1 Page: Application Form for Registration of Physician Qualification Examination and Granting Physician Qualification
Note: 1. The photos uploaded by candidates must meet the requirements.
2. Candidates must sign in person, and fill in the "I promise" column with the date, and whether to apply for medical qualification.
3, should be stamped with the examination opinions and official seal of the test center.
4. The contents of each information point in this form shall be consistent with other application materials.
5. The application form shall not be altered by hand. When it is necessary to modify the information, it should be modified and reprinted in the management information system of the doctor qualification examination, and the candidate himself should re-sign and confirm it.
1 back: copy of the candidate's diploma.
(Please copy it on the back of the original Application Form for Registration of Physician Qualification Examination and Granting Physician Qualification)
Note: 1. The contents of the copy of graduation certificate must be consistent with all the corresponding information in the Application Form for Registration and Granting of Physician Qualification Examination, such as the name of graduation school, professional name, admission and graduation time, etc.
2, enter oneself for an examination academic system shows that training in stages, all stages of education should be submitted.
3 enter oneself for an examination "self-study secondary specialized school examination graduation certificate", should also submit the graduation certificate or proof of study issued by the graduation school.
4. Local candidates with military education should also submit the following materials:
4. 1 A demobilized soldier who was a soldier at the time of enlistment shall submit a copy of demobilization certificate, transfer certificate and discharge certificate;
4.2 The military education is junior college or below, and the graduation certificate is stamped by the local education department, and the enrollment plan that has been audited by the provincial education administrative department at the time of admission is submitted; 4.3 For military education with bachelor degree or above, submit the electronic registration record form of academic credentials of the Ministry of Education or the academic credentials verification certificate issued by the academic credentials certification center of the Ministry of Education.
Page 2: Proof materials related to academic qualification appraisal (printed or copied)
Note: 1. To apply for a junior college degree or above in medical major in colleges and universities, submit the electronic registration record form of academic certificate of the Ministry of Education (printed copy) or the certification report of higher education in China (photocopy).
2, enter oneself for an examination of secondary specialized school medical professional qualifications, submitted to the Guangdong Provincial Department of Education "academic certificate appraisal certificate" (copy).
3. If the degree you are applying for is cultivated in stages, the degree of each stage should be accompanied by a printed copy of the electronic registration filing form of the academic certificate of the Ministry of Education/a copy of the higher education certification report of China (higher education degree) or a copy of the academic certificate of the Guangdong Provincial Department of Education (secondary specialized school degree).
4. China citizens with overseas academic qualifications should submit a copy of the Foreign Academic Degree Certificate to the Study Abroad Service Center of the Ministry of Education.
Note: The submission form for electronic registration of academic credentials of the Ministry of Education should be verified online before April 30th.
Page 3: A copy of the candidate's valid ID card.
Note: 1. My valid identity documents include: the second-generation resident identity card, military officer's card, civilian cadre's card, passport, and valid certificates for candidates from Taiwan, Hong Kong and Macao to and from the mainland (excluding household registration book).
2. Candidates from Hong Kong, Macao and Taiwan must also submit copies of their local identity cards in Hong Kong, Macao and Taiwan.
3. A valid identity must be within the validity period.
4. If the ID card is lost during the registration period, you can temporarily reissue the "temporary identification certificate" (which should include the photo of the candidate).
Page 4: Probation certificate issued by probation institution (unified format)
Note: 1. The official seal stamped on the certificate of passing the examination must be the official seal of the medical institution (the internal department of the non-medical institution), and the name should be the same as the first name in the Practice License of Medical Institution.
2. The official seal of the pilot institution of the assessment certificate must be consistent with the name of the pilot institution on the Application Form for Registration and Granting of Physician Qualification Examination.
3. If the probationary unit is changed during the probation period (including changes in the province and changes from outside the province to our province), the probationary unit at each stage shall issue the Probationary Assessment Certificate.
Page 5: Summary Table of Guangdong Medical Qualification Examination Applicants' Trial Filing confirmed by the health administrative department of prefecture-level cities (my information page).
Note: 1. If it is indeed not filed within the specified time due to special reasons, the probation unit shall give a written explanation of the reasons for not filing, and at the same time submit the original certificate of social security paid by the probation unit for the candidates during the period of 201212013, and the social security department shall affix the special seal for business. The social security payment unit should be consistent with the probation unit.
2. During the probation period, if the probation unit has been changed and has been reported to the original probation unit for filing (flowing in the province), except for the summary table of trial records of applicants for the Guangdong Provincial Physician Qualification Examination filed in the original probation unit.
