5
Venue | Local Lisbon - SANA Metropolitan Hotel Course Total Time | Duração 11 hours at the course site 11 horas presenciais 08:00-19:00 17 pre-course e-learning hours 17 horas de estudo Course credited with 1 ECTS Curso creditado com 1 ECTS a Purpose | Objetivos Provide basic technical skills for Urology Residents, such as basic laparoscopy, basic transurethral resection and basic endoscopy of the upper and lower urinary tract, within the framework of a standardized ESU training program. Proporcionar a Internos de Urologia competências técnicas básicas de laparoscopia, de ressecção transuretral e de endoscopia do aparelho urinário superior e inferior, dentro do enquadramento standard dos programas de treino da ESU. Methodology | Metodologia Hands-on training course with modules focused on technical skills simulation training. 1:1 trainer/trainee ratio. Curso prático de treino em simuladores com módulos orientados para as competências técnicas. Rácio formador/formando 1:1. Course Directors | Direção do Curso Joan Palou, MD, PhD Chairman of the European School of Urology – ESU / EAU Tomé Matos Lopes, MD Director of the Urology University Clinic of FMUL Director of the Urology Department of CHULN Organizing Committee | Organização Ben Van Cleynenbreugel, MD EAU-ESU Board Member Consultant Urologist at KU Leuven, Belgium Chandra Shekhar Biyani, MD Consultant Urologist at Leeds Teaching Hospitals, NHS T., UK Sunjay Jain, MD Consultant Urologist at Leeds Teaching Hospitals, NHS T., UK Tiago Ribeiro Oliveira, MD Urologist of the Urology Departments of Hospital de Santa Maria, CHULN and of the Armed Forces Hospital, HFAR Coordination | Coordenação CFU Centro de Formação Pós-Graduada em Urologia Urology Post Graduate Educacion Centre Tito Palmela Leitão, MD Lecturer of the Urology University Clinic of FMUL Assistant Urologist of the Urology Department of Hospital de Santa Maria, CHULN FMUL Faculdade de Medicina da Universidade de Lisboa Faculty of Medicine of the University of Lisbon Prof. Doutor Fausto J. Pinto Diretor Prof. Doutor J. Melo Cristino Presidente do Conselho Científico Prof. Doutor Joaquim Ferreira Presidente do Conselho Pedagógico Secretariat | Secretariado Unidade de Formação Contínua Faculdade de Medicina da Universidade de Lisboa T: +351 217 985 100 @: [email protected] CFU Centro de Formação Pós-Graduada em Urologia T: +351 966 462 493 @: [email protected] + Oferta Pós-graduada e Submissão ONLINE em www.medicina.ulisboa.pt/formcontinua IFA INSTITUTO FORMAÇÃO AVANÇADA NOV NOV 22 | 23 19 Scientific Endorsements Day 22 Sponsorship Patrocínio Científico Patrocínio do dia 22 Corporate Sponsors Patrocinadores Post Graduate Course | Curso Pós-Graduado de Atualização LISBON UROLOGY BOOT CAMP Boot Camp de Urologia 2019 Official Languages | Línguas Oficiais Portuguese | Português English | Inglês Addressees | Destinatários Day 22 | Dia 22 Portuguese Urology Residents from 1st and 2nd Year Internos de Urologia Portugueses do 1º e 2º Anos Day 23 | Dia 23 Other National & International Urology Residents Vacancies | Vagas Day 22 — 16 delegates | Dia 22 — 16 formandos Day 23 — 16 delegates | Dia 23 — 16 formandos Faculty | Corpo Docente Modules Coordination Coordenação dos Módulos José Santos Dias, MD MODULE C – Coordinator | Coordenador Pedro Oliveira, MD MODULE D – Coordinator | Coordenador Sérgio Pereira, MD MODULE B – Coordinator | Coordenador Tito Palmela Leitão, MD MODULE A – Coordinator | Coordenador Urology Department of Hospital de Santa Maria, CHULN Alberto Silva, MD Hosp. F. Fonseca, Amadora-Sintra Álvaro Nunes, MD Centro Hospitalar Barreiro-Montijo Ben Van Cleynenbreugel, MD UZ Leuven – University Hospitals Leuven Celso Marialva, MD Instituto Português de Oncologia, Lisboa Daniel Reis, MD Hospital de Cascais, Dr. José de Almeida David Martinho, MD Hospital de Santa Maria, CHULN Filipe Lopes, MD Hospital de Egas Moniz, CHLO Frederico Furriel, MD Centro Hospitalar de Leiria Luís Osório, MD Hospital dos Lusíadas, Porto Nuno Domingues, MD Hospital das Forças Armadas, Lisboa Pedro Monteiro, MD Hospital de Egas Moniz, CHLO Rodrigo Garcia, MD Hospital de Santa Maria, CHULN Rodrigo Ramos, MD Instituto Português de Oncologia, Lisboa Rui Lúcio, MD Fundação Champalimaud, Lisboa Sandro Gaspar, MD Hospital de Santa Maria, CHULN Shekhar Biyani, MD Leeds Teaching Hospitals, NHS Trust, UK Tiago Mendonça, MD The Mid Yorkshire Hospitals, Wakefield, UK

