Teaching Excellence Award Nomination Form

Teaching Excellence Award Nomination Form

AP410
Form No: F410
Last Revised: March 2026
Version: V11

The Council of Education invites nominations of eligible individuals for the 2026 Teaching Excellence Award.
Nominee
A Fellow of the Australasian College for Emergence Medicine (FACEM) who was elected to Fellowship at least ten (10) years prior to the nomination and who has given distinguished and extensive service in emergency medicine teaching and learning for the College (‘the nominee’).
Is this a posthumous nomination?*

YesNo
Nominee email*
This will notify the nominee to sign the form
Name

First NameLast Name
Signature
Date

DayMonthYear
Date
Nominator
Nominations will be accepted from Fellows of the College, including retired Fellows, and trainees enrolled in the FACEM Training Program (‘the nominator’). Nominees cannot self-nominate.
Name

First NameLast Name
Membership number
Email*
example@example.com
Signature
Date

DayMonthYear
Date
Supporters
Nominations require the support of two FACEMs (‘supporters’).
Support 1 email*
This will notify Supporter 1 to sign below
Supporter 1

First NameLast Name
Signature
Date

DayMonthYear
Date
Supporter 2 email*
This will notify supporter 2 to sign below
Supporter 2

First NameLast Name
Signature
Date

DayMonthYear
Date
Service to emergency medicine teaching and learning for the College
Nominators should answer the following questions in as much detail as possible to demonstrate the nominee’s service in multiple aspects of emergency medicine teaching and learning for the College over an extended period of time. Additional pages may be attached if required. Nominators are encouraged to gain further information in support of the nomination from other FACEMs and trainees within the relevant emergency department
Over what length of time has the nominee served in emergency medicine teaching and learning?
Detail how the nominee has demonstrated a commitment to, and enthusiasm and passion for emergency medicine teaching and learning for ACEM trainees(inclusive of trainees in any ACEM training program).
How has the nominee committed to further learning and development of skills in postgraduate medical education and training?
How has the nominee promoted and advocated for improvement of teaching and learning at ACEM training sites and/or EMET sites?
What College entities or projects has the nominee been involved with, if any? Focus particularly on those related to emergency medicine education, teaching and learning.
Provide details of involvement in the development of medical education initiatives focused on emergency medicine.
Detail how the nominee has mentored ACEM trainees and/or other medical educators.
Detail how the nominee has gone above and beyond in contributing to emergency medicine teaching and learning, above what would be routinelyexpected of a FACEM/DEMT.
Detail any other relevant information about the nominee’s service to emergency medicine teaching and learning.
Submission
Nominations must be accompanied by a citation of not more than 300 words in support of the nominee and their service in emergency medicine teaching and learning for the College. This should be a summary of the information provided on the nomination form, and, if the nomination is successful, will inform the presentation of the award at the College Ceremony.
Type a question

Write citationUpload citation
Write citation
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Upload the nominee's curriculum vitae *

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For further information about the award, please see AP377 Teaching Excellence Award Policy.

Nominations must be received no later than 5.00pm AEST on Monday 18 May 2026.
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Teaching Excellence Award Nomination Form

Nominee

Nominator

Supporters

Service to emergency medicine teaching and learning for the College

Submission