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PSBIM Exam 2026 Application

PERSONAL DATA

Last Name

First Name

Middle Name

Extension Name

Confirm Email

Contact Number:

Date of Birth:

Birth Place:

Gender:

Nationality:

Marital Status:

Name of Spouse:

PRC Number Equivalent to your country

PRC Number Expiration Date:

PHIC Accreditation Number:

PHIC Accreditation Expiration Date:

Mailing Address:

Office
Home

OFFICE ADDRESS

Office Name:

Street, Barangay:

Town/City:

Zip Code:

Region:

Contact Number:

HOME ADDRESS

Street, Barangay:

Zip Code:

Region:

Contact Number:

EDUCATIONAL BACKGROUND

Bachelor Degree:

Institution:

Year Graduated:

Doctor of Medicine:

Institution:

Year Graduated:

Internship:

Institution:

Year Graduated:

Other:

Institution:

Year Graduated:

RESIDENCY TRAINING (INTERNAL MEDICINE):

Year Level 1:

YL1 Institution:

YL1 Date From:

FROM

YL1 Date To:

Year Level 2:

YL2 Institution:

YL2 Date From:

FROM

YL2 Date To:

Year Level 3:

YL3 Institution:

YL3 Date From:

FROM

YL3 Date To:

Year Level 4:

YL4 Institution:

YL4 Date From:

FROM

YL4 Date To:

Did you train in 2 or more institutions?

If yes, please give details below:

Code: the YL4

Post Deployment Residency Program

In training?:

If yes, please give details below:

• In case a candidate is trained in > 2 different institutions, he/she must submit the ‘certified true copies’ of both the Diploma of completion of residency training program, and letter of certification that he/she had satisfactorily completed a particular Year Level of residency training program from the respective institution. This certification letter must be duly signed by the Chair and Training Officer of the Department of Internal Medicine, and another signature representing the Administration (Medical Director or Chief of Clinics or Chair of the Department of Medical Education and Training) will be accepted. The diploma, however, must be submitted when applying for the oath taking for Diplomate in the same year.

After becoming a PCP Diplomate, which chapter do you intend to belong to:

Please indicate the basis for the choice of chapter:

Proximity to place of residence
Proximity to place of medical practice

Upload Profile Picture

Drag & Drop Files, Choose Files to Upload

Note: High resolution (300dpi) 2x2 picture in black business attire with white background. Max. 2MB file size.

PSBIM Exam Take(s):

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Please tick the box for the special requirements during Written Certifying Examination on March 2026 for pregnant, 60 years old and above and for big body build:

Special Requirements:

EXTRA BIG CHAIR

Please Indicate if:

Pregnant
Breastfeeding

IMPORTANT NOTICE TO CANDIDATES APPLYING FOR THE PSBIM EXAMINATION:

The candidates and designated officials of the institution (Chair, Training Officer, and Medical Director) are responsible for informing the PSBIM of any changes in the candidates qualifications that would affect his/her eligibility to take the examination. In such cases, the candidate must formally withdraw from the examination. Any changes in the candidate's qualifications that would affect his/her eligibility to take the certifying examination must be relayed to the PSBIM by the candidate and designated officials of the institution (Chair, Training Officer, and Medical Director). The candidate must make the proper withdrawal from the examination, policies concerning examination fees will be followed. Both the PCP and the PSBIM reserve the right to disqualify a candidate, or nullify his/her examination results, who is found to have submitted false or fraudulent document/s intentionally or otherwise. The institution must write back to PSBIM (both email and courier) on or before Feb 09 stating whether the candidates are truly qualified or still have deficiencies and therefore are not qualified to take the examination. .

Terms and Conditions

I agree to the PSBIM Terms and Conditions.