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Clinical Fellowship application form

Please refer to the detailed information in the 'About the Clinical Fellowship' section before you apply.  

To apply, please complete both the CANDIDATE and HOME CENTRE forms below and click submit. Any queries regarding filling the forms should be sent by email to the ESPE Office.

Notification of acceptance/refusal: 31 October.

If successful, the applicant should confirm acceptance within 2 weeks of notification.

Once the fellowship is accepted, the fellow should confirm the date of commencement of fellowship to the committee by: 15 December. 

The fellowship should be commenced latest by: 30 June (of the following year).

The CANDIDATE FORM should be completed by the applicant.

The HOME CENTRE form should be completed by the promoter/supervisor of the applicant.  

 

ESPE Clinical Fellowship Candidate Form (to be completed by applicant)

Section 1: Candidate - Personal details

Hospital address, City, Country

Please list if multiple and include membership numbers

Please upload in Microsoft Word format

Please upload in JPEG format only

Section 2: Postgraduate training
Section 3: Present Activity
Section 4: The Training Project
Section 5: Foreign and travel experience (professional)

Please detail activity name and year

Section 6: Language abilities

Rate your abilities as excellent, average, low – ONLY list languages in which you would be able to do the fellowship

Section 7: The Fellowship Project

PDF format only

Please detail your goals and expected outcomes

Section 8: Home supervisor and centre information

(Home centre supervisor/Head of Department)

Include hospital/university and department

(adult and paediatric)

Physicians and other academic personnel

If Yes please answer questions 1-3, if no please answer only questions 5 and 6

Paediatric Endocrine patients only

Outpatient care, follow-up clinics, etc.

Please only answer if there is not a division of paediatric endocrinology in your centre

Staff positions, beds, space, laboratory & equipment

Upload a signed support letter from your home supervisor/promoter

Guidance for supervisor: In the letter please reference your thoughts on the position of the candidate on return from the fellowship, if you think the candidate has potential to set up/develop a division of paediatric endocrinology on completion of the fellowship, what your main reasons for supporting this application are, what the applicants main areas of interest are, what the main goal of the fellowship is and the applicants ability to work as a leader, executor and moderator of a team.

Section 9: Consent and declarations

Please scan your signature and paste to a Word document or PDF file and upload