IFA - medicina.ulisboa.ptIFA INSTITUTO FORMAÇÃO AVANÇADA NOV 22|23 NOV 19 Scientific Endorsements Day 22 Sponsorship Patrocínio Científico Patrocínio do dia 22 Corporate Sponsors

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Page 1: IFA - medicina.ulisboa.ptIFA INSTITUTO FORMAÇÃO AVANÇADA NOV 22|23 NOV 19 Scientific Endorsements Day 22 Sponsorship Patrocínio Científico Patrocínio do dia 22 Corporate Sponsors

Venue | LocalLisbon - SANA Metropolitan Hotel

Course Total Time | Duração11 hours at the course site 11 horas presenciais — 08:00-19:00

17 pre-course e-learning hours 17 horas de estudo

Course credited with 1 ECTS Curso creditado com 1 ECTS

a

Purpose | ObjetivosProvide basic technical skills for Urology Residents, such as basic laparoscopy, basic transurethral resection and basic endoscopy of the upper and lower urinary tract, within the framework of a standardized ESU training program.Proporcionar a Internos de Urologia competências técnicas básicas de laparoscopia, de ressecção transuretral e de endoscopia do aparelho urinário superior e inferior, dentro do enquadramento standard dos programas de treino da ESU.

Methodology | MetodologiaHands-on training course with modules focused on technical skills simulation training. 1:1 trainer/trainee ratio.Curso prático de treino em simuladores com módulos orientados para as competências técnicas. Rácio formador/formando 1:1.

Course Directors | Direção do Curso Joan Palou, MD, PhDChairman of the European School of Urology – ESU / EAU

Tomé Matos Lopes, MDDirector of the Urology University Clinic of FMULDirector of the Urology Department of CHULN

Organizing Committee | Organização

Ben Van Cleynenbreugel, MDEAU-ESU Board MemberConsultant Urologist at KU Leuven, Belgium

Chandra Shekhar Biyani, MDConsultant Urologist at Leeds Teaching Hospitals, NHS T., UK

Sunjay Jain, MDConsultant Urologist at Leeds Teaching Hospitals, NHS T., UK

Tiago Ribeiro Oliveira, MDUrologist of the Urology Departments of Hospital de Santa Maria, CHULN and of the Armed Forces Hospital, HFAR

Coordination | CoordenaçãoCFUCentro de Formação Pós-Graduada em Urologia Urology Post Graduate Educacion Centre

Tito Palmela Leitão, MDLecturer of the Urology University Clinic of FMULAssistant Urologist of the Urology Department of Hospital de Santa Maria, CHULN

