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Enter your name (this will be confidential)
Email address (this will be kept confidential):
Name of Mentor: (this will be kept confidential)
Years Post PhD:
Department:
How many meetings have you had with your mentor?
Have you had difficulty with scheduling meetings with your mentor?
Yes (if so, why?)
No
How would you rate the relationship you have with your mentor?
(1 = very negative; 5 = very positive)
How would you rate the relationship you have with your mentor?
(1 = very negative; 5 = very positive)
1
2
3
4
5
Rating
1
2
3
4
5
What were the most common topics of discussion with your mentor?
Fellowship applications
Career Planning
Promotions
Publication Preparation
Grant writing
HDR Supervision
Work-Life Balance
Networking
Other (specify):
How would you rate the impact of your mentor on increasing your chances of achieving your goals in these areas of discussion?
1 = their advice was not useful;
5 = their assistance has dramatically increased my chances of achieving my goals
How would you rate the impact of your mentor on increasing your chances of achieving your goals in these areas of discussion?
1 = their advice was not useful;
5 = their assistance has dramatically increased my chances of achieving my goals
1
2
3
4
5
Rating
1
2
3
4
5
Have you encountered any breaches of confidentiality with your mentor thus far?
Yes
No
Have you had any disagreements with your mentor?
Yes
No
Are there any issues you would like to discuss confidentially with the administrators of the program?
If “Yes” you will be contacted within two weeks of submitting this survey
Yes
No
Please provide any other relevant comments
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