditional on the successful
applicant agreeing to provide a post-conference report to AIDA/ Te ORA, Medical Deans
Australia and New Zealand and the LIME Network by 4 September 2015.
 The award of the LIME Connection VI Community Bursary is conditional on the successful
applicant agreeing to attend conference proceedings. Delegates are expected to be present at
the conference proceedings on all three days from 9-5pm.
 Delegates are expected to attend the Palm Island visit on Monday 10 August 2015 (organised
and paid for by the LIME Secretariat).
 Flights and accommodation will be organised, booked and paid for by the LIME Secretariat.
 Successful applicants will be accommodated in twin share rooms.
 The LIME Secretariat will ensure that you are sharing a room with someone of the same
gender.
 The LIME Secretariat will ensure where possible, that you are sharing a room with someone
of the same age bracket.
 On request and in special cases the LIME secretariat may be able to organise a room to
yourself – if this should happen you will need to pay half the room costs on check out.
 Flight and accommodation bookings are final and cannot be adjusted unless in special
circumstances.
 In the case of cancellation, your bursary is not transferable to other community members, so
we ask that successful applicants confirm their acceptance of the bursary only if they are sure
they will be able to attend. The LIME Secretariat requires you to inform us of cancellations
due to illness or similar as soon as possible.
 Flights will be organised so that bursary recipients arrive in Townsville on Sunday 9 August
and leave on Friday 14 August. If successful applicants wish to stay in Townsville for longer
(at their own cost) we will attempt to organise flights on different days to accommodate this.
 No reimbursements will be issued for flights, accommodation or other items paid for by the
bursary recipients themselves – all relevant payments must be made by the LIME network.
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1. APPLICATION FORM
LIME CONNECTION VI – ABORIGINAL, TORRES STRAIT ISLANDER AND
MĀORI COMMUNITY BURSARY
First Name:
Surname:
 Male
Preferred Name:
Home Phone:
 Female
Mobile:
Email:
Home Address:
Postal Address:
Please indicate below whether you identify as:

Aboriginal
 Torres Strait Islander
 Aboriginal & Torres Strait
Islander
 Māori
Which Medical School are you involved with?
(provide location of Campus)
Please briefly explain your role/s within the
Medical School.
Iwi Affiliations (Māori applicants):
Hapū Affiliations (Māori applicants):
Marae Affiliations (Māori applicants):
Please indicate your age group:
 18–25
 26–34
 35–44
 45–54
 55 - 64
 65 +
How did you hear about the Bursary?
 Website/Facebook
 Direct
Email
 Word of Mouth
 University
 Other
I hereby provide the LIME Network with permission to use images of me for promotional
and marketing purposes.  Yes  No
 The LIME Reference Group member for my university has signed the checklist (below)
 By submitting this form I agree to abide by the Terms and Conditions as stated the LIME
Network.
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2. PERSONAL STATEMENT
Write a personal statement of up to one A4 page in support of your application. This may include
a description of:
 how the bursary will assist you with your personal and/or professional development;
 your service to Aboriginal and Torres Strait Islander or Māori health or role in
supporting medical education within a Medical School; and
 your future aspirations.
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3. LIME REFERENCE GROUP MEMBERS
BURSARY APPLICATION CHECKLIST:
Applicant Name:
Applicant University:
☐
☐
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The applicant is an Aboriginal, Torres Strait Islander or Māori
community member who works with this medical school;
The applicant has demonstrated an interest in, and had experience
with, Aboriginal, Torres Strait Islander and/or Māori health and
medical education;
The applicant will be assisted in their personal and/or professional
development through receipt of the bursary.
