Prize: Up to £1,000

This biennial travel fellowship was established in 1987 by Mrs Mattie Black in memory of her husband, Dr Malcolm Black FRCOG who died in 1986. Malcolm Black became a Member of the College in 1935 and was elevated to Fellowship in 1947.

The purpose of the fellowship is to enable a College Member of up to five years’ standing or Fellowat the time of application, to travel either to the British Isles or from the British Isles abroad, for a period of time to attend postgraduate training courses or to visit centres of research or of particular expertise within the specialty of obstetrics and gynaecology. Travel and subsistence will be paid to a maximum of £1,000.

CONDITIONS

  • Travel must take place within 12 months of the award being made in December 2018
  • The award may only be used for the purpose outlined in your original application
  • A detailed report (maximum 1,000 words), including pictures if necessary, must be submitted to the RCOG Awards Administrator within eight weeks after travel
  • Applicants must declare whether they have applied for other prizes for the same project.

TO APPLY:

Please send the following documents to the Awards Administrator by email () by midnight on Friday 31 August 2018. Applications received after the closing date will not be accepted.

  • Completed application form
  • Two references from Fellows in clinical practice (see Section 3)
  • A short CV (maximum of four A4 pages) including university details
  • Confirmation from the host institution that your visit has been approved.

SECTION 1

PERSONAL DETAILS

Name of applicant:
RCOG Membership/Trainee number:
Date of RCOG Membership or intended date of sitting exam (if applicable):
Current appointment (Grade and Institution):
Work Address:
Correspondence Address (if different from above):
Telephone number:
Email address:
Date of birth:

SECTION 2

DETAILS OF TRAVEL

Training centre to be visited and their particular expertise:
Name(s) of person(s) to be visited:
Have you enclosed confirmation from the institution that your visit has been approved? (please tick) / YES NO
Estimated duration of visit:
Planned departure date:
Estimated travel costs including subsistence and accommodation:
Please list details of any other financial assistance being requested and/or obtained for the visit:
Please list full details about the programme to be attended:
Please list your objectives for the visit:
Please explain how the benefits of this visit will be applied in your main place of work:

Continue onto a separate sheet if required

SECTION 3

REFERENCE

Please attach two professional character references from Fellows in active clinical practice separately, including how this award will benefit the applicant.

REFERENCE 1

Name:
Role:
Email address:
Telephone:
Relationship to applicant:

REFERENCE 2

Name:
Role:
Email address:
Telephone:
Relationship to applicant:

SECTION 4

How did you hear about this award? Please tick all that apply.

Word of mouth
RCOG website
RCOG email
RCOG magazine
University/Hospital communication
Other

I understand that the grant may only be used for the purpose outlined in the original application and I confirm a written report will be submitted to the RCOG within 8 weeks after travel/completion of the project and that the grant will be acknowledged in any related publications.

APPLICANT SIGNATURE
DATE

1