In addition to (my information page), it is also necessary to submit the original proof that the applicant has paid social security for the candidates for three consecutive months from February 20 12 to April 20 13, and the social security department will affix a special business seal.
3. If the probation unit is changed during the probation period, and the original probation unit is a medical institution outside the province, the original proof that the current probation unit has paid social security for the candidates for three consecutive months from February 20 12 to April 20 13 shall be submitted, and the social security department shall affix the special seal for business.
Page 6: If there are multiple trainee units, a copy of the Practice License of Medical Institution of the corresponding trainee unit shall be submitted at the same time.
Note: 1. During the probation period, the internship unit's Practice License for Medical Institutions must be within the validity period.
2. The probation unit shall have the diagnosis and treatment subjects consistent with the candidates' application categories.
(2) Candidates who apply for assistant doctors in villages and towns (pilot) shall submit the following materials on 7- 16 pages in addition to the materials on 10:
Page 7: Declaration of Applicant's Employment stamped by Township Health Center (unified format of the whole province)
Note: 1. This statement is filled in by the candidate himself and confirmed by the seal of the township health center.
2. The name of the official seal of the township health center covered by this statement should be consistent with the name of the first place on the Practice License of Medical Institutions and the name of the trainee unit on the Application Form for Registration and Granting of Physician Qualification Examination.
Page 8: Copy of the contract signed between the applicant and the township health center to ensure that the applicant will practice in the township health center for not less than 5 years after obtaining the qualification.
Note: 1. The candidates are officially in the staffing of township hospitals, and the contract submitted should be an employment contract with a unified format stipulated by the personnel department;
2. The candidates are informal employees of township hospitals, and the submitted contracts shall be labor contracts in a unified format stipulated by the labor department.
Page 9 (Selection): If the applicants are official staff of township hospitals, they should also submit relevant certification materials issued by the personnel file management department that they are official staff of township hospitals.
10 page: informed consent signed by the candidate himself and his township health center and approved by the county health bureau (unified format in the whole province).
Note: 1. The candidate and the legal representative of the township health center should be signed by themselves.
2. The name of the official seal of township hospitals should be consistent with the name of the first place on the Practice License of Medical Institutions and the name of the trainee unit on the Application Form for Registration and Granting of Physician Qualification Examination.
(3) Candidates applying for the qualification examination for practicing assistant doctors shall submit the following 7-9 pages of materials in addition to 1-6 pages:
Page 7: Practice Time and Examination Qualification Certificate of Assistant Physician (unified format)
Note: 1. Medical institutions that fill in the examination certificate should be consistent with those that fill in the probationary examination certificate.
2. If the probationary unit is changed during the probation period (including changes in the province and changes from outside the province to our province), the probationary unit at each stage shall issue the Practice Time and Assessment Certificate of Assistant Physician.
Page 8: copy of assistant physician's qualification certificate.
Note: The category of this application should be the same as that of the original licensed assistant physician qualification certificate.
Page 9: Copy of practicing certificate of practicing assistant physician.
Note: The practice place in the doctor's practice certificate must be consistent with the trainee unit in the Application Form for Registration and Granting of Physician Qualification Examination and the Certificate of Qualification Examination during Probation Period.
Page 10: If the probation unit is a medical institution without a bed (such as clinic, outpatient department, community health service station, etc.). ), should also be submitted to the trainee units with the same class of teaching physicians (practicing physician level) copy of the doctor's practice certificate.
Page 1 1: Other materials (such as certificate of regularization, certificate of birth date discrepancy, etc.). ) is required by the application.
Note: 1. If the date of birth in the application materials is inconsistent, a certificate issued by the ID card issuing authority or the graduation school (not the internal department of the school) that belongs to the same person is required.
2. Graduate students who graduated in that year should submit the 1 year clinical practice experience certificate issued by the school (not the internal department of the school), including the medical major they studied.
3. Graduate students who graduated in that year can choose to apply in schools or internship units.
4. Article 5 "Confirmation Certificate" of the Provisions on Registration Qualification of Physician Qualification Examination (2006 Edition)
Refers to the certification materials issued by the personnel department in the personnel file of the year when the candidate becomes a full member.
5. Secondary specialized schools and institutions of higher learning that issue candidates' graduation certificates shall meet the requirements of educational administrative departments for running schools. If it is inconsistent with the spirit of relevant documents, it shall submit the approval documents or certification materials of the administrative department of education.
Please keep in mind the materials required for the on-site examination of medical practitioners so as not to delay the application time.