Scholarship Application Please complete all sections. You can save your progress and return later. Thank you for your interest in the EmpowerMED Africa Scholarship. This program supports medical trainees across sub-Saharan Africa through financial support and mentorship to strengthen healthcare systems and improve patient care.Please complete all required fields. You can save your progress and return later using the Save as Draft link.Before you begin, have these ready as PDF files: CV, signed and stamped transcript, proof of enrollment on official letterhead, and two faculty letters of recommendation.Section 1: Applicant InformationFirst Name *Middle NameLast Name *Date of Birth *Gender *Please select an optionFemaleMalePrefer not to sayPrefer to self-describeNationality *Country of Residence *Email Address *Phone Number (with country code) *Section 2: Academic InformationCurrent Level of Training *Medical StudentInternResident/RegistrarFellowOtherPlease specify your level of training *Institution Name *Country of Institution *Field of Study / Specialty *Year of Study / Training Level *Expected Graduation Date *Current GPA / Academic Standing *Section 3: Academic PerformanceDescribe your academic achievements *Maximum 300 words.0 / 300Describe your leadership experience *Maximum 300 words.0 / 300Section 4: Community EngagementDescribe your community service or public health involvement *Maximum 300 words.0 / 300Section 5: Personal StatementDescribe your career goals, how you plan to impact healthcare in your community, and why you are applying to EmpowerMED Africa.Mission and Career Goals *Maximum 1000 words.0 / 1000Section 6: Mission AlignmentHow will you contribute to healthcare improvement in sub-Saharan Africa? *Maximum 500 words.0 / 500Section 7: ResearchDo you have research experience? *YesNoDescribe your research experience *Maximum 500 words.0 / 500Section 8: Financial NeedDo you require financial assistance? *YesNoDescribe your financial need, including tuition, living expenses and any barriers you face *Maximum 500 words.0 / 500Section 9: Career CommitmentWill you contribute to healthcare in sub-Saharan Africa after training? *YesNoExplain how *Maximum 300 words.0 / 300Section 10: Document UploadsPDF files only, up to 10 MB each.CV *Choose FileNo file chosenDelete uploaded fileTranscript *Must be signed, dated and stamped by your institution's Registrar's Office.Choose FileNo file chosenDelete uploaded fileProof of Enrollment *Must be on the official letterhead of your institution.Choose FileNo file chosenDelete uploaded fileLetter of Recommendation 1 *From a faculty member you have worked with.Choose FileNo file chosenDelete uploaded fileLetter of Recommendation 2 *From a second faculty member you have worked with.Choose FileNo file chosenDelete uploaded fileResearch Portfolio (optional) *Choose FileNo file chosenDelete uploaded fileSection 11: RefereesReferees are different from your letter of recommendation writers.Referee 1 Full Name *Referee 1 Email *Referee 2 Full Name *Referee 2 Email *Section 12: DeclarationPlease confirm each statement *I certify that the information provided is accurate.I agree to participate in EmpowerMED Africa mentorship if selected.I understand the selection process is competitive.If selected, I agree to participate in activities that expand EmpowerMED Africa's work, including surveys and fundraising activities.Your application is reviewed by the EmpowerMED Africa Scholarship Selection Committee. See our Privacy Policy for how applicant information is protected.Save as Draft
