Skip survey header

2020 PC-FACS Editorial Leadership Team Application

Eligibility Requirements to Apply for a Position on the Editorial Team

  1. AAHPM member in good standing for at least one year.
     
  2. Current Hospice and Palliative Medicine sub-specialty board certification by one of the 10 cosponsoring members of the American Board of Medical Specialties (ABMS) or the America Osteopathic Association Bureau of Osteopathic Specialists or certification by the Hospice Medical Director Certification Board (HMDCB).
     
  3. At least three years of post-residency professional activity predominately in the field of hospice and palliative medicine.
     
  4. Commitment to AAHPM as evidenced by participation in a committee, project, etc.
     
  5. Attached curriculum vitae and writing sample (upload on the last page of application).
Start of application: *This question is required.
1. Indicate primary board certification and date and other certifications and dates:
Space Cell Board CertificationDate
1 *This question is required
2
3
4
5
2. List positions held in the field of hospice and palliative medicine:
Space Cell PositionFacilityYear
1 *This question is required
2
3
4
5
3. List any positions of leadership within AAHPM (officer, committee chair, SIG chair, etc.):
Space Cell Office/Committee/SIGYear
1 *This question is required
2
3
4
5
4. List any Hospice and Palliative Medicine non-published research (papers, posters or case studies) that you presented at either the Annual Assembly of Hospice and Palliative Care or another national conference. (e.g. ASCO, AAP, AGS, NHPCO, etc.) Please include a description of your role in the research or presentation: 

 
Space Cell Title of PresentationName of MeetingYear PresentedRole in Research/Presentation
1 *This question is required
2
3
4
5
5. List authored research (systematic or narrative review) articles relevant to hospice and palliative medicine that you have published in a peer-reviewed journal (this may include the Journal of Pain and Symptom Management (JPSM). Please include a description of your role in the research and in authorship of the publication:
 
Space Cell ArticleName of JournalYear PublishedRole in ResearchRole in Authorship
1 *This question is required
2
3
4
5
6. List any hospice and palliative medicine articles that you have published in a non-peer reviewed clinical publication (this may include blogs like Geri-Pal or Pallimed); include your role in authorship of the publication:
 
Space Cell ArticleName of JournalYear PublishedRole in Authorship
1 *This question is required
2
3
4
5
7. List any service on an editorial board for a medical publication or as reviewer for any medical journal (this may include service on PC FACS or the AAHPM Quarterly):

 
Space Cell PublicationStart/End Date
1 *This question is required
2
3
4
5
8. List books, videos, web sites, blogs, recordings or webinars you have authored or co-authored related to the field of hospice and palliative medicine (this may include AAHPM-sponsored webinars, Essential Practices in Hospice and Palliative Medicine, HMD Manual, Primer of Palliative Care, HPM PASS or HPM FAST); include your role in authorship:


 
Space Cell TitleMonth/YearRole in Authorship
1 *This question is required
2
3
4
5