c

Ministry of Health
Passport size Male
photograph Republic of Maldives
JOB APPLICATION FORM FOR EXPATRIATE
Applica on Submi ng
Directly
Agency
Please fill all sec ons of this form in CAPITAL LETTERS
EMPLOYMENT INTEREST
Pos on
Grade Basic Salary

BASIC INFORMATION
Personal Title Mr Mrs Ms
First Name Middle Name
Last Name
Gender Male Female Age
Marital Status Date of Birth DD/MM/YYYY
Passport no Passport Expairy DD/MM/YYYY
Personal email
Contact No.
Present Building Name
Address
Apartment / Floor no
Street
City / State
Country
Permanent Building Name
Address
Apartment / Floor no
Street
City / State
Country

EMERGENCY CONTACT INFORMATION

Name
Address
Rela onship
Contact no
Page 1 of 4
 EDUCATION
Secondary Educa on Higher Secondary Educa on
Subject Grade Subject Grade

HIGHER EDUCATION
Course Details
Ins tute / University
Date Acquired
Course Details
Ins tute / University
Date Acquired
Course Details
Ins tute / University
Date Acquired

OTHER TRAININGS
Details
Ins tute / University
Date Acquired
Details
Ins tute / University
Date Acquired
Details
Ins tute / University
Date Acquired

Page 2 of 4
 EMPLOYMENT HISTORY
Company 1 Place
Designa on
Work Detail
Dura on
Last Drawn Salary
Reason Resigned
Company 2 Place
Designa on
Work Detail
Dura on
Last Drawn Salary
Reason Resigned
Company 3 Place
Designa on
Work Detail
Dura on
Last Drawn Salary
Reason Resigned
Company 4 Place
Designa on
Dura on
Last Drawn Salary
Reason Resigned

REFERENCE DETAILS
Referee 1 Name
Posi on
Company Name
Contact no
email
Referee 2 Name
Posi on
Company Name
Contact no
email
Page 3 of 4
 BACKGROUND CHECK

1. Have you got any friends or family working in Ministry of Health? Yes No
If yes, please specify

2. Have you worked in Maldives before? Yes No

If yes, please specify

3. Do you have any past or pending criminal convic on? Yes No

If yes, please specify

4. Are you taking treatment for any illness? Yes No

If yes, please specify

5. Have you taken treatment for any illness for more than 2 months ? Yes No
If yes, please specify

6. Have you applied your documents throught any agencies before? Yes No
If yes, please specify

7. Are you pregnant? Applicable on for female Yes No

If yes, please specify

DECLARATION

I hereby declare that above informa on stated is true. I understand that any job offer made on the basis
of untrue or misleading informa on may be withdrawn or may subject to termina on of employment.
Local Agency Stamp, if applying
Applicants Name _______________________________________________ through agency

Signature _______________________________________________

Date DD / MM / YYYY

DOCUMENTS CHECK LIST

Completed applica on form

Curriculum vitae
Copy of passport bio data page
Copy of academic cer ficates
Previous / Current employer reference le er / Experience le er
Passport size photo (In official a re)
Police clearence cer ficate ( 3 Months Validity )
Pre - Registra on Slip ( From maldives relevant council )
Cer fied english language cer ficate (Olevel / A level / IELTS / TEFL)

