Mentor Background Declaration Form

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Mentor Background Declaration Form

Confidential Document – For Internal Use Only

Personal Details:

Professional Background

1. Have you previously worked (or are you currently working) with any other medical education platforms similar to StudyMEDIC (Eg: coaching for MRCOG, MRCS, PLAB, USMLE, AMC, etc.)?
2. Are you currently associated (as employee, consultant, mentor, or any other capacity) with any platform or organization that could be considered a direct or indirect competitor to StudyMEDIC?
3. Have you signed any non-compete or confidentiality agreements with any previous organizations that might restrict your engagement with StudyMEDIC?

Conflict of Interest Declaration:

4. Do you have any financial, professional, or personal interests that could potentially conflict with your role as a mentor at StudyMEDIC?

Acknowledgment

I hereby declare that the information provided above is true and correct to the best of my knowledge. I understand that any misrepresentation or omission may result in the withdrawal of my application or termination of my engagement with StudyMEDIC.