Skip to main content
Search form
Search
Patients and visitors
Health care professional
Health care and Services
Prevention
Education
Research
Career
About Us
Contact us
Blog
ICM
Foundation
Centre ÉPIC
PGx
MHICC
MHI
Foundation
EPIC Center
PGx
CEPMED
MHICC
English
Français
[Fb]
[Tw]
[Yo]
Make a donation
Contact Us
Search form
Search
Patients and visitors
Health care professional
COVID-19
Health care and Services
Cardiovascular Diseases
To learn more about the main cardiovascular diseases.
Exams and Treatments
To learn more about the exams and treatments available at the MHI.
Clinics and Services
To learn more about the clinics and services at the MHI.
Our Specialists
To view the specialists directory of the MHI.
Infection Prevention
To learn how to stop the spead of infections at the MHI.
Prevention
Prevention Clinics
Adopt a healthy lifestyle
EPIC Center
Education
Fellowships
Internships
Documentation Center
Continuing education
Research
Fields and Themes
Researchers
Chairs
Labs
Infrastructures / Services
Students
Take part in research
About
Career
Why the MHI ?
Jobs
Recruitment activities
Testimonies
Nursing careers
Make an internship
Join us
About Us
Our history
Our present
Our team
Become a volunteer
Users' Committee
Complaints Commissioner
Policies
Frequently Asked Questions
Home
Education
Fellowships
Application Form (fellow)
Demandes des chercheurs - FUCRC
Fellowships
Our fellowships
Application Form
Living in Montreal
Internships
Documentation Center
Continuing education
Fellowships
Share
Aa
-
+
Application Form (fellow)
Status
*
Mrs
Mr
Application for a Fellowship in
*
Cardiac anesthesiology
Cardiac magnetic resonance
Clinical cardiology
Cardiac prevention and rehabilitation
Advanced heart failure and heart transplantation
Interventional cardiology
Adult congenital heart disease
Electrophysiology
Echocardiography
Cardiac surgery
To Begin on
*
1-year fellowship
2-year fellowship
First Name
*
Last Name
*
Current address
*
City
*
Province/State
*
Country
*
Zip/Postal code
*
Permanent address
City
Province/State
Country
Zip/Postal code
Home telephone no.
*
Work telephone no.
Cell phone no.
*
Fax no.
Email Address
*
Academic Training
Medical school
*
City/Country
*
Starting date
*
Graduation date
*
College or University
City/Country
Starting date
Graduation date
Hospital experience
Title/current job
*
Hospital
*
City/Country
*
Starting date
*
Residency
Hospital
City/Country
From (date) to (date)
Additional information and supporting documents required with the application
Citizenship
*
Have you ever been denied a medical license or had a license revoked?
*
Yes
No
Have you taken the following examinations?
The Medical Council of Canada
*
Yes
No
US Medical Licensing Examination
1
2
3
Internal Medicine In-Service Examination
*
Yes
No
Detailed resume
*
Personal letter of interest
*
Three recent letters of recommendation from physicians who acted as your clinical pratice supervisors.
Certified copy of your medical and specialist's diplomas (translated in English or French)
*
Copy of examination result from the Medical Council of Canada, the US Medical Licensing Examination or the Internal Medicine In-Service Examination, if applicable.
Medical Council of Canada
*
US Medical Licensing Examination
3
*
2
*
1
*
Internal Medicine In-Service Examination
*
Two passport photographs
