|Year : 2015 | Volume
| Issue : 3 | Page : 336
Post-doctoral international fellowships in Dermatopathology
|Date of Web Publication||4-May-2015|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Post-doctoral international fellowships in Dermatopathology. Indian J Dermatol Venereol Leprol 2015;81:336
| Application Form|| |
(Use a separate sheet where necessary)
I. Personal details
- Date of birth
- Age in completed years (on 31-3-2015)
- Status (Resident/Faculty in medical college/Independent practicing consultant)
- IADVL membership number & years of membership
- Mobile number
- Corresponding address
- Email address
- Year of passing MBBS
- Postgraduate qualification (MD/DDVL/DD/DNB)
- Year of passing
- Post-qualification experience
- Present position
- Presentations at national/international/zonal/state level conferences in the last three years (Mention the type of presentation, i.e. Oral/Poster/Award paper) (If necessary, attach a separate sheet)
- Publications in peer reviewed indexed journals in the last three years (weightage will be given to the first two authors/corresponding author) (If necessary, attach a separate sheet)
- Projects undertaken (other than thesis)
- Chapters/editors in books (first two authors only) (Give details)
- Awards (state/zonal/national/international) (Give details)
- Any special exposure or previous training in dermatopathology
- Participation in IADVL activities (e.g. organizing IADVL days, health camps, etc.) (Please enclose the necessary proof)
- Contribution to other IADVL members/parent department/patients
IV. Add a separate note on:
- Any other information explaining why you want this fellowship and any information not mentioned above
- Your previous experience or training or any other activity to show your interest in dermatopathology
- Why you are interested in dermatopathology
- How you wish to take your interest further in the subject of dermatopathology for the benefit of the community and IADVL members after completion of your training.
| Declaration|| |
- I have not received any dermatopathology fellowship by IADVL in the past.
- I will submit a brief report about the fellowship soon after the completion.
- I possess a passport and will be willing to travel abroad.
- I will be able to obtain leave from my job (if employed)
- All statements made above by me are true. If any of the above are found false, I abide by the rules of IADVL to take appropriate action (which may include refund of scholarship amount/disqualification from future grants/scholarships/awards).