Forms

408 Sheffield Fund Application Form

Applicants for the 408 Application should read the following information before submitting their application online

Applicants should meet the following criteria

a) be doctors/nurses/or others working in field of Sexual and Reproductive Health
b) be working in full or part-time in the NHS or charitable sector
c) or medical students attending medical school in the UK.

Other rules

a) Applicants will not be considered if they have received funding from the 4-0-8 fund within the three years prior to the meeting being applied for.
b) As the committee only meets on three occasions a year, applications will be considered when submitted by these dates: 

  • Friday 2 February 2018
  • Friday 1 June 2018
  • Friday 24 August 2018

c) Funding will only be provided for attendance at meetings deemed by the Events Committee to be relevant NB. For the purpose of clarity this does not include a degree or diploma course or any other courses leading to an academic award.
d) Funding can be used towards the cost of registration and travel. Applications may include the cost of accommodation but payment will be at the discretion of the Events Committee.

The application form will ask you to submit all of the following details, please ensure you have this information to hand before you start to fill in the online form

  • summary of current work, the main employer and the relevance of the meeting
  • the meeting for which funding is applied
  • other sponsorships applied/expected for this event
  • details of meetings and educational events attended in the previous 24 months. Sources of funding must be declared
  • details of study leave allowance provided by the applicant’s employer and the reason why the employer is not providing funding for the meeting in question
  • declaration that the applicant is in full time or part time employment within the NHS or charitable sector

Within 3 months of attending the event, you will be asked to provide the following information by email to FSRH

  • a certificate of attendance
  • a receipts confirming that they have paid fees and travel/accommodation costs
  • incurred
  • a declaration of sources of funding for the meeting
  • a summary of the meeting of approximately 10 key bullet points

Payments will be made retrospectively on receipt of the satisfactory completion of items above

Applicants must acknowledge the source of funding if they publish anything as a result of receiving the grant from the 4-0-8 Sheffield Fund of the Faculty of Sexual and Reproductive Healthcare.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

* Claims not received within 3 months of the date of the event will only be processed at the discretion of the Faculty.

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here

Application for a grant to assist with CESR - Open to any Diploma/Member/Fellow of the FSRH

The FSRH has a small amount of money originally given to us by the Department of Health (DH) for ‘top up’ funds for doctors wishing to do SRH training. We have agreed with the DH that this money can now be used to provide financial assistance to doctors working towards SRH Consultant eligibility via the CESR route.

Applications will be reviewed by the Chair of the Specialty Advisory Committee (SAC), the Vice President, Strategy and the Chair of the Assessment and Curriculum Committee, using the criteria set out below.

Grants will be awarded of up to £5,000 per applicant. You are not eligible to apply for a second grant if you have already been awarded one.

CRITERIA

  • Current Member/Fellow/Diplomate of the FSRH (subscription fully paid).
  • Registered with the GMC. 
  • Close to applying for a CESR in SRH (aiming to apply within the next 24 months).
  • Finding it difficult to complete all the training needed to complete the CESR curriculum without financial assistance.
  • Clear plan for what you would use the financial assistance for – able to describe which parts of the curriculum this would enable you to complete and to what timescale. 
  • Not had a previous successful application to this fund.

PLEASE NOTE that successfully applying for this fund will have no bearing on the outcome of your CESR as this is decided by the GMC.

TO APPLY

Please apply by filling in the on-line form below. You will receive an immediate notification of receipt and the FSRH will make a decision and inform you of it within 4 weeks of your application date.

In the form you will need to outline briefly your progress so far in meeting the CESR curriculum and what else you need.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

Application for FSRH Associate Membership

Thank you for your interest in becoming an Associate member of FSRH. 

Associate membership can be awarded to medical practitioners and nurses who do not hold the Diploma, Membership Exam or are a current Fellow but may have been awarded a Letter of Competence. 

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

Application form for the FSRH Postgraduate Medical Education Training (provided by University of Worcester as part of their Masters programme in Health Professionals Education)

We are delighted that you are interested in undertaking medical education training with the view of becoming a FSRH Registered Trainer. Successful completion of this training can be used to support your FSRH Registered Trainer application.

 

The information contained in this form will be used to assess your eligibility to attend the upcoming Postgraduate Medical Education training. If accepted you will be referred to the University of Worcester and requested to complete a formal application form. Instruction will be given to you following the review of this initial application.

