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- Deadline of submission November 29, 2019 5pm (No extension)
- PMA number is required
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image INSTRUCTIONS on How to Apply for the Fellowship status at PCP: REQUIREMENTS FOR APPLICATION AS PCP FELLOW
(Effective September 02, 2019)
1. Please read the Implementing Rules and Regulation (IRR) for the Committee on Membership and
Credentialling
2. All documents & requirements must be submitted via the website on or before 5:00 PM (Philippine Standard Time) of November 29, 2019. 3. Incomplete documents will NOT be processed. 4. Receipt of Application will be acknowledged via e-mail. 5. Upon validation, approval of the application by the Chair of the Committee on Membership & Credentialing shall be given via e-mail. I. NAME OF APPLICANT: II DATE OF APPLICATION: III REQUIREMENTS: * date selector 1. Current PCP-Certificate of Good Standing issued by your respective local chapter. (Please attach .JPEG or PDF. 1mb file limit)
NOTE: Documents attesting to compliance of the required Thirty(30) PCP-CPD units per fiscal year for 2 consecutive years.
* 2. Letter of application addressed to the President of the PCP. (Please attach JPEG or PDF. 1mb file limit) * 3. Recent passport size colored picture (high resolution, at least 300dpi) with white background. (Pls. attach your picture in JPG or PDF format, < 1MB file size) * 4. Proof of payment of required processing fee / annual dues. (Pls. attach your copy of payment form in JPG or PDF format, < 1MB file size) *
  • For those paying through the bank please use "BILLS PAYMENT FORM" and use your PRC ID
number as reference number (Union Bank Pasig Branch. In favor of: Philippine College of Physicians). 5. Endorsement letters from two (2) PCP Fellows in good standing. (Pls. attach your copy of letters in JPG or PDF format, < 1MB file size) Sample Template of Endorsement : * 7. Photocopy of Diplomate Board of Certificate. (Pls. attach your copy in JPG or PDF format, < 1MB file size) * 8. Certification of ANY of the following accomplishments: (Pls. attach your copy in JPG or PDF format, < 1MB file size) *
  • Subspecially Fellowship Training/Masteral/Academic Training
  • Active Internal Medicine Practive and/or Teaching (from the Hospital Medical Director / Department Char / PCP Chapter President).
  • Completed research during the prescribed period (copt of abstract).
9. If there are any, submit list of active participation in PCP-related and/or other civic activities during the last two years. Please
refer to the Pro-Forma Template:
Kindly submit the document in PDF format.
  • the list must be verified by your Chapter President and signed by the applicant to attest to its veracity.
FOR INQUIRIES: The Secretariat : Philippine College of Physicians, 22 nd Floor, One San Miguel Avenue Building San
Miguel Avenue corner Shaw Boulevard, Ortigas Centre, Pasig City 1605 Tel. nos 910-2250, 910-2252 to
54 pcp website: www.pcp.org.ph E-mail address: secretariat@pcp.org.ph
PERSONAL DATA PCP CHAPTER WHERE I AM A MEMBER * Last name First name Middle name * * * Extension name Office Address Office name : Street: Town/City: Tel. No.: Zip Code: Region: * * * * * * Region: * * Zip Code: * Town/City: Tel. No.: * * Street: Home Address Mailing Address: * * Place of Birth: * Mobile No.: PCP number: PRC number: PMA number: * * * date selector Birthdate: Gender: * * Marital Status: Name of Spouse: date selector date selector date selector date selector date selector date selector Year Level 1: Year Level 2: Year Level 3: POSTGRADUATE TRAINING
( * Any training pursued after earning Diplomate status)
TRAINING/INSTITUTION Inclusive Dates (e.g. GI Subspecialty / UP-PGH) From To
  • In case a candidate trained in 2-3 different Institutions, he/she must submit 'certified true copies' of both the Diploma
    of completion of subspecialty/masteral/academic training program/s and letter of certification that he/she had
    satisfactorily completed a particular Year Level of training program from another institution.
The Committee on Membership & Credentialing reserves the right to disapprove any applicant who shall be
found to be deficient in his/her qualifications OR who would be found to have submitted fraudulent
documents.
Email Address: * https://pcp.org.ph/index.php/membership/implementing-rules-and-regulations-irr-for-the-committee-on-membership-and-credentials https://pcp.org.ph/images/Membership/EndorsementLetter_for_PCPFellowship.pdf LAST NAME / FIRST NAME / MIDDLE NAME http://pcp.org.ph/images/Membership/ProForma_Letter_for_ListofActiveParticipation.pdf * * Barangay: * Barangay: * Province: * Province: * 6. Photocopy of PMA (Philippine Medical Association) Certificate of Membership (For verification purposes)