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Part A: SGH Attachment Information

Note:
All trainees are required to secure own funding to support their attachments and stay in Singapore. Please specify your funding source for this attachment.



Note:
Due to the time required for administrative procedures, trainees applying for hands on patient management attachment are required to submit application at least 9 months prior to the preferred training start date. Please note that actual training commencement date is subject to completion of the necessary administrative procedures, registration and/or visit pass approvals.

Note:
Please specify your training objectives, highlighting information such as the subspecialty & skills/ techniques/ procedures that you wish to learn in this attachment and the result you hope to achieve from this attachment.

(a)Subspecialty:

(b)Skills/Techniques/Procedures:

(c)Reasons for application:

Part B: Personal Particulars

Note:
Please state name as shown on Passport / Identity Card.




Note:
One recent digital passport-sized colour photograph that meets the following specifications: Image file in JPEG format ('jpg' extension) with a file size of not more than 60 kb

Part C: Contact Information

Note:
Please note that most correspondence will be conducted through this email address, except mailing of hardcopy documents.

 
<Country code><Area code><Phone number>
 
Part D: Education/Medical Qualification

Section 1: Basic Medical Degree Listing (Max. 2 & Min. 1 record is compulsory)



Section 2: Postgraduate Medical Degree / Other Degrees / Fellowship (Master of Medicine equivalent) (Max. 3 & Min. 1 record is compulsory)



Section 3: Medical Licensure Listing (Max. 2 and min. 1 record is compulsory)



Part E: Clinical Appointment/ Experience

Section 1: Rotating internship/ Houseman-ship (Max. 6 & Min. 1 record is compulsory.)



Section 2: All post-housemanship postings (Max. 6 & Min. 1 record is compulsory.)



Section 3: Current Position



Note:
Please provide a summary of your role and responsibilities in the current position, highlighting the subspecialties, if any. Wherever possible, describe types of cases / patients, working hours, teaching sessions, etc.


Note:
Hospital's URL.

Part F: Other Information

Note:
Please list memberships obtained in chronological order.

Note:
Please list publications in chronological order.

English Proficiency











References (Details of Professional Referees)

 
 

Note:
Please specify details of research and training experiences, special projects, scientific work that you have engaged in and any notable accomplishments you have achieved. Also indicate your professional interest and plans for future.

Have you confirmed a clinical / teaching position with an institution in your country upon completion of the training programme in Singapore?


Have you applied for any Fellowship programme in SGH before?


If yes, please indicate Fellowship name and application date (mm/yyyy).

Part G: Administration Information

A. Application

B. Admission

C. Attachment