Residents

* Required items if you would like your professional information listed on the BPGNY website

First Name:*
Last Name:*
Preferred Email address:*
Phone Number*
Current Position (e.g., Resident, Fellow)
Residency Program / Training Institution
Degree(s): (e.g., MD, PhD, MPH)*
Clients served: (Select one)*
Title: (Select one)
Borough: (Select one)
Description of Career Interests (maximum of 200 words): Narrative paragraph describing your experience/relevant training, any specialty areas, other work interests, your professional affiliations, and whatever else you would like to share about your professional life.