Page 4 of 4
 R/MMDC/2016/001

Maldives Medical and Dental Council

Application for Registration and Practising License
It is an offence to practice medicine or dentistry in the Maldives without registration and obtaining a practising
license from the Maldives Medical and Dental Council under the Health care Profession Act Law no. (13/2015)
All medical officers (MBBS or equivalent) have to appear and clear the licensing exam conducted by MMDC to
practice in Maldives.
Notice: 1- Please use BLOCK letters in filling this application form
Applicant must ensure the truth and accuracy of all information provided. Making a false declaration
(including failure to disclose relevant information) is an offence punishable with imprisonment under the
Health care Profession Act
2- Items I to V are to be completed by the applicant.
3- Item VI is to be filled, completed and endorsed by the current employer.
4- Originals and a copy of each certificate, passport/ID and 5 passport size photo (only for registration) must be submitted
along with this application. All originals will be returned after verification.
5- Fees: Non-refundable
Pre registration: MVR 500
Provisional registration: MVR 300
Temporary basic registration: MVR 500
Permanent basic registration: MVR 750
Temporary additional (Specialist) registration: MVR 1000
Permanent additional (Specialist) registration: MVR 1500
Licensing: MVR 500
Reissuing for loss or damage: MVR 1000
Registration License Serial No:
New New Receipt No:
Reissue for Loss / Damage Reissue for Loss / Damage
Extension Renewal Pre Registration

I PERSONAL DETAILS

Name: Sex: M F

Date of Birth: daymonthyear

/ / ID Card / Passport No:
Work Permit No: recent passport
please paste asize
photograph
Nationality: Contact No : here

PermanentAddress:

CurrentAddress:
( If different from above)

E- MailAddress: Marital Status :

II REGISTRATION DETAILS
Registration Number :

Council / Authority of Registration :

Address :

Registered date : daymonthyear

/ / Expiry date : daymonthyear
/ /

Maldives Medical and Dental Council

e-mail: [email protected] tel: +960 3328887 fax:+960 3328889
 III QUALIFICATIONS
Professional Qualification Institute City / Country Duration

IV WORK EXPERIENCE
Organization City Country Position held Duration

V ATTESTATION QUESTIONS

Please answer all questions by selecting Yes or No and provide an explanation when requested.
For questions 1-2, the terms “impaired” and “limited” include but are not limited to impairments or limitations related to physical,
psychological, or emotional disorders or conditions, or chemical dependency or abuse. The purpose and intended use of this
information is to enable the Council to determine whether you meet statutory and rule requirements for licensure. The information
provided remains confidential with the council. If additional space is necessary please attach a separate sheet.

1. Is your cognitive, communicative, or physical capability to engage in the practice of medicine or surgery with reasonable skill
and safety impaired or limited in any way? YES NO

1a. If yes, are the limitations or impairments reduced or ameliorated because you receive ongoing
treatment or participate in a monitoring program? If yes Please describe.

1b. If yes, are the limitations or impairments reduced or ameliorated because of the field of practice, the setting, or the manner in
which you have chosen to practice? Please describe.

2. Are you engaged in any illegal use of controlled substances including the use of illegal
substances or illegal use of legal controlled substances, If Yes Please describe.
YES NO

3.Does your use of alcohol or chemical substance(s), including prescription medications, in any way impair or limit your ability
to practice medicine with reasonable skill and safety?
YES NO

3a. If yes, have you taken any steps (i.e. treatment, psychotherapy, participation in a support group) to discontinue or reduce such
use? Please describe.

Maldives Medical and Dental Council

e-mail: [email protected] tel: +960 3328887 fax:+960 3328889
 4. Have you within the past five years been advised by your treating physician that you have a mental, physical, or emotional
condition, which, if untreated, would be likely to impair your ability to practice medicine with
reasonable skill and safety? YES NO
If “yes”, please answer the following:
4a. With regard to any condition referenced above, are you being treated so that such impairment is avoided?
YES NO
4b. With regard to any condition referenced above, are you in compliance with the recommended treatment?
YES NO
4c.With regard to any condition referenced above, has your treating physician advised you that you are able to practice medicine
with reasonable skill and safety?
YES NO
4d. Identify your treating physician____________________________________________

5.Have you ever been denied a license by any medical council or licensing authority? If, yes give particular
YES NO
._______________________________________________________________________________

6.Has your license to practice medicine been revoked, suspended, restricted ,or conditioned by a Medical council or other licensing.
authority? If so, give particulars
YES NO
__________________________________________________________________________________

7. Have you ever been notified of any investigation by any medical council, or any hospital of any complaints against you relative to
the practice of medicine? If so, give particulars
YES NO
_________________________________________________________________________________

