Surgery Registrar details 2022
Please complete this form and submit. This information is for Dr Maheshwar Naidoo only. This will allow him to plan the tutorials more appropriately. Your personal information will not be distributed to anyone.  Communications will be sent via Whatsapp and email.
Sign in to Google to save your progress. Learn more
Email *
State your full name *
Where or from whom did you hear about the Surgreg teaching course? *
Please state your mobile number. *
What year of Surgery registrar training are you? (If you are a supernumerary registrar please kick that box as well as your year of study). *
Required
What surgery examinations have your completed? *
Required
What clinical rotations have you completed and how many months in each rotation? e.g. "Addington general surgery, 6 months", "Vascular surgery, 6 months" etc. *
Give some information about your medical career thus far e.g. when and where did you qualify with your basic medical degree. Where and when did you do your internship, community service, any medical officer time? *
When will you be sitting for your FCS 2 (Finals)? *
What is the progress on your MMed research project?  What is your topic? Who are your supervisors? What stage are you at? BREC approval? Data collection? Data analysis and write up? Ready for submission? Submitted? *
By ticking this check box, I agree that I wish to be part of the SurgReg training programme. There are no costs involved. I agree to participate in all types of electronic questions. I understand that my answers will not be distributed or made known to anyone. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms