ERN eUROGEN Exchange Programme Application Form

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PLEASE READ THE BELOW FULLY BEFORE APPLYING...

Aims: The ERN eUROGEN Exchange Programme, starting on 1 February 2023, follows and will build upon the successful first exchange programme facilitated by the EC from 2021-2022. By funding exchange visits between ERN healthcare providers (HCPs), it aims to strengthen clinical and organisational expertise and share best practices in the field of healthcare, meet goals and strengthen capacity at the Network level, and share expertise, experiences, and highly specialised knowledge under the scope and framework of the 24 European Reference Networks. Exchanges also fit within the priority of ERN eUROGEN to train and educate the next generation of urologists and surgeons, increase skill levels, offer highly specialised surgical training, and improve patient outcomes in the rare diseases and complex conditions covered by ERN eUROGEN’s Expertise Areas.

Visitor Eligibility: Visitors can be members of the urological multi-disciplinary team (MDT) working at ERN eUROGEN Full Member or Affiliated Partner healthcare providers (HCPs), ERN eUROGEN Supporting Partners (Individual Experts), ERN eUROGEN Patient Advocacy Group (ePAG) advocates and other individuals at the ERN eUROGEN HCP Network Coordinator Representative’s discretion. Visits can be for 1-6 weeks. Upon completion of the programme of an exchange visit, the visitor will receive a certificate stating the visit duration and activities performed. Unfortunately, visitors who are not ERN eUROGEN members are not eligible and would need to be funded by their own ERN to visit an ERN eUROGEN HCP.

Host Eligibility: ERN eUROGEN Exchange Programme hosts can be Full Member or Affiliated Partner healthcare providers (HCPs) in any ERN.

Terms of Funding, Costs, & Reimbursement: Funding will be provided first-come-first-served and limited to the available budget. Therefore, ERN eUROGEN has the right to stop accepting applications at any time. The visitor will be responsible for booking their own travel and accommodation. Travel, accommodation, and subsistence (food/local transport) costs will only be reimbursed up to the maximum unit costs outlined by the European Commission (see pages 13-18 of the EC Unit Costs document). Weekend stays will only be reimbursed when work takes place on the weekend, between working weeks (i.e., in the case of a 2+ week visit), or when travel schedules oblige the visitor to spend an additional night at the location of the visit. The visitor must promptly communicate to ERN eUROGEN any change that may occur in their exchange visit, depending on their availability/decisions, to allow for smooth coordination and adaptation of plans. If visitors cancel their trip after purchasing travel and accommodation, they will not receive reimbursement. Visitors are responsible for arranging travel insurance at their own expense.

HOW TO APPLY: If you and your potential host meet the eligibility criteria and you agree to the terms of funding, costs, and reimbursement, then please complete the below application form. Once you submit, the ERN eUROGEN Coordination Team will be in contact to progress your application. If you have any questions, please email us.

Visitor's name (first name & last name):

Visitor's email address:

Visitor's employing healthcare provider (HCP):

Visitor's position at employing healthcare provider (HCP):

Visitor's expertise areas:

1.1 Complex genital reconstructions (DSDs)

1.2 Bladder exstrophy/epispadias

1.3 Rare urological stone & kidney diseases

1.4 Non-syndromic urogenital tract malformation

1.5 Posterior urethral valve

1.6 Posterior hypospadias

1.7 Urorectal/anorectal malformations

2.1 Complicated & complex pelvic floor disorders

2.2 Rare diseases & conditions affecting the female urethra

2.3 Urethral reconstruction in rare diseases & conditions

2.4 Rare retroperitoneal diseases & conditions

2.5 Interstitial Cystitis

2.6 Adult urogenital reconstructive surgery (transition from WS1)

2.7 Surgery for transgender patients

3.1 Penile cancer

3.2 Testicular cancer

3.3 Adrenal tumours

3.4 Abdomino-pelvic sarcoma

3.5 Rare renal tumour surgery

Visitor's manager's name (first name & last name):

Visitor's manager's email address:

Proposed hosting healthcare provider(s) for visit (check expertise coverage here):

Objectives of visit and expected results (e.g., what do you want to see/learn/discuss, who do you want to meet, and what will you have gained when the visit ends?):

Proposed length of visit (minimum 1 week, maximum 6 weeks):

Proposed number of visits:

Proposed dates of visit(s) (start - end):

Any other information:

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