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2021-2022 SAGES Fellowship Certification – Application

  • I hereby request a SAGES Certificate of MIS Fellowship Training

  • Enter information EXACTLY as they are to appear on the certificate
    Check all that apply
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    In order to complete the application for SAGES certification of your fellowship, the Fellowship Program MUST be accredited by the Fellowship Council and also be in good standing.

    Please exit this application now and check with your Fellowship Program or the Fellowship Council to verify program status/

  • If you're not a SAGES member, please join here
  • Enter a single 4-digit year only.
  • If you are not yet an Active member, please upgrade now to be eligible for certification. Contact Membership Coordinator.

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  • Accepted file types: xls, csv, xlsx, Max. file size: 600 MB.

    This report can be downloaded by the Program Director at the following link and must be attached here.

    1. Login to your account at www.fellowshipcaselog.org
    2. Click "Manage Fellows and View Individual Logs"
    3. Click on the name of the fellow to view
    4. Look for "Summary Reports Available" and click on “Grouped by Tertiary”; please note this may take a few minutes to create
    5. Click on box labeled “Count of Procedures per Third Level Category. Grouped by Type and Role.” This will open up the report within the web page.
    6. Click on the link labeled “Export this report to CSV”
    7. Save file to your computer

    File must be in Excel or CSV format

  • Accepted file types: pdf, doc, docx, Max. file size: 600 MB.
    PDF, DOC, DOCX only.
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  • Accepted file types: pdf, doc, docx, jpg, jpeg, gif, png, Max. file size: 600 MB.
  • Accepted file types: pdf, doc, docx, jpg, jpeg, gif, png, Max. file size: 600 MB.
    PDF, DOC, DOCX, JPG/JPEG, GIF, or PNG only.
  • Accepted file types: pdf, doc, docx, jpg, jpeg, gif, png, Max. file size: 600 MB.
    PDF, DOC, DOCX, JPG/JPEG, GIF, or PNG only.
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