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
    • History
      • Society Background
      • AHNS History Interviews
      • Past Presidents
      • In Memory
    • Strategic Plan
    • Professionalism & Ethics
    • AHNS Foundation
    • AHNS Bylaws
    • AHNS Staff
    • AHNS News and Announcements
  • Heads Up!
  • Leadership
  • Meetings
    • AHNS Virtual Education Series
    • AHNS Meetings Info
    • AHNS Abstracts
    • Exhibitor and Support Opportunities
    • Past Meetings
    • Related Meetings
  • For Patients
  • For Trainees
    • Fellows’ Virtual Tumor Boards
    • Accredited Fellowships
      • Fellowship Match
      • Directory of Fellowships
      • Fellowship Curriculum
      • Certificate of Completion Request
      • Recent Graduates
      • For Program Directors
      • For Current AHNS Fellows
  • Divisions
    • Education
      • Scientific Program/Resident Courses
      • Surgical Videos
      • Journal Club
      • Journals
      • Global Outreach
      • Awards
        • Margaret F. Butler Award
    • 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
  • Sections
    • Endocrine Surgery
    • Skull Base Surgery
    • Reconstructive Head & Neck Surgery
    • Mucosal Malignancy
    • Salivary Gland
    • Cutaneous Cancer
  • Member Central
    • Join AHNS
    • Find-A-Physician
    • Mailing List Order
  • Log In
  • Donate

ATC Fellowship Application

Step 1 of 3

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  • Identifying Information

  • City/State/Country
  • All fellowship applicants are required to be an AHNS member or to have an AHNS membership application submitted and in process before the Fellowship Match occurs. For AHNS membership information, please contact the AHNS membership office at membership@ahns.info 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 2020 match process on July 1, 2019, 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.
  • 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

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Residency/Fellowship 2

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Residency/Fellowship 3

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • 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 jj@ahns.info.
    First and Last Name of Reference 
  • Drop files here or
    Accepted file types: doc, pdf, docx, txt.
  • Drop files here or
    Accepted file types: doc, pdf, docx, txt.
  • Drop files here or
    Accepted file types: doc, pdf, docx, txt.
  • Drop files here or
    Accepted file types: doc, pdf, docx, txt.
  • Drop files here or
    Accepted file types: doc, pdf, docx, txt.
  • 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.
  • Accepted file types: jpg, gif, png, pdf, tif, bmp.
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  • Price: $50.00
  • 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 Ochun@ahns.info to make other payment arrangements.
    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 2019 match. I agree to submit my match list prior to the deadline of June 15, 2018. If I wish to withdraw from the match, I must do so prior to June 1, 2018 by contacting the AHNS office and all of the program(s) that I have applied to.
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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
admin@ahns.info

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Recent Heads Up! Posts

Myers’ Family Summer Travel Fellowship in Otolaryngology Application is Open

New Grant Opportunity from SU2C in Head and Neck Cancer: LOI Deadline March 22, 2021

Apply Now for the AHNS FY2022 Fellowship Match

More News and Announcements

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