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INDIAN COLLEGE OF OBSTETRICIANS & GYNAECOLOGISTS
of
                   The Federation of Obstetric & Gynecological Societies of India

6th Floor, New Building, Cama & Albless Hospital, Mahapalika Marg, Mumbai 400001.

* Tel: 91 - 22 - 2264 23 08* Fax: 91 - 22 - 2267 64 05

Email: icog2005@rediffmail.com website: www.icogonline.org

 



Application Form for International Observor Fellowship

 

 

Name (in Capital)  

                                                                                                        
                                                                      (Surname)                                            (First Name)                                (Middle Name)

 

Date of Birth

 

Permanent Address

 

 

 

 


Telephone Nos.

                                                     (Residence)                                        (Office)                                   (Mobile)

 

 

Fax No.                                                                                                                                                           

 

 

ICOG Member since                                                            ICOG Fellow since                                                  

 

Total Credit Points collected

 

 

 

 


Wish to apply for international Observor Fellowship: (tick whatever is applicable)

 

 

 

  •  Maternal Fetal Medicine (MFM)

 

  •  Reproductive Endocrinology and infertility (RE1 & INF)

 

 

 

 

  • Papers presented
  • Work experience in the field
  • Attended conferences related to the subject
  • Participated as Faculty in Conferences related to the subject

Please furnish a copy of all above documents along with application.

Criteria for application:

Fellowships in Maternal-Fetal Medicine Mount Sinai School of Medicine, New York, USA with Dr Jyotsna Gandhi

  • Fellows or members of ICOG for minimum 2 years
  • No age limit
  • Should have interest in this field - preference given to those who have published or

            presented on this subject

  • Minimum credit points collected = 50 before application
  • Should preferably replicate the course and training in India after returning - at least 4

      trainees to be trained

Fellowships in Reproductive Endocrinology and Infertility at the Royal

Free & University College London with Dr Gordana Prevelic

  • Members or Fellows of ICOG for at least 2 years
  • Should have collected at least 50 credit points through ICOG
  • 2 Fellowships would be reserved for Members less than 40 years and 1 Fellowship would

      be open to all

  • Should preferably replicate and carry out similar training in an Indian set up for at least 4

     such courses
  • Papers presented
  • Work experience in the field
  • Attended conferences related to the subject
  • Participated as Faculty in Conferences related to the subject

Please furnish a copy of all above documents along with application.

Criteria for application:

Fellowships in Maternal-Fetal Medicine Mount Sinai School of Medicine, New York, USA with Dr Jyotsna Gandhi

  • Fellows or members of ICOG for minimum 2 years
  • No age limit
  • Should have interest in this field - preference given to those who have published or

            presented on this subject

  • Minimum credit points collected = 50 before application
  • Should preferably replicate the course and training in India after returning - at least 4

      trainees to be trained

Fellowships in Reproductive Endocrinology and Infertility at the Royal

Free & University College London with Dr Gordana Prevelic

  • Members or Fellows of ICOG for at least 2 years
  • Should have collected at least 50 credit points through ICOG
  • 2 Fellowships would be reserved for Members less than 40 years and 1 Fellowship would

      be open to all

  • Should preferably replicate and carry out similar training in an Indian set up for at least 4

     such courses