GLOBE Application

Pediatrics Global Oncology and Blood Disorders Education (GLOBE) Program

GLOBE Scholar Application (Physicians)
GLOBE Fall 2020

Monday, October 19, 2020 - Friday, November 27, 2020

APPLICATION DEADLINE:

Friday, November 29, 2019 at midnight (EST)

PUBLICATION OF RESULTS:

Friday, January 31, 2020 (or earlier)

APPLICATIONS RECEIVED AFTER THE DEADLINE

WILL NOT BE CONSIDERED
GLOBE Program Overview
The Dana-Farber/Boston Children’s Cancer and Blood Disorders Center (DF/BC) is a large Harvard Medical School affiliated academic hematology/oncology program, serving over 600 new oncology patients and over 1,200 new hematology patients a year, with over 100 research and clinical faculty. The Pediatric Global Oncology and Blood Disorders Education (GLOBE) Program hosts visiting pediatricians mainly from developing and underdeveloped countries as a part of the DF/BC’s Global Health Initiative (GHI). The GLOBE Program is a 4 to 8-week observership experience in which participants attend patient rounds and other clinical activities, as well as participate in teaching conferences under the supervision of a DF/BC staff physician.

During the GLOBE Program, participants learn about how pediatric hematology and oncology care is delivered in our Institution with a focus on quality and multi-disciplinary care, observe how our medical teams are structured, and learn about how the latest diagnostic techniques and protocols are implemented in our Institution. The GLOBE Scholars are encouraged to share their own experience and expertise with our trainees and staff. During their stay, GLOBE Scholars are also expected to design or participate in a clinical, quality, or research project of their own under the mentorship of a DF/BC staff physician.

The GLOBE Program accepts international pediatricians who have either already completed training in pediatric hematology and/or oncology or are in their last year of training and are committed to pursuing a career in the field of pediatric cancer and/or blood disorders. Priority is given to applicants from low- and middle-income countries (as defined by the World Bank Classification System) but applicants from high-income countries are eligible to apply as well.

The GLOBE Scholars can attend a minimum of one and a maximum of two consecutive service rotations. Each service rotation is four weeks long, during which each participant will be assigned to rotate through two of our five disease programs: (1) Benign Hematology, (2) Hematologic Malignancies, (3) Solid Tumors, (4) Neuro-Oncology, and (5) Stem Cell Transplantation. The GLOBE Scholar will work on a daily basis under the guidance and supervision of the service attending. In addition, each GLOBE Scholar will be paired with a clinician who will mentor the participant over the entire length of the program, meet the participant weekly, and oversee the participant’s individual project. We will do our best to meet the applicant’s requests for rotation in a specific service, but because we host national and international students and residents through other programs, placements are done based on availability.

Due to government regulations, international visiting physicians at Dana-Farber Cancer Institute or Boston Children’s Hospital may only participate in clinical activities as observers. These regulations prevent Scholars from having direct patient care responsibilities. Despite this, Scholars may observe clinical interactions fully and participate in bedside didactic teaching and help other team members with tasks that, though part of patient care, are not considered direct care (for example, literature searches regarding a clinical problem, and protocol review). All GLOBE Scholars must comply with the Dana-Farber Cancer Institute and Boston Children’s Hospital Observership Policies at all times.

Finally, it is important for applicants to realize that the GLOBE Program is an informal educational experience. It does not represent a formal subspecialty or fellowship training. Therefore, the GLOBE Scholars will receive a certificate of attendance describing their participation dates and activities, but will not receive any form of licensing or academic credit from Dana-Farber Cancer Institute or Boston Children’s Hospital.
Application Instructions
If you have any questions, please email: globe@dfci.harvard.edu.

Each applicant is responsible for ensuring that the application is complete. All returning applicants are required to submit a completed new application. The Selection Committee will not consider any additional changes once an application has been submitted.

GHI reserves the right to request additional information or verification of information and/or documents submitted. If an applicant is unable to do so, GHI reserves the right to withdraw consideration of the application and may withdraw acceptance.

Applicants must assume all costs involved with the application submission.

We cannot guarantee that the submission of an application will result in acceptance.

We only host 3-4 Scholars each period.

Diversity is a source of strength for the Institute and we provide fair and equitable consideration of applicants for the Pediatrics GLOBE Program without regard to race, color, religion, ancestry, age, national origin, place of birth, gender, gender identity or expression, sexual orientation, disability, genetic information, or any other category protected by federal, state, or local law.

Application Materials
- GLOBE Program Application Form: http://www.jotform.us/GHIglobal/GLOBE
- Updated Curriculum Vitae
- Letter of Support from home institution (hospital/university)
- Copy of current license to practice medicine in country of origin
- Picture in jpeg format
If available, we encourage you to submit the following with your application:
- Proof of English Proficiency (TOEFL or IELTS)
- Copy of Passport
- Copy of US Visa
Submission Instructions
- All information must be completed in English;
- All documents must be e-mailed back as PDF files* (any other format is not acceptable);
- If a form consists of more than one page, upload as a single document;
- Name each file starting with your last name (for example: Smith_CV, Smith_Application, etc.);
- When a signature is required, include original signature and not electronic signature.
*To convert or create PDF files, you could use http://www.freepdfconvert.com/

Upon acceptance to the program, Scholars are required to comply with DF/BC Immunization and Screening requirements. For more detailed information, please refer to the “After you apply”, and “Immunization and Screening requirements” sections.

