Course Registration Form

Thank you for your interest in participating in EDI in Pediatrics: A Self-Guided Course presented by the AAP Section on Pediatric Trainees.
We are excited to have you join the Section on Pediatric Trainees and the Equity, Diversity, and Inclusion (EDI) Workgroup in this month-long exploration engage and better understand values within equity, diversity, and inclusion. This pediatrics-focused curriculum provides opportunities to Read, Watch, Listen, and Engage actively with content provided for each day, over the course of one month.

Each week’s content is centered around one specific theme to address key foundational history and frameworks to understand how participants can participate in improving EDI values at their level of training. Participants are not required to finish every activity, but we encourage you to actively engage in this material in whatever capacity you see fit to maximize your time, learning style, and engagement with this curriculum. If you are participating in this challenge with a larger group, we suggest finding ways to share your learning experience as a community within your physical and virtual spaces.

To participate, please complete the registration form below. Once you submit this form, you have the option to participate in research on the effectiveness of this course.

This course contains daily resources for you to read, watch, listen, and reflect over a period of 4 weeks. If you are registering after April 30, you will receive an email with instructions for accessing the course* within 5 business days of completing this registration form.

The Section on Pediatric Trainees is grateful to the leadership of the EDI Workgroup, specifically, Kendra Moore, MPH; Amundam Mancho, MD, MPH; Aminat Bello; Carmel Bogle, MD, FAAP; Erika Cravanas, MD, FAAP; Brooke Dunn; Saira Khan; Kimberly Marie Najera, MD; Ashley Nmoh; Brigette Obokhae, MS; Forouhideh Peyvandi, MD, MS; and the many volunteers from the SOPT EDI Workgroup, Student National Medical Association (SNMA), and Latino Medical Student Association (LMSA) who helped develop this program.

*AAP Membership is required to access this website. AAP membership is available to medical students for $25/year, and residents who are not part of a dues-sponsored program may join for $150/year. To register, visit shop.aap.org, and complete your membership application form. As part of our commitment to equity, if you are a medical student unable to afford the $25 registration fee, please contact us.

Accreditation and Designation Information
If you are interested in obtaining CME for participation in this course, please look out for verification requirements which will be sent prior to April 1 and linked on our Course Website (AAP login required). The American Academy of Pediatrics is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • AAP designates this Other (Internet Live and Internet Enduring) Activity for a maximum of 15 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • This activity is acceptable for a maximum of 15 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.
  • PAs may claim a maximum of 15 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 Credit(s)TM from organizations accredited by the ACCME or a recognized state medical society.
Questions? Contact AAP Staff, Britt Nagy, MPH, at bnagy@aap.org.
About this Form
As part of the Section's commitment to equity, diversity, and inclusion, we are collecting information to understand more about SOPT members are that are participating in our initiatives. This data will be reported back in summary form to the SOPT Executive Committee and AAP Leadership; no individual identifying information will be included. There is an option at the end of this form to provide feedback on this survey. Beyond your name, email address, membership status, and training level, you are not required to answer any of the questions below.

Thank you in advance for your participation!

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* 1. First Name

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* 2. Last Name

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* 3. Email address

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* 4. Are you a current member of the AAP Section on Pediatric Trainees?

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* 5. List your AAP ID (if applicable)

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* 6. What is your current training/career level?

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* 7. If you are a resident or fellowship trainee, how would you best describe your institution?

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* 8. If you are a fellowship trainee, please list your subspecialty.

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* 9. In which AAP district are you currently located? You may refer to the image below to identify your district.

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AAP District Map

AAP District Map

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* 10. If you are located in North America, please list the 2-letter abbreviation for your state/province.

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* 11. If you are located internationally, please list your country.

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* 12. What is your current gender identity? Check all that apply.

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* 13. With what racial or cultural group(s) do you identify yourself? Check all that apply.

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* 14. Which of the following best represents how you think of yourself? Check all that apply.

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* 15. Under the Americans with Disabilities Act (ADA) you have a disability if you have a physical or mental impairment that substantially limits a major life activity. By this definition, do you have a disability?

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* 16. Please describe the community in which your school/program is located. Check all that apply.

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* 17. Are you an International Medical Graduate or currently in a medical school located outside of the United States?

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* 18. Have you ever participated in an equity, diversity, or inclusion curriculum before?

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* 19. If you answered yes to the question above, in what capacity did you participate in the EDI curriculum? Please check all that apply.

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* 20. What are you hoping to gain from participating in this curriculum?

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* 21. Do you have any feedback on this form?

Thank you for signing up to participate in our course!

Upon submitting this registration form, you will be directed to the course pre-survey. This survey will take no more than 10 minutes to complete; data will be maintained separate from this registration form. We hope that you will consider participating in our research study by completing this pre-survey and the anticipated post-survey associated with this program. More information about our study is provided at the beginning of the survey.
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