蘑菇视频 National Awards Submission Form

Use this form to submit nominations for 蘑菇视频's National Awards. These awards recognize outstanding students, leaders, educators, chapters, and changemakers whose leadership, service, advocacy, and commitment are helping create a more equitable and impactful future in medicine. Please select the appropriate award category and provide the requested information about your nominee.

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Award Category(Required)

Is the Nominee an active medical professor?(Required)

National Golden Apple Award nominees must be medical professors

Yes

Eligible candidates for the National Golden Apple award must be medical professors

Nominator Details

Nominator's Name(Required)

First Last

Nominator's Email(Required)

Enter Email Confirm Email

Nominator's Affiliation(Required)

(School/Chapter, Organization, etc.)

Nominee Details

Nominee's Name(Required)

Prefix First Last

Nominee's Title(Required)

Nominee's Affiliation(Required)

Nominee's Contact Information(Required)

(Email, Phone Number, and/or LinkedIn)

Women Leaders in Medicine Nomination Questions

The 蘑菇视频 Women Leaders in Medicine Award recognizes an individual who has demonstrated outstanding leadership, advocacy, mentorship, or service in advancing women in medicine. This award honors contributions that strengthen opportunities, representation, and leadership for women across medical education and the healthcare profession.

How is her work changing the world?(Required)

Tell us the reason for your nomination. (minimum word count of 200)

Why is she important to you?(Required)

Tell us a bit more about how this woman &/or her work has influenced you as a future physician. (minimum word count of 200)

LGBTQ+ Health Achievement Award Nomination Questions

The 蘑菇视频 LGBTQ+ Health Achievement Award recognizes an individual or group whose leadership, advocacy, scholarship, or service has advanced the health and well-being of LGBTQ+ communities. This award honors meaningful contributions that promote inclusive care, reduce health disparities, and strengthen equity within medicine and healthcare.

How is the school/group/individual advocating for the inclusion and advancement of LGBTQ+ issues?(Required)

Tell us the reason for your nomination. (minimum word count of 200)

Why is the school/group/individual important to you?(Required)

Tell us a bit more about how their work is influencing you as a future physician. (minimum word count of 200)

Racial Justice in Medicine Nomination Questions

The 蘑菇视频 Racial Justice in Medicine Award recognizes an individual or group whose leadership, advocacy, scholarship, or service has made a meaningful contribution toward advancing racial equity and justice in medicine. This award honors efforts that address inequities, promote inclusion, and help create a more just and equitable healthcare system.

How is the school/group/individual achieved exemplary success in advocating for the inclusion and advancement of racial and/or social justice issues in medicine?(Required)

Tell us the reason for your nomination. (minimum word count of 200)

Why is the school/group/individual important to you?(Required)

Tell us a bit more about how their work is influencing you as a future physician. (minimum word count of 200)

James Slayton National Award for Leadership Excellence Nomination Questions

The James Slayton National Award for Leadership Excellence recognizes an 蘑菇视频 national leader who has demonstrated exceptional leadership, management, and dedication beyond the expectations of their role. This award honors a leader whose contributions have helped advance 蘑菇视频 while inspiring and developing future physician leaders.

Please describe how the nominee has demonstrated exceptional leadership beyond the expectations of their national leadership role.(Required)

Include specific examples of how their contributions have advanced 蘑菇视频, strengthened the organization, supported fellow leaders or members, and helped foster the development of future physician leaders. (minimum word count of 200)

Golden Apple National Award Nomination Questions

Name of School's Dean(Required)

Prefix First Last

Dean's Title(Required)

Dean's Email(Required)

Enter Email Confirm Email

Please describe how the nominee has demonstrated excellence in medical education through innovative teaching, mentorship, curriculum development, or other meaningful contributions.(Required)

Include specific examples of how their work has improved the educational experience for medical students or advanced medical education more broadly. (minimum word count of 200)

Paul R. Wright Chapter Success Award Nomination Questions

Named after 蘑菇视频 Executive Director Emeritus Paul R. Wright, this annual honor is awarded to chapters that have promoted 蘑菇视频鈥檚 mission of inspiring future physicians through local events, innovative programming, leadership development or calls to action. The emphasis of this award is chapter commitment to improving member solidarity by increasing awareness, recruitment, and involvement in their chapters. Nominees will be evaluated on the quality and creativity of programs at the local level and their growth throughout the year.

Name of Chapter(Required)

Only chapters that are chartered and in compliance are eligible. Please email members@amsa.org if you have a question about eligibility.

Chapter's Category(Required)

Chapter President's Name(Required)

First Last

Chapter President's Email(Required)

Chapter President's Phone Number(Required)

What makes your chapter unique?(Required)

Describe something you believe makes your chapter stand out as an exceptional 蘑菇视频 chapter.

Describe the top recruitment event your chapter held this year.(Required)

Describe some of the programming and/or events your chapter has held this year.(Required)

蘑菇视频's mission is to foster a community of future physicians through education and advocacy. How does your chapter carry out this mission?(Required)

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