VOS TRAVELLING FELLOWSHIP Dear Colleagues, It gives us a great pleasure to announce the Travelling Fellowship of VOS... The main idea behind starting this fellowship program is to keep our members updated with time. Every year 2 fellows will be selected-one from major city and one from district or Taluka place. The idea is again those who are working at small places they should get an equal opportunity to keep updated with the time. The Fellowship will be for duration of 5 to 7 days at reputed centers in India in different sub specialties of orthopedics. The list of those centers who have agreed to accept the fellows from VOSN is attached. A sum of rupees Fifteen Thousand will be paid to each fellow for this fellowship program for travel, food and their accommodation. After completion of fellowship the fellow will have to submit his report to the Secretary, Fellowship committee, VOSN and it will be mandatory to present his experience in a power point format in the subsequent academic meeting of VOSN. This traveling fellowship will benefit orthopedic Surgeons in many ways. Each fellow will have the Opportunity to interact with many orthopedic leaders which will promote a powerful and professional development network. It will provide them a stepping-stone for future. We are providing the application form with this circular. Those who are interested are requested to kindly submit the application as earliest as possible. Applications received after 10th October will not be accepted. The applications received will be sent to the committee, consisting of senior orthopedic surgeons and their decision will be communicated to the candidates by VOSN immediately. Thanking you, Dr. Ravi Bhajani President, VOS Nagpur Dr. R. M. Chandak Chairman, Fellowship Committee Dr. Devashis Barick Secretary, VOS Nagpur VOS TRAVELLING FELLOWSHIP Official Application: Eligibility: 1. Applicants must have completed approved orthopedic training (including residency and fellowship) on or before 31st March 2012. 2. Applicants must have completed at least 1 year of membership of VOS on or before 31st March 2012. 3. Applicants must be able to take the tour in the year 2012-2013. Exact dates will be communicated to the selected candidates depending upon availabilities of the dates at training centers. 4. Applicants who are participating in clinical activities of VOSN with maximum attendance, case or paper presentations, participation in annual conference of VOSN will be given additional points during selecting process. PROCEDURE: Complete this application and send it to Hon. Secretary, VOS Nagpur Attachments : A recent Passport size Photograph, CV in the requested format. Two recommendation letters in support of your documents are mandatory. One of the recommendation letters is from Executive Member of VOS and the other should be from an orthopedic surgeon, who is familiar with your work. All application forms, recommendation letters & curriculum vitae, letters or certificates supporting your active participation in VOS activities MUST BE COMPLETED AND RECEIVED BY 10th October 2012. Incomplete applications, or those received after that date will not be considered. For More Information, please contact: Dr. Devashis Barick Secretary, VOS Nagpur Dr. R.M. Chandak Chairman. Fellowship committee, VOS, Nagpur. COMPLETE YOUR CURRICULUM VITAE (CV) ON A SEPARATE ATTACHMENT, ACCORDING TO THE FOLLOWING FORMAT WITH THE HEADINGS IN THE FOLLOWING ORDER: a. Name of applicant. b. Special Awards and Honors: List special awards and honors received, while in medical school, residency fellowship or following the completion of your educational program. c. Membership/Leadership Position List, membership or leadership position you have held on National, Regional or Local committee or in professional organizations. d. Peer-reviewed Articles (Published and In Press): List articles published in peer-reviewed journals. Include the title, all authors, journal and year of Publication. Please underline your name and capitalize the name of the journal. You may also list articles in press but not those that are submitted. Only please indicate whether they are published or in press. e. Non-Peer-Reviewed Articles: List articles published in non-peer-reviewed journals (include internet related articles here) f. Textbooks and Textbook Chapters: List textbook or chapter in textbooks that you have authorized or co-authored and the year. g. Other Media: List scientific movies, sound slide programs, exhibits, audio tapes and video tapes which you have developed or co-developed. List the scientific meeting where each has been presented. h. National Scientific Presentations: List scientific presentation that you gave at National meeting (include title of paper, all authors, organization, location and date) i. Regional and Local Scientific Presentation: List scientific presentations that you gave at regional and local meeting (included title of paper, all authors, organization, location and date) j. List your participation in VOSN activities. k. Non-Academic achievements and community Service Activities describe and special non-academic achievements or community service activities which you believe are important. DISCLAMER AND SIGNATURE I certify that above information is true and complete to the best of my knowledge. Signature of Applicant: _____________________ Date : ____________________ Centre who are willing to accept Fellows from VOSN at this stage are as follows: 1. Dr. Rajsekaran, Coimbatore 2. Dr. Ashok N. Johari, Mumbai 3. Dr. Sancheti, Pune 4. Dr. G.S. Kulkarni, Miraj 5. Dr. D.D. Tanna, Mumbai 6. Dr. N.H. Laud, Mumbai 7. Dr. C.J. Thakkar, Mumbai 8. Dr. Sachin Tapaswi, Pune 9. Dr. Anant Joshi, Mumbai Applicant Information I. APPLICANT INFORMATION Name: Last: First: Middle: Date of Birth: Institution: Place of Birth: Citizenship: State: Fax : Zip: Email: State: Mob.: Zip: Office Address: City: Phone: Home Address: City: Phone: Alternate Contact (Admin assistant, etc.) Name : Phone: Email : ------------------------------------------------------------------------------------------------------II. Letters of recommendation from : 1. Name: Institution : Phone : Title: City: State : Zip: 2. Name Institution : Office Address : Phone : Title State: Zip : Office Address: City : III. GRADUATE OF: Graduate of College/ University: Date of Granduation: Degree: IV. POST-GRADUATE EDUCATION INSTITUTION From (Mo/year) to (Name of Location) (Mo/year) 1st Year 2nd Year 3rd Year V. ADDITIONAL EDUCATION OR FELLOWSHIP (NAME AND LOCATION) 1. Type of Education or From (mo/year) to Fellowship (mo/year) Name of Director : Address : 2. Type of Education or Fellowship From (mo/year) to (mo/year): Addess : VI. PROFESSIAL, EMPLOYEMENT SINCE COMPLETION OF RESIDENCY OR FELLOWSHIP (List faculity appointments, Private practice, Full or part-time) academic practice.) 1. Activity 2. Activity 3. Activity 4. Activity Form(mo/year) to (mo/year) Form(mo/year) to (mo/year) Form(mo/year) to (mo/year) Form(mo/year) to (mo/year)