APPLICATION FOR FELLOWSHIP TRAINING

CHECKLIST - APPENDIX A

Checklist of documents to be submitted to Institut Jantung Negara

No.
1.
2.

Name of Documents
Application for IJN Fellowship Form & Letter of Offer
Resume/Curriculum Vitae (Please submit a type written copy)

Reference
Attachment File

3.

Attachment File

7.

Application for Temporary Practising Certificate (T.P.C.) under Medical Act

1971
Application form of Medical Indemnity Insurance Policy from Medical
Protection Society
Two (2) recent Letters of Recommendation including one from current
institution/employment
Certified True Copy of Bona Fide Student certificate from the respective
Medical College (for Indian qualification only)
Certified True Copy of Basic Medical Degree

8.

Certified True Copy of Postgraduate degree(s)

9.
10.
11.

Certified True Copy of compulsory Houseman/Internship Certificate

Certified True Copy of Senior Houseman Certificate with postings specified
Certified True Copy of testimonials of working experience from completion of
Housemanship until now.

4.
5.
6.

12.
13.
14.
15.
16.
17.

18.
19.
20.
21.
22.
23.

Attachment File

(N.B: Every working experience given in the curriculum vitae must be supported
by certified true copy/copies of testimonial from Head of Department/Supervisor
concerned)
Certified True Copy of full registration certificate from the respective Medical
Council, country of practice
Recent Letter of Good Standing from respective Medical Council (Original
Copy) not later than 6 months
Certified True Copy of Birth Certificate / Marriage Certificate
Certified True Copy of passport Please Photostat (all pages) inclusive blank
pages
Eight (8) copies of passport size photographs
Letter of Confirmation from the employer of the country of origin.
State the details of remuneration and emolument received from home country
(Please attach a copy of payslip)
Certified True Copy - Transcript of examination results

See Attachment
File for reference

Fit To Practise Declaration Form

Original Letter from you informing your interest in pursuing fellowship training in
IJN (Kindly state your full name, address and signature)
Full Registration Form
Documentation of Hepatitis B Antigen and Antibody level and Chest X Ray
report
Acceptance (Applicant) from company outside of Malaysia detailing the position
and Salary Print under Letter Head/Company Logo

Attachment File

Attachment File

Note: (Very Important)

Supporting documents, if not in English, must be accompanied by copies of the English translation of the
documents.
Certified True Copy : A professional/public notary/commissioner for oath who certifies the documents must
state his/her full name, designation, telephone number and address.