Foundation Year Two Academic Foundation Training Programme (12 months only)

Health Education Thames Valley

University of Oxford, Medical Sciences Division

Oxford University Hospitals NHS Trust (host organisation)

Application Form 2017-2018

Application Process

All candidates must complete the application form. Candidates should ensure that they follow the instructions carefully especially when answering the questions.

To apply please submit your completed application form via email and write F2 AFP Application 2017 in the subject line to:. The closing date for applications is Friday 31st Marchat midday.

Please note: No application forms received after this date/time will be accepted.

Interviews

Interviews will be held on Wednesday 26th April 2017. Please ensure that you are available to attend on this day. All interviews will be conducted in Oxford. The venue details will be sent to those shortlisted for interview.

APPLICATION FORM FOR INTEGRATED ONEYEAR F2 ACADEMIC PROGRAMMEIN THE OXFORD FOUNDATION SCHOOL - POSTS COMMENCING AUGUST 2017

Section A - Personal Details
Title: / Surname: / Forenames:
If previously known by another name, please specify:
Home Address:
E-mail Address: / Home Telephone Number:
Fax Number: / Mobile Number:
I confirm:
  1. I am making satisfactory progress in F1, my portfolio is fully up to date and I have had a satisfactory ITR YES
  1. that I will be eligible for full registration with the GMC by August 2017 subject to completing my F1 year YES

If you have a disability do you require any specific arrangements to enable you to attend for interview?
YES NO
If yes, please supply details below:
Section B – Qualifications

Please provide details of the medical school from which you have graduated and any other relevant qualifications which have already been awarded at the time of submission of the application. Applicants should be aware that they may be required to provide this evidence. False declarations will result in applicants being removed from the process and possible reporting to the GMC.

Qualification / Place of Study / Grade/Honours / Year

Training Courses Attended: Please provide details of any relevant training courses attended.

Course Title / Training Provider / Duration / Date Completed

Additional achievements: Please provide details of any local/national/international prizes, honours or distinctions that have been awarded.

Prize/Honour/Distinction / Awarding Body / Date Awarded

Publications: In no more than 100 words please provide details of your most relevant publications in journals. Please give full citation details of any published work and then give a statement about your personal contribution to the work.

Section C - Questions

1. We recognise that applicants will have had varying levels of research and teaching experience. Please describe your experience to date (Maximum of 150 words)

2. Please identify your reasons for applying for an academic F2 rotation and how you would use the variety of opportunities available for pursuing academic interests in research and teaching(Maximum of 150 words).

3. Describe one of your non-academic achievements, indicating how this might strengthen your application for an academic foundation post (Maximum of 150 words).

Section D – Rotations

There are three rotations available, please rank the rotations in order of preference (1 to 3) below. Please also confirm any rotations that you do not wish to be considered for by ticking in the relevant column (please note that this may mean you are not offered a post).
Please note that all placements are for four months and will be in the order shown below.
*Only the below full rotations are available. It will not be possible to change a single placement or the location of a placement.
Rotation Number / Placement 1 / Placement 2 / Placement 3
AFP 17-01
(OUH) / Academic / GP / Paediatrics (HGH)
AFP 17-02
(OUH) / Psychiatry / Academic / Geriatric Medicine (JRH)
AFP 17-03
(OUH) / Academic / Psychiatry / Cardiology (JRH)
Section E– Signature
I understand that employment offered in this training programme by a Trust is subject to satisfactory assessment and subject to the information provided on the application form or any other document being correct. The offer of employment from a Trust may therefore be dependent on an additional, informal interview to review and confirm the content of this application.
Any false or misleading information provided on this form or any other document may result in any employment being terminated.
I confirm that I have fairly and honestly completed this application by myself, without significant help or input from other sources.
Applicant Signature / Date
Declaration
If you are related to a member or Senior Officer/Manager of the Trusts involved in the training programme, you must disclose such a relationship. You are also required to declare any involvement, whether directly or indirectly, with any firm, company or organisation which has a contract with Trusts involved in the training programme. Failure to declare any information on these matters may result in your application being rejected or, if it is discovered after appointment that such information has been withheld, then this may lead to dismissal. Please note canvassing of a Senior Officer/Manager shall disqualify an applicant.
Please state any disclosure/declaration related to the above on a separate sheet.
APPLICATION SUBMISSION DETAILS:
To apply please submit your completed application form via email and write F2 AFP Application 2017 in the subject line to: .The closing date for applications is Friday 31st March 2017at midday.