IDSA Request Form: Physician Compensation Initiative Live Learning Sessions

This form can be used to request a Physician Compensation Initiative Live Learning Session from the Infectious Diseases Society of America. 

As part of the Physician Compensation Initiative resources available for members, IDSA offers free, 60- to 90-minute physician-led online informational sessions designed to help increase knowledge among ID physicians about physician compensation negotiation. These virtual sessions are led by experienced IDSA physician members who are equipped with an in-depth understanding of physician compensation topics.  Presenters will share information about Physician Compensation Initiative resources and help participants gain practice and comfort with compensation negotiation tools.

Guidelines & Information

Time Frame

• Requests should be made at least 90 days prior to the event 
• We are unable to accommodate requests made more than 6 months in advance

Cost

• No fees, stipends, or honoraria are required

Miscellaneous

• An agenda of the event is requested (draft agendas are acceptable)

Contact Information

Sponsoring Organization:

Mailing Address (Street, City/Town, State and Zip Code)

This will be an address where any swag or paraphernalia can be sent

Contact Name:

Contact Title:

Contact Email:

Contact Phone:

Website address (if applicable):

Event Information

Event Name:

Start Date (MM/DD/YY) & Time:

End Date (MM/DD/YY) & Time:

Location:

Theme/Purpose of Event:(CME, Annual Meeting, Symposium, etc.)

Speaker Start Time:

Length of time allotted for presentation:

Please select... 60 minutes 90 minutes

The PCI Roadshow Live Learning Events are held online. Are you able to provide IDSA with a calendar invite for the event, including a link to your organization's web conferencing platform (e.g., Zoom/ WebEx)?

Please select... Yes No

Expected Attendance (#):

Invited Audience: 

ID PhysiciansFellowsStudentsOtherCheck all that apply

Explain other invited audience

Please share any potential pain points around compensation specific to your locality.

Please indicate whether the invited audience is:

Pediatric care-focusedAdult care-focusedBoth pediatric and adult care-focused

Presentation Specs

Presentation Format:

Keynote/General AddressCME PresentationPanelRoundtableOther

Please specify:

Will the following AV equipment/services be available? (check all that apply)

LCD Panel/ScreenComputer/LaptopAV Support

Do you need us to supply any of the following? (check all that apply)

Speaker BioSpeaker HeadshotSpeaker Slides/Presentation

Please provide a copy of your draft agenda

Would you be open to sharing an attendee list with IDSA after your event?

YesNo

Would you be open to sharing pictures and/or a recording link from the event?

YesNo

Other Setup (please explain)