MSF CV TEMPLATE : ICU DOCTOR
Any incomplete CV will not be taken into consideration

LAST NAME(S)FIRST NAME(S)AttachPicture Email Address Private Mobile

Home Phone Number- Home Address-PERSONAL DETAILSEDUCATION
Fill in the spaces applicable to your studies

Date of birth

Diploma in MEDICINE

Place of birth

Place (University/City/Country)

All current nationality(ies) :Registration No. :Gender :Male 

Duration of studies - No of years :Female 

FromToDate obtained diploma
Marital Status :Single 

Diploma in INTENSIVE CARE

Married Separated/Divorced  Widow(er)  No. of children if any :Specify speciality :Place (University/City/Country)
Registration No. :Duration of studies - No of years : Language(s),you can speak & understand(written & spoken) in a working environment :FromToDate obtained diploma

A1English     French     Specify speciality :Spanish     Place (University/City/Country)

Arabic     Registration No. :     

Duration of studies - No of years :     From     Date obtained diploma

Others :LEVEL

A2B1

B2 C1C2Diploma in Other SPECIALTY or SubSPECIALTYMSF CV Template : ICU DOCTOR - JUN 2018

To

MSF CV TEMPLATE : ICU DOCTOR
Board of Intensive Care Medicine (if any)
Name of examining Board

Fellow of College of Intensive Care Physicians (if any)
Name of College

Year passed

PROFESSIONAL EXPERIENCE

Registration NoYear

Number of years of AUTONOMOUS practice

Employment History Summary including CURRENT employment
Please complete with most recent post ﬁrstDate(start-end)

Position

Type of ICU activity
Surgical

OB/GYN

Pediatrics

MedicalOtherHospital/
City/Country

OTHER PROFESSIONAL EXPERIENCE
Other professional experiences (medical and non medical) including humanitarian work and other NGOs

Date (start-end)

Position

Type of activity

City/Country

OTHER MEDICAL TRAINING(including nursing education, public health, tropical disease, ALS, ATLS, PALS, ultrasound, anesthesia,emergency medicine, trauma, etc.)

Name of training

Date (start-end)

Duration

MSF CV Template : ICU DOCTOR - Jun 2018

City/Country

MSFCVCVTEMPLATETEMPLATE: :ICUICUDOCTORDOCTORMSF
SELF ASSESSMENT SKILLS I certify that the given information is complete, correct and true
SIGNATURE :CATEGORYDATE :

NOT
trainedPROCEDURE(X if yes)

Critical careSUPERVISED AutonomousCan perform Can PERFORM
under
Independentlysupervision(X if yes)

Bag-valve-mask
Ventilation
Intubation
Advanced airway (including
front of the neck accessand supra-glottic)
Invasive ventilation (incl.
(ventilatory modes,sedation and weaning)
Non-invasive ventilation
Tracheostomymanagement
Central venous lines
insertion and management
PICC access
Intra-osseous accessIntra-arterial access
Cardiac ultrasound (vol.
status/contractility)
FAST Ultrasound Scan
Nutritional managementof ICU patients
Renal replacement therapy
Management of sepsis andseptic shock
Management of septic
haemorrhagic shock
Management of
un-diﬀerentiated shock
Management of patientswith multiple trauma
Management of patientswith severe brain injury
Management of patientswith major burns
Management of ARDSManagement of multiple
organ failureManagement of postoperative patients

MSF CV Template : ICU DOCTOR - Jun 2018

(X if yes)

ExpertEstimatedCan TEACH earlier
experiencein years(X if yes)MSF CV TEMPLATE : ICU DOCTORCATEGORY

NOTtrained

PROCEDURE(X if yes)

Critical careSUPERVISED Autonomous Expert
Estimated
Can perform Can PERFORM Can TEACH earlier
under
Independently
experiencesupervisionin years(X if yes)

(X if yes)

(X if yes)Management of critically ill
obstetrical patientsManagement of critically ill
pediatric patientsManagement of tropicalinfectious diseases
Critically ill patient transport
ICU bed ﬂow management
Ability to lead ICU ward
roundsEnd of life care
Pain management

Anaesthesia Procedural sedation
Regional anesthesia
Inhalational anesthesiaPediatric anesthesia
Obstetric anesthesia

Emergency
medicine

Anesthesia for major trauma
TriageMass casualty incidents
management
Damage control resuscitation
Chest tube insertion

Hospital
Coaching/mentoring/
management teachingteam leading
Formal management
experience
experience

Other(specify)

Please state THREE REFERENCES
NAME

TITLESADDRESS

1.
2.
3.
MSF CV Template : ICU DOCTOR - Jun 2018CONTACT DETAILS