Application

Complete the form below. Applications are reviewed by the Membership Committee and you will be contacted by email once a decision has been made.

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Full name *

First

Last

As it should appear on your membership record and certificates.

Email address *

All correspondence about your application will be sent to this address.

Mobile / WhatsApp number *

Membership category applied for *Full Member - consultant practising hand and microsurgery in EgyptAssociate Member - specialist or registrar working towards consultant appointmentTrainee Member - resident in an accredited training programmeAllied Health Member - hand therapist, physiotherapist, occupational therapist or specialist nurseInternational Member - practising outside Egypt

If you are unsure which applies, see Categories & Eligibility.

Primary specialty *Orthopaedic SurgeryPlastic and Reconstructive SurgeryHand TherapySpecialist NursingOther

Highest qualification held *

For example: MD, MSc, FRCS, MRCS, Egyptian Board.

Year of qualification *

Current post / job title *

Institution or hospital *

Governorate *CairoGizaAlexandriaQalyubiaSharqiaDakahliaBeheiraGharbiaMonufiaKafr El SheikhDamiettaPort SaidIsmailiaSuezNorth SinaiSouth SinaiBeni SuefFaiyumMinyaAsyutSohagQenaLuxorAswanRed SeaNew ValleyMatrouhOutside Egypt

City *

applied as Mobile

Medical syndicate / registration number *

Used to verify professional registration. This is not published in the member directory.

Subspecialty interests

• Hand and wrist trauma
• Microsurgery and replantation
• Peripheral nerve and brachial plexus
• Congenital hand differences
• Wrist and small joint arthroscopy
• Tendon surgery
• Hand therapy and rehabilitation
• Paediatric hand surgery

Select all that apply. Used to help members and referring physicians find the right expertise.

Years of experience in hand and upper limb surgery

If applying as a Trainee: programme and programme director

Leave blank if not applicable. Written confirmation of enrolment will be requested separately.

Proposed by (existing ESSHM member)

Applications are ordinarily supported by a current full member. Leave blank if you do not yet know one.

Anything else the Membership Committee should know

Optional - relevant training, publications, or previous society membership.

Member directory *

• I consent to my name, institution, governorate and subspecialty interests appearing in the ESSHM member directory. You may opt out at any time.

Declaration *

• I confirm the information above is accurate and that I hold the qualifications and appointment stated. I have read the Terms of Membership and the Privacy Policy.

Submit application