8. Have you ever been a defendant in any malpractice lawsuit,, had any malpractice settlement, or have any pending?
If yes, give details
YES NO
__________________________________________________________________________________

9. Have there ever been any criminal charges filed against you? This includes charges of disorderly conduct, assault or battery
or domestic abuse
YES NO

I have carefully read the questions in the foregoing application and have answered them completely without reservations of any
kind, and I declare that my answers and all statements made by me herein are true and correct. Should I furnish any false
,
information in this application, I hereby agree that such act shall constitute cause for the denial, suspension or revocation of my
license to practice medicine in Maldives

Signature: Date : daymonthyear

/ /

VI PROPOSED/CURRENT EMPLOYMENT

Place of Proposed/Current Employment in Maldives:

Address:

Visiting doctor: Position :

Date of Employment: day/ month/ year Contract valid till: day/ month/ year Tel No :
(for contract staff only)

Maldives Medical and Dental Council

e-mail: [email protected] tel: +960 3328887 fax:+960 3328889
 Declaration by Employer
We confirm the authenticity of the information contained herein about this organization and the applicant’s employment status
with us.
Name:

Signature: Date : daymonthyear

/ /
Official Stamp

DOCUMENTS TO BE SUBMITTED
1. Qualification Certificates 6. Experience Certificates
2. Internship Certificate 7. English Language Competency
3. Basic Registration Certificate 8. Passport Copy
4. Specialist Registration 9. Visa Copy
8.Good Standing Certificate
5. Good Standing Certificate 10. Transcript (Specialist)

Instructions to Applicants

1. Copies of the following original documents are to be sent to Maldives Medical and Dental Council (MMDC) in support of application.

a. National Identity Card or Passport.

b. Undergraduate and postgraduate medical qualifications as applicable.

c. Documentary evidence of internship, not less than 52 weeks.

d. Certificate of Good Standing (CGS) issued by the medical licensing authority of the country where the doctor has been practicing
for the last 01 year prior to the application. The CGS received by MMDC must not exceed 03 months from its issued date.

e. Certificates of registration with other medical licensing authority.

2. All foreign applicants are required to submit evidence of competency in English Language to the MMDC.

If test results obtained from the International English Language Testing System (IELTS) test OR the Test of English as a Foreign
Language (TOEFL) within the minimum score stated here can be considered.

IELTS - at least 6 for overall score

TOEFL - 250 marks for computer-based test or 600 marks for paper-based test or 100 marks for
internet-based test.

3. In addition to above, applicants for temporary registration as visiting experts need to submit an original letter from sponsoring
institution registered in the Maldives stating the purpose of the visit and period.

4. Additional notes:

a. Documents in foreign language shall be submitted together with the certified English translations and original copies of the
documents. The Maldives Medical and Dental Council will accept translation by (i) the institute that issued the original
certificate, (ii) any embassy or consulate of the country that issued the original certificate, (iii) relevant regulatory body of the
country that issued the original certificate.

b. All documentation submitted should be complete and legible. The council will not process illegible, unclear or incomplete
copies. Maldives Medical and Dental Council will not be responsible for delays that occur due to submission of illegible
or incomplete documentation.

c. The MMDC may also require the doctor to submit any other documents for evaluation of his/her application.

5. All supporting documentation must be submitted through the employer to the following address:

Secretariat
Maldives Medical and Dental Council
Ministry of Health
Roashanee Building
Sosun Magu
Male’, Maldives

Maldives Medical and Dental Council

e-mail: [email protected] tel: +960 3328887 fax:+960 3328889
 Date: 12.11.2018

Dear Sir / Madam,

This is to inform you that I’m well aware and have no

complaints about getting my ticket refund from the nearest
transit airport from Maldives.
Also I’m aware that I will be getting a return ticket for the
year-end holidays to the nearest transit airport from
Maldives.

Thanking you

Best Regards,

(Signature)

(Candidate Name)