RCOG AWARDS FOR EXCELLENCE IN TRAINERS

TRAINER AWARD – NOMINATION FORM

Name of nominating RCOG trainee representative (must be a RCOG regional trainee representative):

Email address of nominating RCOG trainee representative:

Nominating region/ LETB:

Name of nominated trainer:

Email address of nominated trainer:

Postal address of nominated trainer:

Job title of nominee (e.g. consultant, sonographer etc.):

Formal training roles held by nominee (e.g. head of school, training programme director, college tutor etc.):

Statement of nomination (600 words):

Please outline how the nominee has contributed to the training of obstetrics and gynaecology trainees above and beyond that required by any a formal role the trainer holds (e.g. head of school, training programme director, college tutor etc.).

Please give examples of how the nominee has enhanced training.

Where possible please do not use identifiable text such as the names of trainers, trainees, LETBs, trusts or hospitals etc. in the nomination.