ifmsa scope curriculum - sismfirenze.sism.org/.../11/new-curriculum-vitae-scope.pdf · sism...

SISM Segretariato Italiano Studenti Medicina

Ufficio Nazionale: Padiglione Nuove Patologie, Policlinico Sant’Orsola, Via Massarenti 9, 40138 Bologna

tel/fax: +39 051 399507; email: [email protected]; web: www.sism.org

Codice Fiscale 92009880375

IFMSA SCOPE CURRICULUM

Personal Information

Surname: ________________________;

Name: ________________________;

Date and place of birth: ________________________;

Address: ________________________;

City: ________________________;

Postal code: ________________________;

Country: ________________________;

Nationality: ________________________;

Telephone: ________________________;

e-mail: ________________________;

Education

Medical Studies

Name of University, City, Country:

_______________________________________________________________________

Medical Student since: ________________________;

Clinical Student since: ________________________;

I have completed ___ years of my ____ year long course.

Biochemistry

Biology and Genetics

Histology

Anatomy

Physiology





Psychology/Sociology

Microbiology

Immunology

Pharmacology

Pathology

Epidemiology

Internal Medicine

Cardiology

Endocrinology

Dermatology

Haematology

Nephrology

Infectious Diseases

Neurology

Pneumology

Oncology

General Surgery

Orthopaedics and Traumatology

Ophthalmology

Othorinolaringoiatric

Obstetrics and Gynaecology

Paediatrics

Radiology

Anaesthesiology and Intensive Car

Forensic Medicine

Psychiatry





Others (if you have studied more subjects you do not find on the list above, please fill spaces below and check them):

Laboratory or Clinical Electives (in native country or abroad):

Name of the Institute/Hospital: ________________________;

Department: Laboratory Clinical

City: ________________________; Country: ________________________;

Since ________________________ to ________________________;

Name of the tutor/professor to contact for further information concerning you:

____________________________________________________.

Contact information (tel/e-mail/address) of above Professor/Tutor:

___________________________________________________________________________.

Name of the Institute/Hospital: ________________________;

Department: Laboratory Clinical

City: ________________________; Country: ________________________;

Since ________________________ to ________________________;

Name of the tutor/professor to contact for further information concerning you:

___________________________________________.

Contact information (tel/e-mail/address) of above Professor/Tutor:

___________________________________________________________________________.

Etc... (repeat the scheme above for every Laboratory or Clinical Electives you did).





Other Educational Activities (Lectures, Conferences, Summer Schools, Medical

Courses, etc…)

• ___________________________________________________

• ___________________________________________________

• ___________________________________________________

Languages Spoken

Language: __________________ Level: Basic Sufficient Excellent




Employment History:

(e.g. Part Time Jobs)

• ___________________________________________________

• ___________________________________________________

• ___________________________________________________

Social Skills:

(e.g. Voluntary Work)

• ___________________________________________________

• ___________________________________________________

• ___________________________________________________

Technical Skills:

(e.g. Computer Skills)

• ___________________________________________________

• ___________________________________________________





• ___________________________________________________

Hobbies / Interests:

(e.g. Playing a Musical Instrument, Painting or Playing a Sport)

• ___________________________________________________

• ___________________________________________________

• ___________________________________________________

This application form must be accompanied by all the documents stated in the SCOPE

database.

Place and date

_____________________

Signature

_______________________

ifmsa scope curriculum - sismfirenze.sism.org/.../11/new-curriculum-vitae-scope.pdf · sism...

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