POSTGRADUATE MEDICAL INSTITUTE/ AMEER-UD-DIN MEDICAL COLLEGE/ LAHORE GENERAL HOSPITAL, LAHORE

Application Form for FCPS part-II Training

1. I, Dr. ______S/O, D/O ______

hereby apply for FCPS Part-II Training in the Specialty: ______

a. 04 Years training. b. 05 Years training c. 02 Years training

in the Department of ______LGH, Lahore

2. I have attached the attested photocopies of the following documents along with:-

a. CNIC. b. Domicile c. Result card of the five Professional Examinations. d. MBBS Degree e. Attempt certificate f. House Job certificate g. Medal / Research Paper certificate h. Result card of FCPS Part-I.

Signature: ______

Name: ______

Father’s Name: ______

Address: ______

______

Contact No: ______

E-Mail Address: ______

Dated ______/2014

Note: Please fill the attached Proforma. PROFORMA TO BE ATTACHED WITH THE APPLICATION

Name of Doctor: ______

Applied for FCPS-II training in ______

1. Academic Records:

Sr. No. Prof/ Examination Marks Total Attempt Obtained Marks 1. Ist Prof. Part-I 2. Ist Prof. Part-II 3. 2nd Professional 4. 3rd Professional 5. Final Professional Total Marks

 Conversation formula for MBBS Marks:-

Aggregate marks of all Professional exams. = X Total max. marks of all Professional exams. = Y % age marks = X/Y x 100 = Z Merit marks = Z/5 =______ Note: For Foreign graduates 80% of the aggregate score as calculated by above formula shall be considered.(Z=80%)

 Medal/ Research paper if any ______Yes/ No (attach certificate)  Last date of House Job completion ______ Date of passing FCPS Part-I Examination ______ Duration between the last date of House Job completion and date of passing FCPS part-I exam years______months ______days ______

I have re-checked the above provided information.

Candidate Signature: ______

Counter Checked by EC-PG Section LGH: ______INSTRUCTION FOR APPLICANTS OF FCPS PART-II TRAINING AT LAHORE GENERAL HOSPITAL, LAHORE 1. Last date of applications is 30.06.2014 2. Application form can be downloaded from website of PGMI & LGH, Lahore. 3. Applications need not be recommended by supervisors of courses at Lahore General Hospital, Lahore. 4. Applications will be received at PG Section Lahore General Hospital, Lahore. 5. Merit of short listed candidates will be displayed on website of the institution on 03.07.2014 6. Any reservation regarding merit list of short listed candidates should be intimated on 04.07.2014 before 10:00 am. 7. Interviews will be conducted on 05.07.2014 8. No letter will be issued to any applicant. 9. Candidates, who will not appear in interview, will not be consider for enrollment for FCPS part-II training. 10. Selected candidates will join on 07.07.2014