1. PAEDIATRIC EXPERIENCE
I confirm I do not exceed 24 months (2 years) whole time equivalent experience in Paediatrics (excluding Foundation modules) at point of application as evidenced in my employment history.
Confirm experience (Tickbox)
2. Additional Qualifications
Please state your highest achieving qualification in line with the scoring framework
What is your additional qualification? [Words allowed: 20]
Which of the following best describes your qualification
Select from:
- No qualification
- Postgraduate diploma
- Postgraduate certificate
- Postgraduate (University awarded) MA
- Postgraduate (University awarded) MSc
- Research MD (University award – not training award)
- PhD (University award – not training award)
- Other
Further description of qualification if required (‘Other’) [Words allowed: 50]
3. Transferable Clinical skills
Using the boxes provided, please give up to five of your most significant and relevant examples of transferable clinical skills that you have gained, that demonstrate your understanding of an aptitude for a career in paediatrics.
[For each of 5 examples:]
Description of clinical skill with explanation of relevance to paediatrics [Words allowed: 50]
Description of how this has prepared you for a career in paediatrics [Words allowed: 50]
4. Transferable Clinical experience and reflection
Provide a list of up to 5 examples of clinical experiences with reflections to explain how they have prepared you for a career in paediatrics?
[For each of 5 examples:]
Description of experience and explanation of relevance to paediatric application [Words allowed: 50]
What is your reflection on the experience and how it has prepared you for a career in paediatrics [Words allowed: 50]
5. Quality Improvement Project (QIP)/Audit relevant to application level and experience of applicant
Question: Describe up to 2 projects that demonstrate your involvement in audit/QI and your learning from this.
Marks will be awarded for the best example – i.e. the one that scores the highest according to the criteria.
[For each example:]
Which of the following best describes your QI/Audit project?
- Audit
- QI project
- QI project with multiple cycles
What was your involvement in the audit/QIP?
- Some involvement in the audit/QIP but did not lead it
- Designed the audit/QIP
- Lead the audit/QIP
- Lead the audit/QIP and presented the findings
Briefly describe exactly what your role involved in the audit/QIP project entailed. (e.g. recruiting participants, data collection, etc) [Words allowed: 50]
Briefly describe how/where you presented the audit/QIP and any change in practice that happened as a result. [Words allowed: 50]
6. Research and academic achievements relevant to application level and experience of applicant
Provide a list of up to 2 examples of your research/academic achievements.
Marks will be awarded for the best example – i.e. the one that scores the highest according to the criteria.
[For each example:]
Give a brief description of the example of research/academic achievement [Words allowed: 50]
Which of the following apply to the example of research/academic achievement you have chosen?
- Some involvement in a research project/piece of academic work
- Led on a research project/piece of academic work
- Presented at regional meeting
- National presentation
- Co-author publication
- Significant contribution to recruitment
- Significant contribution to data collection
- Significant contribution to data analysis
- International presentation
Briefly describe the nature of your research project/academic work, your role and what your role involved. [Words allowed: 50]
7. Teaching relevant to application level and experience of applicant
Describe up to 2 of the most significant/relevant examples of activities and learning related to teaching and education that you have helped being involved in.
Marks will be awarded for the best example – i.e. the one that scores the highest according to the criteria
[For each example:]
Briefly describe your example of being involved in teaching. [Words allowed: 50]
Which of the following describe your personal level of involvement in your example of teaching?
- No experience of delivering or organising teaching
- Some participation in delivery of teaching
- Significant contribution to delivery of teaching
- Designed teaching
- Led teaching
- Evaluated
Briefly describe the exact nature of your involvement, including the actions and any evaluation that you carried out [Words allowed: 50]
