Integrated academy of Pediatrics Welfare Society (MP IAP)

MP IAP invites the application for “Dr. K. K. Kaul Gold Medal Award” for “Eminent Teacher in
Pediatrics” serving in a Medical College/Institution in Madhya Pradesh for the year 2019. The award
is instituted by MP IAP in honour of Prof. K K Kaul with the help of Jabalpur Academy of Paediatrics in
2018. The medal will be presented to the selected person in State conference going to be held at
Indore on 10th-11th November 2019. The application should reach to the Secretary MP IAP latest by
10th October 2019. Applications need to be submitted both in soft and 3 hard copies.

Eligibility:

• Full time medical Teachers in Pediatrics or any super specialty of Pediatrics (D.M in Pediatric
super specialty, not internal Medicine) will be eligible.
• The nominee must be a member of the National and State Branch of IAP for minimum 10
years, and should not be in default of payment of dues.
• The nominee should be a full time teacher with at least 10 year of regular service in any
Medical College/Institution in Madhya Pradesh.
• Those who have prematurely retired with less than 5 years of service as a teacher will not be
eligible.
• Those reported for misconduct/ unethical practices/Criminal cases will not be eligible.
• Medical teachers who applied last year needs to reapply for this year award.

Procedure:

Any teaching faculty in the state of MP who is a member of the central IAP and MP branch
and not in default of payment of dues can apply for the Gold medal. Application should be
proposed and seconded by 2 member of CIAP. Nomination papers together in the prescribed
form, (see below) must reach the Academy office in due time to enable the Committee to
scrutinize the award and declare the winner after due verification. If false or incorrect
information, is given the candidate will be debarred from the contest.

Address-
Dr. Mahesh Maheshwari
Secretary MPIAP
Associate Professor
Department of Paediatrics, AIIMS Bhopal
drmaheshkiran@gmail.com / 9425428596
 Application form for Prof. Dr. K K kaul gold medal
Name:
Current Faculty position:
Name of Institution:
Qualifications Year obtained Institution
MD Pediatrics
NBE
DCH
DM (Pediatric super specialty)

Faculty positions held giving dates: From To Institution No of Yrs

As Assistant Professor
As Associate Professor
As Professor
As Professor and HOD

Total years

Academic positions held in scientific associations:

Name of Association........Position held with dates.

International:
National:
State:

Publications: Attach separate lists for national and international journals. (Please include only those
indexed Pubmed or other index Journals approved by Board of governors /MCI

Contribution of chapters to textbooks: National, International (attach list)

Positions held: Chairman, Office bearer, member executive (State, Central IAP, and International
Pediatric Associations).Attach details.

Awards: Fellowship, Membership of National Academy of Medical Sciences.

Fellowship of IAP (Attach proof) Includes FAMS, FIAP, MAMS

Guest speakership, oration- National and International:

Any other award not included:

Signature of Candidate

Attachments-