ACMQ 2018 Fellowship Application

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1. Your current details *This question is required.
Your postgraduate degrees (acronym, e.g., MD) and year earned *This question is required.
Your postgraduate degrees (acronym, e.g., MD) and year earned *This question is required.DegreeYear
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AMA-recognized Specialties
AMA-recognized SpecialtiesSpecialtyBoard Certified (Y/N)Year
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3. Attendance at one or more ACMQ annual meetings in the last three (3) years: *This question is required.
3. Attendance at one or more ACMQ annual meetings in the last three (3) years: *This question is required.YearLocation
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4. CME Forty (40) hours of CME Category I from ACMQ annual meetings, or other educational programs related to quality *This question is required.
4. CME Forty (40) hours of CME Category I from ACMQ annual meetings, or other educational programs related to quality *This question is required.CME activityDatesHours
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5. Are you Certified in Medical Quality (CMQ) by the American Board of Medical Quality? *This question is required.
  • * This question is required.
Did you join ACMQ before March 1, 2008? *This question is required.
Thank you for your Fellowship application. Regrettably, you are not eligible for ACMQ Fellowship at this time, as you are not Certified in Medical Quality (CMQ) by the American Board of Medical Quality. Please obtain this qualification first, then apply again in the future.
Members who joined before March 1, 2008, must complete one or both of the following in order to meet the application requirements.
Authorship of one article, on a topic related to quality, accepted by and published in the American Journal of Medical Quality, or other peer-reviewed journal. In the Comments box, enter the journal/publication name, citation, and date of publication.
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