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Partners Harvard Medical International extends the mission of Harvard Medical School internationally - our philosophy is that every citizen of the world should have access to high quality health care in their own region. Our program teams are composed of those with expertise in clinical care and education and also those with expertise in health care facility design and operation. If you feel that your skills and experience would be a good fit for working with PHMI, please complete the form below to be added to our database.

Note: If you are applying for full-time positions at PHMI, please visit our Careers Page. If you are an organization interested in learning more about PHMI's services, please complete our Prospective Clients Form.

Prefix

Examples: Dr., Mrs., Mr.

First Name*

Last Name*

Suffix

Examples: Jr., III

Degrees

Please enter without any periods.
Examples: MD, PhD, M Ed

Full Name*

Your full name as you prefer it to appear.
Example: Professor John J. Doe, Jr. MD, PhD

Gender

Female
Male

CONTACT INFORMATION

Phone (Office)

Phone (Mobile)

E-mail (Primary)*

E-mail (Secondary)

ASSISTANT

Assistant's Name

If you have an assistant, enter their name and e-mail address in these fields.

Assistant's E-mail

Assistant's Phone

PRIMARY CURRENT POSITION & MAILING ADDRESS

Academic Title

Professional Title

Organization

Department

Address 1*

Address 2

Building

City*

State/Province

Postal Code*

Country*

OTHER CURRENT POSITIONS

Organization

Department

Title

Organization

Department

Title

HARVARD CONNECTIONS

Harvard Faculty Member *

Yes
No
If you are a member of the Faculty at a Harvard School, please indicate it here.

Harvard Club Member/Officer

If you are a Member or Officer of a Harvard Club, please enter the name of the Club here.

Select the country of the Club here.

If you are a Club Officer, please enter your title here.

Alumni

EXPERIENCE & EXPERTISE

Work Area/
Industries

Clinical Specialties

Languages

Country Experience (Personal or Professional)