Do you have any relevant interest to declare?
- None - Yes No
If yes, does it constitute a conflict and prohibit you from carrying out this assessment?
- None - Yes No
Please confirm fellowship level to which this applicant is applying?
- None - Senior Fellowship Fellowship Associate Fellowship
Assessment
The applicant has provided sufficient employment and professional information to demonstrate they have been functioning at the required level
- None - Yes No
There is evidence that the applicant understands their own values and the evidence underpinning leadership and management and used these to inform their practice at a level appropriate this award
- None - Yes No
There is evidence that the applicant has had a significant positive impact had on health or other outcomes through their effectiveness in leadership and management
- None - Yes No
There is evidence that the applicant has had a positive impact on health or other outcomes through their effectiveness in leadership and management
- None - Yes No
The applicant has had a satisfactory professional appraisal in the last 12 months, demonstrating a commitment to continuous quality improvement and professional development
- None - Yes No
There is evidence that the applicant's behaviour in respect to leadership and management meets all domains of FMLMs Leadership and management standards for medical professionals
- None - Yes No
There is evidence that the applicant's behaviour in respect to leadership and management meet the first three domains (self, team player/team leader, corporate responsibility) of FMLMs Leadership and management standards for medical professionals
- None - Yes No
There is evidence that the applicant's behaviour in respect to leadership and management meets the first two domains of FMLMs Leadership and management standards for medical professionals
- None - Yes No
Recommendation
Applicant meets the standards to be awarded at level applied for?
- None - Yes No
If no, should the applicant be awarded at another level?
- None - Yes No
What level
- None - Senior Fellowship Fellowship Associate Fellowship No Award