Failure to comply with proofs of immunization, tuberculosis screen, and health insurance status will result in withdrawal of application and/or acceptance.

Scholars must attend a DFCI orientation on the first day of the GLOBE program

GHI staff is available to help international candidates with the application and on boarding process. Please do not hesitate to contact us during with questions or concerns to: globe@dfci.harvard.edu.
After you Apply
Once we have received your complete application and supporting materials, the Selection Committee will review the application and one member will contact you to schedule an online interview.

Upon acceptance to the Pediatrics GLOBE Program, the following materials will be required:
1. Completed Observership Program Agreement form, signed by both observer and sponsor
2. Receipt of full payment for costs associated with Scholar screening and orientation ($2,000 USD). Payment is accepted via PayPal or personal check. Create a PayPal account or login to your existing account , then go to PayPal's secure payment page and make your payment to observerships@dfci.harvard.edu . Retain confirmation information for your records. If paying by personal check, funds must be drawn on a bank with a US branch. Please make your check payable to Dana-Farber Cancer Institute
3. Proof of federally mandated health insurance for the duration of the stay in the US
4. A copy of the observer's visa (J1, B1 or other)
5. Observer's Health Requirements: Observers are required to submit proof of the following immunizations (record must be translated into English, if applicable ):
Upon approval of the Pediatrics GLOBE Program, Human Resources requires that you submit your online profile on https://careers-dfci.icims.com and fill out all necessary on-boarding forms and agreements, as directed by Human Resources. Completion of all on-boarding forms at least one month before the observer arrives to the US is a requirement in order to be able to attend the DFCI Orientation on the first day of the program.

Immunization and Screening Requirements

All staff (funded, sponsored, temporary), volunteers, and students are required to have a pre-placement screening, based on DFCI infection control standards. A health clearance screening is required annually for those working directly with patients or researchers working with Mycobacterium Tuberculosis.

Tuberculosis Screening

One of the following is required:
1. Documentation of two TB skin tests within the year or one TB skin test within the year with documentation of precious serial (consecutive) negative TB skin tests. Will also accept a negative T-Spot or Q-Gold blood test within one year of starting date.
2. If the TB skin test is over one year, and documentation is not available, a blood-test for TB: T-Spot blood test will be done in lieu of a 2-step TB skin test.
3. Students must provide documentation of a TB skin test or a blood test for TB: T-Spot or Q-Gold blood test with the date of testing and results.
4. For individuals known to be TB skin test positive or have a positive blood test for TB: T-Spot or Q-Gold blood test, written documentation of this along with a chest x-ray report ruling out active tuberculosis is required.
Measles, Mumps, and Rubella Immunity Required

One of the following is required:
1. Documentation of two measles vaccines, two mumps vaccine, and one rubella vaccine or documentation of two MMR vaccines.
2. Proof of immunity to measles, mumps and rubella by titer (blood test).
Hepatitis B Vaccine

One of the following is required for individuals who may be exposed to blood or body fluids:
1. Documentation of the hepatitis B series.
2. Positive antibody test by titer (blood test) for hepatitis B.
3. An individual may decline the vaccine series, but will be required to sign a declination form.
Chicken Pox Immunity Required

One of the following is required:
1. Proof of immunity to chicken pox by titer (blood test).
2. Documentation of two varicella vaccinations.
3. Documentation of varicella (chicken pox) disease from the diagnosing provider/PCP.
Tetanus, Diptheria and Pertussis

It is recommended that all should have 1 dose of Tdap to replace a Td booster.
1. All health care providers should receive a 1-time dose of Tdap regardless of age.
2. There is no minimum interval between Tdap and a previous dose of Td.
3. All adults (who have completed the primary series of a tetanus/diphtheria containing product) should continue to have a booster every 10 years.
Influenza Vaccination

All staff (funded, sponsored, temporary), volunteers, and students are required to follow the Institute’s universal annual Influenza Vaccine Policy. If there is a medical contraindication, supporting documentation from a health care provider must be provided to Occupational Health.

