American Head & Neck Society

Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.

American Head & Neck Society | AHNS


The mission of the AHNS is to advance Education, Research, and Quality of Care for the head and neck oncology patient.

  • About
    • Mission Statement and Purpose
    • Divisions & Services of the Society
      • Education
        • Scientific Program/Resident Courses
        • Surgical Videos
        • Journal Club
        • Journals
        • Global Outreach
        • Awards
          • Margaret F. Butler Award
      • Diversity, Equity and Inclusion Division
      • Patient Care
        • Cancer Survivorship
          • Patient Education on Post-Treatment Care
          • Interviews with Cancer Survivors
        • Cancer Prevention
          • SLIDE DECK: HPV-Related Oropharyngeal Cancer
        • Guidelines/Position Statements
        • Find-A-Physician
      • Research
        • Grant Information
        • Clinical Trial
        • Tissue Banks
      • Administrative Divison
        • Development Service Process for Evaluating Projects Requiring Funding
    • Leadership
    • History
      • Society Background
      • AHNS History Interviews
      • Past Presidents
      • In Memory
    • AHNS Newsletter
    • Professionalism & Ethics
    • AHNS Policies and Procedures (P&P) Manual
    • AHNS Foundation
    • AHNS Bylaws
    • AHNS Staff
    • AHNS News and Announcements
    • COVID-19 Bulletin Board
  • Heads Up!
  • Post a Job
  • Meetings
    • AHNS Virtual Education Series
      • TORS Webinar Series
    • AHNS Meetings Info
    • AHNS Call For Abstracts
    • AHNS Call For Late Breaking Abstracts
    • Exhibitor and Support Opportunities
    • Past Meetings
    • Related Meetings
  • For Patients
  • For Trainees
    • Accredited Fellowships
      • Fellowship Match
      • Directory of Fellowships
      • Fellowship Curriculum
      • Certificate of Completion Request
      • Fellowship Graduates
      • For Program Directors
      • For Current AHNS Fellows
    • AHNS Surgical Videos
    • Fellows’ Virtual Tumor Boards
    • Cutaneous Cancer
  • Sections
    • Endocrine Surgery
    • Skull Base Surgery Section
    • Reconstructive Head & Neck Surgery
    • Mucosal Malignancy Section
      • Mucosal Malignancy Section Patient Information
    • Salivary Gland
    • Cutaneous Cancer
  • Member Central
    • Join AHNS
    • Find-A-Physician
    • Mailing List Order
  • Log In
  • Donate

ATC Fellowship Application

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  • Identifying Information

  • Using your personal email address is highly recommended.
  • City/State/Country
  • All fellowship applicants are required to be an AHNS member or to have an AHNS Resident membership application submitted and in process before the Fellowship Match occurs. For AHNS Resident membership information, please contact the AHNS membership office at [email protected] or 310-437-0559 x 126. [Applicants who have completed their medical education outside of the US or Canada do not need to apply for AHNS membership.]
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  • Education

  • If you are enrolled in a 4-5 year residency in the United States or Canada please answer YES to this question.
  • International applicants complete an online AHNS Fellowship application form. International applicants pay only the $50 processing fee – you do NOT pay the $15 fee for each individual program. Upon the completion of the 2023 match process on July 1, 2022, your application will be distributed to the programs that wish to review international applicants.

    For more information on international applicant eligibility, please visit:

    https://www.ahns.info/residentfellow/fellowships/international
  • Please use the plus button to add more colleges/universities.
    College/University NameDegree ReceivedDate of GraduationCity, State 
  • Please use the plus button to add more colleges/universities.
    College/University NameDegree ReceivedDate of GraduationCity, State 
  • Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 64 MB.
  • Residencies/Fellowships

    On the form below, please include, in chronological order, all residencies, fellowships, preceptorships, teaching appointments and postgraduate education. Please include ALL programs you attended, regardless of if you completed the program or not.
  • Residency/Fellowship 1

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  • Residency/Fellowship 2

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  • Residency/Fellowship 3

  • MM slash DD slash YYYY
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  • Peer References

  • Please list your references below and upload any letters you have received. Letters of reference can be submitted through this form OR sent directly to JJ Jackman (AHNS Associate Executive Director) in the administrative office at [email protected]
    First and Last Name of Reference 
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    Accepted file types: doc, pdf, docx, txt, Max. file size: 64 MB, Max. files: 1.
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      Accepted file types: doc, pdf, docx, txt, Max. file size: 64 MB, Max. files: 1.
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        Accepted file types: doc, pdf, docx, txt, Max. file size: 64 MB, Max. files: 1.
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          Accepted file types: doc, pdf, docx, txt, Max. file size: 64 MB, Max. files: 1.
          • Drop files here or
            Accepted file types: doc, pdf, docx, txt, Max. file size: 64 MB, Max. files: 1.
            • In-Training Exam Score (all years)

            • Professional Liability

            • Disciplinary Actions

            • Please check off all that apply.
            • Additional Attachments

            • Please limit your statement to approximately 800 words - not to exceed 1 page.
              Accepted file types: doc, pdf, docx, Max. file size: 64 MB.
            • Accepted file types: jpg, gif, png, pdf, tif, bmp, Max. file size: 64 MB.
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            • Please select all programs you would like to receive your application. Each additional program is a $15 charge.
            • $0.00
            • If you are unable to pay the application fee with a credit card, please contact AHNS Administrative Coordinator Ochun Farlice at [email protected] to make other payment arrangements.
              American Express
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              MasterCard
              Visa
              Supported Credit Cards: American Express, Discover, MasterCard, Visa
               
            • By submitting this application, I hereby certify that, to the best of my knowledge and belief, I have no physical or mental illness or mental defect that interferes with my professional appointment. All information submitted by me in this application is true and accurate to the best of my knowledge and belief. I agree to be a participant in the American Head and Neck Society 2023 match. I agree to submit my match list prior to the deadline of July 1, 2022. If I wish to withdraw from the match, I must do so prior to July 1, 2022, by contacting the AHNS office.
            • This field is for validation purposes and should be left unchanged.
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            Contact Us

            AHNS, 11300 W. Olympic Blvd, Suite 600
            Los Angeles, CA 90064
            ph: (310) 437-0559 / fx: (310) 437-0585
            [email protected]

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