Bakı Təhsil Məlumat Mərkəzi Açıq Cəmiyyət İnstitutu və Amerika Avstriya Fondu İNC. Salzburg medical seminar 2007 Elan edir salzburg medical seminar

Bakı Təhsil Məlumat Mərkəzi

Açıq Cəmiyyət İnstitutu və

Amerika Avstriya Fondu İNC.

SALZBURG MEDICAL SEMINAR 2007 Elan edir
SALZBURG MEDICAL SEMINAR - bir həftəlik seminar müxtəlif sahədən olan təcrübəli həkimlər üçün təşkil olunmuşdur. Seminarlar Soros Fondu, Amerika Avstriya Fondu və Avstriya Höküməti tərəfindən maaliyyələşdirilir. Seminarlar Salzburqda keçirilir və Kornell Universiteti Tibb Mərkəzi, Filadelfiya Uşaq Xəstəxanası, Hersoq Universiteti Tibb Mərkəzi və Salzburq ümumi xəstəxanası tərəfindən aparılır.

	Su. 28 Yanv. – 3 Fevral (Şənbə)	Pathology Jennifer Hunt, M.D. Dontscho Kerjaschki, M.D.
	4 Mart (Bazar)– 10 Mart (Şənbə)	Pediatric Pulmonary / Asthma Julian Allen, M.D.
	11 Mart (Bazar) –17 Mart (Şənbə)	Neurosurgery Roger Hartl, M.D. Christian Matula, M.D.
	29 Aprel (Bazar)– 5 May (Şənbə)	Psychiatry Michael Sacks, M.D. Wolfgang Fleischhacker, M.D.
	13 May (Bazar) – 20 May (Şənbə)	Pediatric Neurology Gihan Tennekoon,M.D.
	20 May – 26 May (Şənbə)	Maternal and Infant Health Richard Polin, M.D. Friedrich Reiterer M.D.
	27 May (Bazar) – 2 İyun (Şənbə)	Cardiothoracic Surgery Thomas Mihaljevic, M.D. TBC

Son tarix: 1 Noyabr, 2006

Daha ətraflı məlumat üçün:

Bakı Təhsil Məlumat Mərkəzi

Süleyman Rəhimov küç., 183

Tel/Faks: 448 28 45/46

www.beic.az

Open Society Institute/SOROS Foundation

Open Medical Institute

Salzburg Medical Seminars International

2007

Application Form

How to submit your application electronically:
Complete the attached form in ENGLISH electronically and e-mail it back to the Local Soros Foundation/Spin Off organization in your country - for detailed information about your country please visit http://www.aaf-online.org/osi.htm
Please save the application form in the following form: indicate your surname, name, seminar topic, year, e.g.: gassner_josef_neurology_07_appl.doc
Please attach to the application form:

• 
  CV (curriculum vitae) saved as:
  “lastname_firstname_seminartitle_07_cv.doc”
  
• 
  Digital Photograph: lastname_firstname_seminar_year _pic.jpg
  
• 
  Medical Diploma (scanned): lastname_firstname_seminar_year _dip.jpg
  
• 
  Medical License (scanned / if applicable): lastname_firstname_seminar_year _lic.jpg
  
• 
  Specialization Diploma/s: lastname_firstname_seminar_year _spec.jpg
  
• 
  List of English publications (if available): lastname_firstname_seminar_year _publ.doc
  

Country of origin please check one (x)

( ) Albania ( ) Armenia ( ) Azerbaijan ( ) Bosnia ( ) Bulgaria ( ) Croatia ( ) Czech Republic ( ) Estonia ( ) Georgia ( ) Hungary ( ) Kazakhstan ( ) Kyrgyzstan

( ) Latvia ( ) Lithuania ( ) Macedonia ( ) Moldova ( ) Mongolia ( ) Poland ( ) Romania ( ) Russia (Moscow) ( ) Russia (Novosibirsk) ( ) Russia (N. Novgorod) ( ) Russia (Rostov on Don) ( ) Russia (Samara)

( ) Russia (St.Petersburg) ( ) Russia (Vladivostok) ( ) Kosova ( ) Montenegro ( ) Serbia ( ) Slovakia ( ) Slovenia ( ) Tajikistan ( ) Ukraine ( ) Uzbekistan ( ) other: _________________

