ISVIR 2027 — MENTORSHIP AND NATIONAL BEST TRAINER AWARD

Step 1 — Applicant Details *

ISVIR Membership No. (Format: ISVIR-XXXX, C-XX or S-XX) *

Salutation *

Gender *

First Name *

Middle Name

Last Name *

Date of Birth *

Email *

Phone Number *

City *

State / Province *

Country *

Residential / Correspondence Address *

Postal / ZIP Code *

Designation *

Hospital / Institute Address *

Signed Declaration *

PDF, DOC or DOCX; maximum 10 MB.

Application Form *

PDF, DOC or DOCX; maximum 10 MB.

List of former trainees *

Upload at least one supporting document. Multiple files allowed; maximum 10 MB each.

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Scoring *

Please download the file to view the marks allocated to each item.

Enter marks for each item. The item maxima and domain maxima are reproduced from the supplied scoring sheet. Each domain is capped at its printed maximum.

Domain / item	Basis	Max	Marks claimed	Supporting proof (optional)
Domain 1 — Formal training (max 70)
Faculty years in Recognised IR Training Programmes	A5	30		One combined file for this domain.
Thesis guidance (principal guide and co-guide)	A5	25
Established a structured IR fellowship programme	Award item	8
Supervised a structured IR fellow, Indian or international, minimum three months (2 per fellow)	Award item	10
Trained doctors from underserved States or regions (3 per programme or cohort)	Award item	6
Domain 2 — Teaching at meetings and course leadership (max 60)
Lectures, workshops and chairing — ISVIR national and online	A5	20		One combined file for this domain.
Lectures, workshops and chairing — State Chapter	A5	15
Lectures and workshops — other national meetings	A5	10
Lectures and workshops — international meetings	A5	15
Course Director or Co-Director	A5	15
Domain 3 — Educational scholarship (max 60)
Original research on IR education, training or simulation — lead author (6 each)	Award item	18		One combined file for this domain.
Review on IR education or curriculum — lead author (4 each)	Award item	12
Clinical articles as lead or senior (last) author	A3	20
Textbooks, atlases and chapters	A3	20
Lead of a national IR training curriculum or guideline (8); member (4 each)	Award item	12
Competency-based IR training framework adopted nationally (8)	Award item	8
Domain 4 — Educational roles in the Society (max 25)
Chair, ISVIR education or training committee (8); member (3 per term)	Award item	12		One combined file for this domain.
Junior Wing posts	A1	6
State Chapter CME or educational meetings organised	A2	5
Organisation of ISVIR national conferences and meetings	A1	8
Domain 5 — Recognition as an educator (max 20)
Mentorship or teaching award from a recognised medical society	Award item	10		One combined file for this domain.
International award for educational contribution	Award item	8
Orations and named lectures	A6	10
Domain 6 — Innovation in training and outreach (max 20)
Established an IR simulation or phantom laboratory used for formal training	Award item	8		One combined file for this domain.
Validated IR competency assessment tool adopted by others	Award item	5
Teaching visits to resource-limited settings	A9	8
Mentored a trainee who received a national or international IR award (3 per trainee)	Award item	9
Domain 7 — Trainee evaluations (max 100)
Mean evaluator total × 2	B3.8	100		One combined file for this domain.
Total marks claimed			0 / 355	Overall maximum: 355

Some item maxima add up to more than their domain maximum in the supplied sheet. The printed item maxima are preserved, while each domain's claimed score is capped at its printed domain maximum.

I confirm that the applicant details, training record, scores and supporting documents submitted are accurate and complete. *