First Name * Last Name * Date of Birth * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year1986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028 E-mail Address * Contact Number * National Society * - Select -Algerian Society of Internal MedicineAlbanian Society of Internal MedicineInternal Medicine Society of Australia and New ZealandAzerbaijan Internal Medicine SocietyArmenian Association of Internal MedicineArgentinian Society of Internal MedicineAustrian Society of Internal MedicineBelgian Society of Internal MedicineCypriot Society of Internal MedicineCzech Society of Internal MedicineDominican Republic Society of Internal MedicineEgyptian Society of Internal MedicineEstonian Society of Internal MedicineFinnish Society of Internal MedicineFrench Society of Internal MedicineGerman Society of Internal MedicineAssociation of Therapists of GeorgiaIcelandic Society of Internal MedicineIsraeli Society of Internal MedicineItalian Society of Internal MedicineThi-Qar Internists Association-IraqItalian Federation of Associations of Hospital InternistsHellenic Society of Internal MedicineLatvian Society of Internal MedicineLebanese Society of Internal MedicineAssociation of Physicians of MaltaMoroccan Society of Internal MedicineMacedonian Association of Internal MedicineMexican College of Internal MedicineNetherlands Society of Internal MedicineNorwegian Society of Internal MedicinePeruvian Society of Internal MedicinePolish Society of Internal MedicinePortuguese Society of Internal MedicineRomanian Society of Internal MedicineRussian Scientific Society of Internal MedicineSerbian Association of Internal MedicineSlovak Society of Internal MedicineSlovenian Society of Internal MedicineSpanish Society of Internal MedicineSwedish Society of Internal MedicineSwiss Society of General Internal MedicineTurkish Society of Internal MedicineTurkish Association of Internists Federation of Royal Colleges of Physicians UKSociety of Acute MedicineCeylon College of PhysiciansAssociation of Internists of Ukraine Current Position * Eligibility Category * - Select - Currently in Internal Medicine training with at least 2 years completed and ≤35 years of age Within 5 years of completion of specialist training and ≤40 years of age (Select the option that best describes your current status) Research Topics * - Select - Rare and Systemic Autoimmune Diseases Multimorbidity in Internal Medicine Projects should address one of the EFIM priority topics. Please select one. Please submit the Structured Research Proposal * Please submit a Detailed Budget and Justification * Please submit the Description of the Research Group * Please submit the CV of the Main Applicant * Please submit the CV of the Supervisor * Please submit a Letter of Support from the Head of the Research Group * Leave this field blank CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
