1 Honorary Status Will Be Awarded for 3 Years, However You Can Request a Shorter Period
THE UNIVERSITY OF EDINBURGH
COLLEGE OF MEDICINE & VETERINARY MEDICINE
NEW NOMINATION FOR HONORARY STATUS
PERSONAL DETAILS
Title & Full Name:
Qualifications:
Current Post (if applicable):
Current Employer (if applicable):
Date of Birth:
Email Address:
Home Address:
Home/Mobile Telephone:
Work Address:
Work Telephone:
Indicate which address to use for correspondence: Work Home
CLINICAL APPOINTMENTS
This section must be completed by all Clinical Applicants:
Clinical Specialty:
GMC/GDC Registration No. (If applicable):
Type of registration:
/ Consultant GP Register
Below Consultant (StR or Specialty Doctor)
Below Consultant (FY Doctor)
Other – please specify
Main NHS employer e.g. NHS Lothian:
STATUS INFORMATION
Proposed start date of Honorary Status:
Proposed end date of Honorary Status (if applicable)[1]
School/Division/Research Centre/Academic Unit in which Honorary status will be held: This field must be completed or your honorary status application cannot be processed.
Status Sought:
Honorary Professorial Fellow* Honorary Lecturer Honorary Fellow
Honorary Clinical Senior Lecturer Honorary Clinical Tutor
Honorary Clinical Fellow ** Honorary Clinical Fellow (FY Doctor)***
* The title of Honorary Professorial Fellow can only be awarded to staff who have returned to the University having previously held a Personal or Established Chair with the University of Edinburgh. Nominations for Honorary Professorial Fellow should include a letter of recommendation from the Head of School, setting out the agreement reached between you and the school on the expectations involved in the association for the period of the fellowship.
** This title is not available to Foundation Year Doctors
** *This title is applicable to Foundation Year (FY) Doctors only.
Note: This form should only be used to apply for the statuses listed above. Applications for Honorary Professor or Honorary Reader Status will be considered by the College’s Academic Promotions Panel
CONTRIBUTION TO THE UNIVERSITY
A Summary CV must be included with your application
Academic Area of Interest:
Please provide summary of contribution to the work of the University with an indication of percentage of time spent in each (if applicable):
Note: If the majority of your contribution is made to undergraduate teaching, your nomination should be supported / administered by the Centre for Medical Education/MTO
Teaching: Please indicate the type of teaching activity and number of hours you currently teach per week.
Research:
Administration:
VISITOR REGISTRATION
The University operates a Visitor Registration Scheme, which requires all individuals who wish to work or study on University premises and gain access to facilities for more than 5 days to be registered as a Visitor. This will give you access to a University email address.
If you require registration as a Visitor please contact the Research Centre or Academic Unit which is supporting your nomination.
AUTHORISATION
Individual:
I confirm I have included a Summary CV with my application
Name
Signature
Date
Please note, by signing this form, you are agreeing to accept the Honorary Status title proposed, if it is granted by the University of Edinburgh
Head of Division/Unit or nominee:
Name
Signature
Date
Head of School:
Name
Signature
Date
[1] Honorary Status will be awarded for 3 years, however you can request a shorter period by completing this box