CHECK LIST: Please Ensure ALL Relevant Papersare Attached

Ellison Cliffe Travelling Fellowship 2015 Applicant Information

Applicant Information
Title: / First Name: / Surname:
Contact no.: / RSM Membership no.:
Current Address:
Email: / Date of Birth:
Specialty and current position:
Approximate start date of Fellowship: / Approximate end date of Fellowship:
Is this a salaried/funded position: YES/NO / If yes, please state salary/funding:
Please give details of all other funding you have secured for this post:
Personal Referee 1
Title: / First Name: / Surname:
Position:
Tel:
Email:
Address:
Personal Referee 2
Title: / First Name: / Surname:
Position:
Tel:
Email:
Address:
Host Centre Information
Host Centre Name:
Address:
Host Centre Contact
Title: / First Name: / Surname:
Position:
Tel:
Email:
Address:

CHECK LIST: Please ensure ALL relevant papersare attached

Summary Sheet / Analysis of costs and need for funding
Curriculum Vitae / Names of Referees
Statement of interests/career objectives / Supporting statement from host centre
Detailed proposal of time abroad / Confirmation of Study Leave

Applications should be sent electronically to by 1 October 2015

Shortlisted candidates will be interviewed on xxxx

ELLISON CLIFFE TRAVELLING FELLOWSHIP 2015

This Fellowship, valued at £15,000, is open to Fellows of the Royal Society of Medicine who are of specialist registrar or lecturer grade or equivalent or who are consultants within three years of their first consultant appointment.

The award is intended to cover expenses for travel abroad, to one or two centres, for a period of not less than six months, in pursuit of further study, research or clinical training relevant to the applicant’s current interests.

Candidates will normally be expected to take up the Fellowship between 1 January 2016 and 30 June 2017.

Applicants must submit the following:

Completed summary sheet
Curriculum vitae
Statement of current interests, including career objectives
Detailed proposal as to how the time abroad will be spent and where
Detailed analysis of likely costs of period abroad, and statement of need for funding.
Names of two referees
Supporting statement(s) from the proposed host centre(s)
The candidate should confirm that his/her employing authority will grant study leave if the application is successful.

At the end of their Fellowship, the successful candidate(s) will be expected provide a written report about the work undertaken during the tenure of the Fellowship and to at an appropriate RSM educational meeting.

Applications should be sent electronically to at the Royal Society of Medicine by 12 noon 1 October 2015.

Interviews will be held for shortlisted candidates on xxx