Please note that your answer on the supplemental questionnaire must correspond to the information that is provided on your resume to receive credit.
1.
Are you currently licensed to practice medicine by the Maryland Board of Physicians? (If Yes, please submit a copy of your license or license verification with your application.)
Yes
No
2.
If yes, please provide your license type, license number and expiration date below.
3.
This position requires that you possess a Board Certification. Please indicate the field in which you have your Board Certification.
4.
Describe your medical practice experience.
Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
5.
Describe your experience related to maternal and child health, in particular: infant mortality prevention; family planning; Women, Infants, and Children (WIC) program; and/or children with special health care needs.
Please include name of employer, job title, dates of employment, and hours worked per week for each related position with your description. This information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
6.
Describe your management experience including responsibility for developing budgets, tracking expenditures, and staff recruitment and management.
Please include name of employer, job title, dates of employment, and hours worked per week for each related position with your description. This information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
7.
Describe your experience building collaborative working relationships across departments in a matrixed organization.
Please include name of employer, job titles, dates of employments, and hours worked per week for each relevant position with your description. This information must also be reflected in your application. If you do not have this experience, put N/A in the box below.
8.
Describe your experience working in government agencies and/or in community health in an administrative capacity.
Please include name of employer, job title, dates of employment, and number of hours worked per week for each relevant position with your description. This information must also be reflected in your application. If you do not have this experience, please put N/A in the box below.
9.
How did you find out about this position (i.e., State website, State Employee, LinkedIn, Recruiter, AMCHP, APHA, monster.com, etc.)?