Are there declarations on the ICGP application form?

23 September 2020 (updated: 23 September 2021)

Are there declarations on the ICGP application form?

Applicants are required to indicate True or False to declaration 3, 4 and 5 and provide additional information where appropriate.

Declaration One - ICGP Person Specification

I confirm that I have read and understand the entry criteria as listed in the person specification of the ICGP for GP trainee recruitment 2022. I declare that my present experience makes me eligible to commence training with respect to the entry criteria listed therein and satisfy the requirements of the Irish Medical Council for registration onto the trainee specialist register. (tick box)

Declaration Two - Driving License 

There is a work requirement in this role to attend patients/duties at locations other than the main location of work. I confirm that if, for any reason, and at any time during my General Practice Training, I do not possess a full Irish/EEA drivers' licence and do not have access to a vehicle for work purposes I agree to provide a vehicle, or vehicle and driver, at my own expense so that I may continue to fulfil the above requirement. (tick box)

Declaration Three - Garda / Police

I declare that I have not, at any time been convicted (i.e., probation, fine, sentence, penalty) of a criminal offence (e.g., assault, public order, sexual assault) in the Republic of Ireland and / or any other jurisdiction nor are there any charges relating to criminal offences outstanding or pending. I have never been the subject of a Caution or Bound over order. I accept that making a false or misleading declaration may render any offer of a training position and associated employment offers as null and void.

True

False

Date:

If you have indicated False to the above declaration you will be required to provide further details.

Declaration Four - Training Organisation / Programme

I declare that I currently am not, nor was I ever the subject of an investigation by any professional medical training body or its equivalent in the Republic of Ireland and/or any jurisdiction. I accept that making a false or misleading declaration may render any offer of a training position and associated employment offers as null and void.

True

False

Date:

If you have indicated False to the above declaration you will be required to provide further details.

Declaration Five - Medical Council / Licensing Body

I declare that I am not, nor have I been the subject of any investigation by a medical registration or licensing body or authority in any jurisdiction with regard to my medical practice or conduct as a practitioner. I have not been suspended from registration, nor had any restriction on practice nor had my registration or license cancelled or revoked by any medical registration or licensing body or authority in any jurisdiction nor am I the subject of any current suspension or any restrictions on practice. I accept that making a false or misleading declaration may render any offer of a training position and associated employment offers as null and void.

True

False 

Date:

If you have indicated False to the above declaration you will be required to provide further details.