FMUL Faculdade de Medicina da Universidade de LisboaFaculty of Medicine of the University of Lisbon

Prof. Doutor Fausto J. PintoDiretor

Prof. Doutor J. Melo CristinoPresidente do Conselho Científico

Prof. Doutor Joaquim FerreiraPresidente do Conselho Pedagógico

Secretariat | SecretariadoUnidade de Formação Contínua Faculdade de Medicina da Universidade de Lisboa T: +351 217 985 100 @: [email protected]

CFU Centro de Formação Pós-Graduada em Urologia T: +351 966 462 493 @: [email protected]

+ Oferta Pós-graduada e Submissão ONLINE em www.medicina.ulisboa.pt/formcontinua

IFAINSTITUTOFORMAÇÃOAVANÇADA

NOVN O V22|23 19

Scientific Endorsements Day 22 SponsorshipPatrocínio Científico Patrocínio do dia 22

Corporate Sponsors Patrocinadores

Post Graduate Course | Curso Pós-Graduado de Atualização

LISBON UROLOGY BOOT CAMP Boot Camp de Urologia 2019

Official Languages | Línguas OficiaisPortuguese | PortuguêsEnglish | Inglês

Addressees | Destinatários

Day 22 | Dia 22Portuguese Urology Residents from 1st and 2nd YearInternos de Urologia Portugueses do 1º e 2º AnosDay 23 | Dia 23Other National & International Urology Residents

Vacancies | VagasDay 22 — 16 delegates | Dia 22 — 16 formandosDay 23 — 16 delegates | Dia 23 — 16 formandos

Faculty | Corpo DocenteModules Coordination Coordenação dos Módulos José Santos Dias, MD MODULE C – Coordinator | Coordenador

Pedro Oliveira, MD MODULE D – Coordinator | Coordenador

Sérgio Pereira, MDMODULE B – Coordinator | Coordenador

Tito Palmela Leitão, MD MODULE A – Coordinator | Coordenador

Urology Department of Hospital de Santa Maria, CHULN

Alberto Silva, MD Hosp. F. Fonseca, Amadora-Sintra

Álvaro Nunes, MD Centro Hospitalar Barreiro-Montijo

Ben Van Cleynenbreugel, MDUZ Leuven – University Hospitals Leuven

Celso Marialva, MDInstituto Português de Oncologia, Lisboa

Daniel Reis, MDHospital de Cascais, Dr. José de Almeida

David Martinho, MDHospital de Santa Maria, CHULN

Filipe Lopes, MDHospital de Egas Moniz, CHLO

Frederico Furriel, MDCentro Hospitalar de Leiria

Luís Osório, MDHospital dos Lusíadas, Porto

Nuno Domingues, MDHospital das Forças Armadas, Lisboa

Pedro Monteiro, MDHospital de Egas Moniz, CHLO

Rodrigo Garcia, MDHospital de Santa Maria, CHULN

Rodrigo Ramos, MDInstituto Português de Oncologia, Lisboa

Rui Lúcio, MDFundação Champalimaud, Lisboa

Sandro Gaspar, MDHospital de Santa Maria, CHULN

Shekhar Biyani, MDLeeds Teaching Hospitals, NHS Trust, UK

Tiago Mendonça, MDThe Mid Yorkshire Hospitals, Wakefield, UK

Page 2: IFA - medicina.ulisboa.ptIFA INSTITUTO FORMAÇÃO AVANÇADA NOV 22|23 NOV 19 Scientific Endorsements Day 22 Sponsorship Patrocínio Científico Patrocínio do dia 22 Corporate Sponsors

Scientific Programme | Programa 2019Post Graduate Course | Curso Pós-Graduado de Atualização

LISBON UROLOGY BOOT CAMP | Boot Camp de Urologia 2019

22 NOV | NOV

Friday | Sexta-feira 23 NOV | NOV

Saturday | Sábado

07:45 Opening & RegistrationAbertura do Secretariado

08:10 Welcome SessionAbertura do CursoProf. Dr. Tomé Matos Lopes

08:20 Technical Skills Training ModelsModelos de Treino em Competências TécnicasDr. Sunjay Jain

