Online application form {Part Two}

Application form to sit the European Board of Paediatric Surgery PART TWO Examination 2022

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COVID regulations

Incomplete application forms take extra time to process.

If you are looking for a quick turnaround, make sure you help us by submitting everything you are asked to submit.

Do not book your travel and accommodation until you have received confirmation that you have been offered a place to sit the examination. There are limited places every year.

Enter date of exam*

Enter city of exam

Contact Details

Surname*

Email*

Phone*

Address*

Personal/Professional Details

Date of Birth*

Country of Citizenship*

Place and country of birth*

Country of Training*

First Language*

Fluency in Languages*

Language: This exam will be conducted in English. Please confirm that you understand the exam will be conducted in English and sign below that you are fluent in English:

I am fluent in English*

Yes

No

I am a Qualified Paediatric Surgeon*

Yes

No

Year of Qualification*

Is this your first attempt at the Part Two Examination?*

Yes

No

Date passed Part One Examination*

Place and score of your Part One EBPS Examination*

Why do you wish to sit this examination*

Please attach documentation

You must attach a copy of your certificate of completion of paediatric surgery training /Paediatric surgery certificate.You may not be eligible to sit the EBPS Part Two Examination.

Please ensure that you enclose all necessary documents or your application will be returned.
It is essential that you send in either a copy of your certificate of accreditation as a Paediatric Surgeon or other proof of accreditation.
It is further essential that you make payment prior to attending the examination.
Incomplete applications will result in a delay to the admission process.

Applications received without full documentation will not be processed.

Have you enclosed? *

Full CV

A clear scan of your passport

Log Book

Copy of Certificate or proof of accreditation as a Paediatric Surgeon

Full and clear copy of your passport

Copy statement last year residency training programme in Paediatric Surgery signed by Trainer from Training Centre

Upload documentation

Payments

From 2023, Part Two Examination Fee - 799 Euro

How to Pay

1. Bank transfer to:

Name of the account : UEMS EBPS Examination Surgery
Number of account : 001-8052819-52
IBAN Code : BE64 0018 0528 1952
BIC/SWIFT Code : GEBABEBB
Name of the Bank : BNP Paribas Fortis
Address of the Bank : Montagne du Parc 3, 1000 Brussels, Belgium.

2. By Credit card via Paypal Invoice – if you wish to pay by credit card please tick the Paypal box and an invoice will be sent to you allowing payment by credit card. There will be a small fee added to cover the cost of Paypal transaction.

I wish to pay by*

Bank transfer

Paypal, request invoice

PLEASE ENSURE THAT ANY BANK TRANSFER FEE IS NOT DEDUCTED FROM YOUR EXAMINATION FEE; BANK FEES MUST BE PAID SEPARATELY

Cancellation: If a candidate cancels their examination place four weeks prior to attending, they will forfeit 50% of the examination fee. If a candidate cancels during the four weeks leading up to the examination, or does not attend, they will forfeit the full examination fee.

Confirmation

IMPORTANT

Early applications are advised as places are limited and fill quickly.

Examination places are awarded chronologically to applicants who submit full applications. If your application is incomplete and further documentation is required, your name will be placed on the waiting list.

Please DO NOT book your travel and accommodation until you have received confirmation from the Exam Office that you have been offered a place to sit the exam. We cannot accept responsibility for candidates who book travel and accommodation prior to submitting their full application to sit the exam.

EARLY APPLICATION IS STRONGLY ADVISED AS PLACES ARE LIMITED

I confirm that I wish to submit my application to sit PART TWO of the EBPS Examination*

Yes

No

Date of confirmation*

Names of successful part two candidates are passed to the UEMS EBPS committee and uploaded to the European Registry which is available on the UEMS website.

Please confirm acceptance that your name is included*

Yes

No

I consent to UEMS collecting and storing my data from this form*

Yes

Please confirm acceptance that your name is included*

Yes

No

Facebook

Names of successful candidates are uploaded to our website and facebook pages.

Please confirm acceptance that your name is included on Facebook*

Yes

No