Faculty of Sport and Exercise Medicine (UK)
Patron: HRH The Princess Royal
APPLICATION FORM: 1. FELLOWSHIP 2. FELLOWSHIP BY ELECTION
3. MEMBERSHIP 4. MEMBERSHIP BY ELECTION 5. CORRESPONDING FELLOW
(delete as applicable)
Surname
Forenames
Title
Qualifications
Date of Birth
GMC No.
University Graduated from and date
Home Address
Telephone
Fax
E-mail
Fax
E-mail
Current Appointment
Work Address
Telephone
Specialist Register
Trainee
Other
Other (please state)
Enclosures: Please enclose with this application a copy of your full up-to-date C.V., letter describing your involvement
in Sport and Exercise Medicine, letters of support from either 2 Upstanding Fellows of this Faculty if applying for
Fellowship / Corresponding Fellow or 1 Upstanding Fellow of this Faculty if applying for Membership who are willing
to nominate you.
2014 Fees: Please see Faculty website under “Members and Fellows/Members and Fellows fees - all categories”.
Please note that fees are not paid unless the applicant has been awarded relevant category as detailed above.
I hereby request the Council of the Faculty of Sport and Exercise Medicine to recommend my name for election as a Fellow /
Corresponding Fellow / Member (delete as appropriate) at the next Council Meeting. If elected, I promise to abide by the Rules and
Regulations of the Faculty as set out by the Faculty, or such amendments which from time to time may be approved in accordance
with the Council of the Faculty. I also agree to maintain my registration on the relevant specialist list and to inform Council of any
change in circumstances, which may affect my elected status.
Signature
Date
We the undersigned Fellow(s) of the Faculty of Sport and Exercise Medicine (UK) do hereby certify that:
(Name)
of
is, in our estimation, a fit person to be elected as a Fellow/Corresponding Fellow/Member of the Faculty and satisfies
the criteria for Fellowship/Corresponding Fellowship/Membership (delete as applicable).
Name: …………………………………………… Signature: …………………………………….. Date: …………………….
Name: …………………………………………… Signature: …………………………………….. Date: …………………….
1
FACULTY OF SPORT AND EXERCISE MEDICINE (UK), 6 HILL SQUARE, EDINBURGH EH8 9DR
TEL: 0131 527 3404 FAX: 0131 527 3408 EMAIL: r.capaldi@fsem.ac.uk
9.9.13
Faculty of Sport and Exercise Medicine (UK)
Patron: HRH The Princess Royal
Membership and Fellowship Guidelines
Quick Overview of Categories
Fellowship: completed trainees and medical practitioners who have completed specialist
training, including via the CESR route
Fellowship by Election: UK SEM specialists (and rare exceptions from other specialties
who have made an outstanding contribution to UK SEM)
Corresponding Fellowship: Overseas SEM specialists
Membership: Trainees
Membership by Election: UK doctors from other specialties with an interest in SEM
FELLOWSHIP
Medical practitioners who have satisfactorily completed a recognised training programme in Sport and
Exercise Medicine, who have obtained a CCT in Sport and Exercise Medicine (SEM) and who are on the UK
Specialist Register in SEM will be granted Fellowship on application at the discretion of Council, through the
Members and Fellows Committee. Medical practitioners who have completed their training abroad, have
obtained a CESR in SEM and are on the UK Specialist Register in SEM may apply for Fellowship.
FELLOWSHIP BY ELECTION
Medically qualified practitioners who are adjudged by Council through the Members and Fellows Committee to
have made a significant contribution to Sport and Exercise Medicine in the UK may be elected as a Fellow by
Election.
Normally, the applicant should be able to demonstrate a minimum of the equivalent of five years’ full time
experience in SEM.
Normally, the applicant should have completed either a Diploma or MSc in SEM.
The applicant should be able to demonstrate ongoing regular attendance at SEM – related CPD and ideally
membership of BASEM or similar Sport and Exercise Medicine associations.
The applicant must be able to demonstrate that during the period of time in the speciality they have made a
significant contribution to service delivery, education or the development of infrastructure within the speciality
of SEM, and in the case of service delivery should have significant experience of direct involvement with more
than one sport. In the case of service delivery this would involve a minimum of 0.4 WTE of their typical
working week being spent in Sport and Exercise Medicine as an ongoing commitment. Time spent seeing
SEM cases within the typical caseload of another specialty such as General Practise, Orthopaedic surgery or
Emergency Medicine, would not count towards this total.
Medical practitioners who have made outstanding contributions to the work of the Faculty, such as devoting a
significant amount of time to the development of the examination, education programmes, the work of the
Faculty etc. may also be considered.
2
FACULTY OF SPORT AND EXERCISE MEDICINE (UK), 6 HILL SQUARE, EDINBURGH EH8 9DR
TEL: 0131 527 3404 FAX: 0131 527 3408 EMAIL: r.capaldi@fsem.ac.uk
9.9.13
Faculty of Sport and Exercise Medicine (UK)
Patron: HRH The Princess Royal
Medical practitioners who are on the UK Specialist Register as a specialist in other medical disciplines, e.g.
Orthopaedic Surgery, Radiology, Accident & Emergency, General Practice would usually be considered for
Membership by Election unless they are adjudged to have made an outstanding contribution to the Faculty or
to the development of SEM in the UK.


Designation FFSEM(UK)
Full Voting Rights
SENIOR FELLOW
For retired FELLOWS of the Faculty; if the applicant is no longer receiving an income derived from Medicine,
the current fee payable is £26.


Designation FFSEM(UK)
Full Voting Rights
HONORARY FELLOW
The Council may elect, without examination, persons of eminence who have rendered exceptional services to the
science, practice or development of Sport and Exercise Medicine. Honorary Fellows need not be medically
qualified.


Designation Hon.FFSEM(UK)
No Voting Rights
CORRESPONDING FELLOW
The applicant will have been involved with the delivery of SEM services, education or infrastructure over a
period of more than 5 years full time or the equivalent part time.
The applicant will demonstrate CPD pertinent to the area of SEM in which they are involved.
Doctors who are working abroad, who are on the Specialist Register in their Country as a specialist in SEM or
equivalent will be considered.


Designation NONE
No Voting Rights
MEMBER
Medical practitioners on the UK Specialty Training Programme, who have successfully completed ST3 and
ST4 years of training and have passed the Diploma of Sport and Exercise Medicine (UK & Ireland)
examination, may apply for Membership.
MEMBERSHIP BY ELECTION
Medical Practitioners who have obtained the Diploma of Sport and Exercise Medicine (UK & Ireland) or
equivalent and are in good standing with the GMC may apply. Equivalence will be determined by the Faculty
on a case by case basis.
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FACULTY OF SPORT AND EXERCISE MEDICINE (UK), 6 HILL SQUARE, EDINBURGH EH8 9DR
TEL: 0131 527 3404 FAX: 0131 527 3408 EMAIL: r.capaldi@fsem.ac.uk
9.9.13
Faculty of Sport and Exercise Medicine (UK)
Patron: HRH The Princess Royal
The applicant must be able to demonstrate over a two/three year period that at least 0.4 WTE of their job plan
reflects Sport and Exercise Medicine practice. These should lead to approximate equivalence of ST3/4
competencies as per the UK Sport and Exercise Medicine training programme. Time spent seeing SEM cases
within the typical caseload of another specialty such as General Practice, Orthopaedic surgery or Emergency
Medicine, would not count towards this total.
The applicant should be able to demonstrate an ongoing commitment to CPD in SEM (as a minimum of three
years duration). Applicants are expected to have done a minimum of one year post diploma demonstrating an
ongoing commitment to Sport and Exercise Medicine. Applicants are expected to be members of BASEM or
similar Sport and Exercise Medicine associations.
The applicant should be able to demonstrate that they have access to mentorship or the support of colleagues
within the speciality so that their practice is not isolated.
Medical Practitioners who are on the UK Specialist Register as a specialist in another medical discipline and
who practice SEM in a part-time capacity may also apply.


Designation MFSEM(UK)
Full Voting Rights
SENIOR MEMBER
For retired MEMBERS of the Faculty; if the applicant is no longer receiving an income derived from Medicine,
the current fee payable is £26.


Designation MFSEM(UK)
Full Voting Rights
ASSOCIATE MEMBER
Associate Membership is open to medical trainees in UK and Ireland. There would be an administration fee.
SEM trainees, once they have passed the Diploma Exam become eligible for full membership and pay the full
membership fee.


Designation NONE
No Voting Rights
AFFILIATE MEMBER
Undergraduate medical students who are interested in SEM may apply for Affiliate Membership. There is no
fee for Affiliate Membership. All information will be sent by email.


Designation NONE
No Voting Rights
FOUNDATION FELLOWSHIP AND MEMBERSHIP IS NOW CLOSED.
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FACULTY OF SPORT AND EXERCISE MEDICINE (UK), 6 HILL SQUARE, EDINBURGH EH8 9DR
TEL: 0131 527 3404 FAX: 0131 527 3408 EMAIL: r.capaldi@fsem.ac.uk
9.9.13