08:30 Standardized Training Programs in UrologyProgramas Padronizados de Treino em UrologiaDr. Ben Van Cleynenbreugel

08:40 The ESU Boot Camp ProjectO Projeto Boot Camp da ESUDr. Tiago Oliveira

08:50 Boot Camp PresentationApresentação do Boot CampDr. Chandra Shekhar Biyani

09:00 Practical SessionSessão Prática

11:00 Coffee BreakIntervalo

11:15 Practical SessionSessão Prática

13:15 Lunch BreakAlmoço

14:15 Practical SessionSessão Prática

16:15 Coffee BreakIntervalo

16:30 Practical SessionSessão Prática

18:30 Closing SessionEncerramento do curso

07:45 Opening & RegistrationAbertura do Secretariado

08:10 Welcome SessionAbertura do CursoProf. Dr. Tomé Matos Lopes

08:20 Technical Skills Training ModelsModelos de Treino em Competências TécnicasDr. Sunjay Jain

08:30 Standardized Training Programs in UrologyProgramas Padronizados de Treino em UrologiaDr. Ben Van Cleynenbreugel

08:40 The Role of the Portuguese College of UrologyO Papel do Colégio da Ordem dos MédicosDr. Avelino Fraga

08:50 Boot Camp PresentationApresentação do Boot CampDr. Chandra Shekhar Biyani

09:00 Practical SessionSessão Prática

11:00 Coffee BreakIntervalo

11:15 Practical SessionSessão Prática

13:15 Lunch BreakAlmoço

14:15 Practical SessionSessão Prática

16:15 Coffee BreakIntervalo

16:30 Practical SessionSessão Prática

18:30 Closing SessionEncerramento do curso

Module A |Módulo A

LAPAROSCOPYBasic principles,

E-BLUS exercises

Module B |Módulo B

UPPER URINARY TRACT ENDOSCOPYUreteric catheterization, guide-wire placement, URS-SR, RIRS

Module C |Módulo C

TRANSURETHRAL RESECTIONTURP, TURBT,

bladder washout

Module D |Módulo D

LOWER URINARY TRACT ENDOSCOPYRigid cystoscopy, flexible

cystoscopy, bladder catheterization

+ Oferta Pós-graduada e Submissão ONLINE em www.medicina.ulisboa.pt/formcontinua

Page 3: IFA - medicina.ulisboa.ptIFA INSTITUTO FORMAÇÃO AVANÇADA NOV 22|23 NOV 19 Scientific Endorsements Day 22 Sponsorship Patrocínio Científico Patrocínio do dia 22 Corporate Sponsors

Scientific Programme Addendum 2019Post Graduate Course | Curso Pós-Graduado de Atualização

LISBON UROLOGY BOOT CAMP | Boot Camp de Urologia 2019

Coordinator Learning Objectives Module Structure

Dr. Tito P. Leitão - to know basic laparoscopic principles - basic laparoscopic principles 10’

Tutors - to identify and handle laparoscopic equipment - laparoscopic equipment 5’

Dr. Luís Osório - to know pneumoperitoneum establishment techniques - pneumoperitoneum establishment 5’

Dr. Nuno Domingues

Dr. Tiago Mendonça

- to execute basic laparoscopic tasks (depth perception, eye-hand coordination, bimanual dexterity)

- E-BLUS exercises: peg transfer cutting a circle needle guidance laparoscopic suturing

5’25’25’25’25’

Schedule

09:00 - 11:00 Group 1

11:15 - 13:15 Group 4

14:15 - 16:15 Group 3

16:30 - 18:30 Group 2

Coordinator Learning Objectives Module Structure

Dr. Sérgio Pereira - to know basic endoscopic principles of the upper urinary tract

