Application for PCP Fellow – PCP Application Forms

APPLICATION FORM FOR PCP FELLOW STATUS

IMPORTANT REMINDERS:
- Eligible applicants are those who have been conferred as PCP Diplomates in 2023 or earlier
- DEADLINE OF SUBMISSION: December 15, 2025 at 5:00 pm (NO FURTHER EXTENSIONS).
- All fields with the red asterisk(*) require an input.
- All fields without asterisk are optional.
- Please enter valid and correct e-mail address and contact number.
- Only files in JPEG (*.jpg) and PDF(*.pdf) format can be accepted by the system
- Before leaving the site or closing your browser, please wait for the confirmation message,
"Thank you, Doctor. Your application form has been submitted for approval."
This will assure you that your submission has been successful.

REQUIREMENTS FOR APPLICATION AS PCP FELLOW
(Effective October 16, 2024)

INSTRUCTIONS on How to Apply for the Fellowship status at PCP:

1. Please download the 2023 edition of the PCP Profile Brochure and read the Implementing Rules and Regulation (IRR) for the Committee on Credentials and Membership.
Please click on this link: PCP Profile Brochure 2023 Edition

2. All documents & requirements must be submitted via the website on or before 5:00 PM (Philippine Standard Time) of December 15, 2025.

3. Incomplete documents will NOT be processed.

4. Receipt of the Application will be acknowledged via e-mail.

5. Upon validation, approval of the application by the Chair of the Committee on Credentials & Membership shall be sent to the applicant via e-mail.

I. NAME OF APPLICANT

Last Name:

First Name:

Middle Initial:

Extension Name:

II. REQUIREMENTS

Requirement 1-A:

Click or drag a file to this area to upload.

1-A. Current PCP-Certificate of Good Standing issued by your respective local chapter. (Please attach .JPEG or PDF. 1mb file limit)

Requirement 1-B:

Click or drag files to this area to upload. You can upload up to 6 files.

1-B. Must have fulfilled the minimum required fifteen (15) PCP CPD units per fiscal year, or cumulatively earned at least thirty (30) PCP CPD units in the last 2 years. (Please attach .JPEG or PDF. 6mb file limit)

Requirement 2:

Click or drag a file to this area to upload.

2. Letter of Intent to be a Fellow of the College, addressed to the President of the PCP. (Please attach .JPEG or PDF. 1mb file limit)

Requirement 3:

Click or drag a file to this area to upload.

3. High-resolution (300 dpi) photo in black business attire with white background. Photo must have been taken within the last 6 months. (Please attach .JPEG or PDF. 1mb file limit)

Requirement 4:

Click or drag a file to this area to upload.

4. Proof of payment for annual dues for FY 2025-2026 (Php 2,250) and processing fee (Php 1,500). (Please attach .JPEG or PDF. Maximum 1 MB file limit)

INSTRUCTIONS:

For those paying over-the-counter in the bank, please use and fill up the BILLS PAYMENT FORM, and input your PRC ID number as the reference number (Union Bank Pasig Branch. In favor of: Philippine College of Physicians).
For those paying online, please use the PCP online payment system. Under Payment, please check "PCP Annual Dues" and "Application Fee."

Then select "Diplomate - Php 2,250.00" and "Application Fee - Php 1,500.00".

Payment methods:
1. Gcash Bills Payment: - Log-in to your Gcash account - Click "BILLS"
- Search for "Philippine College of Physicians"
- Enter your PRC number, mobile number, and account name of any of the doctors (e.g., Your Name)

2. Bank Transfer:
- Bank: BPI
- Account name: Philippine College of Physicians
- Account number: 4161004079

Requirement 5: (Upload 2 Letter/File)

Click or drag files to this area to upload. You can upload up to 2 files.

5. Endorsement letters from two (2) PCP Fellows who are in good standing. Endorsement Letter for PCP Fellowship Template
Pls. attach your copy of letters in JPG or PDF format, 1mb file limit)

Requirement 6:

Click or drag a file to this area to upload.

6. Photocopy of PCP Diplomate Board Certificate. (Please attach .JPEG or PDF. 1mb file limit)

Requirement 7:

Click or drag a file to this area to upload.

7. Certification of ANY of the following accomplishments:

~ Subspecialty Fellowship Training OR Masteral/Academic Training
~ Certificate of active Internal Medicine practice and/or teaching (signed by the Clinic or Hospital Medical Director/ Dean)
~ Completed research/es during the prescribed period (copy of abstract).
~ Certificate of Employment for a health-related administrative position, be it in government and/or private medical institution.

(Please attach .JPEG or PDF. Maximum 1 MB file limit)

Requirement 8:

Click or drag a file to this area to upload.

8. List of active participation in PCP-related and/or local civic activities during the last two years. This list must be verified by your Chapter President and signed by the applicant to attest to its veracity.

Please refer to the Pro-Forma Template: ProForma_Letter_for_ListofActiveParticipation_v2024
(Please attach .JPEG or PDF. 1mb file limit)

Requirement 9:

Click or drag a file to this area to upload.

9. Scanned copy of PMA Membership Certificate or valid PMA ID.
(Please attach .JPEG or PDF. 1mb file limit)

FOR INQUIRIES:

The Secretariat: Philippine College of Physicians, 22nd Floor, One San Miguel Avenue Building,
San Miguel Avenue corner Shaw Boulevard, Ortigas Centre, Pasig City 1605; Tel. No. 8650-4146

PCP Website: www.pcp.org.ph
E-mail address: secretariat@pcp.org.ph or ferlene.pellena@pcp.org.ph

PERSONAL DATA

PCP CHAPTER WHERE I AM A MEMBER OF:

First 4: Requirement

Last Name:

First Name:

Middle Initial:

Extension Name:

Date of Birth

Place of Birth:

Gender:

Marital Status:

Name of Spouse:

Confirm Email

Mobile Number

PCP Number:

PRC Number:

PMA Number:

OFFICE ADDRESS

OFFICE NAME:

Street, Barangay:

Town/City:

Zip Code:

Region:

Contact Number:

HOME ADDRESS

Street, Barangay:

Zip Code:

Town/City:

Region:

Contact Number:

Mailing Address:

Office
Home

POSTGRADUATE TRAINING

( * Any training pursued after earning Diplomate status)

Institution - Year Level 1:

Date From:

Date To:

Institution - Year Level 2:

Date From:

Date To:

Institution - Year Level 3:

Date From:

Date To:

In case a candidate trained in 2-3 different institutions, he/she must submit 'certified true copies' of both the diploma of completion of subspecialty/masteral/academic training programs and a letter of certification that he/she has satisfactorily completed a particular year level of training program from another institution.

The Committee on Membership & Credentialing reserves the right to disapprove any applicant who shall be found to be deficient in his/her qualifications OR who would be found to have submitted fraudulent documents.

APPLICATION FORM FOR PCP FELLOW STATUS

I. NAME OF APPLICANT

II. REQUIREMENTS

INSTRUCTIONS:

FOR INQUIRIES:

PERSONAL DATA

OFFICE ADDRESS

HOME ADDRESS

POSTGRADUATE TRAINING

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