DRAFT-SFFC

Thank you, , for your interest in the SFFC program.

Grant Requirements

• Institutions who have programs accredited for post-graduate level surgeons seeking clinical training in the surgical disciplines of Bariatric Surgery, Bariatric/MIS Surgery, Colorectal Surgery, HPB Surgery, MIS General Surgery and Thoracic Surgery. Applicants may apply specifically for a robotic-focused fellowship within one of the six disciplines.
• Fellowship programs must be primarily minimally invasive.
• Fellowship programs must be accredited by The Fellowship Council. Certain fellowship programs with ACGME accreditation, which do not receive CMS funding, may be considered.
• Funds are available for fellowship programs in the United States only.
• Institutions may apply for multiple fellows in different disciplines, but a separate application must be submitted for each discipline.
• Submission of a $100 non-refundable fee per application.

Acceptance of FSF Granting Policy

Please check each box to accept the conditions. You must do this before beginning an application.

You cannot continue until you agree to all nine statements above

Programs that not accredited by The Fellowship Council nor the ACGME are not eligible for funding

Programs that receive CMS funding are not eligble to receive funds from the FSF

For approximately how many hours per week will the fellow receive surgical technical skills training in each of the following settings (use a zero to indicate no participation):

Because you indicated this is a brand-new program, we need you to fill out and upload the FSF Case Load Chart for the following people:

• The current program director
• The associate program director
• The most recent past fellow(s), if any

Please use this template and create a new file for each person. Thank you.

Thank you for paying by credit card. Your receipt will be located at the very bottom of your submitted application PDF.

Check Payment

Please note that your check must be received by February 21, 2021 in order for your application to be processed.

Please send your $100 check payment (payable to The Foundation for Surgical Fellowships) to:

Foundation for Surgical Fellowships
ATTN: 2022-2023 Application
11300 W. Olympic Blvd, Suite 600
Los Angeles, CA 90064

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