CPD registration

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working in a non training post are eligible to join the CPD programme.International Fellows, Members and Associates are also eligible.</p> <h2>Submitting your application</h2> <p>Please allow <strong>14 working days</strong> for your application to be processed.</p> <p>If your contact details change while your application is being processed, please email the CPD Office at <a href="mailto:cpd@rcog.org.uk" class="email">cpd@rcog.org.uk</a>.</p> <p>Items marked with an asterisk (*) in the application form are mandatory fields.</p> </div> </div> </div> <div class="component component--form-picker component-width--100 "> <div id="umbraco_form_c1c2dce0c32e41d0825862a484b1ae3f" class="umbraco-forms-form cpdregistrationform umbraco-forms-Corporate"> <form action="/careers-and-training/cpd-revalidation/cpd-registration/" enctype="multipart/form-data" id="form28430060c297487aa486ce047be990ec" method="post"><input data-val="true" data-val-required="The FormId field is required." name="FormId" type="hidden" value="c1c2dce0-c32e-41d0-8258-62a484b1ae3f" /><input data-val="true" data-val-required="The FormName field is required." name="FormName" type="hidden" value="CPD registration form" /><input data-val="true" data-val-required="The RecordId field is required." name="RecordId" type="hidden" value="00000000-0000-0000-0000-000000000000" /><input name="PreviousClicked" type="hidden" value="" /><input name="Theme" type="hidden" value="Corporate" /><input name="RedirectToPageId" type="hidden" value="" /> <input type="hidden" name="FormStep" value="0" /> <input type="hidden" name="RecordState" value="Q2ZESjhJMGVGaGZZV2h0TXY5aC03TDBlb3RtTmJkdDNwVzV3cGJBN2ExQTZPNHZFcHZ3Sk44cFpUdTl3YzdKMkpKVFdiNEJndE1ndzVhbXhHeGEwWFp1SHZFcnJuZ3JpeVVtU3h5aFdtV0xhNDJ4Q0I2T29JZjlneDkxcHlPNlc1aXJXc2c=" /> <div class="umbraco-forms-page" id="d3f94cd8-baf4-4a05-ba2e-b7b906bb353c"> <fieldset class="umbraco-forms-fieldset" id="1c5a387a-a9f1-47c1-cafe-1e714b0d2b2a"> <legend>Your details</legend> <div class="row-fluid"> <div class="umbraco-forms-container col-md-12"> <div class=" umbraco-forms-field name shortanswer mandatory "> <label for="00cc358d-0a99-4183-b5ba-625634820a1b" class="umbraco-forms-label"> Title <span class="umbraco-forms-indicator">*</span> </label> <div class="umbraco-forms-field-wrapper"> <input type="text" name="00cc358d-0a99-4183-b5ba-625634820a1b" id="00cc358d-0a99-4183-b5ba-625634820a1b" data-umb="00cc358d-0a99-4183-b5ba-625634820a1b" class="text " value="" maxlength="255" data-val="true" data-val-required="Please provide a value for Title" aria-required="true" /> <span class="field-validation-valid" data-valmsg-for="00cc358d-0a99-4183-b5ba-625634820a1b" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field forename shortanswer mandatory alternating "> <label for="6135ca07-f262-4228-917f-21f162e7ec85" class="umbraco-forms-label"> Forename <span class="umbraco-forms-indicator">*</span> </label> <div class="umbraco-forms-field-wrapper"> <input type="text" name="6135ca07-f262-4228-917f-21f162e7ec85" id="6135ca07-f262-4228-917f-21f162e7ec85" data-umb="6135ca07-f262-4228-917f-21f162e7ec85" class="text " value="" maxlength="80" data-val="true" data-val-required="Please provide a value for Forename" aria-required="true" /> <span class="field-validation-valid" data-valmsg-for="6135ca07-f262-4228-917f-21f162e7ec85" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field surname shortanswer mandatory "> <label for="b69906c0-0815-45ae-fd1f-6eaab6119a86" class="umbraco-forms-label"> Surname <span class="umbraco-forms-indicator">*</span> </label> <div class="umbraco-forms-field-wrapper"> <input type="text" name="b69906c0-0815-45ae-fd1f-6eaab6119a86" id="b69906c0-0815-45ae-fd1f-6eaab6119a86" data-umb="b69906c0-0815-45ae-fd1f-6eaab6119a86" class="text " value="" maxlength="80" data-val="true" data-val-required="Please provide a value for Surname" aria-required="true" /> <span class="field-validation-valid" data-valmsg-for="b69906c0-0815-45ae-fd1f-6eaab6119a86" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field dateofbirth customdatefield alternating "> <label for="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78" class="umbraco-forms-label"> Date of birth </label> <span id="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_description" class="umbraco-forms-tooltip help-block">Not for publication</span> <div class="umbraco-forms-field-wrapper"> <div class=" fallbackDatePicker"> <span> <label for="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_day">Day:</label> <select data-date-type="day" data-selected="0" data-umb="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_day" id="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_day" name="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_day"> <option value="_none">DD</option> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> <option value="13">13</option> <option value="14">14</option> <option value="15">15</option> <option value="16">16</option> <option value="17">17</option> <option value="18">18</option> <option value="19">19</option> <option value="20">20</option> <option value="21">21</option> <option value="22">22</option> <option value="23">23</option> <option value="24">24</option> <option value="25">25</option> <option value="26">26</option> <option value="27">27</option> <option value="28">28</option> <option value="29">29</option> <option value="30">30</option> <option value="31">31</option> </select> </span> <span> <label for="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_month">Month:</label> <select data-date-type="month" data-selected="" data-umb="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_month" id="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_month" name="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_month" > <option value="_none">MM</option> <option value="January">January</option> <option value="February">February</option> <option value="March">March</option> <option value="April">April</option> <option value="May">May</option> <option value="June">June</option> <option value="July">July</option> <option value="August">August</option> <option value="September">September</option> <option value="October">October</option> <option value="November">November</option> <option value="December">December</option> </select> </span> <span> <label for="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_year">Year:</label> <select data-date-type="year" data-selected="" data-umb="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_year" id="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_year" name="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78_year"> <option value="_none">YYYY</option> <option value="2024">2024</option> <option value="2023">2023</option> <option value="2022">2022</option> <option value="2021">2021</option> <option value="2020">2020</option> <option value="2019">2019</option> <option value="2018">2018</option> <option value="2017">2017</option> <option value="2016">2016</option> <option value="2015">2015</option> <option value="2014">2014</option> <option value="2013">2013</option> <option value="2012">2012</option> <option value="2011">2011</option> <option value="2010">2010</option> <option value="2009">2009</option> <option value="2008">2008</option> <option value="2007">2007</option> <option value="2006">2006</option> <option value="2005">2005</option> <option value="2004">2004</option> <option value="2003">2003</option> <option value="2002">2002</option> <option value="2001">2001</option> <option value="2000">2000</option> <option value="1999">1999</option> <option value="1998">1998</option> <option value="1997">1997</option> <option value="1996">1996</option> <option value="1995">1995</option> <option value="1994">1994</option> <option value="1993">1993</option> <option value="1992">1992</option> <option value="1991">1991</option> <option value="1990">1990</option> <option value="1989">1989</option> <option value="1988">1988</option> <option value="1987">1987</option> <option value="1986">1986</option> <option value="1985">1985</option> <option value="1984">1984</option> <option value="1983">1983</option> <option value="1982">1982</option> <option value="1981">1981</option> <option value="1980">1980</option> <option value="1979">1979</option> <option value="1978">1978</option> <option value="1977">1977</option> <option value="1976">1976</option> <option value="1975">1975</option> <option value="1974">1974</option> <option value="1973">1973</option> <option value="1972">1972</option> <option value="1971">1971</option> <option value="1970">1970</option> <option value="1969">1969</option> <option value="1968">1968</option> <option value="1967">1967</option> <option value="1966">1966</option> <option value="1965">1965</option> <option value="1964">1964</option> <option value="1963">1963</option> <option value="1962">1962</option> <option value="1961">1961</option> <option value="1960">1960</option> <option value="1959">1959</option> <option value="1958">1958</option> <option value="1957">1957</option> <option value="1956">1956</option> <option value="1955">1955</option> <option value="1954">1954</option> <option value="1953">1953</option> <option value="1952">1952</option> <option value="1951">1951</option> <option value="1950">1950</option> <option value="1949">1949</option> <option value="1948">1948</option> <option value="1947">1947</option> <option value="1946">1946</option> <option value="1945">1945</option> <option value="1944">1944</option> <option value="1943">1943</option> <option value="1942">1942</option> <option value="1941">1941</option> <option value="1940">1940</option> <option value="1939">1939</option> <option value="1938">1938</option> <option value="1937">1937</option> <option value="1936">1936</option> <option value="1935">1935</option> <option value="1934">1934</option> <option value="1933">1933</option> <option value="1932">1932</option> <option value="1931">1931</option> <option value="1930">1930</option> <option value="1929">1929</option> <option value="1928">1928</option> <option value="1927">1927</option> <option value="1926">1926</option> <option value="1925">1925</option> <option value="1924">1924</option> </select> </span> </div> <script type="text/javascript"> // define variables var fallbackPicker = document.querySelector('.fallbackDatePicker'); var fallbackLabel = document.querySelector('.fallbackLabel'); var yearSelect = document.querySelector('[data-date-type="year"]'); var monthSelect = document.querySelector('[data-date-type="month"]'); var daySelect = document.querySelector('[data-date-type="day"]'); // populate the days and years dynamically // (the months are always the same, therefore hardcoded) populateDays(monthSelect.value); //populateYears(); //} function populateDays(month) { while (daySelect.firstChild) { daySelect.removeChild(daySelect.firstChild); } // Create variable to hold new number of days to inject var dayNum; // 31 or 30 days? if (month === 'January' | month === 'March' | month === 'May' | month === 'July' | month === 'August' | month === 'October' | month === 'December' | month === '_none') { dayNum = 31; } else if (month === 'April' | month === 'June' | month === 'September' | month === 'November') { dayNum = 30; } else { // If month is February, calculate whether it is a leap year or not var year = yearSelect.value; var isLeap = new Date(year, 1, 29).getMonth() == 1; isLeap ? dayNum = 29 : dayNum = 28; } var blank_option = document.createElement('option'); blank_option.textContent = "DD"; blank_option.value = "_none"; daySelect.appendChild(blank_option); for (i = 1; i <= dayNum; i++) { var option = document.createElement('option'); if (daySelect.getAttribute("data-selected") == i) { option.selected = true; } option.textContent = i; option.value = i; daySelect.appendChild(option); } // if previous day has already been set, set daySelect's value // to that day, to avoid the day jumping back to 1 when you // change the year if (previousDay) { daySelect.value = previousDay; // If the previous day was set to a high number, say 31, and then // you chose a month with less total days in it (e.g. February), // this part of the code ensures that the highest day available // is selected, rather than showing a blank daySelect if (daySelect.value === "") { daySelect.value = previousDay - 1; } if (daySelect.value === "") { daySelect.value = previousDay - 2; } if (daySelect.value === "") { daySelect.value = previousDay - 3; } } } // when the month or year <select> values are changed, rerun populateDays() // in case the change affected the number of available days yearSelect.onchange = function () { populateDays(monthSelect.value); } monthSelect.onchange = function () { populateDays(monthSelect.value); } //preserve day selection var previousDay; // update what day has been set to previously // see end of populateDays() for usage daySelect.onchange = function () { previousDay = daySelect.value; }</script> <span class="field-validation-valid" data-valmsg-for="f7dd8ce4-9570-48d5-bce5-1b8136cf2a78" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field rcogaccountnumber shortanswer "> <label for="5c1c5e64-5c06-4ffe-eeb7-5c6fd81ab300" class="umbraco-forms-label"> RCOG account number </label> <span id="5c1c5e64-5c06-4ffe-eeb7-5c6fd81ab300_description" class="umbraco-forms-tooltip help-block">If applicable</span> <div class="umbraco-forms-field-wrapper"> <input type="text" name="5c1c5e64-5c06-4ffe-eeb7-5c6fd81ab300" id="5c1c5e64-5c06-4ffe-eeb7-5c6fd81ab300" data-umb="5c1c5e64-5c06-4ffe-eeb7-5c6fd81ab300" class="text " value="" maxlength="255" data-val="true" data-val-regex="Please provide a valid value for RCOG account number" data-val-regex-pattern="^[0-9]*$" aria-describedby="5c1c5e64-5c06-4ffe-eeb7-5c6fd81ab300_description" /> <span class="field-validation-valid" data-valmsg-for="5c1c5e64-5c06-4ffe-eeb7-5c6fd81ab300" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field gmcnumber shortanswer alternating "> <label for="cc2a8e24-19b4-45c8-9359-d5cb005f39e1" class="umbraco-forms-label"> GMC number </label> <span id="cc2a8e24-19b4-45c8-9359-d5cb005f39e1_description" class="umbraco-forms-tooltip help-block">If applicable</span> <div class="umbraco-forms-field-wrapper"> <input type="number" name="cc2a8e24-19b4-45c8-9359-d5cb005f39e1" id="cc2a8e24-19b4-45c8-9359-d5cb005f39e1" data-umb="cc2a8e24-19b4-45c8-9359-d5cb005f39e1" class="text " value="" maxlength="80" aria-describedby="cc2a8e24-19b4-45c8-9359-d5cb005f39e1_description" /> <span class="field-validation-valid" data-valmsg-for="cc2a8e24-19b4-45c8-9359-d5cb005f39e1" data-valmsg-replace="true" role="alert"></span> </div> </div> </div> </div> </fieldset> <fieldset class="umbraco-forms-fieldset" id="61608565-0cc5-40b4-f40e-f5cdbb68d765"> <legend>Post</legend> <div class="row-fluid"> <div class="umbraco-forms-container col-md-12"> <div class=" umbraco-forms-field yourcurrentpost shortanswer mandatory "> <label for="d7300973-0fce-4fc6-91c0-12d4ff40a489" class="umbraco-forms-label"> Your current post <span class="umbraco-forms-indicator">*</span> </label> <span id="d7300973-0fce-4fc6-91c0-12d4ff40a489_description" class="umbraco-forms-tooltip help-block">For example Consultant, Specialist Registrar, GP, etc.</span> <div class="umbraco-forms-field-wrapper"> <input type="text" name="d7300973-0fce-4fc6-91c0-12d4ff40a489" id="d7300973-0fce-4fc6-91c0-12d4ff40a489" data-umb="d7300973-0fce-4fc6-91c0-12d4ff40a489" class="text " value="" maxlength="80" data-val="true" data-val-required="Please provide a value for Your current post" aria-required="true" aria-describedby="d7300973-0fce-4fc6-91c0-12d4ff40a489_description" /> <span class="field-validation-valid" data-valmsg-for="d7300973-0fce-4fc6-91c0-12d4ff40a489" data-valmsg-replace="true" role="alert"></span> </div> </div> <fieldset class=" umbraco-forms-field isthisatrainingpost singlechoice mandatory alternating "> <legend class="umbraco-forms-legend"> Is this a training post? <span class="umbraco-forms-indicator">*</span> </legend> <div class="umbraco-forms-field-wrapper"> <div class=" radiobuttonlist radiobuttonlist-vertical" id="fdac0781-2087-47fc-dc7b-bc384fe7fdcc" data-umb="fdac0781-2087-47fc-dc7b-bc384fe7fdcc"> <div> <input type="radio" name="fdac0781-2087-47fc-dc7b-bc384fe7fdcc" id="fdac0781-2087-47fc-dc7b-bc384fe7fdcc_0" data-umb="fdac0781-2087-47fc-dc7b-bc384fe7fdcc_0" value="Yes" data-val="true" data-val-required="Please provide a value for Is this a training post?" data-rule-required="true" data-msg-required="Please provide a value for Is this a training post?" /> <label for="fdac0781-2087-47fc-dc7b-bc384fe7fdcc_0">Yes</label> </div> <div> <input type="radio" name="fdac0781-2087-47fc-dc7b-bc384fe7fdcc" id="fdac0781-2087-47fc-dc7b-bc384fe7fdcc_1" data-umb="fdac0781-2087-47fc-dc7b-bc384fe7fdcc_1" value="No" data-val="true" data-val-required="Please provide a value for Is this a training post?" data-rule-required="true" data-msg-required="Please provide a value for Is this a training post?" /> <label for="fdac0781-2087-47fc-dc7b-bc384fe7fdcc_1">No</label> </div> </div> <span class="field-validation-valid" data-valmsg-for="fdac0781-2087-47fc-dc7b-bc384fe7fdcc" data-valmsg-replace="true" role="alert"></span> </div> </fieldset> <div class=" umbraco-forms-field startdateofpost date mandatory "> <label for="22cab520-c74d-4507-b90d-0f48a779a5f0" class="umbraco-forms-label"> Start date of post <span class="umbraco-forms-indicator">*</span> </label> <div class="umbraco-forms-field-wrapper"> <input type="hidden" name="22cab520-c74d-4507-b90d-0f48a779a5f0" id="22cab520-c74d-4507-b90d-0f48a779a5f0_1" class="datepickerfieldshadow" value="" data-umb="22cab520-c74d-4507-b90d-0f48a779a5f0" /> <input type="text" name="22cab520-c74d-4507-b90d-0f48a779a5f0" id="22cab520-c74d-4507-b90d-0f48a779a5f0" class="datepickerfield" autocomplete="off" value="" data-val="true" data-val-required="Please provide a value for Start date of post" /> <span class="field-validation-valid" data-valmsg-for="22cab520-c74d-4507-b90d-0f48a779a5f0" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field hospitalnameandaddress longanswer alternating "> <label for="e573299e-f8c3-4cfc-dcc0-62185dc16f91" class="umbraco-forms-label"> Hospital name and address </label> <div class="umbraco-forms-field-wrapper"> <textarea class="" name="e573299e-f8c3-4cfc-dcc0-62185dc16f91" id="e573299e-f8c3-4cfc-dcc0-62185dc16f91" data-umb="e573299e-f8c3-4cfc-dcc0-62185dc16f91" rows="2" cols="20" ></textarea> <span class="field-validation-valid" data-valmsg-for="e573299e-f8c3-4cfc-dcc0-62185dc16f91" data-valmsg-replace="true" role="alert"></span> </div> </div> </div> </div> </fieldset> <fieldset class="umbraco-forms-fieldset" id="ac812b48-3021-4398-8980-dd38c2e5b11b"> <legend>Your contact details</legend> <div class="row-fluid"> <div class="umbraco-forms-container col-md-12"> <div class=" umbraco-forms-field emailaddress shortanswer mandatory "> <label for="3596b5c9-2d5c-4e70-e60f-350f80219ef0" class="umbraco-forms-label"> Email address <span class="umbraco-forms-indicator">*</span> </label> <div class="umbraco-forms-field-wrapper"> <input type="email" name="3596b5c9-2d5c-4e70-e60f-350f80219ef0" id="3596b5c9-2d5c-4e70-e60f-350f80219ef0" data-umb="3596b5c9-2d5c-4e70-e60f-350f80219ef0" class="text " value="" maxlength="255" data-val="true" data-val-required="Please provide a value for Email address" aria-required="true" data-val-regex="Please provide a valid value for Email address" data-val-regex-pattern="^[a-zA-Z0-9_.+-]+@[a-zA-Z0-9-]+.[a-zA-Z0-9-.]+$" /> <span class="field-validation-valid" data-valmsg-for="3596b5c9-2d5c-4e70-e60f-350f80219ef0" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field telephone shortanswer mandatory alternating "> <label for="923d8905-595c-4dbc-e72d-e49be3c856a8" class="umbraco-forms-label"> Telephone <span class="umbraco-forms-indicator">*</span> </label> <div class="umbraco-forms-field-wrapper"> <input type="number" name="923d8905-595c-4dbc-e72d-e49be3c856a8" id="923d8905-595c-4dbc-e72d-e49be3c856a8" data-umb="923d8905-595c-4dbc-e72d-e49be3c856a8" class="text " value="" maxlength="255" data-val="true" data-val-required="Please provide a value for Telephone" aria-required="true" data-val-regex="Please provide a valid value for Telephone" data-val-regex-pattern="^[0-9]*$" /> <span class="field-validation-valid" data-valmsg-for="923d8905-595c-4dbc-e72d-e49be3c856a8" data-valmsg-replace="true" role="alert"></span> </div> </div> <div class=" umbraco-forms-field addressforcorrespondence longanswer "> <label for="2c65b35b-77ce-468b-b37c-b0cabd185466" class="umbraco-forms-label"> Address for correspondence </label> <div class="umbraco-forms-field-wrapper"> <textarea class="" name="2c65b35b-77ce-468b-b37c-b0cabd185466" id="2c65b35b-77ce-468b-b37c-b0cabd185466" data-umb="2c65b35b-77ce-468b-b37c-b0cabd185466" rows="2" cols="20" ></textarea> <span class="field-validation-valid" data-valmsg-for="2c65b35b-77ce-468b-b37c-b0cabd185466" data-valmsg-replace="true" role="alert"></span> </div> </div> </div> </div> </fieldset> <div class="umbraco-forms-hidden" aria-hidden="true"> <input type="text" name="c1c2dce0c32e41d0825862a484b1ae3f" /> </div> <div class="umbraco-forms-navigation row-fluid"> <div class="col-md-12"> <input type="submit" class="btn primary" value="Submit" name="__next" data-form-navigate="next" data-umb="submit-forms-form" /> </div> </div> </div> <input name="__RequestVerificationToken" type="hidden" value="CfDJ8I0eFhfYWhtMv9h-7L0eotkhqkk5lx_jivhsBwYC4j8VmYwpzghj2HEzsJ6EygXYXcrdQXyjNMtUEbEIRu9WXzetBTvji0ka5EPG3KReNsyBGlfxUowPU1rmidpT5sSVluT39Flj8dbBUpmEEfFYc3o" /><input name="ufprt" type="hidden" value="CfDJ8I0eFhfYWhtMv9h-7L0eotmvaaeMb4lpsGQTrH6hcnvqV8jmijNVBGzI0WGiw0qFIkb0MrN1Pb6dWls87TrwbdufdHC8NxB-h0ud-T16AmMKfO9pQQMa9k7A5bR89LGl-dAX9OfyO7kd9N2bRXjmdv8" /></form> </div> <div class="umbraco-forms-form-config umbraco-forms-hidden" data-id="c1c2dce0c32e41d0825862a484b1ae3f" data-serialized-page-button-conditions="{}" data-serialized-fieldset-conditions="{}" data-serialized-field-conditions="{}" data-serialized-fields-not-displayed="{}" data-trigger-conditions-check-on="change" data-form-element-html-id-prefix="" data-disable-validation-dependency-check="false"></div> <div id="umbraco-forms-date-picker-config" 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