CERTIFICATE OF ENDORSEMENT

CANDIDATE FOR FELLOWSHIP

Form No. 1
PHILIPPINE OBSTETRICAL AND GYNECOLOGICAL SOCIETY (Foundation), INC.

FIRST ENDORSER

I, ____________________________________________________________, a Fellow in
good standing of the Philippine Obstetrical and Gynecological Society (Foundation), Inc., not a
National Officer of this Society, but from the same region as the candidate, desires to endorse,
Dr. ________________________________________________________to FELLOW Status.

To the best of my knowledge the candidate meets the qualifications for Fellowship as
stated in the By-laws of the Philippine Obstetrical and Gynecological Society (Foundation), Inc.

I have known this candidate since ________ (year) as his/her __________________,

(Teacher/ Colleague/, etc.) and therefore I hereby certify that
Dr.______________________________________________ is professionally and morally upright.

CANDIDATE’S INFORMATION

Full Name _____________________________________________

Mailing Address _____________________________________________
_____________________________________________
Current Hospital Affiliation (60% of practice) _________________________
Region _____________________________________________
E-mail Address _____________________________________________
Mobile No. _____________________________________________

_________________________________________ ________________
Print Name and Signature of the First Endorser Date signed
CERTIFICATE OF ENDORSEMENT
CANDIDATE FOR FELLOWSHIP
Form No. 2
PHILIPPINE OBSTETRICAL AND GYNECOLOGICAL SOCIETY (Foundation), INC.

SECOND ENDORSER

I, _____________________________________________________, a Fellow in good

standing, not a National Officer of this Society, but from the same region as the candidate,
desires to endorse, Dr. _______________________________________________________ to
FELLOW Status.

To the best of my knowledge the candidate meets the qualifications for Fellowship as
stated in the By-laws of the Philippine Obstetrical and Gynecological Society (Foundation),
Inc.

I am the current _____________________, (Chair of OB-GYN/Medical Director/Regional

Director) where the candidate is currently affiliated and therefore I hereby certify that
Dr._____________________________________________ is professionally and morally upright.

CANDIDATE’S INFORMATION

Full Name _____________________________________________

Mailing Address _____________________________________________
_____________________________________________
Current Hospital Affiliation (60% of practice) _________________________
Region _____________________________________________
E-mail Address _____________________________________________
Mobile No. _____________________________________________

_________________________________________ ________________
Print Name and Signature of the Second Endorser Date signed
 GUIDELINES FOR INDUCTION AS FELLOW

THE CANDIDATE:

A. Must be a Diplomate in good standing (no outstanding dues and has attended at
least two (2) Annual Conventions over the last 3 years).
B. Must be endorsed as professionally competent and morally upright by two (2)
active POGS Fellows.
C. Must have devoted to the practice of the specialty for at least two (2) years
D. Must conform to the norms of ethics and professionalism of the discipline

QUALIFICATIONS OF THE ENDORSERS

THE FIRST ENDORSER: (Form No. 1)

1. Must be a Fellow in good standing

2. Must be from the same region as the candidate
3. Must know the candidate for at least five (5) years
4. Must NOT be a national officer (Board of Trustees, Members of Committee on
Credentials and Membership and Committee on Awards)
5. Must NOT be a first degree relative, by affinity and consanguinity

THE SECOND ENDORSER: (Form No. 2)

1. Must be a Fellow in good standing

2. Must be the POGS Regional Director where the candidate is currently practicing
OR
3. Must be the Chair of the Department of OB-GYN or Medical Director who is also
a POGS member of an accredited residency training institution. Must belong to the
institution where the candidate has more than (60%) of his/her practice as an OB-
GYN.
4. Must not be a national officer (Board of Trustees, Members of Committee on
Credentials and membership and Committee on Awards)
5. Must NOT be a first degree relative, by affinity and consanguinity
LIST OF OFFICERS WHO ARE NOT ALLOWED TO ENDORSE A CANDIDATE

Board of Trustees
President Mario A. Bernardino, M.D.
Vice-President Christia S. Padolina, M.D.
Secretary Benjamin D. Cuenca, M.D.
Treasurer Efren J. Domingo, M.D.
P.R.O. Ma.Socorro M. Solis, M.D.
Board Members Ma.Virginia S. Abalos, M.D.
Betha Fe M. Castillo, M.D.
Virgilio B. Castro, M.D.
Melchor C. Dela Cruz, Jr., M.D.
Pilar Lagman-Dy, M.D.
Virgilio M. Novero, M.D.
Milagros Tia-Jocson, M.D.
Ramon T. Reyles, M.D.
Helen Grace Te-Santos, M.D.
Judith M. Sison, M.D.

Committee on Credentials and Membership

Dr. Benjamin D. Cuenca
Dr. Divina P. Rojas
Dr. Evelyn Reinoso
Dr. Abigail Elsie DG Castro
Dr. Leilani B. Coloma
Dr. Mila Z. Ibay
Dr. Lilli May T. Cole
Dr. Carolyn Zalameda-Castro

Committee on Awards
Dr. Ma. Corazon Zaida Noblejas Gamilla
Dr. Rosendo R. Roque
Dr. Walfrido W. Sumpaico
Dr. Leonardo A. Almeda
Dr. Delfin A. Tan
Dr. Lyra Ruth Clemente-Chua
Dr. Evelyn P. Palaypayon