I support this community member’s application for a LIME Connection
Bursary:
Reference Group member name:
Reference Group member signature:
FOR FURTHER INFORMATION AND SUBMISSION OF THIS FORM:
Erin Nicholls or Caitlin Ryan
Level 2, 161 Barry Street, The University of Melbourne, VIC 3053
Email: lime-network@unimelb.edu.au
Phone: +61 3 9035 8294;
Web: www.limenetwork.net.au
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ATTACHMENT 1 - THE LIME NETWORK REFERENCE GROUP MEMBERSHIP LIST
University
Adelaide
ANU
Member
Dr Dylan Coleman
Ms Gaye Doolan
Email
dylan.coleman@adelaide.edu.au
gaye.doolan@anu.edu.au
Phone
W: 08 8303 6878
W: 02 6125 0865
e.curtis@auckland.ac.nz
brad@emergencymedicine.com.au
Scott.mccoombe@deakin.edu.au
wendy.edmondson@flinders.edu.au
W: +64 9 373 7599
W: 07 5595 4469
W: 03 5227 8382
W: 08 7221 8603
Cheryl.davis@flinders.edu.au
r.west@griffith.edu.au
W: 08 8946 7593
W: 07 3735 5406
donald.whaleboat@jcu.edu.au
jacinta.tobin@unimelb.edu.au
W: 07 4781 5126
W: 03 9908 8155
Ms Rose Gilby
A/Prof Peter O’Mara
Position
Lecturer, Yaitya Purruna Indigenous Health Unit
Coordinator of Indigenous Health and Student
Engagement
Senior Lecturer Medical, Director of Vision 20:20
Associate Professor
Lecturer, Public Health, School of Medicine
Acting Director, Poche Centre for Indigenous Health
& Well-Being
Lecturer, Indigenous Health
Professor Indigenous Health & Workforce
Development
Senior Lecturer
Senior Lecturer Medical Education in Indigenous
Health
Lecturer, Indigenous Health Unit
Head of Discipline Indigenous Health
Auckland
Bond
Deakin
Flinders SA
Dr Elana Curtis
Dr Brad Murphy
Dr Scott McCoombe
Prof Wendy Edmonsdon
Flinders NT
Griffith
Ms Cheryl Davis
Prof Roianne West
James Cook
Melbourne
Mr Donald Whaleboat
Dr Jacinta Tobin
Monash
Newcastle
Rose.gilby@monash.edu
Peter.Omara@newcastle.edu.au
W: 03 5022 5500
W: 02 49217734
Notre Dame Sydney
Associate Lecturer Aboriginal & Torres Strait
Islander Health
Associate Dean Aboriginal Health
Director Muru Marri Indigenous Health Unit
miriam.cavanagh@nd.edu.au
W: 02 8204 4491
Notre Dame Fremantle
New South Wales
A/Lecturer Miriam
Cavanagh
Prof David Paul
Prof Lisa Jackson Pulver
David.paul@nd.edu.au
l.pulver@unsw.edu.au
W: 08 9433 0525
W: 02 9385 1769
Otago
Queensland
A/Prof Suzanne Pitama
Dr Maree Toombs
suzanne.pitama@otago.ac.nz
m.toombs@uq.edu.au
W: +64 3 364 3635
W: 07 4633 9716
Sydney
Tasmania
Western Australia
Dr Lilon Bandler
Dr Maureen Davey
Assist/Prof Craig Allen
lbandler@sydney.edu.au
Maureen.davey@utas.edu.au
Craig.allen@uwa.edu.au
W: 02 9036 7577
W: 03 6226 4661
W: 08 6488 8140
Western Sydney
Wollongong
Ms Christine Carriage
Dr Scott Winch
Maori Health Lecturer and Director MIHI
Director, Indigenous Health, School of Medicine
Rural Clinical School
Senior Lecturer in Indigenous Health Education
Senior Lecturer in Medical Practice
Assistant Professor, Centre for Aboriginal & Medical
Dental Health
Indigenous Program Officer
Academic Leader, Indigenous Health
c.carriage@uws.edu.au
swinch@uow.edu.au
W: 02 4620 3637
W: 02 4221 5629
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