CIRSE Fellowship Information and Application
CIRSE Fellowship Information and Application Thank you for your interest in becoming a CIRSE Fellow! You will find in the following pages a brief introduction to CIRSE Fellowship, the requirements necessary to apply and an application form with guidelines. CIRSE Fellowship was established to recognise and honour physicians and scientists who have made a significant contribution to interventional radiology and/or cardiovascular imaging techniques. CIRSE members have the opportunity to be honoured as a Fellow if the following criteria apply: • • • •
The candidate has been a CIRSE member for at least three years. The candidate finished his/her medical specialty training at least five years ago. The candidate has the support of two CIRSE Fellows confirming their aptitude to become a Fellow. (Both supporters may not be Corresponding Fellows, in this case, at least one supporter must be residing in the EU as a CIRSE Fellow) The candidate must have published at least five articles in cardiovascular and interventional radiology, internationally recognised, peer-reviewed scientific journals with an impact factor. Candidates must have been the first author of at least two of these publications. Case reports are excluded.
The applications will be thoroughly assessed by the Membership Committee for preliminary approval. Following this, the names of the applicants receiving preliminary approval will be published on the CIRSE website. After publication, the names will remain posted online for six weeks, during which members will be allowed to comment on the applicants’ suitability as a CIRSE Fellow. After this period, the Membership Committee will make its final decision, subject to ratification by the Executive Committee. If you feel that you meet the above-mentioned criteria and are interested in applying for CIRSE Fellowship, please complete the following application form and return it to the CIRSE office ([email protected]) with the required documentation. For any assistance or further enquiries in regards to the CIRSE Fellowship application, please feel free to contact [email protected].
1
CIRSE Fellowship Application Form Applicant's name: Title First name _______ ________________________
Last name ________________________
CIRSE Member ID: ______________________ CIRSE member since: _________________________ (minimum requirement of three years) CIRSE member refers to full members, in good standing for at least the last three years. Years as a Junior Member cannot be counted. If you are unsure of your membership status, please contact [email protected]. Finished medical specialty training date: _______________________ (DD.MM.YYYY) Training must have been completed at least five years prior to application date. Name and CIRSE ID of First supporter: Title First name _______ ________________________
Last name ________________________
CIRSE Fellow’s ID: ______________________ Name and CIRSE ID of Second supporter: Title _______
First name ________________________
Last name ________________________
CIRSE Fellow/Corresponding Fellow’s ID: ______________________ Support must come from two CIRSE Fellows. Both supporters may not be Corresponding Fellows, in this case, at least one supporter must be residing in the EU as a CIRSE Fellow. Support can be in written form, which you may attach with this application, or the supporters may email [email protected] directly.
2
Five Published Articles on a Cardiovascular and Interventional Radiology Topic Two as first/corresponding author Journal Name
First author? (Required)
Article Title
Yes
1
Yes
2
Remaining three of five required articles Journal Name 3 4 5
First author?
Article Title
Yes / No Yes / No Yes / No
Articles need to have been published in cardiovascular and interventional radiology, in internationally recognised, peer-reviewed scientific journals with an impact factor. Case reports are excluded.
Additional Articles (Optional) Journal Name
First author? Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No
Article Title
Application Checklist: Please review the following checklist before submitting your application to make sure you have all the required documents to be submitted for CIRSE Fellowship.
• •
• •
Completed CIRSE Fellowship Application Form Two letters of support from Fellows (Attached with this application) Or (Have been emailed directly to the CIRSE office) CV (English, 800 word limit, pdf) Membership is in good standing for the three year minimum (If you are unsure of your membership status, please log into your myCIRSE account or contact the CIRSE office)
Thank you for completing your application for CIRSE Fellowship! Please email the application form and documents to [email protected]. The office will then send you an email confirmation with the receipt of your complete application and inform you of any corrections that may be required. You will also be notified by email once your application has been preliminary approved. Please be aware that this can take up to four weeks. Please also note that only emailed applications can be accepted. In the meantime, if you should have any further queries please do not hesitate to contact the CIRSE central office.
Kind regards, CIRSE Membership Department
The candidate has been a CIRSE member for at least three years. The candidate finished his/her medical specialty training at least five years ago. The candidate has the support of two CIRSE Fellows confirming their aptitude to become a Fellow. (Both supporters may not be Corresponding Fellows, in this case, at least one supporter must be residing in the EU as a CIRSE Fellow) The candidate must have published at least five articles in cardiovascular and interventional radiology, internationally recognised, peer-reviewed scientific journals with an impact factor. Candidates must have been the first author of at least two of these publications. Case reports are excluded.
The applications will be thoroughly assessed by the Membership Committee for preliminary approval. Following this, the names of the applicants receiving preliminary approval will be published on the CIRSE website. After publication, the names will remain posted online for six weeks, during which members will be allowed to comment on the applicants’ suitability as a CIRSE Fellow. After this period, the Membership Committee will make its final decision, subject to ratification by the Executive Committee. If you feel that you meet the above-mentioned criteria and are interested in applying for CIRSE Fellowship, please complete the following application form and return it to the CIRSE office ([email protected]) with the required documentation. For any assistance or further enquiries in regards to the CIRSE Fellowship application, please feel free to contact [email protected].
1
CIRSE Fellowship Application Form Applicant's name: Title First name _______ ________________________
Last name ________________________
CIRSE Member ID: ______________________ CIRSE member since: _________________________ (minimum requirement of three years) CIRSE member refers to full members, in good standing for at least the last three years. Years as a Junior Member cannot be counted. If you are unsure of your membership status, please contact [email protected]. Finished medical specialty training date: _______________________ (DD.MM.YYYY) Training must have been completed at least five years prior to application date. Name and CIRSE ID of First supporter: Title First name _______ ________________________
Last name ________________________
CIRSE Fellow’s ID: ______________________ Name and CIRSE ID of Second supporter: Title _______
First name ________________________
Last name ________________________
CIRSE Fellow/Corresponding Fellow’s ID: ______________________ Support must come from two CIRSE Fellows. Both supporters may not be Corresponding Fellows, in this case, at least one supporter must be residing in the EU as a CIRSE Fellow. Support can be in written form, which you may attach with this application, or the supporters may email [email protected] directly.
2
Five Published Articles on a Cardiovascular and Interventional Radiology Topic Two as first/corresponding author Journal Name
First author? (Required)
Article Title
Yes
1
Yes
2
Remaining three of five required articles Journal Name 3 4 5
First author?
Article Title
Yes / No Yes / No Yes / No
Articles need to have been published in cardiovascular and interventional radiology, in internationally recognised, peer-reviewed scientific journals with an impact factor. Case reports are excluded.
Additional Articles (Optional) Journal Name
First author? Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No
Article Title
Application Checklist: Please review the following checklist before submitting your application to make sure you have all the required documents to be submitted for CIRSE Fellowship.
• •
• •
Completed CIRSE Fellowship Application Form Two letters of support from Fellows (Attached with this application) Or (Have been emailed directly to the CIRSE office) CV (English, 800 word limit, pdf) Membership is in good standing for the three year minimum (If you are unsure of your membership status, please log into your myCIRSE account or contact the CIRSE office)
Thank you for completing your application for CIRSE Fellowship! Please email the application form and documents to [email protected]. The office will then send you an email confirmation with the receipt of your complete application and inform you of any corrections that may be required. You will also be notified by email once your application has been preliminary approved. Please be aware that this can take up to four weeks. Please also note that only emailed applications can be accepted. In the meantime, if you should have any further queries please do not hesitate to contact the CIRSE central office.
Kind regards, CIRSE Membership Department
