Oral & Maxillofacial Surgery/Oral Medicine Application

Oral & Maxillofacial Surgery/Oral Medicine Application

Accelerated MBBS A30X Programme for August 2025 entry
Please ensure that you have read our website in full, prior to submitting this form.

You must make sure that you complete and submit in full, all necessary information and documentation alongside your online application.

Failure to submit or provide documentation may deem your application incomplete and not considered for interview.

Section 1 - Student Information
Name - As per passport*

TitleFirst NameMiddle Name(s)Surname
Date of Birth*

DDMMYYYY
Were you born in the UK or Channel Islands?*

YesNo
Nationality*
Please select the country you are a national of
Nationality*
Please select the country you are a national of
Please select your Country of Birth*
If you were born outside of the UK, please enter the date of entry to the UK*

DayMonthYear
Please note, that this programme is only available to those who have 'Home' fee status as per the UKCISA website. Applications that do not fall under this category, would not be considered. You may be asked to provide further evidence to confirm your status within the UK.
Ethnicity*
Address*

Flat/House/Name

Street Address

CityCounty

Post CodeCountry
Contact Address (if different from above)

Flat/House/Name

Street Address

CityCounty

Post CodeCountry
Email*
example@example.com
Phone Number*

Section 2 - Academic Information
University or College

List all University qualifications taken, whether successful or not, including subjects, dates and class (Please include all degrees at Bachelor or Masters level as well as BDS):
Most recent Institution*
Previous Institution
Previous Institution

Are you a member of an Oral & Maxillofacial Surgery, Oral Medicine or MaxilloFacial Surgery Society (such as the BAOMS/BISOM) please list
Academic prizes & distinctions
Other interests, activities and positions of responsibility
List any publications in refereed journals
List presentations to academic meetings specifying whether national or regional
List audit projects completed and presented
Have you held any foundational or core training posts?
Please specify

Section 3 - Supporting Documentation
Official Transcripts from all college/Universities attended (All transcripts in single file PDF format)*

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Reference/recommendation*

Please provide ONE reference from your employer which showcases your suitability for the programme, the recommendation is to be no more than 500 words.
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Personal Statement*

Personal statement must outline your study and career aims
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CV*

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Should be Empty:

University or College