UFH Emergency Medicine Fellowship 2020-2021  academic year application

*1. Please rank ALL the sites you would be willing to join, in the order of preference (check ALL that apply, but DON'T check any that you would NOT be willing to go to).  

For instance, if you would prefer to graduate and work in Guangzhou, would accept Beijing, but don't want to go to any other service area, click the "1" after Guangzhou, "2" after Beijing, and leave the rest blank.

PLEASE NOTE THAT THIS SELECTION REFERS TO THE FINAL EMPLOYMENT DESTINATION. MUCH OF THE TRAINING WILL BE DONE OUTSIDE THE CONTRACTED SERVICE AREA, AS DESCRIBED ABOVE.

*2. How did you hear about the UFH Training Programs? (Please choose all that apply)

*3. Is this the first time you are applying for a position at UFH?

*4. If you answered "no" above, please note what position(s) you applied for in the past

*5. Your Name:

*6. Date of birth (yyyy/mm/dd): 生日

*7. Gender: 性别

*8. Email: 邮箱

*9. Cell phone number: 手机号码

*10. Have you been or are you currently an employee of United Family Healthcare?

*11. Your home town name:

*12. If yes, please state dates and position(s):

*15. List language(s)/dialects you speak and rate fluency level from 0- 4 (Level 2 English or above is a requirement, Mandarin is desirable).

Cannot read or write                                                             = 1

Can speak or read/write some                                             = 2

Can give lectures in that language AND read/write           = 3

Can communicate easily and act as a verbal translator   = 4

A native speaker                                                                   = 5

16. Other language (please specify and grade fluency using the scale above):

17. fluency level of the language stated above

*18. What is your age today?

*19. Citizenship (list all applicable):

*20. Home province:

*21. Location of your Hukou (户口):

*22. In which province do you currently live:

*23. Which medical school did you attend?

*24. High School Attended (School name, city, province)

*25. Bachelor degree: Area of focus

*26. Bachelor degree received from (University name, city, province)

27. Master degree: Area of focus

28. Master degree received from (University name, city, province)

29. PhD degree: Area of focus

30. Ph.D. degree received from (University name, city, province)

31. Other degree(s) (please specify):

*32. Pediatric Experience during TRAINING. Count rotations only if there was direct patient care.

None ---------------------------1

1 month or less-----------------2

1-3 months ---------------------3

More than 3 months -----------4

33. Other pediatric experience

*34. Obstetrics/Gynecology during Training. Count rotations only if there was direct patient care.

None ---------------------------1

1 month or less--------------2

1-3 months -------------------3

More than 3 months -------4

35. Other Obstetrics/Gynecology experiemce(s)

36. Please fill in all other relevent training experience(s).

*37. Skill assessments: choose the best answer in each row

Never Exposed --------------------------------------------1

Seen it done/practiced by others regularly-------2

Done this myself on more than 5 patients -------3

*38. Please upload your resume (2 pages maximum, Word or txt format, in English):

*39. Please upload a photo of yourself (must be less than 1 MB in size, or less than 640x480):

*40. Please upload a copy of your medical school graduation certificate (PDF or image):

*41. Please tell us what led you to decide to become a doctor.(250-500 words)

*42. Please tell us what being an emergency medicine doctor means to you (250-500 words)

*43. Please tell us why you are interested in becoming an emergency physician at a United Family Healthcare facility. (approximately 250-500 words)

Thank you for applying. Our coordinator will contact you shortly. Please send us an e-mail if you do not hear from us in 2 weeks.If you have any concerns or questions, please feel free to e-mail us @ emtp@ufh.com.cn

Healthcare for life!