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ASRS's Empowerment and Opportunity Mentorship Program: Mentee Application 2026

The ASRS Empowerment and Opportunity Section invites you to complete the following application to become a mentee for an exciting and innovative mentorship program. Mentees in this program are ophthalmology residents (priority given to 1^st and 2^nd year residents) with an interest in medical or surgical retina fellowship. If you are a fellow and are interested in the program, you should apply as a mentor on this page.

The main goals of the Empowerment and Opportunity Section are to increase the representation and amplify the voices of Underrepresented in Medicine (URiMs) within the field of retina.

Based on The Association of American Medical Colleges URiM definition, the ASRS Empowerment and Opportunity Section defines URiM as “Those populations that are underrepresented in the medical profession relative to their numbers in the general population. This includes Blacks or African Americans, Hispanics or Latinos, American Indians or Alaska Natives, Native Hawaiians or Other Pacific Islanders, Southeast Asians (for example Cambodian, Laotian, Vietnamese, Hmong, Filipino) and individuals who identify as LGBTQIA+.”

The program offers two tracks. The Family Track centers around the concept of “family” with participating members at various career stages being assigned to mentorship families. Through a series of five professional-led, shared leadership experiences, these families of mentors and mentees cultivate valuable long-term professional relationships that allow for the sharing of insights, experiences and information as a means of helping mentees reach their goal of becoming retina specialists. The dates of the sessions will be released at the beginning of the program. Three will take place exclusively over Zoom, one will take place at the ASRS Annual Meeting in Montreal (and Zoom), and one at the AAO Annual Meeting in New Orleans (and Zoom).

The Traditional Track is designed to provide the more typical one-on-one mentorship experience. The mentors and mentees in the track are also welcome to attend the five sessions, or for the participants to watch the recorded sessions and discuss after the sessions conclude.

New for 2026: Travel grants to attend the ASRS Annual Meeting are not guaranteed for mentees. After the final session of the year (October/November), family track and traditional track mentees who are interested in a travel grant will be invited to submit an application. Grants will then be awarded based on the available budget and the following considerations:

Level of participation in the mentoring sessions throughout the year
Contributions to and engagement with section activities and initiatives
Financial need

Grants will be awarded only to mentees who attend the ASRS Annual Meeting. The exact dollar amount will be determined later in the year. We are hopeful that these will be at least $1,000 each.

If you have any questions about this program or experience any technical issues in submitting your application, please contact Joshua.Friedman@asrs.org.

Please note that the application deadline is Sunday, February 22 at 11:59pm CT.

Full name*

Address

E-mail address*: Be sure to use an e-mail address that you will have access to for all of 2026!

Phone

Are you applying for the Family or Traditional Track Mentorship Program?*

Only Family
Only Traditional
Both but Family as First Preference

Which years and tracks have you participated in this program? Check all that apply*

Pronouns you identify with*

She/Her
He/Him
They/Their
Other

Gender Identity*

Race/Ethnicity. You can select more than one if applicable.*

If you identify as Asian, what country is your ancestry?

What is your cultural identity?: While many relate to their own race/ethnicity/sexual orientation, you can expand upon this

Were you or your parents first generation immigrants (first in family to become a US citizen) to the US?*

Yes, myself
Yes, my parent(s)/guardian(s)
No

Do you identify as LGBTQIA+?*

If so, how do you identify? You can select more than one, if applicable.

Please share any disabilities that you are comfortable in disclosing. (State “None” if this doesn't apply)*

Did you qualify for and or receive need-based financial assistance to attend college and or medical school?*: If this does not apply, put “N/A

Parent(s)/Guardian(s) Highest Level of Education*

Did you grow up in a rural, urban or suburban area?*

Rural
Urban
Suburban

Would you consider the area you grew up in medically underserved?*

Do you have family members that are in the field of medicine?*

If yes to above, what is their profession?

What college(s)/university(ies) have you attended and degrees obtained?*

Residency Program*

Current Year in Residency Program (2024-2025)*

Does your school have a retina fellowship program?*

Have you committed to a career in Ophthalmology with an interest in medical or surgical retina sub-specialty?*

What topics are you interested in having a mentor work with you?*

In 100 words or less, please describe your diversity, equity and inclusion vision for the field of retina?*: (characters remaining: 900)

In 100 words or less, please describe why you are applying to be part of the family or traditional track mentorship program?*: (characters remaining: 900)


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