Please submit photocopies of the first seven (7) documents and original copies of the next four (4) documents.
1. Medical School Diploma
2. PRC Board Certificate
3. Valid PRC License
4. Certificate of Residency Training
5. Specialty Board Certificate
6. Certificate of Fellowship (PCS)
7. Certificate of Completion of a Course on Basic or Advanced Laparoscopic Surgery or a Certificate of Training in Laparoscopic Surgery
8. Preceptorship Certificate signed by a certified preceptor of PALES attesting to at least 10 assisted cases and 10 cases performed with accompanying Histopath Report.
9. Accomplished Application Form
10. Application Letter
Letter must be addressed to:
Raymund Andrew G. Ong, MD
Director, Committee on Membership and Credentials
11. Chapter Endorsement
12. Submit five (5) names of PALES fellows with corresponding email addresses.
(Names of FELLOWS must be coming from the chapter or from the Fellows practicing in the same area. If there is limited numbers of fellows from the area, submit names of fellows from neighboring provinces. Endorsement given by your preceptors will not be accepted.)
13. Five (5) un-edited video of Lap Chole Performed within the last two years
Follow the PALES standard 4-port technique in achieving the Critical View of Safety (CVS)
14. Two pcs. (2x2) colored ID pictures.
Note: The Committee on Membership and Credentials will make a random check on your institution.
Please enclose Php1,500.00 (application fee)
Other fees: (to be settled once application is approved)
Induction fee: Php 2,000.00
Pin: Php 100.00
Download Application Form (PDF) below:
Deadline of submission: MARCH 15, 2019 (FRIDAY)