Step 1 - Make a Payment

A payment of $450 is due immediately on submission of your application for the Post Fellowship Training Program. You will need to complete this step first.

Step 2 - Complete the Form

Before you commence Step 2, we recommend that you work from a saved version of your reply by copying and pasting into the relevant sections below. Be sure to have all the relevant documents ready to complete the application below IN ONE SITTING. This advice is to safeguard you against losing your uploaded information should there be a break in your internet connection or you accidentally navigate away from the page before sending.







     
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    COMPULSORY REQUIREMENTS





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    COVER LETTER (Maximum 500 Words).

    • Why do you believe you are a good candidate for selection into HPB training and a career in HPB surgery?
    • What are your ambitions in HPB surgery?
    • Future job prospects, (details of any proposed overseas training or research and some indication as to future career aspirations)

     

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    EMPLOYMENT DETAILS




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    EDUCATION





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    RESEARCH

    Please provide links where possible for ALL research documentation.

    Original manuscripts

    • Please enter using Vancouver format, beginning with the most recent and listing your name in bold type
    • Where applicable please enter a PubMED reference link.
    • Please do not enter planned publications or publications in preparation








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    PRESENTATIONS
    Please include only those presentations that you have personally given.




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    TEACHING ACTIVITIES



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    ADMINISTRATIVE ACTIVITIES



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    OTHER ACHIEVEMENTS









     
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    REFERREES

    Please list at least 3 consultant surgeons as referees who are able to comment on your surgical training to date, your suitability for ANZHPBA training and your potential as an HPB and ANZHPBA surgeon. This should include at least 1 ANZHPBA member and an HPB surgeon (who is head of a Unit you have worked in previously). Please ensure you have informed your referees that you are applying for the ANZHPBA training program and that they may be contacted.
     
    Referree One (Mandatory field)




     
    Referree Two (Mandatory field)




     
    Referree Three (Mandatory field)




     
    Referree Four




     
    Referree Five




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    CLINICAL PRIVILEGES





     




     




     




     
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    DECLARATION

    I declare that by submitting my application for a Post Fellowship Training position with ANZHPBA that the information contained in this Fellowship Application is true and correct.




     

     
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