Leadership College

Step 3: Apply to become a 2021 Leadership College Scholar

Application deadline for the 2021 Leadership College class is June 30, 2020.  Please complete the online form below.

Questions? Contact Aubrey Cuthbertson, acuthbertson@ncmedsoc.org, 919-833-3836, ext. 116.

Apply Now

Section 1
The NCMS Kanof Institute for Physician Leadership Advisory Board, or a subcommittee thereof, will review this nomination, which must be completed in its entirety. PLEASE NOTE: You will not be able to partially complete the form and save your responses for later; it is suggested that you review the form and then copy and paste your longer responses from another source such as Word or Notepad.
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Section 2
NOTE: For best results, copy your pre-written text (preferably from Notepad or other simple text editor) and paste into the text areas below.
1) Please describe your interest in the Leadership College, including why you should be chosen by the Advisory Committee to participate. (Please limit to 1000 characters or less.)
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2) Please briefly describe the top three issues physicians/PAs face today and the opportunities for leadership. (Please limit to 1000 characters or less.)
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3) What are three of your personal leadership goals? (1000 character limit)
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4) Please describe how your participation in the NCMS Leadership College will benefit you and your practice setting; county and/or specialty society; or the NCMS. (1000 character limit)
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The purpose of the Leadership College is also to assist you in gaining skills to serve a leadership role locally, regionally or statewide. Are you interested in participating in NCMS committees, task forces, projects or leadership positions?
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Section 3
If selected, I agree to complete a project of my choice and to fully participate in all required educational and networking sessions of the NCMS Leadership College as specified in the Program Guidelines.
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The North Carolina Medical Society

Physical Address:
222 N. Person Street
Raleigh, NC 27601
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Phone:
919.833.3836
800.722.1350 (NC only)
919.833.2023 FAX
Mailing Address:
PO Box 27167
Raleigh, NC 27611
 
 

 

        

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