2025 ASCRS Mentor Survey

Please complete this survey if you are interested in participating in any of the 3 ASCRS mentorship programs. Commitment times vary based on the program.

Not sure which program is right for you? Explore your options here.

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* 1. Full Name

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* 2. Email

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* 3. I have been in practice for:

Less than 7 years

7 - 10 years

11 - 15 years

16 - 20 years

More than 20 years

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* 4. Practice Type

Academic

Academic Affiliated Community Hospital

Community Practice

Hospital Based Practice

Private Practice

Military

Other (please specify)

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* 5. Which topics do you feel capable of providing mentorship or have experience assisting mentees with? (Select all that apply):

Application process for colorectal surgery fellowship

Building a research career

Colorectal surgery as a career

Getting involved in ASCRS

Leadership

Surgical education

The business of surgery / How to build a practice

Work-life balance

Diversity, under-represented minorities (URM), gender

Other (please specify)

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* 6. I am interested in participating as a MENTOR for the following events (Select all that apply):

Mentorship Program for General Surgery Residents (July 2025–July 2026)
This is a full year commitment.

1:1 Mentorship Program (May 2025–May 2026)
This is a full year commitment.

Annual Scientific Meeting Speed Mentoring In-Person Event - Sunday, May 11, 2025.
This is a 2 hr commitment with some prep prior to the meeting.

Other opportunities if they should arise