- basic upper tract endoscopic principles 10’

Tutors - to identify and handle endoscopic equipment - endoscopic equipment 10’

Dr. Celso MarialvaDr. Filipe LopesDr. Pedro Monteiro

- to execute basic endoscopic tasks of the upperurinary tract (ureteric catheterization, guidewireplacement, rigid ureteroscopy, access sheathplacement, flexible ureterorenoscopy, basket handling)

- EST 1 exercises: ureteric catheterization and guidewire placement semi-rigid ureteroscopy, EST 1 task 3 access sheath placement, flexibleureterorenoscopy, dormia baskethandling, EST 1 task 3/4

25’

25’50’Schedule

09:00 - 11:00 Group 2

11:15 - 13:15 Group 1

14:15 - 16:15 Group 4

16:30 - 18:30 Group 3

Coordinator Learning Objectives Module Structure

Dr. José Santos Dias - to know basic transurethral resection principles - basic transurethral resection principles 5’

Tutors - to know basic resection energy principles - transurethral resection energy principles 5’

Dr. Álvaro NunesDr. Rodrigo GarciaDr. Rodrigo Ramos

- to identify and handle transurethral resectionequipment

- to execute transurethral resection of the bladder

- to execute transurethral resection of the prostate

- to execute bladder washout

- transurethral resection equipment

- bladder transurethral resection technique

- transurethral resection of the bladder

- prostate transurethral resection technique

- transurethral resection of the prostate

- bladder washout (5 min. + 5 min.)

10’

10’

35’

10’

35’

10’

Schedule

09:00 - 11:00 Group 3

11:15 - 13:15 Group 2

14:15 - 16:15 Group 1

16:30 - 18:30 Group 4

Coordinator Learning Objectives Module Structure

Dr. Pedro Oliveira - to know basic endoscopic principles of the lower urinary tract

- basic lower tract endoscopic principles 15’

Tutors - to identify and handle endoscopic equipment - endoscopic equipment 10’

Dr. Alberto SilvaDr. Daniel ReisDr. David Martinho

- to execute basic endoscopic tasks of thelower urinary tract (rigid & flexible cystoscopy)- to know bladder catheterization equipment- to execute bladder catheterization

- EST 1 exercises: rigid cystoscopy, EST 1 task 2 flexible cystoscopy, EST 1 task 1- bladder catheterization equipment- bladder catheterization technique- bladder catheterization

25’25’10’10’25’

Schedule

09:00 - 11:00 Group 4

11:15 - 13:15 Group 3

14:15 - 16:15 Group 2

16:30 - 18:30 Group 1

Day 22 |Dia 22LAPAROSCOPIC BASIC SKILLS Module A |Módulo A

UPPER URINARY TRACT ENDOSCOPIC BASIC SKILLS Module B |Módulo B

BASIC TRANSURETHRAL RESECTION OF THE BLADDER AND PROSTATE Module C |Módulo C

LOWER URINARY TRACT ENDOSCOPIC BASIC SKILLS – BLADDER CATHETERIZATION Module D |Módulo D

+ Oferta Pós-graduada e Submissão ONLINE em www.medicina.ulisboa.pt/formcontinua

Page 4: IFA - medicina.ulisboa.ptIFA INSTITUTO FORMAÇÃO AVANÇADA NOV 22|23 NOV 19 Scientific Endorsements Day 22 Sponsorship Patrocínio Científico Patrocínio do dia 22 Corporate Sponsors

Scientific Programme Addendum 2019Post Graduate Course | Curso Pós-Graduado de Atualização

LISBON UROLOGY BOOT CAMP | Boot Camp de Urologia 2019

Coordinator Learning Objectives Module Structure

Dr. Ben Van Cleynenbreugel - to know basic laparoscopic principles - basic laparoscopic principles 10’

Tutors - to identify and handle laparoscopic equipment - laparoscopic equipment 5’