Please contact the Liz Nyholm at Liz@nyholms.com if you have not received an acknowledgement of your expression of interest within one week of your submission.

*indicates a required field.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

 

Application for recertification of Faculty Registered Trainer (FRT) status

Before filling in this online form, please have all the relevant information to hand before starting it, you will not be able to save it and then revisit it later, it must be completed in one sitting. 

Please note, that if your internet connection drops, your form and potentially the information you have filled in will not be saved for you to revisit later. You may wish to print and hand fill the paper version if you feel that this suits your circumstances better:


Click here to download and print a pdf version of FRT Recertification form.  

Interim arrangements - recertification of Faculty Registered Trainer status

The General Training Committee will continue to recognise GP Trainers that hold Faculty qualifications who have applied for an FRT number, provided they continue to be recognised by the RCGP as trainers. All other FRTs (who are LoC MEd and PGA holders or who have been recognised by the equivalency route) will continue to require recertification of FRT status on a 5 yearly cycle. This will replace the requirement to recertify LoC MEd.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

Application for recertification of FSRH Registered Trainer - GP Trainer

Application for recertification of FSRH Registered Trainer (FRT) status for NHS Education local Deanery approved GP Trainers (not holding the Keele University/FSRH Postgraduate Course in Medical Education (SRH) or LoC MEd)


FRTs who came through the Deanery approved GP Trainer route

The General Training Committee recognises that current GP Trainers (as approved under the NHS GP training framework across the UK) undertake ongoing medical education as part of the requirements to maintain their skills and knowledge as GP Trainers. To reflect the need to show competence in specific FSRH training qualifications, FRTs who are approved GP Trainers and do not possess the Keele University/FSRH Postgraduate Course in Medical Education (SRH) or LoC MEd will be required to recertify as FRTs using a modified form of the requirements for non-GP Trainers.

Recertification for a GP Trainer who also holds the LoC MEd or Keele University/FSRH Postgraduate Course in Medical Education (SRH)

GP Trainers who possess a Keele University/FSRH Postgraduate Course in Medical Education (SRH) or LoC MEd should recertify using the form for trainers holding the Keele University/FSRH Postgraduate Course in Medical Education (SRH) or LoC MEd. FRT status achieved through the LoC MEd or Keele University/FSRH Postgraduate Course in Medical Education (SRH) route cannot be recertified once it has lapsed. Should a GP trainer cease to hold the GP Trainer status, they would lose their FRT status unless they also hold FRT status through the recertified LoC MEd or the Keele University/FSRH Postgraduate Course in Medical Education (SRH) route.

Recertification requirements

  • Hold a current license to practice and hold trainer approved status from GMC/NMC.
  • Each yearly subscription paid when due.
  • Recertification of DFSRH/MFSRH/FFSRH.
  • 50 credits in core SRH (in this total you may count the credits used to recertify your FFSRH/MFSRH/FSRH Diploma qualification).

Please list below a record of your learning and activity in core SRH to the value of 50 CPD credits over the previous 5-year period. In the light of GMC requirements that GP Trainers, as Approved Educational Supervisors, are required to maintain their medical education and teaching experience, no further evidence of this is required.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

Application for Recertification of the FSRH Diploma

Before filling in this online form, please have all the relevant information to hand before starting it, you will not be able to save it and then revisit it later, it must be completed in one sitting. 

 

Record of CPD activity

Please note: evidence of CPD activity does not need to be submitted upon application. However, the General Training Committee will audit 10% of all applications and reserves the right to ask for supporting documentation for all activity.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here. 

Application for Recertification of the Letter of Competence in Intrauterine Techniques (LoC IUT)

Before filling in this online form, please have all the relevant information to hand before starting it, you will not be able to save it and then revisit it later, it must be completed in one sitting. 

 

Recertification requirements

1. Personal beliefs guidance:

Please see the recertification section of the FSRH website to read the Guidance for those undertaking or recertifying FSRH qualifications whose personal beliefs conflict with the provision of abortion or any method of contraception. This was introduced at the FSRH in May 2017 and you should read this before submitting your recertification application. You are asked below to confirm you have read the guidance and will abide by the principles in it in your practice. This is part of the Faculty’s conditions for recertifying a FSRH qualification.

2. Recertification is free for members who have paid their annual subscription fee or £368.00 for non-members.

3. At least 2 CPD credits relevant to intrauterine techniques, gained from any of the following activity:

Please note: evidence of CPD activity does not need to be submitted upon application. However, the General Training Committee will audit 10% of all applications and reserves the right to ask for supporting documentation for all activity. See below for examples of acceptable evidence.

