ONLINE APPLICATION FORM - ESES - EUROPEAN SOCIETY OF ENDOCRINE SURGEONS

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ONLINE APPLICATION FORM

JFH Scholarship
Fields with asterisk (*) required.
Hospital*
University affilliation*
Country*
Name of candidate*
Date of birth*
E-mail*
Number of endocrine surgeries performed*

Number of operations performed annually:
Thyroid*
Parathyroid*
Adrenal*
GEP-NET*

History of training, career profile (state degree, qualifications, hospital and mentors, etc.):* (Characters left: 2500)
Main field of interest*
Specific goal of travel fellowship*

Involvement in the ESES by surgeons at the applying host institution:
Member (junior) of the ESES since*
Senior ESES member supporting application*
Participation at ESES meetings (year)*
List of abstracts presented at ESES meetings (year)* (Characters left: 2500)
DES examination in endocrine surgery*
List of publications on endocrine topics in the last 3 years* (Characters left: 2500)
Specify languages and level of competence to communicate/converse with clinicians* (Characters left: 300)


List of priority of centres/mentors to visit - priority 1
centre*
mentor*
full time scholarship*
preferred period of scholarship*
List of priority of centres/mentors to visit - priority 2
centre*
mentor*
full time scholarship*
preferred period of scholarship*
List of priority of centres/mentors to visit - priority 3
centre*
mentor*
full time scholarship*
preferred period of scholarship*


List of priority of specific surgeries/disease management type to experience - priority 1
organ*
type of surgery*
full time scholarship*
preferred period of scholarship*
List of priority of specific surgeries/disease management type to experience - priority 2
organ*
type of surgery*
full time scholarship*
preferred period of scholarship*
List of priority of specific surgeries/disease management type to experience - priority 3
organ*
type of surgery*
full time scholarship*
preferred period of scholarship*


ESES
EUROPEAN SOCIETY OF ENDOCRINE SURGEONS
Copyright 2024 All rights reserved
Vienna Medical Academy
Alser Strasse 4
A-1090 Vienna, Austria
Phone +43 1 405 13 83-37
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