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The Association for Surgical Education

The Association for Surgical Education

Impacting Surgical Education Globally

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APACS Re-certification Application

NOTE: To be eligible for re-certification, you must meet the below criteria.

1. ASE member in good standing.
2. Three consecutive years of experience in undergraduate surgical education administration since certification or last re-certification.
3. Served at least 1 year as an active member and/or chair of an ASE Coordinator sub-committee.
4. Presented at least 1 best practice presentation during an annual ASE Coordinator Track Program.

Contact Information

Name(Required)
Institution Address(Required)
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Please confirm the following:(Required)
You must meet all of the below criteria to eligible for re-certification.

Supporting Documents

Accepted file types: pdf, Max. file size: 512 MB.
Please upload a one-page reflective essay about an experience demonstrating continued professional growth.
Accepted file types: pdf, Max. file size: 512 MB.
Best practice presentation(s) during annual ASE Coordinator Track Program
Drop files here or
Accepted file types: pdf, Max. file size: 512 MB.

    Credits

    Years served as a Clerkship Coordinator(Required)
    2 credits earned per year as Clerkship Coordinator, 6 credits maximum. List each year as a Clerkship Coordinator, and click the + button to add years.
    1 credit for each presentation given during the annual ASE Coordinator Program Track(Required)
    1 credit per presentation (at least one presentation required). Please list year and title of the presentation. Click the + button to add year and presentation.
    Please select any of the following which you have completed:
    1 credit each
    Years attended Coordinator Track Program Annual Meeting
    1 credit per year attended, maximum of 3 credits. Click the + button to add years.
    Departmental, institutional, or non-ASE national presentation(s)
    1 credit per presentation, maximum of 3 credits. Click the + button to add presentations.
    Professional development: attend qualifying workshops or seminars
    1 credit per activity, maximum of 3 credits. Click the + button to add activities.
    Please select any of the following which you have completed
    0.5 credits each

    Payment Information

    Billing Address(Required)
    Credit Card(Required)
    American Express
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    MasterCard
    Visa
    Supported Credit Cards: American Express, Discover, MasterCard, Visa
    Expiration Date
     

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    Contact the ASE

    11300 W. Olympic Blvd
    Suite 600
    Los Angeles, CA 90064 USA
    (310) 215-1226
    [email protected]

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