The Hip Society-British Hip Society 2022 Traveling Fellowship Application
Deadline to complete this application is May 15, 2022, by 11:59 pm US CDT.
By completing this application form, you agree to share with The Hip Society, their employees, volunteers, and agents, your personal and contact information. Please review The Hip Society's
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Your Last (Family, Surname) Name:
Your First (Given) Name:
Your date of birth:
as of May 15, 2022
(full years only):
Your headshot (100 MB maximum)
Read the criteria below carefully. All boxes must be checked in order to proceed and be considered eligible for the program. Please contact The Hip Society (email@example.com) with any questions.
I am a board-certified (or board-eligible) practicing orthopaedic surgeon, permanently based (i.e., practicing and residing) in the US or Canada.
I am a hip fellowship-trained orthopaedic surgeon within one (1) to five (5) years of completing fellowship training.
I am able to take 3-4 weeks away from my family and practice (tentatively late August to mid-September 2022).
I am committed to the practice of hip surgery.
I am able to demonstrate documented interest in advancing hip surgery via publications, presentations, and research.
I am NOT a previous HS-BHS Traveling Fellow (previous Fellows are ineligible to re-apply).
I understand that due to the ongoing global public health concerns the 2022 program may be postponed or canceled.
I certify that the information presented in this application and the accompanying documentation is accurate and true.
Please sign this Affidavit portion (use your mouse or other navigation device to sign).