2026 Faculty Development Scholarship Application
Contact Information
Full Name
Gender
Male
Female
Non Binary/3rd Gender
Prefer not to say
Email Address
What is your discipline? (Select one)
Please select...
Physician
Nurse Practitioner
Registered Nurse
Chaplain
Social Worker
Physician Assistant
Other
Please specify other discipline
What is your primary specialty/or practice area? i.e. Palliative Care, Pediatrics etc.
What is the name of your primary institution or employer?
Country of Residence
As part of this application, I attest I have taken the Faculty Development Pre-requisite (Mastering Tough Conversations course or a Powered by VitalTalk course offered at home institutions):
Yes
Eligibility
Please describe your current professional role, including any teaching responsibilities and the clinical population you serve. In your response, note whether you work in a safety-net setting, serve historically marginalized communities, or support patients with limited access to care.
How do you plan to use the VitalTalk Faculty Development training in your work or educational setting? How would your participation in Faculty Development help extend communication skills training access to clinicians who might otherwise not receive it?
Please describe why receiving a scholarship would increase your access to faculty development, including any funding limitations without scholarship support.
Do you identify as a member of a group that is underrepresented in healthcare or academia? (Optional)
Black or African American
Hispanic or Latinx
Native American or Alaska Native
Native Hawaiian or Other Pacific Islander
Asian
Middle Eastern or North African
LGBTQ+
Person with a disability
First-generation college graduate
Other (please specify)
Prefer not to say
Please specify (if 'Other' selected above):
Availability
Please indicate all the course cohorts you are available to attend. Note spots are limited in each. Please only select dates you have known availability as individual scholarships are assigned to specific course dates.
R1 May 19-21, 2026; R2 October 7-9, 2026
R1 September 16-18, 2026, 2025; R2 December 9-11, 2026
R1 December 1-3 2026, R2 March 30- April 1 2027
I understand that as a scholarship recipient I would receive 40% of the total cost of Faculty Development. I would be responsible for the remaining tuition of $3594.
I confirm
Contact Information