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ABOUT
OUR STORY
OUR VALUES
OUR IMPACT
OUR PEOPLE
CONTACT
PROJECTS
ABOUT PROJECTS
CURRENT PROJECTS
PREVIOUS PROJECTS
SERVICES
COVID-19
TRAINING
CONSULTANCY
GET INVOLVED
VOLUNTEER
PAID ROLES
FUNDRAISE
NEWS
DONATE
DONATE
Apply – PGF
Email Address
*
Full Name
*
Phone Number
Name of organization/clinic you currently work in (Government or non-government)
*
Clinic location in camps or host communities
*
Have you completed your MBBS / MBChB and are fully registered with the Bangladesh Medical and Dental Council (BMDC)
*
Yes
No
Please provide your medical registration number. If you do not have a number please explain why not
*
How many years since you've graduated from medical school?
*
Do you have good command over conversational English?
*
Yes
No
Do you meet the essential requirements for the PGF (See the top of the page to download)
Yes
No
Other
Other
Date available to attend PGF
*
Cohort C: June 13, 2019 - September 9, 2019
Cohort D: September 19, 2019 - December 9, 2019
Can you attend either Cohort C or D if accepted?
*
Yes
No
If you answered no to above, please explain
Does your supervisor/organization consent to you attending the PGF?
*
Yes
No
Please describe in detail why you are interested to attend the PGF and how this will benefit your career
*
0 / 500
If accepted onto the PGF, do you agree to attend a minimum of 75% of the lectures and participate in at least 2 clinical shadowing opportunities?
*
Yes
No
If accepted onto the PGF, do you understand and accept that if you do not attend more than 75% of the PGF you will not pass the PGF? (See Participant Form for list of holidays and days off)
*
Yes
No
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