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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: Consent and declarations

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