Scholarship Request

Scholarship Opportunitites

Effective 1 April 2011 and annually for three years, the WIP Foundation, in cooperation
with DARADIA: The Pain Clinic of Kolkata, West Bengal, India, is pleased to announce the following annual scholarship opportunities for physicians.

I. INTERVENTIONAL PAIN TECHNIQUES COURSE FOR PHYSICIANS

DESCRIPTION: A two-week introductory course on interventional pain management.
VALUE: Rs. 23,000 INR (for Indians); $1,150 USD (for international participants)
AWARD: 1 Indian candidate and 1 international candidate per year will be accepted free of cost.
(Course is offered every month.)

II. FELLOWSHIP PROGRAM FOR PHYSICIANS

DESCRIPTION: A three-month pain fellowship program.
VALUE: Rs. 45,000 INR (for Indians); $2,500 USD (for international participants)
AWARD: 1 Indian candidate and 1 international candidate per year will be accepted for 50% less cost.
(Every 3 months: 1st of Jan, April, July, Oct)

III. REVIEW COURSE FOR PHYSICIANS PREPARING FOR FIPP CERTIFICATION

DESCRIPTION: A four to five day review course
VALUE: Rs. 25,000 INR (for Indians); $900 USD (for international participants).
AWARD: 1 Indian candidate and 1 international candidate per year will be accepted for 50% less cost.
(No fixed date at this time. To be organized once a year and will be declared every year once dates are finalized.)

ELIGIBILITY CRITERIA

Indian candidates must be post-graduate doctors who reside and practice in the Republic of India.
International candidates must be post-graduate doctors who reside and practice outside of the Republic of India.
All scholarship recipients are responsible for their own expenses of travel (both air and ground transportation to/from airport and hotel, etc.), lodging, food, etc.*
*Some Clinic guest rooms (AC) may be available and, if so, participants must pay $40 USD per day (includes all food, internet, airport transfer) for this accommodation.
Applicants must complete both the Standard Scholarship Application (posted on the website of the WIP Foundation) as well as the Supplemental Scholarship Application (page two of this bulletin).

For a complete description of these educational activities, please visit the website of:
www.daradia.com and select “Pain Management Courses by DARADIA for Post-Graduate Doctors”

Family Name*
First Name*
Middle Name
Address*
Street AddressCityState / Province / RegionZip / Postal CodeCountry
Phone (country code area code)*
Email
Program*
Introduce yourself to us. Why did you go into medicine and, specifically, what influenced you to specialize in pain management, and how many years have you been practicing pain medicine?
What are your personal professional goals as a pain medicine specialist for your own practice, your region where you work, and internationally if you are interested in the global forum?*
Describe the characteristics of your clinical practice, i.e., multidisciplinary or specialized – and please define; private clinic or affiliated with an academic medical center? If affiliated with a hospital or university, please identify by name.**
Are you a solo practitioner or are there other physicians practicing with you? If others, please indicate their areas of specialization.**
What are the strengths of your pain center, clinically as well as scholarly? Does your pain center offer training programs for physicians or non-physicians? Do you have a fellowship training program? Please describe a two-year history, as applicable.*
Do you and/or others in your pain center participate in research? If so, please provide a two-year history of research projects describing briefly the specific aims of the project, project duration and current status, and identify the principal investigator.*
Have you written abstracts, articles, book chapters, or books that have been accepted for publication in the past two years? If so, please attach a bibliography.*
Conclude your narrative with a statement of learning objectives that you have for the specific activity or activities associated with your scholarship application*

Scholarship Request

Scholarship Opportunitites

I. INTERVENTIONAL PAIN TECHNIQUES COURSE FOR PHYSICIANS

II. FELLOWSHIP PROGRAM FOR PHYSICIANS

III. REVIEW COURSE FOR PHYSICIANS PREPARING FOR FIPP CERTIFICATION

ELIGIBILITY CRITERIA

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