  • Attendance at courses/meetings relevant to IUT
    Evidence: certificate of attendance, programme of meeting and brief reflection on how this will influence your future practice.
  • Reading of appropriate current peer reviewed publications e.g. JFPRHC, BMJ
    Evidence: reference of article, and brief reflection on how this will influence your future practice: 1 CPD credit per article
  • Reading of FSRH CEU guidelines on intrauterine methods and completion of self-assessment questions 

    • Reading of CEU guidance: 1 CPD credit 
    • Completion of self-assessment questions: 1 CPD credit. This CPD activity may not be counted towards CPD if used to fulfil section ‘Option 2 (b)’ on the below form. 
    • Evidence of reading: date read and brief reflection on how this will influence your future practice.
      Evidence of questions: mark sheet, date completed and brief reflection on how this will influence your future practice.
  • Peer observation: 1 CPD credit for observing a peer perform an insertion and giving feedback afterwards, 1 CPD credit for being observed performing an insertion by a peer and discussing feedback afterwards. The observer/person being observed must hold a current LoC IUT.  Evidence: date and name of observer/person being observed and brief outline of what you learned from this, either as an observer or from being observed)
  • Audit of IUT – personal or local 
    Evidence: date, summary of audit, brief description of your role in audit: 1 CPD credit

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form.

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

Application for Recertification of the Letter of Competence in Subdermal Contraceptive Implant Techniques (LoC SDI)

Before filling in this online form, please have all the relevant information to hand before starting it, you will not be able to save it and then revisit it later, it must be completed in one sitting. 

 

Recertification requirements

 

1. Personal beliefs guidance:

Please see the recertification section of the FSRH website to read the “Guidance for those undertaking or recertifying FSRH qualifications whose personal beliefs conflict with the provision of abortion or any method of contraception”. This was introduced at the FSRH in May 2017 and you should read this before submitting your recertification application. You are asked below to confirm you have read the guidance and will abide by the principles in it in your practice. This is part of the Faculty’s conditions for recertifying a FSRH qualification.

2. Recertification is free for members who have paid their annual subscription fee or £368.00 for non-members.

3. At least 2 CPD credits relevant to subdermal contraceptive implant techniques, gained from any of the following activity:

Please note: evidence of CPD activity does not need to be submitted upon application. However, the General Training Committee will audit 10% of all applications and reserves the right to ask for supporting documentation for all activity. See below for examples of acceptable evidence.

  • Attendance at courses/meetings relevant to SDI
    Evidence: certificate of attendance, programme of meeting and brief reflection on how this will influence your future practice.

  • Reading of appropriate current peer reviewed publications e.g. JFPRHC, BMJ
    Evidence: reference of article, and brief reflection on how this will influence your future practice: 1 CPD credit per article

  • Reading of FSRH CEU Guidance on subdermal contraceptive implant methods and completion of self-assessment questions 

    • Reading of CEU guidance: 1 CPD credit 
    • Completion of self-assessment questions: 1 CPD credit.

 

 

This CPD activity may not be counted towards CPD if used to fulfil section ‘Option 2 (b)’ on the below form.

 

    • Evidence of reading: date read and brief reflection on how this will influence your future practice.
    • Evidence of questions: mark sheet, date completed and brief reflection on how this will influence your future practice.

  • Peer observation: For LoC IR you can claim 1 CPD credit for observing a peer perform an insertion or removal and giving feedback afterwards, 1 CPD credit for being observed performing an insertion or removal by a peer and discussing feedback afterwards.

  • For LoC IO you can claim 1 CPD credit for observing a peer perform an insertion and giving feedback afterwards, 1 CPD credit for being observed performing an insertion by a peer and discussing feedback afterwards.

  • For LoC RO you can claim 1 CPD credit for observing a peer perform a removal and giving feedback afterwards, 1 CPD credit for being observed performing a removal by a peer and discussing feedback afterwards.

The observer/person being observed must hold a current LoC SDI.
Evidence: date and name of observer/person being observed and brief outline of what you learned from this, either as an observer or from being observed)

  • Audit of SDI – personal or local 
    Evidence: date, summary of audit, brief description of your role in audit: 1 CPD credit

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form.

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

 

 

 

Apply or Re-register to become a Menopause Principal Trainer

Please complete all parts of this form before clicking submit.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.