Dr. Luís Osório - to know pneumoperitoneum establishment techniques - pneumoperitoneum establishment 5’

Dr. Rui Lúcio

Dr. Tiago Mendonça

- to execute basic laparoscopic tasks (depth perception, eye-hand coordination, bimanual dexterity)

- E-BLUS exercises: peg transfer cutting a circle needle guidance laparoscopic suturing

5’25’25’25’25’

Schedule

09:00 - 11:00 Group 1

11:15 - 13:15 Group 4

14:15 - 16:15 Group 3

16:30 - 18:30 Group 2

Coordinator Learning Objectives Module Structure

Dr. Sérgio Pereira - to know basic endoscopic principles of the upper urinary tract

- basic upper tract endoscopic principles 10’

Tutors - to identify and handle endoscopic equipment - endoscopic equipment 10’

Dr. Filipe LopesDr. Pedro MonteiroDr. Shekhar Biyani

- to execute basic endoscopic tasks of the upperurinary tract (ureteric catheterization, guidewireplacement, rigid ureteroscopy, access sheathplacement, flexible ureterorenoscopy, basket handling)

- EST 1 exercises: ureteric catheterization and guidewire placement semi-rigid ureteroscopy, EST 1 task 3 access sheath placement, flexibleureterorenoscopy, dormia baskethandling, EST 1 task 3/4

25’

25’50’Schedule

09:00 - 11:00 Group 2

11:15 - 13:15 Group 1

14:15 - 16:15 Group 4

16:30 - 18:30 Group 3

Coordinator Learning Objectives Module Structure

Dr. José Santos Dias - to know basic transurethral resection principles - basic transurethral resection principles 5’

Tutors - to know basic resection energy principles - transurethral resection energy principles 5’

Dr. Álvaro NunesDr. Rodrigo GarciaDr. Sandro Gaspar

- to identify and handle transurethral resectionequipment

- to execute transurethral resection of the bladder

- to execute transurethral resection of the prostate

- to execute bladder washout

- transurethral resection equipment

- bladder transurethral resection technique

- transurethral resection of the bladder

- prostate transurethral resection technique

- transurethral resection of the prostate

- bladder washout (5 min. + 5 min.)

10’

10’

35’

10’

35’

10’

Schedule

09:00 - 11:00 Group 3

11:15 - 13:15 Group 2

14:15 - 16:15 Group 1

16:30 - 18:30 Group 4

Day 23 |Dia 23LAPAROSCOPIC BASIC SKILLS Module A |Módulo A

UPPER URINARY TRACT ENDOSCOPIC BASIC SKILLS Module B |Módulo B

BASIC TRANSURETHRAL RESECTION OF THE BLADDER AND PROSTATE Module C |Módulo C

Coordinator Learning Objectives Module Structure

Dr. Pedro Oliveira - to know basic endoscopic principles of the lower urinary tract

- basic lower tract endoscopic principles 15’

Tutors - to identify and handle endoscopic equipment - endoscopic equipment 10’

Dr. Daniel ReisDr. David MartinhoDr. Frederico Furriel

- to execute basic endoscopic tasks of thelower urinary tract (rigid & flexible cystoscopy)- to know bladder catheterization equipment- to execute bladder catheterization

- EST 1 exercises: rigid cystoscopy, EST 1 task 2 flexible cystoscopy, EST 1 task 1- bladder catheterization equipment- bladder catheterization technique- bladder catheterization

25’25’10’10’25’

Schedule

09:00 - 11:00 Group 4

11:15 - 13:15 Group 3

14:15 - 16:15 Group 2

16:30 - 18:30 Group 1

LOWER URINARY TRACT ENDOSCOPIC BASIC SKILLS – BLADDER CATHETERIZATION Module D |Módulo D

+ Oferta Pós-graduada e Submissão ONLINE em www.medicina.ulisboa.pt/formcontinua

Page 5: IFA - medicina.ulisboa.ptIFA INSTITUTO FORMAÇÃO AVANÇADA NOV 22|23 NOV 19 Scientific Endorsements Day 22 Sponsorship Patrocínio Científico Patrocínio do dia 22 Corporate Sponsors

