1
Micro/2005/1
For office use only
Index No.
SELECTION EXAMINATION FOR DIPLOMA IN MEDICAL MICROBIOLOGY
CURRICULUM VITAE
A. Personal information
Name:
Professional Details:
Family name
Current employment
Other names
Institution
Post
Previous name if any
Permanent/Temporary
Address
Date of appointment to post
Telephone
Mobile
E-mail
Family details
Married/Single
Spouse: Name
Children:
Number
Occupation
Institution
Ages
B. Career specific information
1. Self development
Have you undergone training /workshops/seminars?
1. (a) In microbiology
Title
Place held
1.
2.
3.
4.
Duration
Year
1. (b) In any field related to medicine or other skills (eg.communication/statistics/management)
Title
Place held
Duration
Year
1.
2.
3.
4.
2
2. Work experience in microbiology
Have you worked in a microbiology related environment?
Institution
Service
Duration
Year
Oral/Poster
Year
Teaching
Research
3. Research
Have you presented papers at scientific conferences
Discipline
Conference
Title of paper
Microbiology
Others
4. Publications
Have you published any scientific papers?
4. (a) In microbiology
Title
Journal
4. (b) In any other field related to medicine
Title
Journal
*Research paper review/case report/letter etc
Pages; Vol:
Year
Type of article*
Pages;Vol:
Year
Type of article*
3
5 Awards received for work related to Medicine (post graduation)
Research:
Other activities:
6 Activities in relation to dissemination of knowledge in Medicine
Resource person at public seminars
Title of seminar
Place held
Newspaper article authorships
Title
Newspaper
Contributions to public education through electronic media
Title of Talk/Panel discussion
Media & Programme
Date/Year
Date/Year
7 Extra-curricular activities
Sports:
School/university/club/National
1.
2.
3.
4.
Literature/Poetry
Art & creative
work
Others (specify)
Signature
MdeSW/2005
Year