NAME:

PMCV CANDIDATE NUMBER:

PRIORITY GROUP:
HOW TO COMPLETE THIS GUIDE:
All components must have evidence inserted on the corresponding Worksheet and clearly referenced or Hyperlinked. Applications
without sufficient evidence will not be scored.
Multiples of criteria may be included (up to the certain value if indicated by a maximum score)
Templates for some evidence and FAQs can be found online www.rmhdoctors.org.au
This form must be completed and submitted electronically in PDF format
The purpose of this guide is not to achieve the maximum points available but to give a comparison of how one Intern Evidence
Based CV compares to another using set criteria.
COMPONENTS:

MAXIMUM
POINTS
AVAILABLE

SELF
ASSESSMENT

SECTION 1: ADDITIONAL QUALIFICATIONS

10 (Total)

Please self
assess total
points per
component

Copy of qualification (or progress) to be attached

Qualifications can be gained prior, during or post medical
studies
Qualifications must be complete unless specifically stated
PhD or equivalent Doctorate

10 (or 4 points per

year completed)

Masters Degree

8 (or 3 points per

year completed)

Other Bachelor Degree (Not MBBS or MBChB)

Research Year (BMedSc) / Honours year

Diploma (From an accredited institution - TAFE/Uni/Tertiary

etc.)

REFERENCE

Total Score: Additional Qualifications

Section 2: Work and volunteer employment

20 (Total)

SECTION 2
EVIDENCE
WORKSHEET

(within past 4 years ONLY from 01/01/10)

Letter of service required (on letter head) detailing hours,

duration and role of employment undertaken
Regular is defined as on a weekly, fortnightly or monthly
basis
Paid employment: (select one option only)
Paid regular (min 8 hours per week) employment for a
continuous minimum period for 12 months
Paid regular (min 5 hours per week) employment for a
continuous minimum period for 3 months

10
2 points per
occasion (Max 4
points)

Paid regular employment completed prior to 01/01/2010

Volunteer employment: (select one option only)

Regular volunteer employment (min 8 hours per month) for a
continuous period of 6 months
Regular volunteer employment (less than 8 hours per month)
for a continuous period of 6 months
1 point per
Volunteer experience (min 1 day duration, can be overseas)

5
2

Cannot be part of medical degree (ie. Elective Clinical placement)

experience (Max 3
points)

Committee or leadership role within a community group (i.e.

University, religious, cultural group, sporting group etc.)

3 points per role

(Max 6 points)

Total Score: Work and Volunteer Employment

ADMIN
ASSESSMENT

Section 3: Conferences, Workshops, Seminars and Short

Courses
Certificate or letter of attendance must be included

10 (Total)

Topics can be in regard to, but are not limited to,

professionalism, scholar / teacher, health advocacy,
management and leadership, collaboration and
communication skills

Full day or multi day conference, workshop, meeting, course, medically 2 per meeting
(max 6 points)
related.
(cannot form any compulsory coursework from MBBS such as first aid,
life support etc)

day conference, workshop, meeting, course, medically

related.

1 per day
(max 4 points)

2 per course (max

Completion of short course, certificate, conferences, non6 points)
medically related (language, arts, music, toast masters,
cooking etc.)
Total Score: Conferences, Workshops, Seminars and Short Courses

Section 4: Research, publications, presentations and Teaching 15 (Total)

Reference for published materials must be provided

Evidence of incomplete research must be accompanied by
a detailed letter of confirmation from the chief / senior
investigator
Presentation of formal teaching requires confirmation from
supervisor confirming dates, types of teaching and topic
Article in peer reviewed journal (or book chapter) 1st or 2nd
author

8
4

rd

3 author or below
Non peer reviewed article

2 (max 4 points)

Well advanced significant study (incomplete at time of

application)
Presentation at peer reviewed meeting

International
Verbal

8 per verbal

Poster

4 per poster

National
Verbal

6 per verbal

Poster

3 per poster

Regional
Verbal

4 per verbal

Poster

3 per poster

2 per pres. (max. 4

Formal presentation at peer reviewed meeting (at hospital
points)
level) or teaching sessions to colleagues
Total Score: Research, publications, presentation and Teaching

SUB TOTAL SCORE:

PERSONAL ACHIEVEMENTS & THE HOSPITALS VALUES

List up to 5 personal life achievements in line with Melbourne Health values that have contributed to or reflect your exceptional personal
qualities and/or capabilities. Areas of inclusion are, but not limited to, positions of responsibility held, additional qualifications, volunteer
work music and language, personal endeavours of merit, academic achievements, awards received and sporting/social achievements
Within the space provided please provide a summary explanation of your selected achievements and how each relates to the Melbourne
Health value selected
Only text within the designated space below will be assessed
Evidence is not required for this component.

1. CARING

2 .UNITY

3. DISCOVERY

4. INTEGRITY

5. RESPECT

Total Score: Personal endeavours, outstanding achievements and demonstrated leadership

MOTIVATION: WHY DO YOU WANT TO BE AN INTERN AT THE ROYAL MELBOURNE HOSPITAL?

Within the space provided please outline your reasons for wanting to complete your internship at the Royal Melbourne
Hospital.
Your motivation can be both personal and professional reasons

Total Score: Personal endeavours, outstanding achievements and demonstrated leadership

Grand Total Score