Fondation pour le Développement de la Médecine Interne en
Europe
Stiftung für die Förderung der Inneren Medizin in Europa
Foundation for the Development of Internal Medicine in
Europe
http://www.fdime.org/
Summer 2015
http://www.esim2015summer.org/
EUROPEAN SCHOOL OF INTERNAL MEDICINE – SUMMER SCHOOL 2015
Venue: Free Beach, Costa Rei – Muravera CA, Sardinia, Italy
Course dates: Sunday 7 June to Friday 12 June 2015
(Residents Arrive: Sunday 7 June; Residents Depart: Saturday 13 June)
http://www.esim2015summer.org/
ESIM BURSARY APPLICATION FORM
We have a limited number of bursaries available to pay for the registration fees to enable Young Internists
to attend the forthcoming Summer Course of the European School of Internal Medicine.
The funding is provided by the Foundation for the Development of Internal Medicine in Europe (FDIME)
specifically intended for YIs from EFIM-affiliated member countries that are currently experiencing
financial hardship.
Applicants must meet the following criteria:


Come from an EFIM member country and provide a letter of support from their National Society
Be able to communicate in English (this is essential: all lectures & interaction is in English)
Be towards the end of their training in Internal Medicine and under the age of 36 years.
Type (or print clearly) your details below. Note the ‘Additional Important Information’ on page 2.
Send completed form, CV, letter of support to: Mrs Romy Alig e-mail: apply@fdime.org
FAMILY NAME:
1ST Name(s):
Postal Address:
Country:
Date of Birth:
Nationality:
Gender
(Male/Female):
E-mail address 1:
E-mail address 2:
Mobile Telephone:
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What is your field of interest/subspecialty?
Where do you practice (hospital/university/private)?
Free Motivation Statement (approx 150 words)
(Please indicate the reasons why you think this course will be valuable to you)
Essential supporting documents required with this application:
1. Your current and up-to-date CV (include any publications)
2. Letter of Support from your National Society of Internal Medicine
Your Name
Date Submitted:
Additional Important Information:
1. The ESIM bursary (Registration fee) will pay for attendance at the ESIM course, accommodation
and meals for 6 nights stay at the ESIM venue, and organised social activities throughout the week.
Attendees should bring their own money for any personal expenses incurred outside of the ESIM
activities during Free Time.
2. The ESIM bursary does not cover travel expenses. Successful applicants should seek support for
their travel from their National Society of Internal Medicine or from another sponsor. Successful
applicants will be responsible for making their own travel booking to the Cagliari Airport, Sardinia,
and to check for any visa requirements if living outside the EU.
3. Candidates who are selected to attend ESIM are required to prepare and present a 10 minute clinical
case study with accompanying Powerpoint slides.
4. A 200 – 300 word report written in English will be required from the successful applicants within
one month after attending ESIM.
Please e-mail your completed form before the closing date: 24.04.2015
Send to: Mrs Romy Alig, FDIME-ESIM Bursary Administrator.
E-mail: apply@fdime.org
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