Application for the IAC International Board of Cytopathology Examination

A voluntary examination for IAC medical members (MIAC) of at least two years.

For this form you will require:

Information about your degree and specialist training.
Name and email of a colleague or superior in the medical profession who can attest to your character and professional standards, this physician does not have to be Fellow or Member of the Academy
A copy of your current CV indicating your medical education, specialist certification and current employment. Publications are not necessary.
A passport sized photograph (head shot, 250 x 300 pixel). Please do not scan your passport or identification card.
The CONTINUE BUTTON is bottom right.
The application fee is Euro 450 and can be paid on-line using a credit card, Applepay or Paypal. If your application is not approved the payment can be refunded.

"*" indicates required fields

Step 1 of 3

Personal Information

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Date

I would like to sit the exam in:*

15. May 2025 22nd Int. Congress of Cytology, Florence, Italy

6. November 2025, ASC 73rd Annual Scientific Meeting, St. Louis, MO, U.S.A

Your Given Name*

Given Name

Your Family Name*

Family Name

Your six digit membership number*

Your email*

Please enter your contact email

Phone*

The examinations are planned together with national cytology societies. Below is the list of currently planned examination sites.

Has your postal address changed recently?*

Yes

Where shall we send IAC postal correspondence?

If you enter your work address, please include department name and institute name.

Address Line 1*

Address Line 2

Address Line 3

City / Town*

Postal Code

(If required) State / Region /Province

Not every address requires a state

Country*

Your professional information

Current Position*

Since*

Month/Year

Current Employer*

Name of employer

Your work address, if Hospital or Medical Center include name of institute and department*

I am a certifiied specialist in my country of residence*

Yes

Please explain the qualification situation and regulations in your country*

I passed my specialist exam in (subject)*

Year*

Note of recommendation

A brief note of recommendation indicating how long your colleague or superior has know you and in what capacity. This does NOT have to be a Fellow or Member of the Academy.

You need an email of recommendation from a colleague or superior in the medical profession who can attest to your character and professional standards.

Email to support my application*

I have a colleague who will support my application

I do not have a colleague who can support my application

Please explain your situtation and why you can not name a colleague to attest to your professional standards*

Name of colleague to recommend your professional charachter*

Email address*

Please enter the email address of the colleague to support your application. When you submit this form an email will be sent to them automatically requesting a few lines in regard to your professional ideals.

Please upload a current copy of your CV*

Your current employment should be indicated.

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 146 MB.

Please upload a passport sized photograph. For internal use only.*

We require a head shot. Please do not upload a copy of your passport.

Accepted file types: jpg, png, pdf, Max. file size: 146 MB.

After submitting you will be directed to the payment page. Payment can be refunded if you are unable to attend.