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. In addition to the broad range of services and benefits offered to all CIRSE members, CIRSE Fellows privilege from: Exclusive right to apply for election to a position on the CIRSE Executive Committee and the CIRSE Executive Board Inclusion in the CVIR reviewer database and consideration as CVIR reviewer CIRSE members have the opportunity to be honoured as a Fellow if: The candidate has been a full CIRSE member for at least three years. The candidate finished his/her medical specialty training in Radiology at least five years ago. The candidate has successfully passed EBIR or 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 on a cardiovascular and interventional radiology topic, in internationally recognised, peer‐reviewed scientific journals with an impact factor. Case reports and letters to the editors are excluded. The applications will be 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. 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.
CIRSE Fellowship Application Form
Applicant Details Title First name Last name ________ ______________ ____________________ CIRSE member since: _________________________
CIRSE ID __________
Requirement of: Full membership, in good standing, for three consecutive years. If you are unsure of your membership status, please log into your myCIRSE account or contact [email protected]
Specialty Training Declaration I confirm that I have completed my specialty medical training in Radiology and/or Interventional Radiology I completed this training: _________________________________ (DD.MM.YYYY) Training must have been completed at least five years prior to application date.
EBIR holder or Letters of Endorsement If the applicant is an EBIR holder, endorsement from two CIRSE Fellows is not required.
EBIR: I have successfully completed the EBIR exam (Please tick) Or Name and CIRSE ID of First CIRSE Fellow supporter: Title First name Last name CIRSE ID ________ ______________ ____________________ __________ Name and CIRSE ID of Second CIRSE Fellow/Corresponding Fellow supporter: Title First name Last name CIRSE 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.
Five Published Articles on a Cardiovascular and Interventional Radiology Topic
Journal Name
Article Title (Plus co‐authors)
1 2 3 4
5
Articles need to have been published on a cardiovascular and interventional radiology topic, in internationally recognised, peer‐reviewed scientific journals with an impact factor. Case reports and letters to the editors are excluded.
Additional Articles (Optional)
Journal Name
Article Title (Plus co‐authors)
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 Including o Specialty Training declaration o EBIR Declaration Or o Two letters of support from Fellows (Attached) or (Emailed directly) 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
CIRSE Fellowship Application Form
Applicant Details Title First name Last name ________ ______________ ____________________ CIRSE member since: _________________________
CIRSE ID __________
Requirement of: Full membership, in good standing, for three consecutive years. If you are unsure of your membership status, please log into your myCIRSE account or contact [email protected]
Specialty Training Declaration I confirm that I have completed my specialty medical training in Radiology and/or Interventional Radiology I completed this training: _________________________________ (DD.MM.YYYY) Training must have been completed at least five years prior to application date.
EBIR holder or Letters of Endorsement If the applicant is an EBIR holder, endorsement from two CIRSE Fellows is not required.
EBIR: I have successfully completed the EBIR exam (Please tick) Or Name and CIRSE ID of First CIRSE Fellow supporter: Title First name Last name CIRSE ID ________ ______________ ____________________ __________ Name and CIRSE ID of Second CIRSE Fellow/Corresponding Fellow supporter: Title First name Last name CIRSE 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.
Five Published Articles on a Cardiovascular and Interventional Radiology Topic
Journal Name
Article Title (Plus co‐authors)
1 2 3 4
5
Articles need to have been published on a cardiovascular and interventional radiology topic, in internationally recognised, peer‐reviewed scientific journals with an impact factor. Case reports and letters to the editors are excluded.
Additional Articles (Optional)
Journal Name
Article Title (Plus co‐authors)
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 Including o Specialty Training declaration o EBIR Declaration Or o Two letters of support from Fellows (Attached) or (Emailed directly) 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
