SASES Step 1 Fellowship Application

SASESFor SurgeonsTraining and FellowshipsSASES Step 1 Fellowship Application

This application allows you to apply for the various followships that are offered to members.

The fellowships differ in terms of area of subspecialty, country, required duration.

Please see the details of the various fellowships before applying. Ensure that you only apply for fellowships that you are interested in and that you are able to attend for the required minimum length of stay.

Date of completion of form*
DD slash MM slash YYYY
Full Name*
First Name Surname
Contact Number*
Email*
Fellowships:
Fellowships you wish to apply for:*
- 1. J&J - Leuven, Belgium, 3 months
- 2. Medtronic- Amsterdam, Colorectal, 3 months
- 3. Storz - Bavaria, Germany, 2 months
Which is your first choice?*
Which is your second choice?*
Which is your third choice?*
Are you a SASES member?*
- Yes
- No
Are you registered with HPCSA to practice as a general surgeon?*
- Yes
- No
HPCSA Registration number (MP)
Are you able to take leave and travel for the minimum time required?*
- Yes
- No
Years of experience as a qualified surgeon?*
- More than 10 years
- 6-10 years
- 2-5 years
- Less than 2 years
Have you applied for a SASES fellowship previously?*
- Yes
- No
Have you been awarded a SASES fellowship previously?*
- Yes
- No
Number of Congress Presentations by you?
Number of publications?

Lists to be uploaded in step 2 form.
Local area meetings:
National congresses:
International:
SASES congress/ webinar:
Laparoscopic Experience in the last 1-2 years:
Upload log book in step 2 form.
Number of laparoscopic operations in the last 1-2 years? - self performed
Please enter a number less than or equal to 1000.
Number of laparoscopic biliary or upper GI operations in this period?
Please enter a number less than or equal to 1000.
Number of diagnostic laparoscopy or lap. appendectomy?
Please enter a number less than or equal to 1000.
Number of lap. colorectal procedures? (excl. appendix)?
Please enter a number less than or equal to 1000.
Number of lap. hernia repairs?
Please enter a number less than or equal to 1000.
Number of other lap. or thoracoscopic procedures?
Please enter a number less than or equal to 1000.
Employment:
In which town or city do you do most of your work?
What percentage of your work is in a state hospital?
What percentage is in a private setting?
Languages that you have some understanding of?
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Our Mission The Society was established to promote high standards of endoscopic surgery in South Africa. It will disseminate knowledge and training via academic meetings, training courses and sponsorships.