	Seminar you are applying for check only one (x)	Date	Deadline
( )	Pathology	Sun. Jan. 28 – Sat. Feb. 3	Nov. 1, 2006
( )	Internal Medicine	Sun. Feb. 18 – Sat. Feb. 24	Nov. 1, 2006
( )	Pediatric Pulmonary / Asthma	Sun. March 4 – Sat. March 10	Nov. 1, 2006
( )	Neurosurgery	Sun. March 11 – Sat. March 17	Nov. 1, 2006
( )	Bone and Joint Surgery	Sun. March 18 – Sat. March 24	Nov. 1, 2006
( )	Ob/Gyn/Reproductive Medicine	Sun. March 25 – Sat. March 31	Nov. 1, 2006
( )	Public Health Education *	Sun. April 8 – Sat. April 14	Nov. 1, 2006
( )	Pediatric Emergency Medicine	Sun. April 15 – Sat. April 21	Nov. 1, 2006
( )	Ophthalmology	Sun. April 22 – Sat. April 28	Nov. 1, 2006
( )	Psychiatry	Sun. April 29 – Sat. May 5	Nov. 1, 2006
( )	Cardiology	Sun. May 6 – Sat. May 12	Nov. 1, 2006
( )	Pediatric Neurology	Sun. May 13 – Sat. May 20	Nov. 1, 2006
( )	Maternal and Infant Health	Sun. May 20 – Sat. May 26	Nov. 1, 2006
( )	Cardiothoracic Surgery	Sun. May 27 – Sat. June 2	Nov. 1, 2006
( )	Infectious Diseases	Sun. June 3– Sat June 9	March 1, 2007
( )	Adolescent Medicine	Sun. June 10 – Sat. June 16	March 1, 2007
( )	Urology	Sun. June 17– Sat. June 23	March 1, 2007
( )	ENT	Sun. June 24– Sat. June 30	March 1, 2007
( )	Family Medicine	Sun. July 1– Sat. July 7	March 1, 2007
( )	Neurology	Sun. July 8 – Sat. July 14	March 1, 2007
( )	ESU Master Class in Urology **	Sun. July 15– Sat. July 21	March 1, 2007
( )	Anesthesiology	Sun Sept. 2 - Sat. Sept. 8	March 1, 2007
( )	Pediatric Gastroenterology	Sun. Sept. 16 – Sat. Sept. 22	March 1, 2007
( )	Oncology	Sun. Sept. 23 – Sat. Sept. 29	March 1, 2007
( )	Imaging	Sun. Sept. 30 – Sat. Oct. 6	March 1, 2007
( )	Drug Replacement Therapy *	Sun. Oct. 7 – Sat. Oct. 13	March 1, 2007
( )	Pediatric Anesthesiolgy / Critical Care	Sun. Oct 21 – Sat. Oct. 27	March 1, 2007
( )	Pediatric Palliative Care in Cancer and Aids *	Sun. Oct. 28– Sat. Nov. 3	March 1, 2007
( )	Rehabilitation Medicine	Sun. Nov. 18 – Sat. Nov. 24	March 1, 2007

* by invitation of OSI only ** Selection by ESU
Have you ever applied for participation in a Salzburg Medical Seminar International of the Open Medical Institute?

Yes

No

If yes, were you selected and did you attend?

Yes

No

If yes, please provide the date and name of the seminar:

Personal information:

Title:
Name:
	Last name (surname as it appears in your passport)	First name (given name)

Sex:

		Male			Female
Date of Birth:
			Day			Month	Year
Place of Birth:
Country of Citizenship:
Medical license number:										Date issued:
Passport number:										Date issued:
ID number:										Date issued:

Work address:

Name of Institution:
Department:
Street:	Number:
City:		Postal code:
Country:
Work-Phone:
Work-Fax:
Work-Email:

Home address:

Street:	Number:
City:		Postal code:
Country:
Home Telephone:
Home Fax:
Email:

EDUCATION

Medical School/Institute:

Name:	City & Country:
Dates attended:	Degree:
Specialty:

Other University/College:

Name:	City & Country:
Dates attended:	Degree:
Name:	City & Country:
Dates attended:	Degree:

Practical Training (internships, residencies, specializations, other practical training or fellowships):

Name of Institute/Hospital:	Dates:
Specialty:	Location:

Have you had any training or attended any medical conferences abroad?

Yes

No

If yes, please describe:

PROFESSIONAL EXPERIENCE

Describe your current position and responsibilities:



Other (previous) work experience:


List fields of special scientific or clinical interest:



List any teaching appointments you have or have held:


List below (or on a separate sheet) titles of any papers you have presented at conferences:



List below (or on a separate sheet) titles of your publications: Please highlight English

publications



List any positions you hold with professional organizations or societies:



List any awards or honors:

ESSAY SECTION

Describe below your reasons for applying for this fellowship and what you hope to accomplish.




Describe how you will share the information you gain at the seminar with your colleagues upon returning to your country.



I CERTIFY THAT THE INFORMATION GIVEN IN THIS APPLICATION IS COMPLETE AND ACCURATE TO THE BEST OF MY KNOWLEDGE.
I CONFIRM, THAT IF SELECTED I WILL SHARE, FOR FREE, ALL THE INFORMATION I ACQUIRE WITH MY COLLEAGUES WHEN I RETURN TO MY HOME COUNTRY.

Name	Date