Health and Social Services

Debt Reduction Sponsorship Application

Application for sponsorship is restricted to students/residents training in a Canadian program.
To apply for a Debt Reduction Sponsorship, please fill in the form below completely, or print the form, fill it in and fax or mail it to the fax number or address provided at the bottom of the page.

General: Each year of sponsorship requires two years of service commitment, with maximum allowable sponsorship being two years. Each year of completed service obligation provides a prorated financial credit against the grant should the contract be discontinued before the total commitment has been fulfilled. Physicians beginning practice in PEI to fulfill the commitment for the Medical Trainee sponsorship are not eligible for Moving Expense Allowance or Return-in-Service Grants.
*Note: Family Medicine in RIII are not eligible for this sponsorship

Required fields are marked with a red star (*).

Please enter the following information...

First name:	*
Last name:	*
Present Street: (where you live right now)	*
Present City:	*
Present Province:	* If your province or state isn't listed, please choose None.
Present Country:
Present Postal Code:	*
Present Telephone:	() *
Fax:	() *
Email Address:	*

Home Street: (your permanent home address)
Home City:
Home Province:	If your province or state isn't listed, please choose None.
Home Country:
Home Postal Code:
Home Phone:	()
Medical School:
Medical School Year:
Residency Program:
Residency Program Year:
Completion Date: Expected Date for Completion of Speciality
Marital Status:
No. Children:
Career of Spouse:
Career Plans:
Sponsorship Request:	Medical Student (year IV only): $15,000/year Resident (year I or year II only): $20,000 (maximum) Resident (years IV,V,VI): $25,000/year

For further information:
Sheila MacLean
Physician Recruitment/Medical Education Coordinator
Medical Programs 16 Garfield Street
PO Box 2000
Charlottetown, PE
C1A 7N8
Tel: (902) 368-6302
Fax: (902)368-6136
email: smmaclean@ihis.org