Middle Eastern Respiratory Syndrome (MERS) Screening

Middle Eastern Respiratory Syndrome (MERS) Screening for applicants coming from the Arabian Peninsula or neighboring countries, including Bahrain, Gaza Strip, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, the United Arab Emirates, the West Bank, and Yemen.
Applicant Information
First Name (as it appears on your passport) *
Last Name (as it appears on your passport) *
Gender Identity *

Male Female
Date of Birth *

Month Day Year
Citizenship *
Address at Home Country *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Phone Number *

Area Code Phone Number
Skype ID *
Google Hangouts ID
Full Name *

First Name Last Name
Medical School

Please provide your education in chronological order, beginning with the current or most recent.
Are you currently a medical school student? *

Yes No
Are you currently a medical resident? *

Yes No
Thank you for your interest in the GLOBE Program. Unfortunately, medical students and medical residents are not eligible for this program.
1. Degree *
Name of Institution *
Date when degree was obtained *

Month Day Year
Location: city, state, and country *
2. Degree *
Name of Institution *
Date when degree was obtained *

Month Day Year
Location: city, state, and country *
3. Degree *
Name of Institution *
Date when degree was obtained *

Month Day Year
Location: city, state, and country *
Training and Employment
1. What is your medical license/specialty? *
Select all that apply
If other, please note your medical license.
2. Have you completed a fellowship training in pediatric oncology and/or hematology? *

Yes No
If yes, please provide the dates, duration, institution name, and location of institution.

0/200
3. Do you treat hematology AND oncology pediatric patients? *

Yes No
If No, please explain.

0/200
4. Do you treat ONLY adult oncology patients? *

Yes No
If you are treating adults and children with cancer, please indicate:
Percentage of time you spend treating adults:
Percentage of time you spend treating children:
N/A
5. How many years have you been practicing as a pediatric oncologist/hematologist (please indicate the number of years)? *
Years
6. How many people report to you directly (i.e. how many people do you formally supervise)? *
Please list the title/position of the person to whom you report directly at your hospital (i.e. your supervisor's title/position) *
7. How did you hear about the GLOBE Program?

0/50
8. Have you participated in another observership experience outside of your country before? *

Yes No
If yes, please provide the year, duration, institution and short description of the observership experience.

0/200
9. Are you applying as a physician and nurse team? *

Yes No
If yes, please provide name of nurse team applicant.
10. Has a past GLOBE Scholar referred you to our program?

Yes No
If yes, please give name of GLOBE Scholar:
Please provide your training and employment in chronological order, beginning with the current or most recent.
1. Name of Hospital/Institution *
Position *
Start date of employment or training *

Month Day Year
End date of employment or training *

Month Day Year
Location: city, state, and country *
2. Name of Institution *
Position *
Start date of employment or training *

Month Day Year
End date of employment or training *

Month Day Year
Location: city, state, and country *
3. Name of Institution *
Position *
Start date of employment or training *

Month Day Year
End date of employment or training *

Month Day Year
Location: city, state, and country *
Questions about your Institution
1.Name of your current hospital/institution: *
2. How many beds does your hematology/oncology unit have? *
3. What year was your hematology/oncology unit established? *
4. What is the status of your hospital? *
5. Is your hematology/oncology unit part of a children's hospital? *

No Yes
If yes, please give the name of the hospital
6. Is your institution affiliated with a teaching or academic university? *

No Yes
If yes, please give the name of the university
7. Is your institution the ONLY facility where pediatric hematology/oncology patients receive care?

Yes No.
If not, how many other facilities treat children with cancer (public and private)?
8. Does your unit treat hematology AND oncology patients? *

Yes No
If No, please explain
9. Do you treat patients from other countries?

Yes No
If yes, please state the countries where patients come from?
10. How many new hematology/oncology patients do you see at your hospital each year? *
11. How many pediatric oncologists/ hematologists exist in your country approximately? Please indicate number below:
12. How many full-time hematologists/oncologists work on your unit? *
13. Are there physicians other than hematologists/oncologists at your unit who treat children with cancer and blood disorders? *

Yes No
If yes, please explain
14. Do you have teaching responsibilities?

Yes No
If yes, please explain (50 words or less)
15. How many full time nurses work in your unit?
A. During the day *
What is their shift? (ex 9am-5pm or 9:00-17:00) *
B. During the night *
What is their shift? (ex 9am-5pm or 9:00-17:00) *
C. During Weekends *
What is their shift? (ex 9am-5pm or 9:00-17:00) *
Letter of Intent & Goal Setting
1. Please state your specific areas of interest and exposure to:
a) Pediatric Oncology *

Please write a minimum of 100 and a maximum of 200 words. 0/200
b) Pediatric Blood Disorders (Hematology) *

Please write a minimum of 100 and a maximum of 200 words. 0/200
c) Global Health and/or Public Health, Health Policy, Advocacy, etc. in your home country *

Please write a minimum of 100 and a maximum of 200 words. 0/200
2. What are your long-term professional goals and how will participating in GLOBE help you achieve them? *

Please list at least four goals. 0/300
3. What are your learning objectives during your participation in the GLOBE Program? These should be SMART (Specific, Measurable, Achievable, Relevant, and Time-bound). Please name at least 3 objectives. *

Please write a minimum of 100 and a maximum of 200 words. 0/300
4. Why do you want to come to DF/BC over other leading Institutions in the US? Please be specific (Ex: work with a specific physician, learn about a specific protocol or clinical services, location, research interest, etc.) *

Please write a minimum of 100 and a maximum of 200 words. 0/300
In a scale of from 1 to 5, with 1 being the most interested and 5 the least interested, how would you rate your interest in being exposed to the following areas: