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The Cap Application form is an essential document for pathology residents seeking fellowship opportunities. It serves as a comprehensive tool that captures vital information about the applicant, including their educational background, clinical experience, and training history. Each applicant must provide personal details such as their name, addresses, and contact information, alongside their newly-affixed passport-sized photograph. The form allows applicants to specify the type of fellowship they are pursuing, ranging from specialties like Blood Banking/Transfusion Medicine to Surgical/Oncologic Pathology. Additionally, applicants will detail their educational journey, including medical school and residency training, alongside dates and outcomes of national board examinations. Information about medical licensure and board certifications is also required, ensuring a holistic view of the candidate’s qualifications. It’s important to note that the applicants must also provide a list of references who will submit letters of recommendation, reflecting their professional capabilities and character. Lastly, the submission includes a certification that all provided information is accurate and complete, emphasizing the ethical obligation to uphold integrity throughout the application process.

Cap Application Example

College of American Pathologists Residents Forum

Standardized Application for Pathology Fellowships

Applicant Name

Last name

First

Middle

Fellowship Type

This application is being made for a fellowship in (please check one):

Blood banking/Transfusion medicine

Breast pathology

 

 

Chemistry

Cytopathology

 

 

Dermatopathology

Diagnostic immunology

 

 

Forensic pathology

Gastrointestinal pathology

 

 

Genitourinary pathology

Gynecologic pathology

 

 

Hematopathology

Medical microbiology

 

 

Molecular genetic pathology

Neuropathology

 

 

Pathology informatics

Pediatric pathology

 

 

Pulmonary/Mediastinal pathology

Renal pathology

 

 

Soft tissue/Bone pathology

Surgical/Oncologic pathology

 

 

Other, please specify:

 

Please affix a recent passport-

sized photo here.

If submitting electronically,

include a recent passport-style photo in .JPG format with the application.

Training period for which applying:

Start date

Finish date

Personal Data

Other names used:

Present Address

Street

City

State

ZIP / Postal code

 

 

 

 

Permanent Address

Street

City

State

ZIP / Postal code

 

 

 

 

Telephone

Home

Work

Mobile

Fax

 

 

 

 

 

 

 

 

E-mail:

Citizenship

Country of citizenship

Visa status

 

 

© 2013 College of American Pathologists. All rights reserved.

http://www.cap.org/apps/docs/pathology_residents/residents_forum_standardized_fellowship_application.doc0429201314

Education

(Mo/Yr)

(Mo/Yr)

(Undergraduate School)

(Major)

(Degree)

 

to

 

 

 

 

 

 

 

 

(Mo/Yr)

(Mo/Yr)

(Graduate School, if applicable)

(Major)

(Degree)

 

to

 

 

 

 

 

 

 

 

(Mo/Yr)

(Mo/Yr)

(Medical School)

(Country)

(Degree)

 

to

 

 

 

 

 

 

 

 

(Mo/Yr)

(Mo/Yr)

(Residency)

 

(AP, CP, AP/CP, other)

 

to

 

 

 

 

 

 

 

 

(Mo/Yr)

(Mo/Yr)

(Other GME, if applicable)

 

Area of training

 

to

 

 

 

 

 

 

 

 

(Mo/Yr)

(Mo/Yr)

(Other GME, if applicable)

 

Area of training

 

to

 

 

 

 

 

 

 

 

Other Experience

In chronological order, list other educational experiences, jobs, military service or training that is not accounted for above.

(Mo/Yr)(Mo/Yr)

 

to

 

 

(Mo/Yr)

(Mo/Yr)

 

to

 

 

(Mo/Yr)

(Mo/Yr)

to

National Boards

Please indicate national board examination dates and results received.

 

USMLE Step 1

 

 

USMLE Step 2

 

 

 

 

 

USMLE Step 3

 

Date passed

Score (optional)

CK - Date passed

Score (optional)

 

CS - Date passed

Score (optional)

Date passed

 

Score (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For graduates of international medical schools, are you ECFMG-certified?

Yes

No If yes, provide certificate number and date granted.

 

 

 

 

 

 

 

 

 

 

 

 

 

ECFMG Certificate Number

 

 

 

 

 

 

Date ECFMG Certificate Granted

 

 

 

 

 

 

 

 

 

 

 

 

MM-YYYY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMLEX Level 1

 

 

COMLEX Level 2

 

 

 

 

COMLEX Level 3

 

 

 

Date passed

 

Score (optional)

Date passed

 

Score (optional)

 

Date passed

 

Score (optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical Licensure

Please list any states in which you hold a license to practice medicine. Please provide a license number. If an application is pending in a state, please write “pending.”

(State)

(Date Issued)

(Medical License Number)

(Active?)

 

 

 

 

 

Yes

No

 

 

 

 

 

 

 

 

(State #2)

(Date Issued)

(Medical License Number)

(Active?)

 

 

 

 

 

 

Yes

No

 

 

 

 

 

 

 

Have you ever been reprimanded, or had your license suspended or

 

Yes (If so, please explain in an attached sheet.)

 

 

 

 

 

 

 

revoked in any of these states?

 

 

No

 

 

 

 

 

 

Yes (If so, please explain in an attached sheet.)

 

 

Have you ever been named in (and/or had a judgment against you) in

 

 

 

 

 

 

 

 

a medical malpractice legal suit?

 

 

No

 

 

 

 

 

 

 

 

 

© 2013 College of American Pathologists. All rights reserved.

http://www.cap.org/apps/docs/pathology_residents/residents_forum_standardized_fellowship_application.doc0429201314

Board Certification

Please indicate any areas of board certification.

Board

Area of Certification

Date of Certification

Honors, Awards, Publications, Presentations, Memberships, Leadership/Research Experience

Please list on attached application forms or include this information in your CV.

Letters of Recommendation and/or References

Please list the individuals who will write your letters of recommendation. At least three are required.

Reference #1

Name

Title

Institution

Address

Telephone

Reference #2

Name

City

State

ZIP / Postal Code

 

 

 

Email

Title

Institution

Address

Telephone

Reference #3

Name

City

State

ZIP / Postal Code

 

 

 

Email

Title

Institution

Address

City

State

ZIP / Postal Code

Telephone

Email

Reference #4 (optional)

Name

Title

Institution

Address

City

State

ZIP / Postal Code

Telephone

Email

Signature (may omit if submitting electronically)

I hereby certify that all of the information on this application is accurate, complete, and current to the best of my knowledge, and that this application is being made for serious consideration of training in the Pathology Fellowship indicated. I understand that accepting more than one fellowship position constitutes a violation of professional ethics and may result in the forfeiture of all positions.

Signature

Date

© 2013 College of American Pathologists. All rights reserved.

http://www.cap.org/apps/docs/pathology_residents/residents_forum_standardized_fellowship_application.doc0429201314

Honors and Awards (if explicitly listed on CV, include highlights here with reference to location on CV)

© 2013 College of American Pathologists. All rights reserved.

http://www.cap.org/apps/docs/pathology_residents/residents_forum_standardized_fellowship_application.doc0429201314

Publications and Presentations (if explicitly listed on CV, include highlights here with reference to location on CV)

© 2013 College of American Pathologists. All rights reserved.

http://www.cap.org/apps/docs/pathology_residents/residents_forum_standardized_fellowship_application.doc0429201314

Memberships and Leadership/Research Experience (if explicitly listed on CV, include highlights here with reference to location on CV)

© 2013 College of American Pathologists. All rights reserved.

http://www.cap.org/apps/docs/pathology_residents/residents_forum_standardized_fellowship_application.doc0429201314

Residents Forum Suggested Timeline for Application

Beginning one-and-a-half years before the proposed start of a fellowship for which the application is being made, the following timeline is recommended:

December 1 Deadline for receipt of the completed Residents Forum Standardized Application and all supporting documentation (letters of recommendation, etc.)

March 1 Deadline for program to make offers to applicants

Application Packet Check-list

Completed Standardized Fellowship Application Form with Signature

Updated Curriculum Vitae (CV)

Included cover letter and/or personal statement

Checked with the fellowship director or coordinator whether there are other items that should be included

Included photo

© 2013 College of American Pathologists. All rights reserved.

http://www.cap.org/apps/docs/pathology_residents/residents_forum_standardized_fellowship_application.doc0429201314

Form Characteristics

Fact Name Description
Application Purpose This form is used by applicants seeking fellowships in various pathology specialties, including Blood banking/Transfusion medicine and Molecular genetic pathology.
Photo Requirement Applicants must affix a recent passport-sized photo to the form. For electronic submissions, the photo must be included in JPG format.
Personal Data Section This section collects the applicant's name, various addresses, phone numbers, email, citizenship status, and visa information.
National Board Examination Applicants are required to indicate the dates and results of their national board examinations, including USMLE and COMLEX scores.
Medical Licensure The form requires applicants to list their medical licenses, including states, license numbers, and status (active or pending).
Signature Applicants must sign the application (or certify electronically) to affirm the accuracy and completeness of their information.

Guidelines on Utilizing Cap Application

After completing the Cap Application form, it is crucial to review the entire document for accuracy and completeness. Submitting the application is the next step, which often involves either mailing a physical copy or submitting it electronically. Ensure all required components, including letters of recommendation, are included as specified.

  1. Applicant Information: Fill in your last name, first name, and middle name.
  2. Fellowship Type: Mark the type of fellowship for which you are applying by checking the appropriate box.
  3. Photo Submission: Affix a recent passport-sized photo to the designated area. If submitting electronically, upload a .JPG format photo.
  4. Training Period: Indicate the start date and finish date for the fellowship.
  5. Personal Data: Enter any other names used, your present and permanent addresses, and contact information. Include home, work, mobile, and fax numbers, as well as your email address.
  6. Citizenship: Provide your country of citizenship and your visa status.
  7. Education: List your educational background chronologically. Include your undergraduate school, graduate school (if applicable), medical school, and residency details along with the relevant dates and degrees obtained.
  8. Other Experience: Detail other relevant educational experiences, jobs, military service, or training not previously mentioned.
  9. National Boards: Document the dates and results of your national board examinations, as well as any ECFMG certification details for international medical school graduates.
  10. Medical Licensure: Specify any states where you hold a medical license, including the license number and status (active or pending).
  11. Board Certification: List any areas of board certification you hold, along with the date of certification.
  12. Honors, Awards, Publications, Presentations, Memberships, Leadership/Research: Summarize this information briefly or state that it is included in your CV.
  13. Letters of Recommendation: Provide the names, titles, institutions, addresses, and contact information for at least three references.
  14. Signature: Sign the form, certifying that the information is accurate. If submitted electronically, signing may be omitted.

What You Should Know About This Form

What is the Cap Application form used for?

The Cap Application form is used by individuals applying for pathology fellowships through the College of American Pathologists. It gathers essential personal, educational, and professional information to facilitate the fellowship application process.

What information is required on the Cap Application form?

The form requests various details such as the applicant’s name, address, contact information, citizenship, education history, national board examination dates and results, medical licensure information, and the areas of board certification. A recent passport-sized photo is also required, either physically affixed or submitted electronically in .JPG format.

How should I submit my photo with the application?

If submitting the application electronically, include a recent passport-style photo in .JPG format within the application file. For paper submissions, place the photo directly on the form at the designated area.

Are there specific fellowships that I can apply for using this form?

Yes, the application allows candidates to choose from a specific list of fellowship types, such as Blood Banking/Transfusion Medicine, Cytopathology, Hematopathology, and many others. Be sure to check the box for the fellowship type you are applying for.

How many letters of recommendation are required?

A minimum of three letters of recommendation is required. The application form includes space to list the names, titles, institutions, addresses, and contact information for the individuals providing these recommendations.

What should I do if I have pending medical licenses?

If you have any medical license applications pending, indicate that status by writing “pending” in the appropriate section of the application form. Include details about issued licenses as applicable.

What happens if I have a malpractice suit against me?

If you have ever been involved in a medical malpractice suit, you are required to disclose this information in the application. You can do so by explaining the circumstances on an attached sheet.

How do I ensure my application is considered complete?

To ensure completeness, verify that you have filled out all required sections, affixed a recent photo, and included any necessary documentation such as transcripts or CVs. Remember to sign the application if submitting by paper.

What certification do I need for international medical school graduates?

International medical school graduates must indicate their ECFMG certification status on the application. If certified, you will need to provide your ECFMG certificate number and the date it was granted.

Common mistakes

Completing the CAP Application form can be a detailed process, and it's easy to make mistakes. Let's discuss some common errors that people encounter while filling out this important application.

First and foremost, many applicants forget to check the fellowship type they are applying for. This section is crucial as it determines the specific fellowship program you will be considered for. Always double-check that you have accurately marked your desired specialty to avoid any confusion.

Another frequent misstep is neglecting to include a recent passport-sized photo. If you submit your application electronically, it’s important to include the photo in the correct format (.JPG). Not including a photo may make your application appear incomplete, potentially impacting the review process.

Individuals sometimes overlook providing accurate dates for their training periods. Providing the correct start and finish dates is vital. Ensure that all dates match your educational history and are listed chronologically to paint a clear picture of your qualifications.

Furthermore, not including all relevant experiences in the "Other Experience" section can leave gaps in your application. List every educational experience, job, and training that is relevant, even if it isn’t officially required. This extra detail helps convey your dedication and background more fully.

Some candidates fail to indicate their citizenship and visa status entirely. This information not only affects eligibility but can also influence the admissions committee's view of your application. Always ensure that this crucial section is filled out completely and accurately.

Missing details about national board examinations is another common error. Make sure to include dates and scores for any board exams taken, as this information is key to demonstrating your qualification levels. If you have not taken a particular exam yet, simply indicate that, rather than leaving it blank.

Many applicants do not include their license information properly. It’s essential to list all states where you hold or have applied for a medical license, along with the corresponding numbers. Remember to note if any licenses are pending; transparency is crucial here.

Additionally, the letters of recommendation section is often filled out inadequately. At least three references are required, so be proactive in gathering this information ahead of time. Make sure to list the references with their correct titles and contact information, and remember that missing this section can leave a poor impression.

Finally, many individuals hastily skip over signing the application or forget to date it. Even if submitting electronically, ensure that your signature is included where necessary, as it confirms the veracity of the information provided. Carelessness here can lead to significant delays in the application process.

Filling out the CAP Application does not have to be overwhelming. By being mindful of these common mistakes, you can increase the chances of your application standing out positively.

Documents used along the form

When applying for a pathology fellowship, several accompanying documents may be required alongside the CAP Application form. Each of these documents serves a unique purpose and helps to create a comprehensive view of your qualifications and experiences. Below is a brief description of nine common forms that applicants often submit with their application.

  • Curriculum Vitae (CV): This document outlines your educational background, work experience, publications, presentations, and other relevant achievements. It provides a detailed overview of your professional journey and qualifications.
  • Personal Statement: In this statement, you discuss your reasons for pursuing a pathology fellowship, your career aspirations, and what you hope to gain from the experience. It is your opportunity to showcase your passion and dedication.
  • Letters of Recommendation: Usually, you will need at least three letters from professional references who can speak to your qualifications and character. These letters should highlight your skills, experience, and suitability for the fellowship.
  • Official Transcripts: These are academic records that verify your educational qualifications. They should be obtained from your educational institutions and sent directly to the fellowship program.
  • National Board Scores: Documentation of your scores from national board examinations, such as USMLE or COMLEX. These scores are important in demonstrating your competency and readiness for advanced training.
  • ECFMG Certification (if applicable): For international medical graduates, proof of your Educational Commission for Foreign Medical Graduates (ECFMG) certification is often required, including the certificate number and the date it was granted.
  • Medical Licensure Information: Details regarding any states where you hold a medical license. This includes license numbers, issue dates, and the status of each license (active or pending).
  • Honors and Awards Documentation: A list of any awards or recognitions you have received throughout your academic and professional career should be included. This highlights your achievements and commitment to excellence.
  • Publications and Presentations List: If you have contributed to any published works or have presented at conferences, you should provide a summary or list of these items. This showcases your involvement in the medical field and your research capabilities.

Submitting these documents along with your CAP Application form not only strengthens your application but also allows the selection committee to better understand your background and accomplishments. Be sure to review specific fellowship program requirements, as they may vary in what they request. Good luck with your application!

Similar forms

  • Medical School Application - Similar to the Cap Application form, this document collects personal information, educational history, and details about training periods. Both forms require a photo and a declaration of accurate information.

  • Residency Application - Like the Cap Application, this form details a candidate's educational background, national board exam results, and medical licensure status. It emphasizes the applicant's commitment to a specific field of medicine.

  • Job Application for Medical Positions - A job application form typically requests personal data, educational qualifications, and relevant experiences, paralleling the structure and required information of the Cap Application.

  • Fellowship Application for Other Specialties - This document often mirrors the Cap Application in collecting fellowship-specific information, educational history, and recommendation details, emphasizing the seriousness of the applied fellowship.

  • Endorsement Letters - While not a form, letters of recommendation share a close relationship with the Cap Application. They provide supporting documentation of the applicant's qualifications and experiences.

  • Continuing Medical Education (CME) Application - This application gathers personal information, educational background, and licensure status, similar to what is found in the Cap Application, focusing on professional development.

  • State Medical Board Application - This document requires comprehensive information about a physician’s education, training, and background, maintaining the same detail-oriented approach as the Cap Application.

  • Grant Application for Medical Research - Like the Cap Application, this form calls for details about the applicant's academic background and relevant experiences. It also requires a declaration of the accuracy of presented information.

Dos and Don'ts

When filling out the CAP Application form for Pathology Fellowships, it is important to approach the process methodically. Consider the following guidelines to ensure your application stands out.

  • Do fill out all personal data accurately. Ensure that your name, contact information, and citizenship details are correct.
  • Do check the fellowship type you are applying for and confirm that you meet all relevant qualifications.
  • Do attach a recent passport-sized photo, following the guidelines provided.
  • Do provide clear and comprehensive information regarding your education and training, including dates and degrees.
  • Don’t leave any sections blank. This could lead to delays in processing your application.
  • Don’t submit your application without double-checking for errors. Proofreading can prevent mistakes that may affect your application’s credibility.

Misconceptions

Below are some common misconceptions about the Cap Application form, along with clarifications for each.

  • It's only for residents. Many assume this application is exclusively for current residents. In fact, it’s also open to those who have completed their residency and are seeking fellowship opportunities.
  • The photo requirement is optional. Some believe that including a photo is not necessary. However, applicants are required to affix a recent passport-sized photo with the form, or include one if submitting electronically.
  • Only medical school details are required. Many think that only their medical school education needs to be listed. In reality, the application asks for a full educational history, including undergraduate and graduate schools and any additional training you’ve completed.
  • Your license status isn't important. Some overlook the medical licensure section. This is crucial, as the application requests details about licenses held and any issues related to medical malpractice or disciplinary actions.
  • A high board score guarantees acceptance. Many believe that achieving top scores on national board exams secures their place in a fellowship. While scores are important, the selection process considers various factors, including experience and recommendations.
  • You only need three references. Some applicants think they can provide just three references. However, at least three letters of recommendation are required, and an optional fourth can enhance your application.
  • The signature can be skipped if applying online. There is a misconception that the signature requirement can be ignored for electronic submissions. In truth, you should still certify the accuracy of the information provided, even if you are submitting the application digitally.

Key takeaways

Filling out the Cap Application form is an important step toward securing a fellowship in pathology. It is essential to pay close attention to detail to ensure all information is accurate and complete.

  • Choose the Correct Fellowship Type: Carefully check the box for the fellowship type you are applying for. This decision directs your application to the appropriate selection committee.
  • Recent Photo Requirement: Affix a recent passport-sized photo to your application, or include a JPEG photo if submitting electronically. A clear photo helps maintain a professional appearance.
  • Personal and Contact Information: Double-check the accuracy of your personal data and contact information. This information is crucial for potential follow-ups from the selection committee.
  • Educational Background: Provide a detailed account of your educational history, including specific degrees and schools attended along with the dates. Ensure that the timeline is chronological and complete.
  • National Boards and Licensure: Accurately report your national board examination results and any medical licenses held. If any applications are pending, clearly note that status.
  • References: List at least three individuals who will provide letters of recommendation. Be sure to follow up with them to confirm they will submit their letters on your behalf.

Completing the Cap Application form thoroughly presents your qualifications clearly. By paying attention to these key areas, you enhance your chances of a successful application.