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Email address

First name

Last name

City of Residence

Country of Residence

Cell Phone Number

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Whatsapp Number

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Current Work

Major

If your major is not listed above, specify it here

Specialty

Workplace for trainees and practitioners:

Preferred education language

Any Residency?

Yes exists

Which field?

Name of the institution

Location of the institution

Any Fellowship?

Yes exists

Which field?

Name of the institution

Location of the institution

Name of Degree (1)

Year in which you obtained the degree (1)

Institution from which your degree was obtained (1)

Name of Degree (2)

Year in which you obtained the degree (2)

Institution from which your degree was obtained (2)

Name of Degree (3)

Year in which you obtained the degree (3)

Institution from which your degree was obtained (3)

Do you have teaching experience?

Yes exists

The main institute where you taught

Teaching Awards

Please mention the major teaching award if any

Any Research Experience

Yes exists

H-index on Research Gate if available

Number of citations if available

Rsearch Awards

The major research award

COURSES or LECTURES that you would like to present through MedMinds Academy?

Please List main topics or fields if you are not decided about the exact lecture or course; for example you can say Anatomy, Physiology, GI, Cardiology, Neurology, etc...

A sample of a previous lecture or course given by you if available (Link), or e-mail us a previous power point presentation for a lecture or course you presented.

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