Radiological Society of North America

Name:

Title:

Institution:

Address:

Email:

*Note that this information is the primary contact date on file. To update your personal information, please go to the My Account page.

Teaching Specialties

Select all of the areas for which you have expertise and can lecture/teach. Then, rank what you have selected in order of your proficiency.

Area	Rank
Chest Radiology
Diagnostic Radiology
Emergency Radiology
Gastrointestinal
Genitourinary
Interventional Radiology
Medical Physics
Molecular Imaging
Musculoskeletal
Neuroradiology
Nuclear Medicine
Oncologic Imaging
Pediatric Radiology
Radiation Oncology
Radiology Research
Vascular Radiology
Women's Imaging

Select the languages in which you speak fluently enough to lecture in below.

Hold down the Ctrl (windows) / Command (Mac) button to select multiple options.

Do you have teaching experience? Yes No

Please describe, being sure to include any teaching or practice experience in low to middle income countries.

Which topics are you passionate about teaching? What are your strengths in the classroom?

Do you have experience creating educational content for online use? Yes No

Please describe.

Do you have experience or knowledge about the procurement of radiological equipment for institutions? Yes No

Please explain.

The GLC Program Director will be expected to serve for 3 years, while supporting team members may apply for 18-month terms. Please tell us if you would like to be considered for the Program Director role, a team member role, or both.

Supporting Information

Letter of Intent: Let us know why you are interested in participating.

Use the space below to submit additional information that would assist the Committee on International Radiology Education in its selection.

The RSNA will be responsible for costs associated with air travel, hotel accommodations, ground travel to/from the airport, meals, travel medical insurance and other incidental expenses. Because of the mission based nature of this program airline tickets are purchased in no higher than premium economy class.

I acknowledge this statement on the GLC travel policy.

RSNA Global Learning Center

RSNA Team Member Application