Subject Matter Expert EnrollmentSubject Matter Expert Enrollment FormSubject Matter Expert Enrollment FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Learning Session *Road to residency in USAFirst Name *This is how it will appear on the announcementsLast Name *This is how it will appear on the announcementsSpeciality/Subspeciality *Position/Academic Rank *chooose one rank (e.g. Professor or Consultant – not both)Name of Institution/Hospital/University *Choose one affiliation to be included in the announcementsCity/State *Country *Email Address *WhatsApp *Linkedin Link or work webpage *type “no” if not availableTwitter handle *type “no” if not availableBiosketch *In less than 250 words Professional Photo * Click or drag a file to this area to upload. .png, .jpg, .jpeg format; shows the face and shoulders; shows the face and shoulders, square shape, professional background; this picture will be posted on the website CV * Click or drag a file to this area to upload. .pdf, .doc, .docx format; Mock Interviews Schedule *Oct 5th, 2024Oct 12th, 2024Oct 19th, 2024Oct 26th, 2024Nov 2nd, 2024Nov 9th, 2024Nov 16th, 2024Nov 23th, 2024Nov 30th, 2024Dec 7th, 2024Dec 14th, 2024Dec 21st, 2024Attestation of SME Responsibilities *I attest to reading the SME Responsibilities outlined by the Facilitator and will abide with themSlide Preparation Use the slide template provided by the facilitator (that contains the relevant logos) Do not include any patient personal information (e.g. name, date of birth, medical record number) Day of Session Join 15 minutes before the session starts to confirm everything is in working order Use a quiet location with stable, high-speed internet Please use a computer that has a camera Position the webcam so the whole face is visibleIn the event of unforeseen unavailability, i.e. unable to present with less than one month notice *I give permission to a colleague to present my slides on my behalfConsent to record presentation and share with learners *I gave permission to record my talk and share with learnersConsent to share pdf of presentation with learners *I gave permission to share the pdf of my talk with the learnersConsent to include content of my presentation in SAMA Learning Management System (Moodle) *I gave permission to content of my presentation in SAMA Learning Management System (Moodle)probono *I understand that I am volunteering my time and will not be paid for this learning activitySubmit form