2023 Nikitas J. Zervanos Outstanding Program Director Award

Nomination Form for the 2023 Nikitas J. Zervanos Outstanding Program Director Award

2023 Nikitas J. Zervanos
Outstanding Program Director Award

Nomination Form

Nominees must: 

  • Be a current member of the AAFP and the AFMRD
  • Be actively directing a family medicine program for at least 10 years
    • Nominees who actively directed a family medicine program for at least ten years who either transitioned into a new position or will be transitioning into a new position will be considered eligible to receive this award. Transitions must be within two years of the date the award is presented.
  • Demonstrate leadership and advancement of the specialty
  • Have served as a mentor to residents or medical students
  • Have made contributions to the community he or she serves
  • Have made contributions to the organizations of the family of family medicine
  • Not be a current member of the AFMRD Board of Directors or the AAFP Commission on Education
  • Not have served as a Board member of the AFMRD within the last year.
  • Have significant leadership experience at the national level 

A program director may be nominated by other family medicine residency directors, faculty, residents, or a state chapter of the AAFP.

Please enter the required information and upload the required supporting documents.
Fields marked with * are required. 

All information must be submitted by Thursday, October 1, 2020

 

 

NOMINATOR INFORMATION