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q / THE BRITISH ASSOCIATION OF UROLOGICAL SURGEONS
35-43 Lincoln’s Inn Fields
London
WC2A 3PE / Tel: 020 7869 6950
Fax: 020 7404 5048
Email:

BAUS SECTION OF ENDOUROLOGY

RESIDENTIAL SURGICAL COURSE

The BAUS Section of Endourology, in association with the BAUS Office of Education, will be running the 12th Residential Operative Endourology Course at Broadgreen Hospital, Liverpool from 2-4 October 2017.

The Course will feature mentored training with the delegates as primary surgeon and Consultant assistance. All delegates will be expected to carry out procedures including Laparoscopic Nephrectomy, a Flexible Ureteroscopy and a PCNL and probably a Laparoscopic Pyeloplasty. Although it is desirable for the candidate to be able to perform both laparoscopic procedures (nephrectomy and pyeloplasty) and PCNL, it will be acceptable to choose either solely the laparoscopic procedures or stone procedures (PCNL, Flexible ureteroscopy) or both. Please state your preference when making your application. Places on this course are strictly limited to 4.

The course fee is £500 and this covers three days of operative experience training and accommodation.All successful applicants will receive full details, including the location of the venue and information on hotel accommodation in the area. To apply for your place on this course, please send back this form, CV summary of logbook, a letter of support from your trainer and your cheque for £500 made payable to British Association of Urological Surgeons. The closing date for applications is Friday, 4 August 2017 although you are encouraged to submit your application at the earliest opportunity. All applications will be reviewed by the Organising Committee and applicants will be notified if they have a place on the course by the 15 August.

The Section of Endourology, in collaboration with The Urology Foundation, will be able to award 4 travelling scholarships to the 4 successful applicants on the operative residential course. All applicants will be expected to include an outline of their proposed itinerary for a visit to an endourological centre of excellence with their course application.

Please return the completed form to:

Charlotte Taylor, BAUS Section of Endourology

35-43 Lincoln’s Inn Fields, London WC2A 3PE

BAUS SECTION OF ENDOUROLOGY

RESIDENTIAL SURGICAL COURSE

REGISTRATION FORM

I would like to attend the Course at Broadgreen Hospital, Liverpool from 2-4 October 2017

SURNAME ………………………………………………….……….…………………………………………

*Prof / Dr / Mr / Mrs / Miss / Ms (* delete as appropriate)

FORENAME..……………………………………..……ROTATION ………………………………………...

BAUS MEMBERYes/NoNTN …………………………………………….

HOSPITAL ………………………………………………………………………………………………………......

ADDRESS FOR CORRESPONDENCE ………………………………………………………………………………

………………………………………………………………………………………. POST CODE:…………………….

TEL .……………………………………………………. E-MAIL ......

FRCS Urol date awarded………………………………………………………………………………………………..

PLEASE ENCLOSE:

CURRICULUM VITAE

SUMMARY LOG BOOK

LETTER OF SUPPORT FROM PROGRAMME DIRECTOR AND PRESENT TRAINER

OUTLINE ITINERARY FOR TRAVELLING FELLOWSHIP

ADDITIONAL LAPAROSCOPIC TRAINING TO DATE:

Courses attended ………………………………………………………………………………………………………………………………………......

…………………………………………………………………………………………………………………………………………….

Please find enclosed my cheque for £500made payable to: British Association of Urological Surgeons

- this must be in £UK sterling (tick if appropriate)

Signature: ...... Date: ......

No refunds will be made on cancellations less than 6 weeks before the course date

Please return completed form to:

Charlotte Taylor, BAUS Section of Endourology

35-43 Lincoln’s Inn Fields, London WC2A 3PE

The British Association of Urological Surgeons Limited (registered in England and Wales)

Registered Charity No: 1127044 Registered Company No: 06054614 VAT Registration No: 380 5441 59