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PDF: REQUEST FOR PART-TIME RESIDENCY TRAINING
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Source: postgraduate.medicine.dal.ca // Topic: Part Time Jobs
File Size: 77.35 kb // Total of Page: 2 Page(s)
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Short Desciption: request for part-time training must be done in advance, the resident must ...
At what level of training is the applicant applying for part-time training? ...
Content Inside: The Royal College of Physicians and Surgeons of Canada Le Collège royal des médecins et chirurgiens du Canada
Credentials Unit Unité des titres
REQUEST FOR PART-TIME RESIDENCY TRAINING
This form is to be completed by program directors for residents who request part-time residency training. The request for part-time training must be done in advance, the resident must give a reason why part-time residency training is being requested (i.e. family responsibility) and must be approved by the program director as well as the Postgraduate Dean. A syllabus for the applicants entire program (full- and part-time components) must be provided by the Program Director. Part-time commitment must equal at least 50 percent of that of a full-time resident.
Name of resident applying for part-time training:
please print complete name
Specialty: Name of Program Director:
please print
University:
1. At what level of training is the applicant applying for part-time training? Level: PGY-1 PGY-2 PGY-3 PGY-4 PGY-5 PGY-6 2. Please state the start
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