ICP Fellowship form

Eligibility criteria for ICP Fellowship can be found Here

For any queries, please email at api.hdo@gmail.com or call at - (022) 6666 3224.

Please mention NA in case of no information available for any point.

* is required

PDF Form

Basic Info

First Name *

Middle Name

Surname *

API Membership Number *

Date of Joining *

Date of Birth *

Address Residence *

City *

State *

Country *

Pin Code *

Address Office *

City *

State *

Country *

Pin Code *

Contact

Telephone

Mobile *

Email *

Degree

Postgraduate degree in Medicine *

Year of passing*

Institute*

University*

Other Professional Qualification

Year of passing

Institute

University

Add Row

Experience in Medical Profession after Postgratuation in Medicine

Name of Hospital/Clinic/Organisation

Location

Number of Beds (if applicable)

Post held

Period Served year wise (From)

Period Served year wise (To)

Add Row

Publications (If number of publications in Journals exceeds 8, publications which can qualify as research papers may be listed under Research work section .)

a. Number of Publications in Indexed National / International Journals

b. Number of Chapter in Books / monograms

c. Editorship of National level or State level Book /Monogram/Update Series

Honours And Awards

(a) Oration in National / State Association Meeting

Title of Oration

Organisation

Year

Add Row

(b) Award National / International / or State level

Title of Award

Organisation

Year

Add Row

Research work

(a) Research sanctioned & funded by Research Agency

(b) Departmental Research. (To qualify, the findings should be published in National/International Journal) Do not include papers already listed under Publications

Contribution to API

Post held in Organisation/Meeting

Name of Organisation/Meeting/CME

National/Zonal/Under API/ICP State level

Year

Add Row

Participation in CME or Scientific Sessions of API or ICP as Faculty

Speaker/Chairperson/Other

Title of Talk / Session

Name of meeting

Year

Add Row

Social welfare / Community service. (Include under the headings given below, with documentry evidence)

(a) Emergency services during National calamities (Quakes/Floods/Cyclones,etc)

(b) Public education Programme (Radio), TV talk/writing in news papers.

(c) Service in Rural Areas

Service

Add Row
Indian College of Physicians Citation

Please share the details of two proposers for recommendation

The Fellows proposing and seconding the nomination for Fellowship of Indian College of Physicians should highlight the professional / scientific achievements of the candidate and the contribution to A. P. I. from personal knowledge in 200 words and email them to api.hdo@gmail.com

Proposer

Name

Membership No.

Mobile Number

Email

Seconder

Name

Membership No.

Mobile Number

Email

Note The Fellowship form should be proposed and seconded by Founder Fellow / Fellow of ICP only. In case there are more than 3 nominations by any proposer/seconder, the first three nominations in order of receipt in API Office and complete in all respects will be considered for award of Fellowship of ICP and the others rejected for consideration.

The Indian College of Physicians

The Indian College of Physicians is the academic wing of the The Association of Physicians of India, a professional body of consultant physicians formed in 1944. It’s members are physicians with postgraduate qualifications in different specialities. ICP was started in 1986 and its first convocation was held in January 1987.

Links

JAPIICPPRFMembers Directory

Contact Info

Association of Physicians of India
Unit 6 & 7, Ground Floor,Turf Estate, Off Dr. E. Moses Road,Near Mahalaxmi Station (West), Mumbai – 400 011.
Tel : (022) 6666 3224Email : api.hdo@gmail.com
© 2025 - apiindia.org | All Rights Reserved
Powered by