Hypertension Specialist Recognition
Application Form
Joint Royal Colleges of Physicians Training Board
Specialty Training Curriculum for Clinical Pharmacology and Therapeutics
Hypertension Module (amendment August 2010)
The purpose of this module is to equip future physicians with the essential knowledge, aptitude and
skill to function as independent hypertension specialists supporting other cognate specialties within
the framework of the National Health Service.
Applicants completing their training within Great Britain and Ireland prior to the introduction of
the module should also use the form below. Those who have completed their training several
years ago and are no longer in contact with their educational supervisor, should seek a BHS member
to act as a referee. See list of members on the BHS website or contact Jackie Howarth for assistance
at: bhs@le.ac.uk.
This form should be downloaded, completed and returned to Jackie Howarth at the address at
the foot of the form together with payment of the administration fee, see below.
If approved, the BHS Executive Committee will issue a certificate to recognise completion of the
Hypertension Module or equivalent experience. The certificate will not guarantee competence in any
of the specified areas.
The applicant should ensure that their Educational Supervisor can confirm that they have satisfied the
following learning objectives and gained the required competencies as specified in the Hypertension
Module. A copy of the completed form will be sent to the applicant’s nominated Educational
Supervisor (or equivalent) for verification. Please advise this person in advance.
Date of Application.................................................................
Applicant's Details
First Name
Last Name
GMC Number
Email address
Job Title
Place of Work
Medical Specialty 1
Medical Specialty 2
Date of CCT Award
Spec 1
Date of CCT Award
Spec 2
Date of completion
of training
Deanery in which
Training
undertaken
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Title
Educational Supervisor’s or Equivalent's Details
First Name
Last Name
Title
GMC Number
Email address
Job Title
Place of Work
The Supervisor should certify that the candidate has satisfied the following learning
objectives as specified in the Hypertension Module:
Signature
Able to apply diagnostic and management knowledge and
skills to the prevention of cardiovascular diseases, due to
hypertension and other cardiovascular risk factors.
Able to formulate a differential diagnosis of potential causes
for raised blood pressure and develop an appropriate
treatment plan incorporating lifestyle modification and
pharmacological therapy.
Has the necessary understanding and appreciation of the
role of multidisciplinary working across specialties and
primary care to facilitate the most cost-effective and efficient
management of hypertensive patients.
Possesses the ability to advise, develop and evaluate the
Clinical Effectiveness of hypertension and cardiovascular risk
services in partnership with other cognate disciplines.
The Supervisor should certify that the candidate has gained the following
competencies as specified in the Hypertension Module:
Signature
The trainee is competent in the assessment and
management of hypertension and cardiovascular risk in all
patient groups.
The trainee is competent in the practical aspects of diagnosis
and assessment of hypertension and cardiovascular risk.
The trainee has the knowledge and skills to assess and
manage patients with hypertension and metabolic
abnormalities
The trainee has knowledge and skills to manage
hypertensive patients and reduce cardiovascular risk using
non-pharmacological therapies.
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The trainee has the knowledge and skills to manage
hypertensive patients and reduce cardiovascular risk using
pharmacological therapies.
The trainee has the knowledge and skills to investigate and
manage patients (including children and pregnant women)
with accelerated hypertension (Grade 3; malignant,
emergencies and urgencies).
Administration Fee - Payment Details:
BHS Members .............................................................................................. £50.00
Non-members (to include one year’s BHS membership subscription) ....... £100.00
I wish to pay:
 By Cheque/Bank Draft
Payable to ‘British Hypertension Society’ and drawn on a UK bank
 By Credit Card:
 Mastercard  Visa  American Express
NB Credit card payments are subject to an additional charge (Mastercard, Visa & Amex: 2.95%)
 By Debit Card:
 Visa Delta  Maestro
Card No ……………………………………………………………… Expiry Date …………………......
Card Security Code (last 3 digits on back of card) …………
Maestro only: Valid From Date or Issue No ……...
Cardholder’s signature ………………………………………………………………………………........
Name, billing address and postcode of cardholder .....................................................................
…………………………………………………………………………………………………………………….
………………………………………………………………………………….…………………………………

Please return with cheque or card details to:
Jackie Howarth
British Hypertension Society
c/o Hypertension Research Team
Clinical Sciences Wing
Glenfield Hospital
Leicester
LE3 9QP
bhs@le.ac.uk
Tel: 07717 467973
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