IP Fellowship Form

INTERVENTIONAL PULMONOLOGY FELLOWSHIP

APPLICATION FORM AND EVALUATION DOCUMENT FOR THE SELECTION OF FELLOWSHIP

📢 Important Announcement: IP Fellowship Application Update

The fellowship is currently full, but new opportunities will open starting January 1, 2027, with new cohorts every three months.

📅 Application Deadlines:

For a January 1 start: Apply by June 30, 2026
For an April 1 start: Apply by August 31, 2026
For a July 1 start: Apply by October 31, 2026
For a September 1 start: Apply by December 31, 2026

🔹 We encourage early applications, as slots are limited for each intake.

Family Name:

First Name:

Country:

Malaysia Others

If Others, please fill in:

Address:

Hospital where you currently work ( Private practice / Academic Institution / Government Hospital ):

Medical Degree:

Scientific societies of which you are a member:

Email:

Mobile Phone:

Possibility of professionally developing the acquired skills

Potential of establish IP practice in your country

Do you plan to develop an IP activity as part of your private practice?

Do you have any sponsors for the program?

Medical specialty (Pulmonary/Respiratory Thoracic Surgery/Other):

Previous experience in Interventional Pulmonology training ( Specify: year, city, country, period ):

Interventional Pulmonology courses ( Specify: year, city, country, period):

Communications / Lectures / Presentations in national / international congresses and conferences (Attach supporting documents in *.pdf format):

Publication on IP in national/international journals (Attach supporting documents in *.pdf format):

Research grants related with IP:

Time worked in basic Bronchoscopy (years):

Time worked in an Interventional Pulmonology Unit (years):

Total number flexible bronchoscopies in your life:

Total number rigid bronchoscopies in your life:

Thoracic Endoscopy

Flexible bronchoscopy

Linear EBUS

Radial EBUS

Electromagnetic Navigation Bronchoscopy

Rigid Bronchosocopy

Pleural procedures

Pleural drainage

Tube placement

Thoracoscopy

Pleurodesis

Pleural biopsy

Do you have the resources to be able to pay for the stay and expenses related to the program?

Yes No

Do you have problems in your country to obtain a visa to reside in Malaysia?

Yes No

Does your personal and family situation allow you to complete the 3-month training program?

Yes No

Upload CV ( *.pdf only )

Suggested Date for Fellowship Period: