Enhanced Skills Application Form

Enhanced Skills Category 2 Application

Personal Information
Name
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone
Birthdate*
DD slash MM slash YYYY
Medical School:*
Year of graduation from medical school:*
Location of Family Medicine Residency Training:*
Year of graduation from Family Medicine Residency:*
College of Physicians & Surgeons License#*
If you do not have a CPSBC license#, please provide your current provincial license # and update the Enhanced Skills office with your BC # as soon as it is set up.
Country of Citizenship*
If not a Canadian citizen, please complete:
- Landed Immigrant/Permanent Resident
- Working Visa
- Certified Refugee
- Other
Program Application Information
What type of applicant are you?*
If you are an IMG applicant, please note the additional letter requirements at the bottom of this form.
- CMG - R2 in Family Practice Residency
- Return-Entry Physician (includes IMG applicants who have completed their Return of Service)
- IMG - R2 in BC Family Practice Residency
- IMG - Currently completing Return of Service
Requested Training Area*
Please select the program you would like to apply for. If you do not see the program you are interested in, or if you would like to self-design, please choose 'Other' and fill in the question below.
Other/Self-Design
If you have selected 'Other' in the question above, please describe what kind of training you are interested in.
Requested amount of training time (6 weeks - 12 months):*
Requested start date:
Preferred training location/preceptor (if applicable):
Personal statement:*
Please outline why you are interested in this program and what you wish to accomplish.
Please upload a current CV*
Drop files here or

Max. file size: 20 MB.
Reference Letters
We require 3 reference letters to support your application. Please have your referees submit these letters directly to the Enhanced Skills office via email: lindsay.gowland@familymed.ubc.ca
Letter of Community Support
This is a letter from someone in the community (hospital Chief of Staff, Chair of the CHC etc.) identifying the need and confirming the willingness of the community to utilize the skills of the physician once acquired. This letter is helpful but not absolutely required. If you would like to include one, please have the referee submit it directly to the Enhanced Skills office via email: lindsay.gowland@familymed.ubc.ca
Letter from Ministry of Health (IMG Applicants only)
This is a letter from the Ministry of Health giving approval to defer or pause a Return of Service commitment for the duration of training. It is required for all IMG applicants. Please have this letter emailed directly to the Enhanced Skills office via email: lindsay.gowland@familymed.ubc.ca
Letter from Health Authority (IMG Applicants only)
This is a letter from the Health Authority giving approval to defer or pause a Return of Service commitment for the duration of training. It is required for all IMG applicants, unless you are a UBC R2 applying for training from July - September. Please have this letter emailed directly to the Enhanced Skills office via email: lindsay.gowland@familymed.ubc.ca

Enhanced Skills Category 2 Application

Personal Information

Program Application Information

Reference Letters

Letter of Community Support

Letter from Ministry of Health (IMG Applicants only)

Letter from Health Authority (IMG Applicants only)