Thank you for your interest in becoming a mentor for the BMA committee mentoring programme.

Our goal is to support the medico-political development of members and to give them the skills required to be effective committee members and future leaders. The programme is designed to help committee members set and achieve their goals and realise their full potential through guidance from mentors.

Please complete the form below telling us about yourself, your interest in mentoring, and the skills and knowledge you feel you could pass on to a mentee.

If you have any questions regarding the mentoring programme or the application process, please do not hesitate to contact us at mentoring@bma.org.uk.

By completing this form, you are giving consent to the BMA corporate EDI (equality, diversity and inclusion) team to use the details provided for the sole purpose of mentor-mentee matching.

Your personal information and contact details will remain secure and confidential. They will not be disclosed outside of the corporate EDI team. Once we have matched you to a mentee, we will send you their contact details for you to connect with them, at which point you will be permitted to share your contact details with them. For further information about how the BMA processes personal data, please see our full privacy policy.

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* 1. Please enter your title and full name:

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* 2. Please enter your email address:

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* 3. Please enter your BMA membership number:

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* 4. Please enter your specialty (if applicable):

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* 5. Please enter your primary grade (if applicable):

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* 6. Please enter your location:

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* 7. Please list the BMA committees on which you are currently sitting or have previously sat on and the dates of your membership:

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