PERSONAL INFORMATION | DADOS PESSOAIS

Name | Nome

E-mail Mobile | Telemóvel

Address | Morada Postal code | CPostal

Work place | Local de Trabalho

In accordance with the law in force, article 13 of RGPD (EU) 2016/679, I hereby declare my voluntary consent to Faculty of Medicine of the University of Lisbon for the processing of my personal information provided in this registration form exclusively within this course, in what concerns the foreseen effects of eligibility and participation for as long as necessary to fulfil this recollection’s objective. I authorize that my personal data may be retained for statistical purposes, without time limit and provided they will be processed anonymously and uncharacterized, leaving the nature of personal data as defined in the law.

Nos termos da lei em vigor, art. 13 do RGPD (EU) 2016/679, declaro o meu consentimento à Faculdade de Medicina da Universidade de Lisboa para o tratamento da informação pessoal aqui prestada exclusivamente no âmbito deste Curso, para os efeitos de elegibilidade e de participação no mesmo e pelo tempo necessário ao cumprimento deste objetivo. Autorizo que os meus dados pessoais sejam conservados na forma de registo académico, sem limite temporal e sob salvaguarda dos meus direitos de confidencialidade e de acesso, podendo ser usados para fins estatísticos desde que sejam processados de forma anónima e irreconhecível.

REGISTRATION | INSCRIÇÃORegistration Fee | Valor da Inscrição: 650 €The registration fee includes: scientific programme, course materials, lunches and coffee breaks and certificates. CFU-FMUL is not responsible for travel and accommodation arrangements and costs of the individual attendees.O valor da inscrição inclui: o programa científico, materiais, almoços e coffee breaks e certificados. O CFU-FMUL não se responsabiliza pelas reservas e custos de deslocação e alojamento dos participantes.

PAYMENT | PAGAMENTO

Payment only available by bank transfer | Pagamento apenas disponível por Transferência Bancária

Organization detailsName: AIDFM – Associação para Investigação e Desenvolvimento da Faculdade de Medicina (C.C. 469/CFU/14)Address: Av. Prof. Egas Moniz 1649-028 Lisbon | VAT Nr PT 503 218 111

Bank information

Name: BANCO SANTANDER TOTTA | Agency: Hospital de Santa Maria | Address: Av. Prof. Egas Moniz 1649-035 Lisbon

IBAN - PT50 0018 0000 3666 5472 0018 0 | BIC/SWIFT: TOTAPTPL

RECEIPT | RECIBO

Name | Nome Tax ID # | Contribuinte

Address | Morada

FILLOUT AND SUBMISSION INSTRUTIONS | INSTRUÇÕES DE PREENCHIMENTO E ENVIO1 - Download this editable PDF file to your computer. Please fill out all the required fields directly in this form. Descarregue este PDF editável para o seu PC. Em seguida preencha p.f. diretamente neste Boletim de Inscrição todos os campos assinalados.

2 - Save the document. Please attach it to an email along with the proof of payment and send to: Grave o documento e anexe-o a um email remetendo-o, junto com o comprovativo de pagamento, para:

[email protected] | [email protected]

APPLICATION FORM | BOLETIM DE INSCRIÇÃO

+ Oferta Pós-graduada e Submissão ONLINE em www.medicina.ulisboa.pt/formcontinua

IFAINSTITUTOFORMAÇÃOAVANÇADA

Post Graduate Course | Curso Pós-Graduado de Atualização

LISBON UROLOGY BOOT CAMP | Boot Camp de Urologia 2019

Post Graduate Course | Curso Pós-Graduado de Atualização

LISBON UROLOGY BOOT CAMP | Boot Camp de Urologia 2019

NO VN O V22|23 19